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Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-plus family treatment model: role of depression in declining adherence over time.
AIDS and Behavior. 2009 Jun; 13(Suppl 1):S82-S91.The authors conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.
Research Triangle Park, North Carolina, Family Health International [FHI], 1989 Nov. , 4,  p.Under contract with the U.S. Agency for International Development (USAID), Family Health International compared 2 brands of condoms for acceptability in Mali, Sri Lanka, and the Dominican Republic. Lifestyle 3, 3.4 mils thick, was compared with Prime, 2.6 mils, to determine whether the thicker of the 2 could be potentially distributed by USAID in developing countries. 65 current condom users, sexually active, and free of STDs for the past year were provided with the Lifestyle 3 condoms, informed that they were thicker, and then interviewed after 1 month of use. 8 condoms were given to each user in the Dominican Republic, and 15 for each in Sri Lanka and Mali. No study data was available for Sri Lanka due to political unrest. Lifestyle 3 was, however, well-accepted in Mali and the Dominican Republic, with additional strength and security cited as extremely desirable factors by over 1/2 of the study participants. Greater protection against both pregnancy and AIDS was considered important. Almost all who were interested in buying the stronger condoms said that they would pay more for them. Lifestyle 3 condoms were also reported to be more comfortable with sensitivity comparable to Prime. The breakage rate for the stronger condom was 1:143, comparable to Consumer Report's March, 1989, study results of 1:140. The Lifestyle 3's labelless silver foil packaging was also found to be overwhelmingly preferred to the standard plastic packaging of other brands. Addition studies of both breakage rates and consumer preference for condom packaging are encouraged. Limited market introduction of Lifestyle 3 is also suggested.
Advances in Contraceptive Delivery Systems. 1986 Feb; 2(1):84-103.This pamphlet, edited by an ad hoc committee of several consultants, scientists, theologians, public health and family planning directors, and an international attorney, covers the following topics: contra-conception; choices of contraceptives; contraceptive package information; copper IUDs; pelvic inflammatory disease (PID); sexually transmitted diseases; and acquired immunodeficiency syndrome. It includes a questionnaire for sexually transmitted diseases (STDs). Professor Joseph Goldzieher describes the "Contra-Conception" database as "a synthesis of up-to-date literature and contemporary guidelines, designed to provide ready access for practicing physicians and medical students." It contains data on several types of hormonal contraception. "Contra-Conceptions" is designed to allow the physician to set his or her own pace when working with the computer, and no previous computer experience is required. 1 of the program's many innovative features is the patient-profiling/decisionmaking section which can be used in the doctor's office to help decide what type of hormonal contraceptive is appropriate for a particular patient. The program permits the doctor to evaluate the significance of patient variables such as parity, smoking, menstrual difficulties and helps the doctor to identify the risks and benefits of the various methods and, ultimately, to make a balanced decision in the context of the most recent data. Contraceptive drugs and devices should include detailed information on the following: description of formula or device; indication, usage, and contraindications, clinical pharmacology and toxicology; dose-related risk; pregnancies per 100 women year; and detailed warning. The sequence of major pathophysiological reactions associated with copper IUDs is identified as are special problems of pelvic infections in users of copper IUDs. Those women who use oral contraceptives (OCs) or a barrier method of contraception or whose partners use a condom have a lower frequency of PID than women not employing any protection. It is well established that copper IUDs cause different types and different degrees of PID. Women using copper IUDs are more at risk for pelvic infection. There is a higher frequency of salpingitis and PID when copper IUDs are employed especially when the population is nulligravidas under the age of 25. The pamphlet lists criteria for the diagnosis of salpingo-oophoritis and actue salpingitis.
Paper presented at the Meeting of Experts between Family Planning Administrators and Commercial Marketing Executives, Penang, Malaysia, September 22-24, 1974. 16 pDistribution of the condom in Japan is briefly surveyed and its marketing approaches and method are explored. Contraceptives involving less medical technology appear to be more conducive for commercial distribution since they require less attention from medical personnel and fewer medical facilities. Japan is one country where the condom is the major contraceptive distributed through nonclinical channels. Nearly 75% of family planning acceptors in Japan were using the condom in 1973. Condoms are not distributed through public health facilities, probably because Japan does not have any national family planning policies or programs to provide services and information to the public. Condoms are sold in drug stores and by door-to-door females salespeople. The Japanese have already accepted the 2-child family norm. Advertisement for condoms does not have to emphasize the family planning aspect of the product. It focuses on happiness and pleasure derived from the use of condoms. Attempts have been made to make the use of condoms more convenient and to remove the psychological barrier by removing verbal communication between client and seller.
Washington, D.C., Futures Group, 1983 Feb 14. 130 p.The process model developed in this paper for marketing analysis, planning, implementation, and control of contraceptive social marketing (CSM) programs is circular, with the last stage feeding back into the 1st. In the 1st stage, analysis, it is necessary to examine the market, the consumers, and the organization and structure within which the CSM program must operate. This includes geographical factors, distribution and sales outlets, local resources, behavioral factors, user status, media patterns, and staff resources. The 2nd stage, planning, involves setting marketing program objectives, market target segmentation, marketing mix strategies, identifying the media that will be used and establishing interpersonal contacts. The 3rd stage involves the development, testing, and refinement of plan elements. This involves the concepts and components of the products, distribution, pricing, concept and message communication, and program testing and training. Product tests concentrate on names, packaging, and logo. In the 4th stage, implementation, the full program is put into effect, requiring the implementing of the plan of action prepared in stage 2, monitoring marketing progress, and monitoring the institutional/structural performance of the CSM organization. As part of this step the communication elements of advertising, publicizing, and promotion must be activated. The 5th stage, in-market effectiveness assessment, can tell if the program is meeting its goals, any corrections which need to be made, and how the next cycle should be planned. At the 6th stage the monitoring and assessment is fed back into stage 1 to identify problems and revise the procedure. The author discusses the uses the methods of primary and secondary marketing research as well as qualitative and quantitative market research methods. The following types of research should be given priority: 1) research that will fill serious information gaps, 2) research that is most likely to be applied for marketing decision-making, 3) research that will reduce the risk of uncertainty associated with making major program changes, and 4) research that provides essential, periodic indicators of market response to ongoing program activities.