Browsing by Author "Price, Matt"

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    Barriers and Facilitators of Family Planning Use in Fishing Communities of Lake Victoria in Uganda
    (Journal of primary care & community health, 2020) Nanvubya, Annet; Wanyenze, Rhoda K.; Kamacooko, Onesmus; Nakaweesa, Teddy; Mpendo, Juliet; Kawoozo, Barbarah; Matovu, Francis; Nabukalu, Sarah; Omoding, Geoffrey; Kaweesi, Jed; Ndugga, John; Bagaya, Bernard; Chinyenze, Kundai; Price, Matt; Van Geertruyden, Jean P.
    Family planning (FP) is a key element in the conduct of research and is essential in managing family sizes. Although fishing communities (FCs) are targeted populations for HIV prevention research, their FP practices are poorly understood. We explored barriers and facilitators of FP use in FCs of Lake Victoria in Uganda. Methods: We employed a mixed-methods approach comprising a cross-sectional survey, in-depth interviews, and focus group discussions in 2 FCs. Multivariable logistic regression was used to analyze quantitative data and a thematic approach to generate themes from the qualitative data. Results: Up to 1410 individuals participated in the survey and 47 in the qualitative study. Just over a third (35.6%) used FP. The most commonly used methods were condoms, pills, and injectables. In Kigungu community, participants whose religion was Anglican and Muslim were more likely to use FP than Catholics (adjusted odds ratio [aOR] 1.45; 95% CI 1.05-1.99 and aOR 1.45; 95% CI 1.05-2.07, respectively). Participants were more likely to use FP if they had satisfactory FP knowledge compared to those with no satisfactory FP knowledge (aOR 1.79; 95% CI 1.23-2.61), or if they were married compared to their single counterparts (aOR 1.84; 95% CI 1.32-2.57). In both communities, participants were more likely to use FP if they had 2 or more sexual partners in the past 12 months than those with less than 2 sexual partners (aOR 1.41 95% CI 1.07-1.87 and aOR 2.60; 95% CI 1.36-4.97). Excessive bleeding and delayed fecundity; fertility desire; gender preferences of children; method stock outs and lack of FP trained personnel constituted barriers to FP use. There were also cultural influences in favor of large families.
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    Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda
    (BMC public health, 2020) Nanvubya, Annet; Wanyenze, Rhoda K.; Nakaweesa, Teddy; Mpendo, Juliet; Kawoozo, Barbarah; Matovu, Francis; Nabukalu, Sarah; Omoding, Geoffrey; Kaweesi, Jed; Ndugga, John; Kamacooko, Onesmus; Chinyenze, Kundai; Price, Matt; Van Geertruyden, Jean P.
    Knowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. victoria in Uganda to inform future FP education programs in FCs. Methods: We conducted a comparative cross-sectional survey among participants aged 15–49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted. Results: Of the 1410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39–2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77–5.81), being married (aOR: 1.59 95% CI: 1.11–2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18–2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common
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    Factors Associated with Consistent Condom Use in Ugandan Fishing Communities' Cohort
    (PAMJ-One Health, 2022) Nakazibwe, Hope Grania; Muturi-Kioi, Vincent; Abaasa, Andrew; Kibengo, Freddie; Hughes, Peter; Price, Matt
    fishing communities continue to face a heavy burden of HIV-infection. Access to HIV prevention methods remains problematic. Provision of affordable interventions such as condoms can help, but there is limited information on consistent condom use and associated factors among members of fishing communities around Lake Victoria. we promoted and provided free condoms to HIV negative fisherfolks enrolled in a longitudinal observational cohort between 2012 and 2017 in Uganda. We defined consistent condom use as a participant self-reporting 100% condom use while having sex with a new sexual partner. in total 615 persons were analysed. Of these 63 (10.2%) reported consistent condom use. Being male, Muslim and mobile were independently associated with high consistent condom use while having sex under influence of alcohol and having genital discharge or sores were associated with low use. findings suggest low consistent condom use, calling for attention to barriers to consistent condom use.
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    Prevalence and correlates of HIV infection among adolescents and young people living in fishing populations along Lake Victoria Fishing Communities in Uganda
    (Pan African Medical Journal, 2020) Nanyonjo, Gertrude; Asiki, Gershim; Ssetaala, Ali; Nakaweesa, Teddy; Wambuzi, Mathias; Nanvubya, Annet; Mpendo, Juliet; Okech, Brenda; Kato Kitandwe, Paul; Nielsen, Leslie; Nalutaaya, Annet; Welsh, Sabrina; Ssentalo Bagaya, Bernard; Chinyenze, Kundai; Fast, Pat; Price, Matt; Kiwanuka, Noah
    fishing communities in Uganda are key populations for HIV, with persistently higher prevalence and incidence than the general population. Methods: between March and August 2014, a cross sectional survey was conducted in 10 fishing communities of Lake Victoria in Uganda. Data was collected on socio-behavioural characteristics using interviewer administered questionnaires and venous blood collected for HIV testing. Prevalent HIV infections among adolescents and young people aged 13 to 24 years was estimated and the factors associated with those infections determined using multi variable logistic regression modelling. Results: HIV prevalence was 10.8% among the 630 (96.5%) who provided a blood sample. Females were 3.5 times as likely to have HIV infection as males (aOR=3.52, 95% CI: 1.34-9.22). Young people aged 20-24 years were twice as likely to be HIV infected as those aged 13-19 years (aOR=1.77, 95% CI: 0.05-2.10), participants without formal education or those who had studied up to primary level were more likely to be HIV infected than those who had post primary education ((aOR=2.45, 95% CI: 1.19-5.07) or (5.29 (1.35-20.71) respectively). Reporting more than one sexual partner in the past 6 months was associated with HIV prevalent infection than those reporting no sexual partners (aOR=6.44, 95% CI: 1.27-32.83). Conclusion: adolescents and young people aged 13-24 years in fishing communities around Lake Victoria, Uganda, have a high HIV prevalence, with females having a three-fold higher level than males. These findings highlight the need to improve HIV prevention among young females living in these fishing communities.
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    Sustained virological response and drug resistance among female sex workers living with HIV on antiretroviral therapy in Kampala, Uganda: a cross sectional study
    (Sexually transmitted infections, 2019) Namale, Gertrude; Kamacooko, Onesmus; Bagiire, Daniel; Mayanja, Yunia; Abaasa, Andrew; Kilembe, William; Price, Matt; Ssemwanga, Deogratius; Lunkuse, Sandra; Nanyonjo, Maria; Ssenyonga, William; Mayaud, Philippe; Newton, Rob; Kaleebu, Pontiano; Seeley, Janet
    We assessed the prevalence and risk factors associated with virological failure among female sex workers living with HIV on antiretroviral therapy (ART ) in Kampala, Uganda. Methods We conducted a cross-sectional study between January 2015 and December 2016 using routinely collected data at a research clinic providing services to women at high risk of STIs including HIV. Plasma samples were tested for viral load from HIVseropositive women aged ≥18 years who had been on ART for at least 6 months and had received adherence counselling. Samples from women with virological failure (≥1000 copies/mL) were tested for HIV drug resistance by population-based sequencing. We used logistic regression to identify factors associated with virological failure. Results Of 584 women, 432 (74%) with a mean age of 32 (SD 6.5) were assessed, and 38 (9%) were found to have virological failure. HIV resistance testing was available for 78% (28/38), of whom 82.1% (23/28) had at least one major drug resistance mutation (DRM), most frequently M184V (70%, 16/23) and K103N (65%, 15/23). In multivariable analysis, virological failure was associated with participant age 18–24 (adjusted OR (aOR)=5.3, 95% CI 1.6 to 17.9), self-reported ART nonadherence (aOR=2.6, 95% CI 1.2 to 5.8) and baseline CD4+ T-cell count ≤350 cells/mm3 (aOR=3.1, 95% CI 1.4 to 7.0). Conclusions A relatively low prevalence of virological failure but high rate of DRM was found in this population at high risk of transmission. Younger age, self-reported ART non-adherence and low CD4+ T-cell count on ART initiation were associated with increased risk of virological failure.