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Background: Tenofovir disoproxil fumarate (TDF) has high antiretrovirus (ARV) activity and available in fixed dose combination (FDC). However, it has been found to cause renal dysfunction. Objectives: To document the prevalence, incidence, pattern of occurence and associated factors of nephrotoxicity in patients initiated on TDF based ART regimen in Mitchell's Plain CHC ARV Clinic and make recommendations. Methodology: The study was conducted by reviewing retrospective records of all ARV naïve HIV positive adults initiated on TDF based ARV regimen from January 2016 to June 2016. The creatinine clearance (CrCl) was calculated from follow up parameters till June 2018. Results: 87 patients were included in the study and 56% were female. The mean age was 34 years. Majority, 83%, had normal renal function at ART initiation. Older age [OR = 1.11; 95% CI (1.03–1.19), p =0.005], was associated with an increased probability of non-normal renal function at baseline. The incidence of CrCl < 90ml/min were 1.5% at 1 month post ARV initiation, 3.3% at 4 months, 6.1% at 12 months and 2.8% at 24 months while the prevalence were 10.5%,11.5%, 20.4% and 16.7% respectively. Older age and male gender were independently associated with prevalence of renal impairment. Conclusion: Renal dysfunction in patients initiated on TDF based regimen in this study varied and were relatively small when compared to the prevalence of renal dysfunction at initiation. Majority of the decline in CrCl were transient and patients were found to have recovered after further follow up. It is recommended that the frequency of renal function monitoring in patients on TDF regimen be done within programmatic guidelines based on patients' risk factors and potential poor outcomes.

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We examined the links between HIV-stigma, loneliness and sleep quality in 181 people living with HIV (PLWH) who completed an online self-report questionnaire. Results suggested that the indirect effect of stigma on poorer sleep through increased loneliness was significant. Researchers will address implications for research on stigma and health.

We hypothesized that higher levels of self-compassion among people living with HIV (PLWH) would be related to lower levels of loneliness, which in turn would be associated with better psychological well-being (lower levels of depression and negative affect and higher positive affect). 106 PLWH completed an online survey that measured demographic variables, self-compassion, loneliness, and psychological well-being. Mediation analyses revealed that loneliness mediated the relationship between self-compassion and depression and negative affect, but not positive affect. These findings indicate that encouraging self-compassion may have a positive effect on psychological well-being among people living with HIV by reducing loneliness.

We hypothesized that the links between spirituality and lower HIV-related stigma would be accounted for by lower levels of shame, and that this mediation model would be moderated by ethnicity in 106 people living with HIV (PLWH). Moderated mediation analyses revealed that higher spirituality was associated with reduced levels of shame, which in turn was associated with lower levels of HIV-related stigma. The indirect effect of spirituality on lower stigma through reduced shame was significant for White but not for Non-White PLWH. It is possible that other mechanisms exist to explain how spirituality operates on stigma for minorities living with HIV.

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In recent decades, governments and non-governmental organizations (NGOs), both national and international, have employed various approaches to improve socio-economic conditions in Africa. Influenced by neo-liberalism, public-private partnerships (PPPs) are now widely used to deliver social programs and services integral to those efforts. This study examines a sample of such collaborations addressing HIV/AIDS and malaria in Togo's Maritime Region. The analysis focuses on relationship dynamics—governance structure, communication, trust levels, and decision making—to gauge partnership effectiveness in delivering health services, as perceived by selected government and NGO representatives. I interviewed leaders from government agencies and NGOs, national and international—all experienced in such collaborations. They described partnership dynamics, issues impeding partnership success and how those concerns might be addressed. This is the first investigation of public-private health-related partnerships in any Togolese region. The analysis contributes empirically to the broader literature concerning the employment by developing nations of cross-sector collaboration for health service delivery. In Togo, national and international NGOs must be granted legal identity, formal governmental acknowledgement under a national regulatory statute, in a process fraught with obstacles. The study concludes that the Togolese government should systematically develop a framework for guiding its partnerships with NGOs, including ways to build mutual trust among those participating in them. Such action would foster mutual engagement in policy decisions, while also honoring the government's rightful stance as final arbiter. Neither of these steps can occur without more open, effective communication among all involved. The study offers recommendations for helping all parties address reported concerns about communication and trust. In characterizing the dynamics of these partnerships, the study enriches our understanding of the challenges confronting the government, NGOs and civil society in Togo. / Ph. D.

Migrant Child is a poetry collection about injustice in the United States of America and the international community. The purpose of the collection is to humanize social injustice in the present, so as to show the reader that discrimination still happens in the United States in 2016. To that end, the collection draws on comparisons from civil rights movements of the 1960s and from present day. It is also meant to reflect injustices the author experiences in his own life. The poetry collection was created after the author spent six months volunteering throughout the State of Florida. The poems in the collection center around Hispanic communities in the United States, refugees seeking asylum, individuals living HIV and AIDS, male rape, and familial abuse. Several poems are written in the epigraph format, so as to place the reader in the author’s desired mindset for that particular poem. In addition, multiple poems in this collection have been inspired by the poets Yusef Komunyakaa, Sylvia Plath, Anne Sexton, and Allen Ginsburg. In present day, discrimination and prejudice are still experienced by minority communities in the United States, and Migrant Child is not by any extent an exhaustive list of all communities that are, in the present, experiencing social injustice.

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