Suzanne Maman
Biographic Data
| ID | 129843 |
|---|---|
| NAME | Suzanne Maman |
| GIVEN NAMES | Suzanne |
| FAMILY NAME | Maman |
| SIGNATURE | MAMAN S |
| AFFILIATIONS | University of North Carolina at Chapel Hill |
| ORCID | 0000-0003-4048-1585 |
| VERIFIED | Yes |
| TOTAL WORKS | 107 |
| TOTAL CITATIONS | 222 |
| AUTHOR COUNT | 107 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2000 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 7 |
Understanding the Influence of PrEP Motivations and Concerns on PrEP Use Among Pregnant Women in Lilongwe, Malawi
Understanding PrEP misconceptions and their impact on PrEP initiation and use among pregnant and lactating women in Malawi
Mother-to-child transmission (MTCT) of HIV remains a challenge in Eastern and Southern Africa. Oral pre-exposure prophylaxis (PrEP) is a powerful tool to reduce MTCT, but women face barriers to effective use including those related to inaccurate comprehension of PrEP To understand women’s misconceptions about PrEP and their potential impact on PrEP use, we conducted interviews with 33 pregnant and lactating women in Malawi using PrEP, and ten PrE…
Engaging Family Members to Support Exclusive Breastfeeding, Responsive care, and Antiretroviral Therapy Adherence Among Families with Children who are HIV-Exposed and Uninfected
Children who are HIV-exposed and uninfected (CHEU) are at increased risk for poor growth, health, and development compared to children who are HIV-unexposed and uninfected. To support families with CHEU, we assessed the acceptability of engaging family members to support women living with HIV (WLWH) with exclusive breastfeeding (EBF) and antiretroviral therapy (ART) adherence and to engage in responsive infant caregiving. We conducted trials of i…
Private sector antimalarial sales a decade after “test and treat”
Background: The World Health Organization has promoted "test and treat" guidelines for malaria since 2010, recommending all suspected malaria cases be confirmed with a parasitological test, typically a rapid diagnostic test (RDT), prior to treatment with antimalarial medications. However, many fevers at private drug shops in Uganda continue to be treated presumptively as malaria without diagnostic testing. Methods: = 46) recorded information abou…
Mechanisms to enhance racial equity in health care
Background: As medical and public health professional organizations call on researchers and policy makers to address structural racism in health care, guidance on evidence-based interventions to enhance health care equity is needed. The most promising organizational change interventions to reduce racial health disparities use multilevel approaches and are tailored to specific settings. This study examines the Accountability for Cancer Care throug…
Perspectives and experiences of Zambian pregnant and postpartum women receiving two intervention models to increase uptake of male partner HIV testing
This study explored the experiences of pregnant women who received two intervention models for increasing uptake of male partner HIV testing in antenatal settings. As part of a randomised trial, we interviewed twenty participants who received partner notification services only while 22 received the partner notification plus HIV self-testing. Thematic analysis was used to analyse the data. Partner notification services helped to initiate discussio…
Reaching Out-of-school Adolescent Girls and Young Women at Risk for HIV Through Their Social Networks
“Testing for malaria does not cure any pain” A qualitative study exploring low use of malaria rapid diagnostic tests at drug shops in rural Uganda
The World Health Organization recommends all suspected malaria cases be confirmed with a parasitological test, typically a rapid diagnostic test (RDT), prior to treatment. Despite recommendations, many fevers presenting at private drug shops are treated presumptively as malaria without diagnostic testing. The purpose of this qualitative study was to describe community perceptions of RDTs and explore ways to improve malaria case management at drug…
‘When I have these kits … I have confidence’ – HIV self-testing provides agency for women in their sexual decision-making
Oral fluid-based HIV self-testing (HIVST) has emerged as a promising approach to increasing HIV testing coverage, particularly among high-risk populations. Understanding the experiences of women using self-tests and offering them to their sexual partners (secondary distribution) is crucial for determining the potential of HIVST. Qualitative in-depth interviews were conducted among 32 women at high risk of HIV infection, including women who engage…
Intimate partner violence perpetration and sexual risk behaviour
In this study we examined factors that predict involvement in different patterns of sexual risk behavior and IPV perpetration among young men in Tanzania ( n = 979), with a focus on identifying factors that distinguish men who engage in both behaviours from those who do not. Risk factors were drawn from three domains thought to be upstream drivers of both IPV and sexual risk: poverty, adverse childhood experiences, and inequitable gender norms. A…
The sky is the limit; I am going there”
Young women in South Africa face elevated risk of HIV infection compared to male peers. Cash transfers may mitigate their risk for HIV; however, there is limited understanding of mechanisms of impact. We explored hope as one potential mechanism. Longitudinal qualitative analysis was used to explore how cash transfer recipients in the HPTN 068 study conceptualised hope and how the intervention influenced their hope over time. We found the interven…
The influence of cash transfers on engagement in transactional sex and partner choice among adolescent girls and young women in Northwest Tanzania
Cash transfers are theorised to reduce adolescent girls and young women's economic vulnerability and engagement in transactional sex; however, the processes involved remain unclear. We conducted longitudinal cross-sectional, and narrative timeline in-depth interviews with young women aged 15-23 years in northern Tanzania enrolled in a cash transfer intervention. We analysed data using a thematic approach guided by the transactional sex framework.…
Relationships Between Stigma and Intimate Partner Violence Among Female Sex Workers Living With HIV
Violence against female sex workers (FSWs) perpetrated by their intimate (i.e., non-commercial) partners, particularly against FSWs living with HIV, is understudied. Stigma can deplete the economic resources, social relationships, and mental well-being of stigmatized people, which may increase their intimate partner violence (IPV) risk. We quantitatively assessed relationships between HIV stigma and sex work stigma and IPV victimization among FSW…
Contextualising men’s role and participation in PMTCT programmes in Malawi and Zambia
This study sought to explore and contextualise the man's role in antenatal services, and the barriers and strategies for engaging men in prevention of mother-to-child HIV transmission (PMTCT). We conducted 143 interviews with pregnant and breastfeeding women, male partners, health workers and policy makers in Malawi and Zambia. We employed thematic and critical discourse analysis using the hegemonic masculinity perspective. We found that men's ro…
The mediating role of partner communication on contraceptive use among adolescent girls and young women participating in a small-group intervention in Malawi
Though effective reproductive health interventions have been developed for adolescent girls and young women (AGYW) in sub-Saharan Africa, few have explored whether specific components of the interventions are responsible for observed changes in behaviour. Data for this longitudinal mediation analysis come from a quasi-experimental, sexual and reproductive health study conducted among AGYW (age 15-24) in Malawi. We assessed the extent to which the…
A mixed-methods study of resilience and return to school among adolescent mothers in South Africa
Up to two-thirds of South African adolescent mothers drop out of school, which increases their HIV risk and other poor health outcomes. Despite variability in adolescent mothers' schooling trajectories, we have a limited understanding of their re-enrollment in school following the life-changing circumstance of childbirth. In this paper, we draw on qualitative interviews ( n = 16) and quantitative surveys ( n = 109) with adolescent mothers (aged 1…
Developing a framework for cash transfer programs that foster sustained economic empowerment to reduce sexual risk among adolescent girls and young women
Our findings suggest that providing economic resources to AGYW through CT without ensuring self-agency is unlikely to be an effective long-term intervention for economic empowerment. Using these findings we developed a framework for CT programs with three key pillars for developing self-agency: 1) emotional efficacy, to increase AGYW's perception of rewards associated with developing self-agency; 2) social efficacy, to build constructive relation…
The Impact of Maternal Depression and Parent–Child Interactions on Risk of Parasitic Infections in Early Childhood
Maternal depressive symptoms are associated with poor parent-child interactions, particularly acceptance of behavior, involvement with children, and variety of interactions, but these exposures do not independently impact risk of parasitic infection in children
Individual and Relationship-Level Correlates of Transactional Sex Among Adolescent Girls and Young Women in Malawi
Transactional sex increases HIV risk among adolescent girls and young women (AGYW). Understanding the individual and dyadic nature of transactional sex may provide evidence for risk reduction interventions. Multilevel logistic regression was used to cross-sectionally examine correlates of transactional sex among AGYW in Lilongwe, Malawi. Participants (N = 920) reported 1227 relationships. Individual-level associations were found between being div…
The Intersection of Intimate Partner Violence Perpetration and Sexual Risk Behavior Among Young Men in Tanzania
Contraceptive Conversations among Adolescent Girls and Young Women and Their Partners, Peers, and Older Female Family Members in Lilongwe, Malawi
In sub‐Saharan Africa, adolescent girls and young women (AGYW) have high levels of unmet need for contraception, particularly those who are unmarried or nulliparous. Conversations with partners, peers, and family members influence AGYW contraceptive decision‐making yet little is known about conversation content and impact or how they vary by relationship status and parity. This paper draws on qualitative data from 60 AGYW (aged 15–24) participati…
IPV victimization in pregnancy increases postpartum STI incidence among adolescent mothers in Durban, South Africa
Women, and specifically, adolescents, are at high risk of HIV and STIs during the postpartum period. Biological and behavioral factors contribute to adolescents’ susceptibility. However, the influence of behavioral factors, like intimate partner violence (IPV), on postpartum STI acquisition has been understudied. The study’s purpose is to determine whether IPV victimization during pregnancy predicts incident STIs in the first 6 months postpartum.…
Intimate partner violence and postpartum emotional distress among South African women
In this study we aimed to identify factors that condition (i.e. buffer or exacerbate) the impact of exposure to intimate partner violence (IPV) on postpartum emotional distress among South African women. Hypothesised buffering factors included: socioeconomic status, family social support, and religiosity. Hypothesised exacerbating factors included: baseline distress, HIV status, and childhood abuse. Longitudinal analyses examined interactions bet…
Conceptualization of Empowerment and Pathways Through Which Cash Transfers Work to Empower Young Women to Reduce HIV Risk
Although cash transfers (CT) are hypothesized to reduce AGYW's HIV risk, little is known about the mechanisms through which CT empower AGYW. We explored the impact of a CT intervention on AGYW's sexual decision-making in order to describe the pathways through which the cash may influence risk behavior. The study employed qualitative methods involving: 20 longitudinal in-depth interviews (IDIs), 40 cross-sectional IDIs, 20 narrative IDIs, and two …
Socioeconomic Predictors of Transactional Sex in a Cohort of Adolescent Girls and Young Women in Malawi
The intersections of HIV and violence
The purpose of this paper is to review the available literature on the intersections between HIV and violence and present an agenda for future research to guide policy and programs. This paper aims to answer four questions: (1) How does forced sex affect women's risk for HIV infection? (2) How do violence and threats of violence affect women's ability to negotiate condom use? (3) Is the risk of violence greater for women living with HIV infection…
A comparison of HIV/Aids-related stigma in four countries
HIV-Positive Women Report More Lifetime Partner Violence
Objectives. Experiences of partner violence were compared between HIV-positive and HIV-negative women. Methods. Of 340 women enrolled, 245 (72%) were followed and interviewed 3 months after HIV testing to estimate the prevalence and identify the correlates of violence. Results. The odds of reporting at least 1 violent event was significantly higher among HIV-positive women than among HIV-negative women (physical violence odds ratio [OR] = 2.63; 9…
A comparison of HIV stigma and discrimination in five international sites
The role of religion in HIV-positive women's disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo
The Process of Ending Abuse in Intimate Relationships
This article explores the suggestion that the transtheoretical model of behavior change is a promising conceptual framework for understanding how women end abuse in their intimate relationships. In-depth interviews were conducted with 78 women who were either currently in or had recently left abusive relationships. These results suggest that the model is consistent with how women describe surviving their abusive situations, and they have implicat…
It's all the time in my mind
Competition and Humiliation
We use data collected from in-depth interviews with men ( n = 30) in the Dominican Republic to explore how men's concern about being perceived as masculine influences their interactions with their social networks and how those interactions drive men's sexual behaviors and use of violence. Men's sexual and violent behaviors were shaped by the need to compete with other men for social status. This sense of competition also generated fear of humilia…
Development, validation, and performance of a scale to measure community mobilization
Evidence of social network influence on multiple HIV risk behaviors and normative beliefs among young Tanzanian men
Social venues that protect against and promote HIV risk for young men in Dar es Salaam, Tanzania
Using Participatory Mapping to Inform a Community-Randomized Trial of HIV Counseling and Testing
Participatory mapping and transect walks were used to inform the research and intervention design and to begin building community relations in preparation for Project Accept, a community-randomized trial sponsored by the National Institute of Mental Health. Project Accept is being conducted at five sites in four countries: Thailand, Zimbabwe, South Africa, and Tanzania. Results from the mapping exercises informed decisions such as defining commun…
Structural Barriers to Receiving Health Care Services for Female Sex Workers in Russia
Female sex workers in Russia have been particularly vulnerable to recent social, political, and economic changes. In this article, we describe the facilitators and barriers for sex workers receiving health care services in St. Petersburg, Russia. We conducted observations at medical institutions and nongovernmental organizations and in-depth interviews with 29 female sex workers. We identified the following barriers: poverty, not having documents…
Contraceptive Conversations among Adolescent Girls and Young Women and Their Partners, Peers, and Older Female Family Members in Lilongwe, Malawi
In sub‐Saharan Africa, adolescent girls and young women (AGYW) have high levels of unmet need for contraception, particularly those who are unmarried or nulliparous. Conversations with partners, peers, and family members influence AGYW contraceptive decision‐making yet little is known about conversation content and impact or how they vary by relationship status and parity. This paper draws on qualitative data from 60 AGYW (aged 15–24) participati…
Equality in the Home and in the Community
Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania
Addressing Intimate Partner Violence Among Female Clients Accessing HIV Testing and Counseling Services
The World Health Organization recommends that HIV counseling and testing (HCT) programs implement strategies to address how intimate partner violence (IPV) influences women's ability to protect themselves from and seek care and treatment for HIV infection. We discuss the process used to adapt a screening and brief intervention (SBI) for female clients of HCT services in Rakai, Uganda-a setting with high prevalence of both HIV and IPV. By outlinin…
Terms Used for People Living With HIV in the Democratic Republic of the Congo
For this study we conducted in-depth interviews with 29 youth living with HIV (YLWH) and key informant interviews with 8 HIV care/support providers. We describe terms used to portray people living with HIV (PLWH) in Kinshasa, Democratic Republic of the Congo. Labels commonly used, mostly derogatory, described PLWH as walking corpses, dangers to others, or people deserving to die before others get infected. Blame and other accusations were directe…
Questioning Mandatory Hiv Testing During Pregnancy
Schuklenk and Kleinsmidt’s recent proposal1 to pilot mandatory HIV testing of pregnant women during antenatal care in areas with high HIV prevalence rates provides a plausible ethical justification for compulsory testing and treatment—if such a program were likely to succeed. The authors fail, however, to provide evidence that their program would be successful. In addition, they overlook several basic implementation problems likely to accompany a…
The intersections of HIV and violence
The purpose of this paper is to review the available literature on the intersections between HIV and violence and present an agenda for future research to guide policy and programs. This paper aims to answer four questions: (1) How does forced sex affect women's risk for HIV infection? (2) How do violence and threats of violence affect women's ability to negotiate condom use? (3) Is the risk of violence greater for women living with HIV infection…
Women's barriers to HIV-1 testing and disclosure
In view of the ever-increasing HIV/AIDS epidemic in sub-Saharan Africa, the expansion of HIV-1 voluntary counselling and testing (VCT) as an integral part of prevention strategies and medical research is both a reality and an urgent need. As the availability of HIV-1 VCT grows two limitations need to be addressed, namely: low rates of HIV-1 serostatus disclosure to sexual partners and negative outcomes of serostatus disclosure. Results from a stu…
The Process of Ending Abuse in Intimate Relationships
This article explores the suggestion that the transtheoretical model of behavior change is a promising conceptual framework for understanding how women end abuse in their intimate relationships. In-depth interviews were conducted with 78 women who were either currently in or had recently left abusive relationships. These results suggest that the model is consistent with how women describe surviving their abusive situations, and they have implicat…
HIV-Positive Women Report More Lifetime Partner Violence
Objectives. Experiences of partner violence were compared between HIV-positive and HIV-negative women. Methods. Of 340 women enrolled, 245 (72%) were followed and interviewed 3 months after HIV testing to estimate the prevalence and identify the correlates of violence. Results. The odds of reporting at least 1 violent event was significantly higher among HIV-positive women than among HIV-negative women (physical violence odds ratio [OR] = 2.63; 9…
High Rates and Positive Outcomes of HIV-Serostatus Disclosure to Sexual Partners
Motivations, Understanding, and Voluntariness in International Randomized Trials
Research on informed consent conducted in wealthy countries has found that subjects' understanding of research often is incomplete or, at times, inaccurate. 1 Other studies reveal a subtler clouding of the distinction between treatment and research, whereby patient/subjects know they are in research, but view research as treatment for their disease. 2Such a misunderstanding may compromise meaningful decision-making about participation in clinical…
Community preparedness for HIV vaccine trials in the Democratic Republic of Congo
This paper reports on an assessment of community preparedness for HIV vaccine trials in the Democratic Republic of Congo. Formative research was conducted in the capital city of Kinshasa during the period October 2003 to March 2004 to answer questions pertinent to planning trials of a preventive HIV vaccine and to identify related issues. Twenty-seven in-depth interviews and two focus groups were held with potential trial participants and communi…
Skinning the goat and pulling the load
Transactional sex has been associated with risk of HIV infection in a number of studies throughout sub-Saharan Africa. Urban young women are economically vulnerable and at heightened risk of HIV infection in Tanzania; yet there are few studies that have explored relationship dynamics, including transactional sex, in this setting. This paper sheds light on the broader context of sexual relationships among youth at risk for HIV, how transactional s…
Questioning Mandatory Hiv Testing During Pregnancy
Schuklenk and Kleinsmidt’s recent proposal1 to pilot mandatory HIV testing of pregnant women during antenatal care in areas with high HIV prevalence rates provides a plausible ethical justification for compulsory testing and treatment—if such a program were likely to succeed. The authors fail, however, to provide evidence that their program would be successful. In addition, they overlook several basic implementation problems likely to accompany a…
The role of religion in HIV-positive women's disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo
A comparison of HIV/Aids-related stigma in four countries
It's all the time in my mind
A comparison of HIV stigma and discrimination in five international sites
Using Participatory Mapping to Inform a Community-Randomized Trial of HIV Counseling and Testing
Participatory mapping and transect walks were used to inform the research and intervention design and to begin building community relations in preparation for Project Accept, a community-randomized trial sponsored by the National Institute of Mental Health. Project Accept is being conducted at five sites in four countries: Thailand, Zimbabwe, South Africa, and Tanzania. Results from the mapping exercises informed decisions such as defining commun…
Access to Treatment in Hiv Prevention Trials
Access to treatment, in HIV vaccine trials (HVTs), remains ethically controversial. In most prevention trials, including in South Africa, participants who seroconvert are referred to publicly funded programmes for treatment. This strategy is problematic when there is inadequate and uneven access to public sector antiretroviral therapy (ART) and support resources. The responsibilities, if any, of researchers, sponsors and public health authorities…
Factors associated with self-reported adherence to antiretroviral therapy in a Tanzanian setting
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 completed a survey that included self-reported adherence over four days and over one month. Less than 95% adherence on either measure was considered "poor." Factors associated with adherence in…
The complexity of consent
Informed consent has historically been a cornerstone to ensuring autonomy during HIV testing. However, recent changes to global guidance on HIV testing have led to substantial debate on what policy provisions are necessary to ensure that consent remains meaningful in the context of testing. Despite disproportionate rates of testing during pregnancy, pregnant women's perspectives on the HIV testing process are underrepresented in the testing disco…
Acceptability of a group intervention for initiates of antiretroviral therapy in Tanzania
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 the acceptability of a group intervention for patients and their supporters, which aimed to decrease stigma, harness social support and improve adherence. Twenty-eight ART patients attended a fo…
HIV risk perceptions, knowledge and behaviours among female sex workers in two cities in Turkmenistan
This paper describes HIV risk behaviour patterns among street- and bar-based female sex workers in the Turkmenistan cities of Ashgabat and Mary. Street-based sex workers had little to no knowledge of HIV and primarily used condoms when condom use was initiated by clients. Bar-based sex workers had HIV knowledge and reported regularly using condoms mainly with first-time clients. While sex workers perceived themselves to be at low risk for acquiri…
Engaging Key Stakeholders to Assess and Improve the Professional Preparation of MPH Health Educators
Objectives. We described the process of engaging key stakeholders in a systematic review of requirements for a master of public health (MPH) degree within the Department of Health Behavior and Health Education, University of North Carolina Gillings School of Global Public Health, and summarized resulting changes. Methods. A benchmarking study of 11 peer institutions was completed. Key stakeholders (i.e., current students, alumni, faculty, staff, …
Social venues that protect against and promote HIV risk for young men in Dar es Salaam, Tanzania
Looking to the future
This paper examines the approaches heterosexual men and women in South Africa use to engage their partners in discussions of HIV and risk factors in their relationships. These strategies entail balancing the risks of infection while managing the challenges of maintaining a relationship. In a context in which there is a great deal of insecurity in relationships it is especially challenging to discuss HIV risks with partners. Our findings reveal th…
The infant feeding choices and experiences of women living with HIV in Kinshasa, Democratic Republic of Congo
HIV transmission through breastfeeding is a significant public health challenge. While breastfeeding provides important nutrition, and results in reduced morbidity and mortality, there is a risk of HIV transmission through breastfeeding. International prevention of mother-to-child transmission (PMTCT) guidelines recommend exclusive breastfeeding for six months among HIV-infected women on antiretroviral therapy. Promoting exclusive feeding has pro…
HIV testing for pregnant women
Ethical and human rights concerns have been expressed regarding the global shift in policies on HIV testing of pregnant women. The main purpose of this research was to conduct a policy analysis using a human rights-based approach of national policies for HIV testing of pregnant women. We collected HIV testing policies from 19 countries including: Cambodia, China, Guyana, Haiti, India, Jamaica, Kenya, Moldova, Papua New Guinea, Russian Federation,…
Understanding the diversity of male clients of sex workers in China and the implications for HIV prevention programmes
Male clients of sex workers have been overlooked in China's HIV prevention efforts. This study aims to examine men's practices and attitudes toward extramarital sexual relationships, motivations for visiting female sex workers (FSWs), perceptions of sexually transmitted infection (STI)/HIV risk and risk prevention strategies used. One hundred and eighty-six clients of FSWs with varying socio-economic statuses were interviewed in different sex wor…
Medicine (100 works) · Psychology (70 works) · Adolescent Sexual and Reproductive Health (67 works) · HIV/AIDS Research and Interventions (62 works) · Family medicine (53 works) · Environmental health (49 works) · Nursing (44 works) · Sociology (44 works) · Human immunodeficiency virus (HIV (43 works) · Public health (40 works)