M Shahmanesh
Biographic Data
| ID | 173310 |
|---|---|
| NAME | M Shahmanesh |
| GIVEN NAMES | M |
| FAMILY NAME | Shahmanesh |
| SIGNATURE | SHAHMANESH M |
| AFFILIATIONS | Africa Health Research Institute |
| ORCID | 0000-0001-7129-8535 |
| VERIFIED | Yes |
| TOTAL WORKS | 61 |
| TOTAL CITATIONS | 10 |
| WORKS AS AUTHOR | 61 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2008 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
Spatial mapping of HIV testing and antiretroviral therapy initiation uptake among the adolescents and youth in rural KwaZulu-Natal, South Africa
This study investigated the spatial distribution of HIV testing and antiretroviral therapy initiation among adolescents and youth in rural KwaZulu-Natal, South Africa, to inform the optimal allocation of HIV services. The sample included 5,352 participants aged 13-35 years from nested cohort studies within Africa's largest population-based prospective cohorts, with global positioning system data collected for all homesteads. HIV testing prevalenc…
How do community contexts shape relationship dynamics? A case study of young people living in informal settlements in eThekwini municipality, South Africa
For young people intimate relationships are a key space in which health and wellbeing are strengthened or undermined. This study seeks to understand how contextual factors shape relationship quality among young heterosexual people in informal settlements in eThekwini Municipality, South Africa. In-depth interviews with (N = 30) young (ages 18-30) heterosexual women and men living in informal settlements, stakeholders (N = 13, aged 18+) and partic…
Long-acting HIV pre-exposure prophylaxis integrated with community-based sexual and reproductive health services in South Africa (Lapis)
ClinicalTrials.gov Identifier-NCT06250504. Registered: 01 February 2024
Relationship-level factors influencing intimate partner violence and relationship quality among young couples in an urban informal settlement in South Africa
Couples programming is an evidence-based strategy to prevent intimate partner violence (IPV) and strengthen relationship quality. Stepping Stones Creating Futures (SSCF) is a 21-session participatory programme for young adults (18-30 years) that integrates gender equity, communication and livelihoods skills, and has been evaluated in informal settlements in eThekwini, South Africa. Zithandani SSCF is an adaptation engaging young heterosexual coup…
“It felt like a weight was being taken off of my shoulders”
In South Africa, many young people relocate from rural to urban areas for education, attending day schools while residing in rented accommodation. Migration exposes them to risk, including alcohol and drug abuse, sexual exploitation and violence. We developed and assessed a support system for young migrants, aged 14-24 in KwaZulu-Natal, South Africa. Five trained peer navigators conducted needs assessments for 283 young internal migrants between …
The effect of multi-level HIV prevention interventions on common mental disorders among adolescents and young adults in rural South Africa
This study evaluated the effect of multi-level HIV prevention interventions delivered through DREAMS (Determined, Resilient, Empowered, AIDS-free, Motivated, and Safe) program on common mental disorders (CMD) among adolescents and young adults (AYA) in rural South Africa. We used longitudinal data from two cohorts of AYA aged 13–35 years (N = 2184 for cohort 1 and N = 3067 for cohort 2), recruited between May 2017 and December 2018, with data col…
Understanding the mental health of adolescents and young adults in rural South Africa through participatory research
Most mental health problems in adulthood begin during adolescence. Factors such as poverty, violence, and unemployment contribute to the high burden of mental health problems. In Africa, the lack of resources for diagnosis, treatment, and management exacerbates the situation. Research on adolescent mental health has mostly focused on negative psychological effects, while positive attributes like coping, resilience, and emotional growth have been …
Sexual and reproductive health interventions for mobile adolescents and young people in sub-Saharan Africa
Research exploring SRHR interventions for mAYP is limited in sub-Saharan Africa. Future research and interventions should be underpinned by an understanding of young people's health and wellbeing more broadly, and foreground the social, cultural, religious and economic factors shaping mAYP's SRH needs
Examining the resilience of mobile youth in KwaZulu-Natal, South Africa
The accessibility and availability of protective resources offered support and provided strength to young people. This fostered resilience for these young people and in a way incorporated aspects of the collectivist communities they live in. Considering resources that are easily available in resource limited settings is important as young people may be more comfortable and confident to access and use. These protective factors may help curb some o…
Finding knowledge
Identification of candidacy for SRH information in this setting was largely ad-hoc, but once aware of need, youth were able to identify and discriminate between multiple information sources. However, this information landscape was strongly shaped by formal provider and parent views of what youth should know and do, and peer sources limited own knowledge. Future interventions could address concerns at various points on the candidacy journey
Exploring the Interplay of Social and Physical Factors in Risk Dynamics and Transitions Across the Life-Course of Female Sex Workers in Blantyre, Malawi
Sexual risk amongst female sex workers (FSW) varies across the life-course and is influenced by socio-economic and interpersonal factors that affect behavioural choices and engagement in HIV/STI care. We explored transitions in the life-course of FSW to understand the dynamics of sexual risk in Blantyre, Malawi. We implemented a nested longitudinal qualitative study as part of the AMETHIST Consortium, a study testing approaches to reduce HIV tran…
Alcohol Use and the Pre-exposure Prophylaxis Continuum of Care Among Men in Rural South Africa
Despite freely available oral HIV pre-exposure prophylaxis (PrEP), HIV incidence among young men in South Africa remains high. This study explores the impact of alcohol use on PrEP initiation and continuation among South African men. We performed a secondary data analysis from a trial involving men aged 16-29, randomly selected in KwaZulu-Natal. Participants were referred to sexual health services, and those who were HIV negative and sexually act…
Walking a tightrope
Supportive social relations are crucial to wellbeing as young adults transition to independence, especially when these transitions are impeded by limited employment and educational opportunities, leading to lengthy 'waithoods'. Yet, there is limited empirical evidence on what young adults' support networks look like in highly resource-constrained settings. We therefore analysed the core support networks of 929 16-29 year-old rural South Africans …
Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa
Combination HIV prevention packages have reduced HIV incidence and improved HIV-related outcomes among young people. However, there is limited data on how package components interact to promote HIV-related prevention behaviours. We described the uptake of HIV prevention interventions supported by Determined, Resilient, Empowered, AIDS-free, Motivated and Safe (DREAMS) Partnership and assessed the association between uptake and HIV-related behavio…
Increasing HIV testing and linkage to care among men in rural South Africa using conditional financial incentives and a decision support app
Men in sub-Saharan Africa are less likely to accept HIV testing and link to HIV care than women. We conducted a trial to investigate the impact of conditional financial incentives and a decision support application, called EPIC-HIV, on HIV testing and linkage to care. We report the findings of the trial process evaluation to explore whether the interventions were delivered as intended, identify mechanisms of impact and any contextual factors that…
Looking for the future – Hope and adolescent risk behaviour in rural KwaZulu-Natal, South Africa
We investigate the relationship between hope and risky behaviour and the role of migration among young people in northern KwaZulu-Natal, South Africa. We use data from a cohort of n = 5248 adolescents and young adults (AYA) aged 13-35 recruited and followed up in 2017-2019. We conducted a structured quantitative survey to assess levels of hope among AYA using a validated tool/scale. 44% of participants were aged 13-17 years, 63% were still in sch…
Effect of a Male-Targeted Digital Decision Support Application Aimed at Increasing Linkage to HIV Care Among Men
Incident pregnancy and mental health among adolescent girls and young women in rural KwaZulu-Natal, South Africa
Pregnancy can place adolescent girls and young women (AGYW) at risk of poor mental health. However, evidence linking youth pregnancy to mental health in resource-limited settings is limited, especially where HIV incidence is high. We analysed a population-representative cohort of AGYW aged 13-25 in rural KwaZulu-Natal to assess how adolescent pregnancy predicts subsequent mental health. Among 1851 respondents, incident pregnancy (self-reported pa…
Population health impact, cost-effectiveness, and affordability of community-based HIV treatment and monitoring in South Africa
Community-based delivery and monitoring of antiretroviral therapy (ART) for HIV has the potential to increase viral suppression for individual- and population-level health benefits. However, the cost-effectiveness and budget impact are needed for public health policy. We used a mathematical model of HIV transmission in KwaZulu-Natal, South Africa, to estimate population prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) …
Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the Covid-19 pandemic
Globally, 28.4 million non-emergent (‘elective’) surgical procedures have been deferred during the COVID-19 pandemic. This study evaluated the impact of the COVID-19 pandemic on elective breast- or colorectal cancer (CRC) procedure backlogs and attributable mortality, globally. Further, we evaluated the interaction between procedure deferrals and health systems, internationally. Relevant articles from any country, published between December 2019–…
Adaptation and pre-test of a shortened Stepping Stones and Creating Futures intervention focused on HIV for young men in rural South Africa
Men’s engagement in HIV prevention and treatment is suboptimal, including in South Africa. We sought to address this through adapting an evidence-based intervention, Stepping Stones and Creating Futures (SSCF), to strengthen its HIV content and provide a more scalable (shorter) intervention in rural South Africa. We then conducted a mixed methods pre-test of the intervention among young men aged 18–35 years. To adapt SSCF, we reviewed the current…
Impact of DREAMS interventions on experiences of violence among adolescent girls and young women
DREAMS aims to reduce HIV incidence among adolescent girls and young women (AGYW) by tackling drivers of HIV risk including gender-based violence. We evaluate the impact of DREAMS on recent experiences of violence perpetuated by men against AGYW. AGYW cohorts were randomly selected from demographic platforms in South Africa (rural KwaZulu-Natal) and Kenya (Nairobi informal settlements and rural Gem sub-county). AGYW aged 13–22 years were enrolled…
Is hope associated with HIV-acquisition risk and intimate partner violence amongst young women and men? A cross-sectional study in urban informal settlements in South Africa
Hope is a concept that may mediate between the structural constraints people live under and their HIV-acquisition risk behaviours/experiences. Drawing on data collected as the baseline for an intervention trial between September 2015 and September 2016, among young (18-30-year-old), out-of-school women and men in urban informal settlements in Durban, South Africa, we assess whether hope, assessed by the Snyder Hope Scale, is associated with HIV-r…
Influences on decision-making about disclosure of HIV status by adolescents and young adults living with HIV in KwaZulu-Natal, South Africa
Background: Adolescents and young adults living with HIV (AYA) are faced with the challenge of living with a life-long chronic condition. We investigated the influences on the decisions by AYA to disclose their HIV status to family, intimate partners and friends. Methods: Twenty AYA aged between 15 and 24 years were purposely selected through local community-based organisations in eThekwini municipality and uMkhanyakude district in KwaZulu-Natal …
Thetha Nami ngithethe nawe (Let’s Talk)
ClinicalTrials.gov Identifier-NCT05405582. Registered: 6th June 2022
Suicidal Behavior Among Female Sex Workers in Goa, India
Objectives. We sought to study suicidal behavior prevalence and its association with social and gender disadvantage, sex work, and health factors among female sex workers in Goa, India. Methods. Using respondent-driven sampling, we recruited 326 sex workers in Goa for an interviewer-administered questionnaire regarding self-harming behaviors, sociodemographics, sex work, gender disadvantage, and health. Participants were tested for sexually trans…
HIV prevention while the bulldozers roll
Walking a tightrope
Supportive social relations are crucial to wellbeing as young adults transition to independence, especially when these transitions are impeded by limited employment and educational opportunities, leading to lengthy 'waithoods'. Yet, there is limited empirical evidence on what young adults' support networks look like in highly resource-constrained settings. We therefore analysed the core support networks of 929 16-29 year-old rural South Africans …
Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting
Objective To systematically review the evidence for effectiveness of HIV and sexually transmitted infection (STI) prevention interventions in female sex workers in resource poor settings. Method Published and unpublished studies were identified through electronic databases (Cochrane database, Medline, Embase, and Web of Science), hand searching and contacting experts. Randomized‐controlled‐trials and quasi‐experimental studies were included if th…
Suicidal Behavior Among Female Sex Workers in Goa, India
Objectives. We sought to study suicidal behavior prevalence and its association with social and gender disadvantage, sex work, and health factors among female sex workers in Goa, India. Methods. Using respondent-driven sampling, we recruited 326 sex workers in Goa for an interviewer-administered questionnaire regarding self-harming behaviors, sociodemographics, sex work, gender disadvantage, and health. Participants were tested for sexually trans…
HIV prevention while the bulldozers roll
Understanding the role of peer group membership in reducing HIV-related risk and vulnerability among female sex workers in Karnataka, India
In Karnataka state, South India, we analyzed the role of membership in peer groups in reducing HIV-related risk and vulnerability among female sex workers (FSWs). Data from three surveys conducted in Karnataka, a behavioral tracking survey and two rounds of integrated biological and behavioral assessments (IBBAs), were analyzed. Using propensity score matching, we examined the impact of group membership on selected outcomes, including condom use,…
Community mobilization, empowerment and HIV prevention among female sex workers in south India
These findings support the hypothesis that community mobilization has benefits for empowering FSWs both individually and collectively. HIV prevention is strengthened by improving their ability to address different psycho-social and community-level sources of their vulnerability. Future challenges include the need to develop social, political and legal contexts that support community mobilization of FSWs, and to prospectively measure the impact of…
Young people’s perceptions of smartphone-enabled self-testing and online care for sexually transmitted infections
Remote STI self-testing and online care appealed to these young people. It addressed barriers they associated with conventional STI services, thus may benefit public health through earlier detection and treatment. Our findings underpin development of online care pathways, as part of ongoing research to create this complex e-health intervention
Sexualized drug use (‘chemsex’) and high‐risk sexual behaviours in HIV ‐positive men who have sex with men
OBJECTIVES: The incidence of sexually transmitted infections (STIs) and HIV infection remains high in gay, bisexual, and other men who have sex with men (MSM) in the UK, and sexualized drug use ("chemsex") and injecting drug use ("slamsex") may play a part in this. We aimed to characterize HIV-positive MSM engaging in chemsex/slamsex and to assess the associations with self-reported STI diagnoses and sexual behaviours. METHODS: Data from a 2014 s…
Exploring the views and experiences of HIV positive patients treated for cancer
Community perceptions of the socio-economic structural context influencing HIV and TB risk, prevention and treatment in a high prevalence area in the era of antiretroviral therapy
Following calls for targeted HIV prevention interventions in so-called "hotspots", we explored subjective perceptions of community members in places considered to be high HIV and tuberculosis (TB) transmission areas and those with low prevalence. Although more people now have access to antiretroviral therapy (ART), some areas are still experiencing high HIV transmission rates, presenting a barrier to the elimination of HIV. A rapid qualitative as…
Evaluating the impact of the DREAMS partnership to reduce HIV incidence among adolescent girls and young women in four settings
DREAMS is, to date, the most ambitious effort to scale-up combinations or 'packages' of multi-sectoral interventions for HIV prevention. Evidence of its effectiveness in reducing HIV incidence among AGYW, and demonstrating which aspects of the lives of AGYW were changed, will offer valuable lessons for replication
Awareness and uptake of layered HIV prevention programming for young women
In representative population-based samples, awareness and uptake of DREAMS were high after 1 year of implementation. Evidence of 'layering' (receiving multiple interventions from the DREAMS core package), particularly among more socio-economically vulnerable AGYW, indicate that intervention packages can be implemented at scale, for intended recipients, in real-world contexts. Challenges remain for higher coverage and greater 'layering', including…
Home-based intervention to test and start (Hits) protocol
This trial was registered on 28 November 2018 on, identifier https://clinicaltrials.gov
Chemsex behaviours among men who have sex with men
Insights into the social context of living with a dual diagnosis of HIV and cancer
As growing numbers of people living with HIV also develop cancer, a holistic understanding of their experiences is essential to the provision of patient centred care. Both conditions are linked to powerful beliefs in our society that may affect experiences. This study explored how HIV and cancer were represented in UK newspapers to gain insight into the social context of living with a dual diagnosis. We performed an initial content analysis of HI…
Young people’s experiences of sexual and reproductive health interventions in rural KwaZulu-Natal, South Africa
Despite efforts to address HIV-infection, adolescents and young peoples' (AYP) engagement in interventions remains suboptimal. Guided by a risk protection framework we describe factors that support positive and negative experiences of HIV and SRH interventions among AYP in rural KwaZulu-Natal, South Africa, using data from: community mapping; repeat semi-structured individual interviews (n= 58 in 2017, n=50 in 2018, n=37 in 2019-2020); and group …
Implementation of HIV Self-Testing to Reach Men in Rural uMkhanyakude, KwaZulu-Natal, South Africa. a DO-ART Trial Sub Study
Background: KwaZulu–Natal, South Africa has one of the highest HIV prevalence rates globally. Persons <35 years and men have lower rates of HIV testing. HIV self-testing (HIVST) may overcome many barriers of facility-based HIV testing in order to identify HIV positive young persons and men and link them to care. We investigated whether HIVST distribution was a feasible approach to reach men and assessed the proportion of participants who reported…
Effect of peer-distributed HIV self-test kits on demand for biomedical HIV prevention in rural KwaZulu-Natal, South Africa
Study objective We investigated two peer distribution models of HIV self-testing (HIVST) in HIV prevention demand creation compared with trained young community members (peer navigators). Methods We used restricted randomisation to allocate 24 peer navigator pairs (clusters) in KwaZulu-Natal 1:1:1: (1) standard of care ( SOC): peer navigators distributed clinic referrals, pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) informatio…
Acceptability of a tablet-based application to support early HIV testing among men in rural KwaZulu-Natal, South Africa
Uptake of HIV testing remains low among men in South Africa. As part of a trial, we assessed the acceptability of a theoretically derived and adapted tablet-based-application (EPIC-HIV1) in rural South Africa. We conducted 20 in-depth interviews with men aged ≥18 years and offered a tablet-based survey to all men aged ≥15 years who received EPIC-HIV1 (Sep-Dec 2018). We conducted a descriptive analysis of the survey and used Self-Determination The…
This is what is going to help me’
Young migrants in sub-Saharan Africa are particularly vulnerable to HIV-acquisition. Despite this, they are consistently under-served by services, with low uptake and engagement. We adopted a community-based participatory research approach to conduct longitudinal qualitative research among 78 young migrants in South Africa and Uganda. Using repeat in-depth interviews and participatory workshops we sought to identify their specific support needs, …
Measuring transactional sex in different contexts
Background: Adolescent girls and young women across sub-Saharan Africa are at disproportionate risk of HIV infection compared to their male counterparts. Transactional sex has been identified as an important proximate risk for infection in this population. Definitions and measures of transactional sex vary, necessitating improved measures to better estimate prevalence across settings, over time, and to understand the mechanisms through which tran…
Thetha Nami
Local youth were able to use evidence to develop a contextually adapted peer-led intervention to deliver biosocial HIV prevention
Common mental disorders and HIV status in the context of DREAMS among adolescent girls and young women in rural KwaZulu-Natal, South Africa
We found high prevalence of probable CMD among AGYW in rural South Africa, but it was only associated with HIV serostatus when not controlling for HIV acquisition risk factors. Our findings highlight that improving mental health service access for AGYW at high risk for HIV acquisition might protect them. Interventions already reaching AGYW with CMD, such as DREAMS, can be used to deliver mental health services to reduce both CMD and HIV risks. Th…
Lives Interrupted
We examine data from young women and men in South Africa and young female sex workers in Uganda to explore the inequalities and hardships experienced during the COVID-19 pandemic and investigate the opportunities and ability presented to navigate in a virtual world to build an inclusive supportive future for young people on the move. We argue that against the backdrop of a fragile past, young people who see their today disturbed, tomorrow reshape…
Transcription as a Key Phase of Data Analysis in Qualitative Research
Transforming spoken words into written text in qualitative research is a vital step in familiarizing and immersing oneself in the data. We share a three-step approach of how data transcription facilitated an interpretative act of analysis in a study using qualitative data collection methods on the barriers and facilitators of HIV testing and treatment in KwaZulu-Natal, South Africa
Secondary Distribution of HIV Self-Testing Kits to Social and Sexual Networks of PLWH in KwaZulu-Natal, South Africa. A Brief Report
Background: To reach 95% of persons living with HIV (PLWH) knowing their HIV status, alternative testing approaches such as HIV self-testing (HIVST) and secondary HIVST kit distribution are needed. We investigated if secondary HIVST kit distribution from male and female PLWH in South Africa would successfully lead to their contacts testing for HIV and linking to care if positive. Methods: Male and female PLWH participating in an HIV treatment tri…
Medicine (47 works) · HIV/AIDS Research and Interventions (43 works) · Adolescent Sexual and Reproductive Health (40 works) · Environmental health (31 works) · Psychology (29 works) · Family medicine (28 works) · Nursing (26 works) · Psychological intervention (22 works) · Sociology (22 works) · Public health (21 works)