Browsing by Author "Haambokoma M"

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    An exploration of multi-level factors affecting routine linkage to HIV care in Zambia's PEPFAR-supported treatment program in the treat all era.
    (2024) Chipungu J; Smith H; Mwamba C; Haambokoma M; Sharma A; Savory T; Musheke M; Pry J; Bolton C; Sikazwe I; Herce ME; Research Department, Social and Behavioral Science Unit, Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.
    Multiple steps from HIV diagnosis to treatment initiation and confirmed engagement with the health system are required for people living with HIV to establish full linkage to care in the modern treat all era. We undertook a qualitative study to gain an in-depth understanding of the impeding and enabling factors at each step of this linkage pathway. In-depth interviews were conducted with fifty-eight people living with HIV recruited from ten routine HIV care settings supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) in Lusaka, Zambia. Using a semi-structured interview guide informed by an established conceptual framework for linkage to care, questions explored the reasons behind late, missed, and early linkage into HIV treatment, as well as factors influencing the decision to silently transfer to a different clinic after an HIV diagnosis. We identified previously established and intersecting barriers of internal and external HIV-related stigma, concerns about ART side effects, substance use, uncertainties for the future, and a perceived lack of partner and social support that impeded linkage to care at every step of the linkage pathway. However, we also uncovered newer themes specific to the current test and treat era related to the rapidity of ART initiation and insufficient patient-centered post-test counseling that appeared to exacerbate these well-known barriers, including callous health workers and limited time to process a new HIV diagnosis before treatment. Long travel distance to the clinic where they were diagnosed was the most common reason for silently transferring to another clinic for treatment. On the other hand, individual resilience, quality counseling, patient-centered health workers, and a supportive and empathetic social network mitigated these barriers. These findings highlight potential areas for strengthening linkage to care and addressing early treatment interruption and silent transfer in the test and treat era in Zambia.
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    Intention to receive new vaccines post-COVID-19 pandemic among adults and health workers in Lusaka, Zambia.
    (2025-Mar-19) Sharma A; Kerkhoff AD; Haambokoma M; Shamoya B; Sikombe K; Simbeza SS; Zulu N; Geng EH; Eshun-Wilsonova I; Le Tourneau N; Pry JM; Division of Infectious Diseases, School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States of America.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; Division of Epidemiology, School of Medicine, University of California, Davis, California, United States of America. Electronic address: jmpry@ucdavis.edu.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Division of HIV, Infectious Diseases and Global Medicine Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, California, United States of America.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    OBJECTIVES: To estimate intention to receive newly introduced adult vaccines among community members and healthcare workers (HCWs) in Lusaka, Zambia in the context of previous COVID-19 vaccine uptake and perceived disease threat and, identify trusted sources of vaccine information. METHODS: We conducted a cross-sectional survey among a random sample of community members and a convenience sample of HCWs from 13 November to 15 December 2023. We evaluated future vaccination intentions by self-reported COVID-19 vaccine uptake, community role, vaccine type (COVID-19 booster, HIV, tuberculosis, malaria, pneumonia, diarrheal disease) and source of information using adjusted, mixed effects Poisson regression and adjusted probability models. RESULTS: We enrolled 395 (79.2 %) community members and 104 (20.8 %) HCWs (N = 499). There was high intention to receive new vaccines among community members (mean score = 83.6 %) and HCWs (mean score = 86.0 %), though intentions varied by vaccine type. Prior COVID-19 vaccine uptake (0, 1, 2+ doses) impacted intentions to receive a novel COVID-19 vaccine among community members (43.3 %, 62.8 %, 79.7 %, respectively) but were not associated with any other vaccine types. Intention to receive a vaccine was strongly associated with perceived disease severity and susceptibility as well as age, sex, education, and household income. Social media as a vaccine information source was associated with lower overall vaccine intention among community members, while health system and community sources were associated with higher overall intention to receive new vaccines. Government was a highly trusted source of vaccine information among all participants. CONCLUSION: Prior COVID-19 vaccination uptake did not predict future non-COVID-19 vaccine intention in Zambia. Perceived threat and select socio-demographic factors were key predictors, suggesting the need for rapid research to design communication strategies and identify trusted sources per target population.