Introduction: HIV remains a leading cause of death globally, with over two-thirds of the cases in sub-Saharan Africa. Zimbabwe, a country located in East Africa, part of Sub-Saharan Africa, ranks in the top five countries with the highest prevalence of HIV in Africa (HIV prevalence in Zimbabwe estimated as 21.4% in 2019). Previous studies demonstrated HIV testing prevalence of 66.9% in East Africa. This study aimed to assess the prevalence of HIV testing amongst women of reproductive age in Zimbabwe, alongside some predictors of HIV testing amongst this population. Methods: Cross-sectional study design using the 2015 Demographic and Health Surveys (DHS) data for women aged 15-49. The prevalence of HIV testing as the outcome variable and the highest educational level, age at first sex, current marital status, and condom use as the predictor variables of interest were assessed. Descriptive statistics (frequencies, percents) and test of significance (using Chi-squared test)were conducted. Bivariate and multivariate logistic regression were completed to assess for the independent relationship between each predictor variable and HIV testing prevalence and, all predictor variables and HIV testing prevalence, respectively. Odds ratio estimates, 95% confidence intervals and p-values werereported. All analyses were performed using the Statistical Analysis System (SAS) version 9.4. The initial sample size included 9955 women. However, the effective sample size used in the statistical analysis was 7130 after accounting for missing variables. Results: About 9 in 10 women in the sample had ever been tested for HIV. Secondary education was the most prevalent highest level of education (64%). About 67% women had their first sex at age 15-19; peak incidence seen at ages 17 and 18 (15.3%). Multivariate analysis showed statistically significant associations between all independent variables and HIV testing (P-value Conclusion: Increasing highest educational level, age at first sex and condom use in Zimbabwe would likely increase the prevalence of HIV testing further. Focused education on the importance of HIV testing before the age of 15 will be beneficial in ensuring HIV testing as soon as sexual intercourse is established. Policy efforts are needed to address these HIV testing predictors. Causality is not implied.

Ample research explores individual factors associated with sexual violence, yet individual, dyadic, and environmental influences on intimate partner sexual violence (IPSV) occurring in the larger context of non-intimate partner violence (NIPSV) remain relatively unexplored. The current study aimed to determine the extent to which county-level indicators in combination with individual and dyadic factors are associated with sexual violence across relationship types. Reported IPSV and NIPSV cases were obtained from the Tennessee Bureau of Investigation’s (TBI) online incident-based reporting system. County-level variables indicative of neighborhood physical disorder, violent crime, income inequality, firearm prevalence, and community alcohol use patterns were retrieved from the online resource County Health Rankings and Roadmaps. Using a nested case–control design, we determined significant sexual violence risk within younger cohorts and across relationship types, finding three significant county-level factors: 1) income inequality, 2) rate of firearm fatalities, and 3) percentage of female residents. Suggested prevention and intervention efforts include targeting younger age groups for IPSV and NIPSV education, developing resources for a range of relational partners, improving legal access and law enforcement training for reporting, and continued examination of the role of firearms.

Emerging research suggests that childhood adversities may increase both the risk and symptomology of posttraumatic stress disorder (PTSD) in our veteran population. Over 40% of our reintegrating military veterans return with significant mental health issues led by combatrelated PTSD. PTSD impacts veterans in numerous areas including unemployment, increased criminal justice involvement, increased treatment costs, divorce, co-morbid mental illness, greater levels of domestic violence, homelessness, high college dropout rates, suicide, and long term health problems. The purpose of this study is to investigate the impact of childhood adversities (abuse, neglect, and poverty) upon the severity of combat-related PTSD in veteran populations. Specifically, the researcher examines the direct effects of: (1) childhood trauma; (2) childhood neglect; and (3) childhood poverty (as assessed based on socioeconomic status [SES]) upon the severity of combat-related PTSD. This study of student veterans (n=102) receiving services from a veteran service center at a major metropolitan university in Central Florida is a non-experimental, explanatory, retrospective survey design using structural equation modeling (SEM) to test the relationships among study variables. Findings strongly supported a relationship between childhood trauma and neglect and the severity of combat-related PTSD. Similarly, findings also supported that no relationship existed between childhood SES and the severity of combat-related PTSD. Both childhood trauma and neglect were significantly associated with combat-related PTSD at an even greater effect than that of combat exposure. SES was not found to be significant in the severity of combat-related PTSD. The findings iv suggest that preventive screening policies to reduce costs and severity of combat-related PTSD might be needed.

Introduction Zambia is aiming to achieve the World Health Organisation (WHO) target of 90% vaccination coverage among children under five years. The 2018 Zambia Demographic and Health Survey (ZDHS) established that Copperbelt province had the highest vaccination coverage at 83%. However, Luapula province was lowest at 67%. The aim of this study was to identify predictors of full vaccination among children aged 12-23 months in Zambia. Methods A cross-sectional design was used to draw information about individual, relationship, community and societal predictors of full vaccination among children aged 12-23 months. Data was collected using a structured closed question format interview administered to mothers from the 2018 ZDHS. The information collected was on background characteristics such as age and education of mothers with vaccinations of their children. chi-square test was used for associations and binary logistic regression was used for multivariable analysis. Results Children born from mothers 20-24 years were most vaccinated 27.4%. Logistic regression showed higher education 10.55 AOR; 95% CI, 1.27-87.53, ability to read whole sentence 1.59 AOR; 95% CI, 1.07-2.35, currently working 1.37 AOR; 95% CI, 1.01-1.86, owning a mobile telephone 1.44 AOR; 95% CI, 1.00-2.34, residing in rural area 1.46 AOR; 95% CI, 1.67-3.62, watching television daily 1.92 AOR; 95% CI, 1.15-3.21 and belonging to a middle category 1.91 AOR; 95% CI, 1.15-3.15 increased odds of full vaccination. Conclusion This study has shown that predictors of full vaccination cut across all the four levels of the Socio Ecological Model (SEM) hence the need for a holistic approach.

Introduction: The current study examined the psychosocial predictors (Type D personality, anxiety, depression & social support) in patients following MI. It further assessed the influence of these psychosocial predictors on quality of life of MI patients. Methods: In this prospective cohort study, 300 patients with definite myocardial infarction were recruited and assessed at baseline (2 -8 weeks) post MI (time 1). Out of 300 participants 191 completed assessments at 9 months follow up (time 2). Type D personality was evaluated with Distress scale 14(DS-14). Depression and anxiety were assessed with Hospital anxiety and depression scale (HADS). Social support was measured with Social support scale (SSS), while quality of Life was assessed with WHO quality of life scale (WHOQOL-BREF) at time 1 and time 2. Results: Analysis revealed that a significantly high percentage of MI patients had Type D personality characteristics, high levels of anxiety, depression and low level of social support. Type D personality and depression emerged as most significant predictors of quality of life after controlling for sociodemographic and clinical variables at time 1 and time 2 assessments. Discussion & Conclusion: This research emphasized the importance of Type D personality, anxiety, depression, and lack of social support in risk stratification for adverse outcomes such as impaired quality of life. This research highlighted the need for a more personalized approach to therapeutic interventions along with medical treatment for the management and rehabilitation of MI patients. / Fatima Jinnah Women University of Pakistan and The Higher Education Commission

The objective of this research study is to explore trajectories of health-related quality of life (HRQoL) in older breast cancer survivors, along with their predictors. HRQoL is important because patients who show severe symptoms may wish to consider therapies or treatment plans that lead to better HRQoL. Older people are more vulnerable to low HRQoL scores since old age is associated with deteriorating health, multiple comorbidities, and low-socioeconomic status. To examine the HRQoL trajectory among older women with breast cancer, we used the data queried from the Surveillance, Epidemiology and End Results Medicare Health Outcomes Survey database. A total of 1,089 older (≥ 65 years) women who were diagnosed with breast cancer in 1998-2012 and participated in the survey before and after the cancer diagnosis were identified. HRQoL was measured using SF-36/VR-12 questionnaire and summarized as Physical Component Summary (PCS) Score and Mental Component Summary (MCS) Score. Latent Class Growth Mixture Modeling was conducted to identify distinct groups of women with a similar trajectory of HRQoL. The results showed that there were three latent classes of HRQoL trajectories for PCS: the high-declining (46.5% of the sample), mid-declining (36.0%), and the low-improving (17.5%). Two latent classes of HRQoL trajectories were identified for MCS: high-stable (76.5%) and low-declining (23.5%). The results showed that age at diagnosis, BMI, level of education, geographic region, tumor grade, tumor size, and number of comorbidities were some of the major predictors of health-related quality of life. These predictors were further explored using multinomial logistic regression analysis which identified number of comorbidities as the most significant predictor for HRQoL-PCS scores and level of education as the most significant predictor for HRQoL-MCS scores. This suggests that future research needs to be conducted, identifying the most common comorbidities in older breast cancer survivors to develop interventions that better the physical HRQoL in patients, in addition to the development of mental HRQoL interventions for patients that are less educated.

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