Browsing by Author "Halwindi, Hikabasa"

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    Alcohol consumption and tobacco smoking associated with decreased antiretroviral therapy adherence among people living with HIV in Zambia: Evidence from a 2023 national NCDs/ HIV survey.
    (2026) Zyambo, Cosmas; Somwe, Paul; Musukuma, Mwiche; Mandyata, Chomba; Bwembya, Phoebe; Phiri, Henry; Chavula, Malizgani; Halwindi, Hikabasa; Zulu, Joseph; Mutale, Wilbroad
    BACKGROUND: In order to achieve the 95-95-95 goals and obtain optimal benefits from ART, PLWH must adhere to prescribed medication. AIM: Investigate factors associated with ART adherence in a clinical setting in Zambia. METHODS: National cross-sectional study involving 193 clinics across all 10 provinces of Zambia. The primary outcomes assessed were ART adherence status, associated behavioral factors, and clinical characteristics. Logistic regression analysis was conducted to evaluate associations between these factors and ART adherence. Both unadjusted odds ratios (UOR) and adjusted odds ratios (AOR) were calculated, with adjustments made for relevant covariates, and all estimates reported with 95% confidence intervals. RESULTS: Of the 5,204 PLWH, 7.1% were non-adherent to ART (9.7% males vs 5.9% females). Of those who were non adherent, 60% and 22% consumed alcohol and smoked tobacco respectively. In adjusted analysis, age; 45-59 (AOR: 0.5, 95% CI:0.32-0.79), 60+ (AOR: 0.26, 95% CI: 0.12-0.59) and education; Primary (AOR: 0.6, 95% CI: 0.4-0.9), secondary (AOR: 0.57, 95% CI: 0.4-0.82), college/university (AOR: 0.5, 95% CI: 0.29-0.89) were associated with decreased odds of being non-adherence to ART. In contrast, being male (AOR: 1.45, 95% CI:1.07-1.98), being in informal employment (AOR:1.65, 95% CI:1.15-2.36), having average yearly income; > $160 (AOR: 1.55, 95% CI: 1.16-2.06), Alcohol consumption; healthy consumption (AOR: 2.72, 95% CI: 1.9-3.89), unhealthy consumption (AOR: 2.76, 95% CI: 1.8-4.22), indeterminant consumption (AOR: 3.03, 95% CI: 2.04-4.5) and tobacco smoking (AOR: 95% CI: 2.03 1.42-2.9) were associated with increased odds of being non-adherence to ART. CONCLUSIONS: ART non-adherence among PLWH in Zambia is 7.1%, with higher rates in males. Substance use especially alcohol and tobacco are common among the non-adherent. The associations between alcohol consumption, tobacco smoking, and ART adherence highlight the potential value of targeted support strategies. These results can inform future longitudinal research and contribute to the development of evidence-based interventions.
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    Lost in translation: key lessons from conducting dissemination and implementation science in Zambia.
    (2024-Oct-29) Maritim, Patricia; Munakampe, Margarate N. ; Nglazi, Mweete; Mweemba, Chris; Sikombe, Kombatende; Mbewe, Wilson; Silumbwe, Adam; Jacobs, Choolwe; Zulu, Joseph M.; Herce, Michael ; Mutale, Wilbroad ; Halwindi, Hikabasa
    BACKGROUND: As the field of implementation science continues to grow, its key concepts are being transferred into new contexts globally, such as Low and Middle Income Countries (LMICs), and its use is constantly being reexamined and expanded. Theoretical and methodological positions commonly used in implementation research and practice have great utility in our work but in many cases are at odds with LMIC contexts. As a team of implementation scientists based in Zambia, we offer this commentary as a critical self-reflection on what has worked and what could limit us from fully utilizing the field's promise for addressing health problems with contextual understanding. MAIN BODY: We used a 'premortem,' an approach used to generate potential alternatives from failed assumptions about a particular phenomenon, as a way to reflect on our experiences conducting implementation research and practice. By utilizing prospectively imagined hindsights, we were able to reflect on the past, present and possible future of the field in Zambia. Six key challenges identified were: (i) epistemic injustices; (ii) simplified conceptualizations of evidence-informed interventions; (iii) limited theorization of the complexity of low-resource contexts and it impacts on implementation; (iv) persistent lags in transforming research into practice; (v) limited focus on strategic dissemination of implementation science knowledge and (vi) existing training and capacity building initiatives' failure to engage a broad range of actors including practitioners through diverse learning models. CONCLUSION: Implementation science offers great promise in addressing many health problems in Zambia. Through this commentary, we hope to spur discussions on how implementation scientists can reimagine the future of the field by contemplating on lessons from our experiences in LMIC settings.