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Melissa Watt

Adjunct Associate Professor of Global Health
Duke Global Health Institute
Box 90519, Trent Hall 333, Durham, NC 27708
Trent Hall, Room 329, BOX_90519, Durham, NC 27708

Selected Publications


The Disclosure Dilemma: Willingness to Disclose a Positive HIV Status Among Individuals Preparing for HIV Testing During Antenatal Care in Tanzania.

Journal Article AIDS and behavior · March 2021 HIV status disclosure can reduce transmission risks and improve care engagement. Individuals may have strong feelings about HIV disclosure even prior to diagnosis. We assessed willingness to disclose a positive HIV status among pregnant women and their mal ... Full text Cite

"She Just Told Me Not To Cry": A Qualitative Study of Experiences of HIV Testing and Counseling (HTC) Among Pregnant Women Living with HIV in Tanzania.

Journal Article AIDS and behavior · January 2021 HIV testing and counseling (HTC) in antenatal care is extremely effective at identifying women living with HIV and linking them to HIV care. However, retention is suboptimal in this population. We completed qualitative interviews with 24 pregnant women liv ... Full text Cite

Screening for Traumatic Experiences and Mental Health Distress Among Women in HIV Care in Cape Town, South Africa.

Journal Article Journal of interpersonal violence · November 2020 Traumatic events can negatively affect clinical outcomes among HIV positive women, particularly when those events result in ongoing psychological distress. Consequently, there have been calls to integrate screening and treatment of traumatic experiences an ... Full text Cite

Hypertension burden and challenges across the hypertension treatment cascade among adults enrolled in HIV care in northern Tanzania.

Journal Article J Clin Hypertens (Greenwich) · August 2020 Failure to address hypertension among people living with HIV (PLWH) may undermine the significant progress made toward reducing mortality among this high-risk population in sub-Saharan Africa (SSA). Here, the authors report hypertension prevalence, diagnos ... Full text Link to item Cite

Integrated mental health screening for obstetric fistula patients in Mali: From evidence to policy.

Journal Article PloS one · January 2020 BackgroundObstetric fistula significantly impacts women's mental health and well-being. Routine screening for mental health in fistula repair programs can be a gateway to link patients to services, and can produce routine data to inform programmat ... Full text Cite

A counseling intervention to address HIV stigma at entry into antenatal care in Tanzania (Maisha): study protocol for a pilot randomized controlled trial.

Journal Article Trials · December 2019 BackgroundHIV-related stigma significantly impacts HIV care engagement, including in prevention of mother-to-child transmission of HIV (PMTCT) programs. Maisha is a stigma-based counseling intervention delivered during the first antenatal care (AN ... Full text Cite

Attitudes Toward Long-Term Use of Antiretroviral Therapy Among HIV-Infected Pregnant Women in Moshi, Tanzania: A Longitudinal Study.

Journal Article AIDS and behavior · September 2019 Adherence to antiretroviral therapy (ART) during pregnancy and the postpartum period is necessary to prevent vertical HIV transmission and to secure the long-term health of an HIV-infected woman. Health behavior theory suggests that patients' attitudes tow ... Full text Cite

Vulnerable at Each Step in the PMTCT Care Cascade: High Loss to Follow Up During Pregnancy and the Postpartum Period in Tanzania.

Journal Article AIDS and behavior · July 2019 In 2013, Tanzania adopted the World Health Organization's Option B+ guidelines for prevention of mother-to-child transmission of HIV (PMTCT), whereby all HIV-infected pregnant women initiate lifelong antiretroviral therapy. This study examined retention in ... Full text Cite

Predictors of postpartum HIV care engagement for women enrolled in prevention of mother-to-child transmission (PMTCT) programs in Tanzania.

Journal Article AIDS care · June 2019 Prevention of mother-to-child transmission of HIV (PMTCT) is a foundational component of a comprehensive HIV treatment program. In addition to preventing vertical transmission to children, PMTCT is an important catch-point for universal test-and-treat stra ... Full text Cite

Serostatus disclosure among a cohort of HIV-infected pregnant women enrolled in HIV care in Moshi, Tanzania: A mixed-methods study.

Journal Article SSM - population health · April 2019 HIV-infected pregnant women face complex decisions about whether and how to disclose their serostatus. Previous studies have shown that HIV disclosure is associated with better care engagement, emotional adjustment to the disease, and reduced risk of HIV t ... Full text Cite

Experiences of Fetal or Infant Loss among Tanzanian Women in HIV Care.

Journal Article Journal of loss & trauma · January 2019 This study examined the impact of fetal or infant loss on HIV care engagement. We conducted semi-structured interviews with 15 HIV-infected women who experienced fetal or infant loss while enrolled in prevention of mother-to-child transmission (PMTCT) serv ... Full text Cite

HIV Disclosure Among Pregnant Women Initiating ART in Cape Town, South Africa: Qualitative Perspectives During the Pregnancy and Postpartum Periods.

Journal Article AIDS and behavior · December 2018 For women enrolled in prevention of mother-to-child transmission (PMTCT) programs, non-disclosure of their HIV status can be a significant barrier to sustained HIV care engagement. To explore decision-making surrounding HIV disclosure among HIV-infected pr ... Full text Cite

Avoidant Coping Mediates the Relationship Between Self-Efficacy for HIV Disclosure and Depression Symptoms Among Men Who Have Sex with Men Newly Diagnosed with HIV.

Journal Article AIDS and behavior · October 2018 HIV diagnosis presents a critical opportunity to reduce secondary transmission, improve engagement in care, and enhance overall well-being. To develop relevant interventions, research is needed on the psychosocial experiences of newly diagnosed individuals ... Full text Cite

Attitudes toward alcohol use during pregnancy among women recruited from alcohol-serving venues in Cape Town, South Africa: A mixed-methods study.

Journal Article Social science & medicine (1982) · October 2018 BackgroundThe Western Cape Province of South Africa has one of the highest rates of fetal alcohol spectrum disorder (FASD) globally. Effective prevention of FASD requires understanding women's attitudes about alcohol use during pregnancy and wheth ... Full text Cite

Development of a coping intervention to improve traumatic stress and HIV care engagement among South African women with sexual trauma histories.

Journal Article Evaluation and program planning · June 2018 This paper describes the development and preliminary trial run of ImpACT (Improving AIDS Care after Trauma), a brief coping intervention to address traumatic stress and HIV care engagement among South African women with sexual trauma histories. We engaged ... Full text Cite

Retention in HIV Care During Pregnancy and the Postpartum Period in the Option B+ Era: Systematic Review and Meta-Analysis of Studies in Africa.

Journal Article Journal of acquired immune deficiency syndromes (1999) · April 2018 BackgroundUnder Option B+ guidelines for prevention of mother-to-child transmission of HIV, pregnant and breastfeeding women initiate antiretroviral therapy for lifelong use. The objectives of this study were: (1) to synthesize data on retention i ... Full text Cite

Delays contributing to the development and repair of obstetric fistula in northern Tanzania.

Journal Article International urogynecology journal · March 2018 Introduction and hypothesisDelays in receiving obstetric care during labor contribute to high rates of maternal morbidity in sub-Saharan Africa. This exploratory study was conducted to identify important delays experienced during the development a ... Full text Cite

Improving AIDS Care After Trauma (ImpACT): Pilot Outcomes of a Coping intervention Among HIV-Infected Women with Sexual Trauma in South Africa.

Journal Article AIDS and behavior · March 2018 Improving AIDS Care after Trauma (ImpACT), a coping intervention for HIV-infected women with sexual abuse histories, was evaluated for feasibility and potential efficacy in a public clinic in Cape Town, South Africa. Sixty-four participants were enrolled p ... Full text Cite

Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.

Journal Article AIDS and behavior · November 2017 South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruit ... Full text Cite

HIV-Risk Behaviors and Social Support Among Men and Women Attending Alcohol-Serving Venues in South Africa: Implications for HIV Prevention.

Journal Article AIDS and behavior · November 2017 Alcohol use is associated with increased HIV-risk behaviors, including unprotected sex and number of sex partners. Alcohol-serving venues can be places to engage in HIV-related sexual risk behaviors, but are also important sites of social support for patro ... Full text Cite

The Disclosure Dilemma: Willingness to Disclose a Positive HIV Status Among Individuals Preparing for HIV Testing During Antenatal Care in Tanzania.

Journal Article AIDS and behavior · March 2021 HIV status disclosure can reduce transmission risks and improve care engagement. Individuals may have strong feelings about HIV disclosure even prior to diagnosis. We assessed willingness to disclose a positive HIV status among pregnant women and their mal ... Full text Cite

"She Just Told Me Not To Cry": A Qualitative Study of Experiences of HIV Testing and Counseling (HTC) Among Pregnant Women Living with HIV in Tanzania.

Journal Article AIDS and behavior · January 2021 HIV testing and counseling (HTC) in antenatal care is extremely effective at identifying women living with HIV and linking them to HIV care. However, retention is suboptimal in this population. We completed qualitative interviews with 24 pregnant women liv ... Full text Cite

Screening for Traumatic Experiences and Mental Health Distress Among Women in HIV Care in Cape Town, South Africa.

Journal Article Journal of interpersonal violence · November 2020 Traumatic events can negatively affect clinical outcomes among HIV positive women, particularly when those events result in ongoing psychological distress. Consequently, there have been calls to integrate screening and treatment of traumatic experiences an ... Full text Cite

Hypertension burden and challenges across the hypertension treatment cascade among adults enrolled in HIV care in northern Tanzania.

Journal Article J Clin Hypertens (Greenwich) · August 2020 Failure to address hypertension among people living with HIV (PLWH) may undermine the significant progress made toward reducing mortality among this high-risk population in sub-Saharan Africa (SSA). Here, the authors report hypertension prevalence, diagnos ... Full text Link to item Cite

Integrated mental health screening for obstetric fistula patients in Mali: From evidence to policy.

Journal Article PloS one · January 2020 BackgroundObstetric fistula significantly impacts women's mental health and well-being. Routine screening for mental health in fistula repair programs can be a gateway to link patients to services, and can produce routine data to inform programmat ... Full text Cite

A counseling intervention to address HIV stigma at entry into antenatal care in Tanzania (Maisha): study protocol for a pilot randomized controlled trial.

Journal Article Trials · December 2019 BackgroundHIV-related stigma significantly impacts HIV care engagement, including in prevention of mother-to-child transmission of HIV (PMTCT) programs. Maisha is a stigma-based counseling intervention delivered during the first antenatal care (AN ... Full text Cite

Attitudes Toward Long-Term Use of Antiretroviral Therapy Among HIV-Infected Pregnant Women in Moshi, Tanzania: A Longitudinal Study.

Journal Article AIDS and behavior · September 2019 Adherence to antiretroviral therapy (ART) during pregnancy and the postpartum period is necessary to prevent vertical HIV transmission and to secure the long-term health of an HIV-infected woman. Health behavior theory suggests that patients' attitudes tow ... Full text Cite

Vulnerable at Each Step in the PMTCT Care Cascade: High Loss to Follow Up During Pregnancy and the Postpartum Period in Tanzania.

Journal Article AIDS and behavior · July 2019 In 2013, Tanzania adopted the World Health Organization's Option B+ guidelines for prevention of mother-to-child transmission of HIV (PMTCT), whereby all HIV-infected pregnant women initiate lifelong antiretroviral therapy. This study examined retention in ... Full text Cite

Predictors of postpartum HIV care engagement for women enrolled in prevention of mother-to-child transmission (PMTCT) programs in Tanzania.

Journal Article AIDS care · June 2019 Prevention of mother-to-child transmission of HIV (PMTCT) is a foundational component of a comprehensive HIV treatment program. In addition to preventing vertical transmission to children, PMTCT is an important catch-point for universal test-and-treat stra ... Full text Cite

Serostatus disclosure among a cohort of HIV-infected pregnant women enrolled in HIV care in Moshi, Tanzania: A mixed-methods study.

Journal Article SSM - population health · April 2019 HIV-infected pregnant women face complex decisions about whether and how to disclose their serostatus. Previous studies have shown that HIV disclosure is associated with better care engagement, emotional adjustment to the disease, and reduced risk of HIV t ... Full text Cite

Experiences of Fetal or Infant Loss among Tanzanian Women in HIV Care.

Journal Article Journal of loss & trauma · January 2019 This study examined the impact of fetal or infant loss on HIV care engagement. We conducted semi-structured interviews with 15 HIV-infected women who experienced fetal or infant loss while enrolled in prevention of mother-to-child transmission (PMTCT) serv ... Full text Cite

HIV Disclosure Among Pregnant Women Initiating ART in Cape Town, South Africa: Qualitative Perspectives During the Pregnancy and Postpartum Periods.

Journal Article AIDS and behavior · December 2018 For women enrolled in prevention of mother-to-child transmission (PMTCT) programs, non-disclosure of their HIV status can be a significant barrier to sustained HIV care engagement. To explore decision-making surrounding HIV disclosure among HIV-infected pr ... Full text Cite

Avoidant Coping Mediates the Relationship Between Self-Efficacy for HIV Disclosure and Depression Symptoms Among Men Who Have Sex with Men Newly Diagnosed with HIV.

Journal Article AIDS and behavior · October 2018 HIV diagnosis presents a critical opportunity to reduce secondary transmission, improve engagement in care, and enhance overall well-being. To develop relevant interventions, research is needed on the psychosocial experiences of newly diagnosed individuals ... Full text Cite

Attitudes toward alcohol use during pregnancy among women recruited from alcohol-serving venues in Cape Town, South Africa: A mixed-methods study.

Journal Article Social science & medicine (1982) · October 2018 BackgroundThe Western Cape Province of South Africa has one of the highest rates of fetal alcohol spectrum disorder (FASD) globally. Effective prevention of FASD requires understanding women's attitudes about alcohol use during pregnancy and wheth ... Full text Cite

Development of a coping intervention to improve traumatic stress and HIV care engagement among South African women with sexual trauma histories.

Journal Article Evaluation and program planning · June 2018 This paper describes the development and preliminary trial run of ImpACT (Improving AIDS Care after Trauma), a brief coping intervention to address traumatic stress and HIV care engagement among South African women with sexual trauma histories. We engaged ... Full text Cite

Retention in HIV Care During Pregnancy and the Postpartum Period in the Option B+ Era: Systematic Review and Meta-Analysis of Studies in Africa.

Journal Article Journal of acquired immune deficiency syndromes (1999) · April 2018 BackgroundUnder Option B+ guidelines for prevention of mother-to-child transmission of HIV, pregnant and breastfeeding women initiate antiretroviral therapy for lifelong use. The objectives of this study were: (1) to synthesize data on retention i ... Full text Cite

Delays contributing to the development and repair of obstetric fistula in northern Tanzania.

Journal Article International urogynecology journal · March 2018 Introduction and hypothesisDelays in receiving obstetric care during labor contribute to high rates of maternal morbidity in sub-Saharan Africa. This exploratory study was conducted to identify important delays experienced during the development a ... Full text Cite

Improving AIDS Care After Trauma (ImpACT): Pilot Outcomes of a Coping intervention Among HIV-Infected Women with Sexual Trauma in South Africa.

Journal Article AIDS and behavior · March 2018 Improving AIDS Care after Trauma (ImpACT), a coping intervention for HIV-infected women with sexual abuse histories, was evaluated for feasibility and potential efficacy in a public clinic in Cape Town, South Africa. Sixty-four participants were enrolled p ... Full text Cite

Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.

Journal Article AIDS and behavior · November 2017 South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruit ... Full text Cite

HIV-Risk Behaviors and Social Support Among Men and Women Attending Alcohol-Serving Venues in South Africa: Implications for HIV Prevention.

Journal Article AIDS and behavior · November 2017 Alcohol use is associated with increased HIV-risk behaviors, including unprotected sex and number of sex partners. Alcohol-serving venues can be places to engage in HIV-related sexual risk behaviors, but are also important sites of social support for patro ... Full text Cite

Risk for Alcohol-Exposed Pregnancies Among Women at Drinking Venues in Cape Town, South Africa.

Journal Article Journal of studies on alcohol and drugs · September 2017 ObjectiveSouth Africa's Western Cape Province has one of the highest rates of fetal alcohol spectrum disorder globally. Alcohol-serving venues are likely important sites to identify women at high risk of having a child with fetal alcohol spectrum ... Full text Cite

Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa.

Journal Article Substance use & misuse · May 2017 BackgroundSouth Africa has experienced a tremendous rise in methamphetamine use since the year 2000. Sex trading is a global phenomenon that has been observed in active drug users and has been associated with risks for HIV infection and violence.< ... Full text Cite

Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians.

Journal Article BMC Fam Pract · March 16, 2017 BACKGROUND: Acute respiratory tract infections (ARTIs) are a common reason for antibiotic overuse worldwide. We previously showed that over 80% of outpatients presenting to a tertiary care hospital in Sri Lanka with influenza-like illness received antibiot ... Full text Open Access Link to item Cite

Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism.

Journal Article Journal of affective disorders · March 2017 BackgroundWomen who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. Predictive pathways from maternal childhood trauma to child outcomes, as mediated ... Full text Cite

Missed opportunities for timely diagnosis of pediatric lupus in South Africa: a qualitative study.

Journal Article Pediatr Rheumatol Online J · February 23, 2017 BACKGROUND: Systemic Lupus Erythematosus (SLE) is a serious multisystem autoimmune disease, which is more aggressive in children and people of African descent. In South Africa, pediatric SLE (pSLE) patients are at high risk for severe disease. Similar to p ... Full text Link to item Cite

Intimate partner violence among men and women who use methamphetamine: A mixed-methods study in South Africa.

Journal Article Drug and alcohol review · January 2017 IntroductionThe prevalence of methamphetamine use has risen dramatically in parts of South Africa. Globally, methamphetamine has been linked to intimate partner violence (IPV) and other forms of aggression. The aim of this mixed-methods study was ... Full text Cite

A nurse-delivered mental health intervention for obstetric fistula patients in Tanzania: results of a pilot randomized controlled trial.

Journal Article Pilot and feasibility studies · January 2017 BackgroundObstetric fistula has severe psychological consequences, but no evidence-based interventions exist to improve mental health in this population. This pilot trial evaluated a psychological intervention for women receiving surgical care for ... Full text Cite

HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa.

Journal Article AIDS and behavior · October 2016 South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse tre ... Full text Cite

HIV testing and sero-prevalence among methamphetamine users seeking substance abuse treatment in Cape Town.

Journal Article Drug and alcohol review · September 2016 Introduction and aimsMethamphetamine use is highly prevalent in parts of South Africa, and there is concern this will contribute to the country's substantial HIV epidemic. We examined the feasibility of implementing routine HIV testing at a commun ... Full text Cite

"Nothing Is Free": A Qualitative Study of Sex Trading Among Methamphetamine Users in Cape Town, South Africa.

Journal Article Arch Sex Behav · May 2016 South Africa is facing an established epidemic of methamphetamine, known locally as "tik." Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the expe ... Full text Link to item Cite

Psychological Symptoms and Social Functioning Following Repair of Obstetric Fistula in a Low-Income Setting.

Journal Article Matern Child Health J · May 2016 Objectives Obstetric fistula is a maternal injury that causes uncontrollable leaking of urine or stool, and most women who develop it live in poverty in low-income countries. Obstetric fistula is associated with high rates of stigma and psychological morbi ... Full text Link to item Cite

Alcohol Use During Pregnancy in a South African Community: Reconciling Knowledge, Norms, and Personal Experience.

Journal Article Maternal and child health journal · January 2016 ObjectivesDue to high rates of fetal alcohol spectrum disorder (FASD) in South Africa, reducing alcohol use during pregnancy is a pressing public health priority. The aim of this study was to qualitatively explore knowledge and attitudes about mat ... Full text Cite

Experiences of social support among women presenting for obstetric fistula repair surgery in Tanzania.

Journal Article Int J Womens Health · 2016 OBJECTIVE: An obstetric fistula is a childbirth injury resulting in uncontrollable leakage of urine and/or feces and can lead to physical and psychological challenges, including social isolation. Prior to and after fistula repair surgery, social support ca ... Full text Link to item Cite

Maladaptive coping mediates the influence of childhood trauma on depression and PTSD among pregnant women in South Africa.

Journal Article Archives of women's mental health · October 2015 Antenatal mental disorders compromise maternal and child health, and women who have experienced childhood trauma may be at increased risk for such disorders. One hypothesis is that early trauma leads to the development and use of maladaptive coping strateg ... Full text Cite

HIV/AIDS-related stigma in South African alcohol-serving venues and its potential impact on HIV disclosure, testing and treatment-seeking behaviours.

Journal Article Global public health · October 2015 Alcohol-serving venues in South Africa are sites for high-risk behaviours that may lead to HIV transmission. Prevention and treatment interventions are sorely needed in these settings, but HIV-related stigma may limit their effectiveness. This study explor ... Full text Cite

Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania.

Journal Article Int J Behav Med · October 2015 BACKGROUND: Obstetric fistula is a childbirth injury prevalent in sub-Saharan Africa that causes uncontrollable leaking of urine and/or feces. Research has documented the social and psychological sequelae of obstetric fistula, including mental health dysfu ... Full text Link to item Cite

The mental health experiences and needs of methamphetamine users in Cape Town: A mixed methods study.

Journal Article South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · September 2015 BackgroundSouth Africa has a burgeoning problem of methamphetamine use, particularly in the Western Cape. Although methamphetamine has been associated with elevated psychological distress, there has been little examination of the mental health nee ... Full text Cite

Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: A mixed-methods study.

Journal Article Drug Alcohol Depend · July 1, 2015 BACKGROUND: Since 2000, there has been a dramatic increase in methamphetamine use in South Africa, but little is known about the experiences of out-of-treatment users. This mixed-methods study describes the substance use histories, addiction symptoms, and ... Full text Link to item Cite

Development of an intervention to improve mental health for obstetric fistula patients in Tanzania.

Journal Article Eval Program Plann · June 2015 Obstetric fistula is a debilitating childbirth injury that has been associated with high rates of psychological distress. Global efforts have helped to link women to surgical repair, but thus far no evidence-based interventions exist to address the psychol ... Full text Link to item Cite

Perceptions of successful ageing in Sri Lankan older people: A qualitative study

Journal Article Asian Journal of Gerontology and Geriatrics · June 1, 2015 Background. This study explores the opinions and views of Sri Lankan older people about successful ageing. Methods. 30 females and 28 males aged 63 to 85 (median, 69) years recruited from 4 locations in a southern district in Sri Lanka participated in 8 fo ... Cite

Experiences of forced sex among female patrons of alcohol-serving venues in a South African township.

Journal Article Journal of interpersonal violence · May 2015 South Africa has among the highest rates of forced sex worldwide, and alcohol use has consistently been associated with risk of forced sex in South Africa. However, methodological challenges affect the accuracy of forced sex measurements. This study explor ... Full text Cite

Traumatic stress and the mediating role of alcohol use on HIV-related sexual risk behavior: results from a longitudinal cohort of South African women who attend alcohol-serving venues.

Journal Article Journal of acquired immune deficiency syndromes (1999) · March 2015 BackgroundIn South Africa, alcohol contributes to the HIV epidemic, in part, by influencing sexual behaviors. For some, high levels of alcohol consumption may be driven by previous traumatic experiences that result in traumatic stress. The purpose ... Full text Cite

Mediators of interpersonal violence and drug addiction severity among methamphetamine users in Cape Town, South Africa.

Journal Article Addict Behav · March 2015 South Africa has high rates of interpersonal violence and a rapidly growing methamphetamine epidemic. Previous research has linked experiences of interpersonal violence to higher rates of substance use, and identified mental health constructs as potential ... Full text Link to item Cite

HIV testing behaviors and attitudes among community recruited methamphetamine users in a South African township.

Journal Article AIDS Behav · January 2015 Methamphetamine users in South Africa are at high risk for HIV infection and transmission, but little is known about HIV testing in this population. We examined HIV testing behaviors and attitudes in 362 methamphetamine users recruited using chain referral ... Full text Link to item Cite

Mental Health and Substance Use Among Patients in a North Carolina HIV Clinic.

Journal Article N C Med J · 2015 BACKGROUND: The HIV/AIDS epidemic is a significant public health concern in North Carolina, and previous research has pointed to elevated mental health distress and substance use among HIV-infected populations, which may impact patients' adherence to medic ... Full text Open Access Link to item Cite

Respondent driven sampling is an effective method for engaging methamphetamine users in HIV prevention research in South Africa.

Journal Article Drug Alcohol Depend · October 1, 2014 BACKGROUND: South Africa, in the midst of the world's largest HIV epidemic, has a growing methamphetamine problem. Respondent driven sampling (RDS) is a useful tool for recruiting hard-to-reach populations in HIV prevention research, but its use with metha ... Full text Link to item Cite

Positive choices: outcomes of a brief risk reduction intervention for newly HIV-diagnosed men who have sex with men.

Journal Article AIDS and behavior · September 2014 Positive choices (PC), a brief sexual risk reduction intervention conducted with newly HIV-diagnosed men who have sex with men (MSM), was evaluated for preliminary efficacy. Participants were enrolled if they reported unprotected anal intercourse (UAI) in ... Full text Cite

"It's better for me to drink, at least the stress is going away": perspectives on alcohol use during pregnancy among South African women attending drinking establishments.

Journal Article Social science & medicine (1982) · September 2014 The Western Cape of South Africa has one of the highest rates of fetal alcohol spectrum disorders (FASD) globally. Reducing alcohol use during pregnancy is a pressing public health priority for this region, but insight into the experiences of women who dri ... Full text Cite

Longitudinal cohort study of depression, post-traumatic stress, and alcohol use in South African women who attend alcohol serving venues.

Journal Article BMC psychiatry · August 2014 BackgroundIn South Africa, alcohol use poses a public health burden. Hazardous alcohol use often co-occurs with psychological distress (e.g., depression and post-traumatic stress). However, the majority of the research establishing the relationshi ... Full text Cite

Food insecurity and alcohol use among pregnant women at alcohol-serving establishments in South Africa.

Journal Article Prevention science : the official journal of the Society for Prevention Research · June 2014 South Africa has the highest rate of fetal alcohol syndrome (FAS) in the world. While efforts have been made to curb the high rate of FAS, little is known about situational factors that may contribute to alcohol use during pregnancy. In the current paper, ... Full text Cite

Men (and women) as "sellers" of sex in alcohol-serving venues in Cape Town, South Africa.

Journal Article Prevention science : the official journal of the Society for Prevention Research · June 2014 The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine a ... Full text Cite

The relationship between attending alcohol serving venues nearby versus distant to one's residence and sexual risk taking in a South African township.

Journal Article Journal of behavioral medicine · June 2014 South Africa remains a country with one of the highest prevalence rates of HIV/AIDS at 18% among 15-49 year olds. Underdeveloped urban areas, or townships, are particularly hard hit by the HIV/AIDS epidemic. Alcohol use in these townships has been establis ... Full text Cite

Caregiving expectations and challenges among elders and their adult children in Southern Sri Lanka.

Journal Article Ageing Soc · May 1, 2014 The elderly population in Sri Lanka is growing rapidly. Elders are traditionally cared for in the homes of their adult children, but the shifting socio-economic environment in Sri Lanka challenges this arrangement. This paper describes the dynamics of elde ... Full text Link to item Cite

Drinking before and after pregnancy recognition among South African women:The moderating role of traumatic experiences

Journal Article BMC Pregnancy and Childbirth · March 5, 2014 Background:South Africa has one of the world's highest rates of fetal alcohol spectrum disorder (FASD) and interpersonal trauma. These co-occurring public health problems raise the need to understand alcohol consumption among trauma-exposed pregnant women ... Full text Cite

The impact of methamphetamine ("tik") on a peri-urban community in Cape Town, South Africa.

Journal Article Int J Drug Policy · March 2014 BACKGROUND: Over the last decade, South Africa's Western Cape has experienced a dramatic increase in methamphetamine ("tik") use. Our study explored local impressions of the impact of tik use in a peri-urban township community in Cape Town, South Africa. M ... Full text Link to item Cite

Drinking before and after pregnancy recognition among South African women: the moderating role of traumatic experiences.

Journal Article BMC pregnancy and childbirth · March 2014 BackgroundSouth Africa has one of the world's highest rates of fetal alcohol spectrum disorder (FASD) and interpersonal trauma. These co-occurring public health problems raise the need to understand alcohol consumption among trauma-exposed pregnan ... Full text Cite

Beliefs about fetal alcohol spectrum disorder among men and women at alcohol serving establishments in South Africa.

Journal Article The American journal of drug and alcohol abuse · March 2014 BackgroundSouth Africa has one of the highest rates of fetal alcohol spectrum disorder (FASD) in the world. However, little is known about what men and women who attend alcohol serving establishments believe about alcohol use during pregnancy and ... Full text Cite

Religious coping among women with obstetric fistula in Tanzania.

Journal Article Glob Public Health · 2014 Religion is an important aspect of Tanzanian culture, and is often used to cope with adversity and distress. This study aimed to examine religious coping among women with obstetric fistulae. Fifty-four women receiving fistula repair at a Tanzanian hospital ... Full text Link to item Cite

Drinking in the Context of Life Stressors: A Multidimensional Coping Strategy Among South African Women.

Journal Article Substance use & misuse · January 2014 This study explored narratives of drinking as a coping strategy among female drinkers in a South African township. In 2010-2011, we conducted qualitative in-depth interviews with 54 women recruited from 12 alcohol-serving venues. Most women drank heavily a ... Full text Cite

Men who report recent male and female sex partners in Cape Town, South Africa: an understudied and underserved population.

Journal Article Archives of sexual behavior · October 2013 The HIV/AIDS epidemic in South Africa has largely focused on the needs of heterosexual men and women. However, little is known about the sexual risk histories of men who have sex with both men and women (MSMW). Furthermore, we know very little about the ps ... Full text Cite

Risk patterns preceding diagnosis among newly HIV-diagnosed men who have sex with men in New York City.

Journal Article AIDS patient care and STDs · June 2013 Men who have sex with men (MSM) are at high risk for contracting and transmitting HIV. They are increasingly encouraged to get tested, but understanding of the interplay between HIV testing and risk behavior is limited. One hundred fifty newly HIV-diagnose ... Full text Cite

Gender-based violence, alcohol use, and sexual risk among female patrons of drinking venues in Cape Town, South Africa.

Journal Article Journal of behavioral medicine · June 2013 Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk an ... Full text Cite

Co-occurring psychosocial problems and HIV risk among women attending drinking venues in a South African township: a syndemic approach.

Journal Article Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · April 2013 BackgroundIn South Africa, women comprise the majority of HIV infections. Syndemics, or co-occurring epidemics and risk factors, have been applied in understanding HIV risk among marginalized groups.PurposeThe purposes of this study are t ... Full text Cite

Providers' attitudes towards treating depression and self-reported depression treatment practices in HIV outpatient care.

Journal Article AIDS Patient Care STDS · March 2013 Depression is highly prevalent among HIV-infected patients, yet little is known about the quality of HIV providers' depression treatment practices. We assessed depression treatment practices of 72 HIV providers at three academic medical centers in 2010-201 ... Full text Link to item Cite

Food insufficiency, substance use, and sexual risks for HIV/AIDS in informal drinking establishments, Cape Town, South Africa.

Journal Article Journal of urban health : bulletin of the New York Academy of Medicine · December 2012 HIV/AIDS is concentrated in impoverished communities. Two critical aspects of poverty are food insufficiency and substance abuse, and both are associated with sexual risks for HIV/AIDS in southern Africa. The current study is the first to examine both hung ... Full text Cite

Methamphetamine use is associated with childhood sexual abuse and HIV sexual risk behaviors among patrons of alcohol-serving venues in Cape Town, South Africa.

Journal Article Drug and alcohol dependence · November 2012 BackgroundSouth Africa's Western Cape has experienced a dramatic increase in methamphetamine ("meth") use over the past decade. There is concern that meth may further fuel the HIV epidemic in this country because of its association with risky sexu ... Full text Cite

Alcohol-serving venues in South Africa as sites of risk and potential protection for violence against women.

Journal Article Substance use & misuse · October 2012 This qualitative study explores alcohol-serving venues as sites of risk or protection from violence against women (VAW) in one South African community. In 2010, we conducted in-depth interviews with 31 female patrons, 13 male patrons and 11 venue staff, an ... Full text Cite

Gender-based violence and HIV sexual risk behavior: alcohol use and mental health problems as mediators among women in drinking venues, Cape Town.

Journal Article Social science & medicine (1982) · October 2012 Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. ... Full text Cite

Posttraumatic stress disorder symptoms mediate the relationship between traumatic experiences and drinking behavior among women attending alcohol-serving venues in a South African township.

Journal Article Journal of studies on alcohol and drugs · July 2012 ObjectiveSouth Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazard ... Full text Cite

AIDS-related stigma, HIV testing, and transmission risk among patrons of informal drinking places in Cape Town, South Africa.

Journal Article Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · June 2012 BackgroundAIDS-related stigma as a barrier to HIV testing has not been examined within the context of high at risk environments such as drinking venues. Of particular importance is whether AIDS-related stigma is associated with HIV transmission ri ... Full text Cite

"Because he has bought for her, he wants to sleep with her": alcohol as a currency for sexual exchange in South African drinking venues.

Journal Article Social science & medicine (1982) · April 2012 Previous research has documented the practice of transactional sex in sub-Saharan Africa and its association with gender-based violence, gender inequalities and HIV risk. At the same time, it has been suggested that women may use transactional sex to obtai ... Full text Cite

The protective role of religious coping in adolescents' responses to poverty and sexual decision-making in rural Kenya.

Journal Article Journal of research on adolescence : the official journal of the Society for Research on Adolescence · March 2012 In this study, we explored how adolescents in rural Kenya apply religious coping in sexual decision-making in the context of high rates of poverty and Human Immunodeficiency Virus (HIV). Semi-structured interviews were conducted with 34 adolescents. One-th ... Full text Open Access Cite

Pregnancy, alcohol intake, and intimate partner violence among men and women attending drinking establishments in a Cape Town, South Africa township.

Journal Article Journal of community health · February 2012 The highest rates of fetal alcohol syndrome worldwide can be found in South Africa. Particularly in impoverished townships in the Western Cape, pregnant women live in environments where alcohol intake during pregnancy has become normalized and interpersona ... Full text Open Access Cite

Perceived acceptability of home-based couples voluntary HIV counseling and testing in Northern Tanzania.

Journal Article AIDS care · January 2012 It is estimated that 5.6% of the Tanzanian population ages 15-49 are infected with HIV, but only 30% of adults have ever had an HIV test. Couples' testing has proven to increase testing coverage and introduce HIV prevention, but barriers include access to ... Full text Open Access Cite

THE DEVELOPMENT AND FEASIBILITY OF A BRIEF RISK REDUCTION INTERVENTION FOR NEWLY HIV-DIAGNOSED MEN WHO HAVE SEX WITH MEN.

Journal Article Journal of community psychology · August 2011 Men who have sex with men (MSM) represent more than half of all new HIV infections in the United States. Utilizing a collaborative, community based approach, a brief risk reduction intervention was developed and pilot tested among newly HIV-diagnosed MSM r ... Full text Open Access Cite

Mental health and HIV sexual risk behavior among patrons of alcohol serving venues in Cape Town, South Africa.

Journal Article Journal of acquired immune deficiency syndromes (1999) · July 2011 BackgroundAlcohol-serving venues in South Africa provide a location for HIV prevention interventions due to risk factors of patrons in these establishments. Understanding the association between mental health and risk behaviors in these settings m ... Full text Cite

Acceptability of a group intervention for initiates of antiretroviral therapy in Tanzania.

Journal Article Glob Public Health · 2011 The success of antiretroviral therapy (ART) programmes requires high adherence and retention in care. In light of healthcare shortages, group interventions may be optimal ways to deliver information and provide support to ART patients. This study assessed ... Full text Link to item Cite

Intimate partner violence and the association with HIV risk behaviors among young men in Dar es Salaam, Tanzania.

Journal Article Journal of interpersonal violence · October 2010 There is growing evidence of the association between gender-based violence and HIV from the perspective and experiences of women. The purpose of this study is to examine these associations from the perspective of young men living in Dar es Salaam, Tanzania ... Full text Cite

Mental health treatment to reduce HIV transmission risk behavior: a positive prevention model.

Journal Article AIDS and behavior · April 2010 Secondary HIV prevention, or "positive prevention," is concerned with reducing HIV transmission risk behavior and optimizing the health and quality of life of people living with HIV/AIDS (PLWHA). The association between mental health and HIV transmission r ... Full text Cite

Integrating HIV prevention into services for abused women in South Africa.

Journal Article AIDS and behavior · April 2010 The relationship between intimate partner violence (IPV) and HIV risk is well documented, but few interventions jointly address these problems. We developed and examined the feasibility of an intervention to reduce HIV risk behaviors among 97 women seeking ... Full text Cite

Factors associated with self-reported adherence to antiretroviral therapy in a Tanzanian setting.

Journal Article AIDS care · March 2010 This study aimed to determine the level of antiretroviral adherence and factors associated with adherence among patients receiving free antiretroviral therapy (ART) at one clinic in Tanzania. Adult patients were recruited into the cross-sectional study and ... Full text Cite

"It's all the time in my mind": facilitators of adherence to antiretroviral therapy in a Tanzanian setting.

Journal Article Social science & medicine (1982) · May 2009 Although HIV positive patients' adherence to antiretroviral therapy (ART) is relatively high in African nations, as compared with industrialized nations, few studies have explored why. In the research presented here we aimed to understand the dynamics of g ... Full text Cite

Missed opportunities for religious organizations to support people living with HIV/AIDS: findings from Tanzania.

Journal Article AIDS patient care and STDs · May 2009 Religious beliefs play an important role in the lives of Tanzanians, but little is known about the influence of religion for people living with HIV/AIDS (PLWHA). This study shares perspectives of PLWHA and identifies opportunities for religious organizatio ... Full text Cite

Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes.

Journal Article BMC Public Health · March 4, 2009 BACKGROUND: Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes ... Full text Link to item Cite

Providing support to IPV victims in the emergency department: vignette-based interviews with IPV survivors and emergency department nurses.

Journal Article Violence against women · June 2008 The authors compare perspectives of intimate partner violence (IPV) survivors and emergency department (ED) nurses on types of social support IPV victims need at different stages of readiness to disclose and leave a relationship. Qualitative interviews (16 ... Full text Cite