Title: Investigating the Acceptability and Effectiveness of Menstrual Hygiene Management Methods Among Young Women in Zimbabwe: A Mixed Methods Study
PRINCIPAL INVESTIGATOR: Mandikudza Tembo (PhD Candidate)
Through the provision of comprehensive educational material and menstrual hygiene products such as the menstrual cup, disposable pads, and reusable pads, the goal of this study is to improve menstrual hygiene management amongst adolescents in Zimbabwe. This study will be nested within an ongoing cluster randomized trial, Community based interventions to improve HIV outcomes in adolescents in Zimbabwe (CHIEDZA), which aims to improve HIV outcomes in people aged 16-25 years in Zimbabwe. This study will be a mixed methods study including qualitative research to develop the MHM intervention that will be nested within a broader HIV and SRH-focused intervention being delivered within the CHIEDZA trial. A quantitative questionnaire and qualitative FGDs will be used to evaluate the acceptability and effectiveness of the MHM intervention on menstrual management, reproductive tract infections, and psychosocial wellbeing. Self-collected swabs will also be collected in a sub-sample of girls to estimate BV prevalence, and a sub-sample of used menstrual cups will be tested for specific bacterialinfections.
ProjectPERIOD: September 2018 – September 2022
Title: Bridging the Gap in HIV testing and care for children in Zimbabwe (B-GAP Project)
Name of Funder: Medical Research Council (MRC) UK, Department for International Development (DFID)
Study Investigators: Rashida Ferrand, Chido Dziva Chikwari
Project Precis: Compared to adults’ children have poor HIV testing, treatment and programmatic outcomes. To achieve the UNAIDS 90-90-90 targets, there is now an urgent need to improve HIV testing and engagement with HIV treatment and care services among children and adolescents – a group that is difficult to reach and has lower treatment success.
Aims: The aim of this project is to investigate two interventions aimed at improving uptake of HIV testing and engagement with HIV care for children aged 2 – 18 years.
- To investigate the effectiveness of targeted HIV testing and counselling offered to children living in households with HIV positive individuals in identifying undiagnosed HIV-an approach known as index-linked HIV testing
- To investigate the effectiveness of community-based support offered to HIV-infected children and their caregivers in improving linkage to care and viral suppression
- To estimate the costs and cost-effectiveness of target testing and HIV support strategies
- To conduct a process evaluation of the interventions’ implementation, mechanisms of impact and local context to inform the components required for sustainability and scalability.
Methods: Individuals living with HIV attending selected primary healthcare clinics in and Mangwe and Bulawayo will be approached by research assistants and asked whether if they have children or adolescents in their households who have not been tested for HIV. If they do, 3 options will be offered for the children to access HIV testing and counselling (HTC):
1) Clinic-based HTC
2) Home-based HTC performed by community health workers.
3) An HIV oral mucosal test given to the individual to test their children in the privacy of their home (assisted HIV self-testing)
Participants will be followed up to assess whether HIV testing occurred and the HIV test result. Children who test HIV-positive or are identified as HIV positive but not linked to care will be referred for HIV care and treatment. They will also be offered an evidence-based community-based support intervention to facilitate linkage and retention into care over 12 months. A mixed method process and cost-effectiveness evaluation of the testing and support interventions will be conducted to assess sustainability and scalability.
Project Timeline: April 2017-March 2020
Title: The IMpact of Vertical HIV infection on child and Adolescent Skeletal development in Harare, Zimbabwe: the IMVASK Study
Name of Funder: Wellcome Trust UK
Principle Investigator: Ruramayi Rukuni (PhD Candidate)
Project Precis: Impaired linear growth (stunting), is one of the most common manifestations of vertically-acquired HIV which can adversely impact bone and muscle development and function, particularly during adolescence – a critical period of somatic growth. We hypothesize that the accrual of bone mass in children with HIV during growth may be reduced, which will put them at increased risk of adverse musculoskeletal outcomes e.g. fracture risk earlier in life compared to uninfected peers. This study will estimate the impact of HIV infection on musculoskeletal disease in children and inform the need for potential interventions to optimize peak bone mass and reduce risk of osteoporosis in adulthood.
Aim: To determine the impact of HIV infection on bone mineral density (bone mass/bone size) in peri-pubertal children aged 8-16 years established on antiretroviral therapy (ART).
- To determine the prevalence of low-BMD among children with HIV compared to children without HIV.
- To analyse the risk factors for low-BMD among children with HIV.
- To compare the rate of bone mass accrual between children with HIV and without HIV.
300 children with HIV established on ART and 300 children without HIV, aged 8-16 years will be recruited into a frequency-matched prospective cohort study. Detailed musculoskeletal assessments including dual-energy X-ray absorptiometry (DXA) will be conducted at baseline and one year.
Project Timeline: May 2018 – May 2020