Shajy Isac
Datos Biográficos
| ID | 78423 |
|---|---|
| NOMBRE | Shajy Isac |
| NOMBRES | Shajy |
| APELLIDO | Isac |
| FIRMA | ISAC S |
| AFILIACIONES | Karnataka Health Promotion Trust |
| ORCID | 0000-0002-4272-7748 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 49 |
| TOTAL DE CITAS | 37 |
| TOTAL COMO AUTOR | 49 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2010 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2025 |
| ÍNDICE H | 3 |
Essential newborn care practices in selected public health facilities using observation of 2603 normal deliveries in Uttar Pradesh, India
INTRODUCTION: Essential newborn care (ENBC) practices are recommended for all births to improve neonatal survival. This paper aims to understand the facility-level variations and factors associated with the essential newborn care practices by providers in higher-level public health facilities in 25 high priority districts (HPDs) of Uttar Pradesh (UP). METHODS: We used observational cross-sectional quantitative data from 48 selected public health …
Programmatic mapping and population size estimation of key population in India
India has the world’s second-largest HIV burden. Key populations of female sex workers (FSW), men who have sex with men (MSM), hijra/transgender (H/TG) people, and people who inject drugs (PWID), are disproportionately affected by the HIV epidemic. A community-led programmatic mapping and population size estimation (PMPSE) was carried out in 651 districts of 32 States and Union Territories of India. The goal was to identify the hotspots, network …
An analytical approach towards attaining leave no one behind using patterns and distributions of inequalities in antenatal and facility delivery coverage in Uttar Pradesh, India
The proposed health equity framework suggests that to achieve LNOB status, understanding inequality with the coverage status is important. If coverage is high and inequality persists, identify the program layer at which maximum inequality persists to identify the left behinds. Whereas, if coverage is poor, programs are required to improve coverage first. Findings also call for a systematic way of collecting and organizing granular data to underst…
That is because we are alone’
This qualitative study was conducted in Uttar Pradesh state, India to explore how interrelated socio-economic position and spatial characteristics of four diverse villages may have influenced equity in coverage of community-based maternal and newborn health (MNH) services. We conducted social mapping and three focus group discussions in each village, among women of lower and higher socio-economic position who recently gave birth, and with communi…
Boys’ perspectives on girls’ marriage and school dropout
Girls' education has for many decades been central to the global development agenda, due to its positive impact on girls' health and wellbeing. In this paper, the authors revisit boys' attitudes, behaviours and norms related to girls' education, following the Samata intervention to prevent girls' school dropouts in Northern-Karnataka, South India. Data were collected from 20 boys in intervention villages before and after the intervention, and ana…
Declining fertility and increasing use of traditional methods of family planning
Uttar Pradesh (UP), with more than 220 million people, is the most populous state in India. Despite a high unmet need for modern family planning methods, the state has experienced a substantial decline in fertility. India has also seen a decline during this period which can be attributed to the increased prevalence of modern methods of family planning, particularly female sterilisation, but in UP, the corresponding increase was marginal. At the s…
Assessing awareness and use of HIV self-testing kits after the introduction of a community-based HIV self-testing programme among men who have sex with men in Kenya
Men who have sex with men (MSM) bear a disproportionate burden of new HIV infections in Kenya, while experiencing discrimination, leading to suboptimal levels of HIV care. HIV self-testing (HIVST) is a tool to increase HIV screening and earlier diagnosis; however, questions remain regarding how best to scale-up HIVST to MSM in Kenya. The main objective of this study was to examine changes in knowledge and use of HIVST after implementation of a co…
A cross-sectional survey exploring HIV and HCV prevalence among men who purchase sex in Dnipro, Ukraine
Prevalence of HIV and HCV in this population was high. Given high rates of study enrolment and testing, efforts should be made to reach men who purchase sex with expanded STBBI programming
I have the confidence to ask’
Gender norms serve to normalise gender inequalities and constrain girls’ agency. This paper examines how girls’ agency, along a continuum, is influenced by the interplay between constraining and enabling influences in the girls’ environments. We analyse data from a qualitative study nested within a cluster randomised evaluation of Samata, a multi-layered programme supporting adolescent girls to stay in school and delay marriage in Karnataka, Sout…
Adolescent Girls and Their Family Members’ Attitudes Around Gendered Power Inequity and Associations with Future Aspirations in Karnataka, India
Intergenerational differences in inequitable gender attitudes may influence developmental outcomes, including education. In rural Karnataka, India, we examined the extent of intergenerational (adolescent girls [AGs] vs. older generation family members) dis/agreement to attitudes around gendered power inequities, including gender roles and violence against women (VAW). Unadjusted and adjusted logistic regression examined associations between inter…
Exploring the dynamics of workplace typologies for sex workers in Eastern Ukraine
We examine the typologies of workplaces for sex workers in Dnipro, Ukraine as part of the larger Dynamics Study, which explores the influence of conflict on sex work. We conducted a cross-sectional survey with 560 women from September 2017 to October 2018. The results of our study demonstrate a diverse sex work environment with heterogeneity across workplace typologies in terms of remuneration, workload, and safety. Women working in higher presti…
Understanding the roles of community health workers in improving perinatal health equity in rural Uttar Pradesh, India
The study found that ASHAs built relationships, counselled and supported many pregnant women of lower socio-economic positions. Ongoing inequities in health facility births and perinatal mortality were perpetuated by overlapping contextual issues beyond the ASHAs' purview. Supporting ASHAs' integration with community organisations and health system strategies more broadly is needed to address these issues and optimise pathways between equity in i…
Closing the gap on institutional delivery in northern India
INTRODUCTION: Meeting ambitious global health goals with limited resources requires a precision public health (PxPH) approach. Here we describe how integrating data collection optimisation, traditional analytics and causal artificial intelligence/machine learning (ML) can be used in a use case for increasing hospital deliveries of newborns in Uttar Pradesh, India. METHODS: Using a systematic behavioural framework we designed a large-scale survey …
The contribution of district prioritization on maternal and newborn health interventions coverage in rural India
BACKGROUND: In 2001, India prioritized eight most socioeconomically disadvantaged states known as Empowered Action Group (EAG) states and in 2013, it prioritized 190 of the 718 as high priority districts (HPDs) to accelerate the decline in maternal and newborn mortality. This paper assesses whether the HPDs achieved a greater coverage of maternal and newborn health interventions than the non-HPDs and HPDs in EAG states achieved greater coverage t…
The Samata intervention to increase secondary school completion and reduce child marriage among adolescent girls
BACKGROUND: Secondary education and delayed marriage provide long-term socio-economic and health benefits to adolescent girls. We tested whether a structural and norms-based intervention, which worked with adolescent girls, their families, communities, and secondary schools to address poverty, schooling quality and gender norms, could reduce secondary school drop-out and child marriage among scheduled-caste/scheduled-tribe (SC/ST) adolescent girl…
Assessing the influence of conflict on the dynamics of sex work and the HIV and HCV epidemics in Ukraine
BACKGROUND: Armed conflict erupted in eastern Ukraine in 2014 and still continues. This conflict has resulted in an intensification of poverty, displacement and migration, and has weakened the local health system. Ukraine has some of the highest rates of HIV and Hepatitis C (HCV) in Europe. Whether and how the current conflict, and its consequences, will lead to changes in the HIV and HCV epidemic in Ukraine is unclear. Our study aims to characte…
Media, nationalism, and the body
Public health and media discourses on men and HIV prevention in India have largely focused on changing knowledge, attitudes and risk behaviour pertaining to condom use and safe sex. Little attempt has been made towards intervening in areas such as masculinity, dominant gender norms and intimate partner violence (IPV) that have been shown to have a direct link to HIV prevalence. In this paper, drawing on findings from an ethnographic study in nort…
Evaluation of community-based HIV self-testing delivery strategies on reducing undiagnosed HIV infection, and improving linkage to prevention and treatment services, among men who have sex with men in…
This study is one of the first programme science studies in Sub-Saharan Africa exploring the effectiveness of integrating HIVST interventions within already existing HIV prevention and treatment programmes for MSM in Kenya at scale. Findings from this study will inform national best approaches to scale up HIVST among MSM in Kenya
What determines violence among female sex workers in an intimate partner relationship? Findings from North Karnataka, south India
Clinical Trials NCT02807259
Incidence, prevalence and associated factors of mother-to-child transmission of HIV, among children exposed to maternal HIV, in Belgaum district, Karnataka, India
The study findings suggest that mother's age above 30 years and breastfeeding beyond 26 weeks is associated with higher rates of HIV transmission from mother to child. It confirms the benefits of providing anti-retrovirals (Nevirapine) in reducing mother to child transmission of HIV. Effective strategies to promote safe infant feeding practices, including avoidance of mixed feeding beyond 26 weeks among HIV infected mothers, is critical to reduce…
Prevalence and correlates of psychological distress among 13–14 year old adolescent girls in North Karnataka, South India
Prospectively registered at ClinicalTrials.GovNCT01996241 . November 27, 2013
Exploring male adolescents' perceptions of gender relations in South India
In Northern Karnataka, South India, boys' behaviours and attitudes towards girls are regarded as one of the many important proximate structural barriers impeding girls' access to education and academic performance in rural communities. In response to these barriers, public health practitioners developed an intervention, known as the Parivartan program, to confront the wider social and structural influences that shape adolescent boys' perspectives…
The cost of safe sex
There is some evidence that female sex workers (FSWs) receive greater earnings for providing unprotected sex. In 2003, the landscape of the fight against HIV/AIDS dramatically changed in India with the introduction of Avahan, the largest HIV prevention programme implemented globally. Using a unique, cross-sectional bio-behavioural dataset from 3591 FSWs located in the four Indian states where Avahan was implemented, we estimate the economic loss …
Developing a Mental Health Measurement Strategy to Capture Psychological Problems among Lower Caste Adolescent Girls in Rural, South India
Adolescent girls vulnerable to early marriage and school dropout in rural India may be at elevated risk of psychosocial problems. However, few screening instruments have been culturally adapted and validated to measure this risk. This paper describes the process by which the Primary Health Questionnaire PHQ-9, a screening instrument for depression, was tested for cultural validity as part of the Samata evaluation - an intervention to support low …
Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
While Kenya has had a long-standing national HIV-prevention program, evidence on the level of exposure to its interventions and related effects on behavioral changes among female sex workers (FSWs) is limited. Using cross-sectional behavioral data collected in 2013 from 1 357 FSWs aged 18 years and above in Nairobi, Kenya, this study explores the relationship between FSW program exposure levels and behavioral outcomes including condom use, sexual…
The barriers and enablers to education among scheduled caste and scheduled tribe adolescent girls in northern Karnataka, South India
This qualitative study explored the barriers and enablers to scheduled caste/scheduled tribe (SC/ST) adolescent girls entering into, and completing secondary education in northern Karnataka, South India. In-depth interviews were conducted with 22 adolescent girls, their respective parent/guardian (n = 22) and 11 teachers, recruited purposively from 11 villages within two districts in northern Karnataka. Multiple barriers were identified to disadv…
Personal, interpersonal and structural challenges to accessing HIV testing, treatment and care services among female sex workers, men who have sex with men and transgenders in Karnataka state, South I…
BACKGROUND: Despite high HIV prevalence rates among most-at-risk groups, utilisation of HIV testing, treatment and care services was relatively low in Karnataka prior to 2008. The authors aimed to understand the barriers to and identify potential solutions for improving HIV service utilisation. METHODS: Focus group discussions were carried out among homogeneous groups of female sex workers, men who have sex with men and transgenders, and programm…
The cost of safe sex
There is some evidence that female sex workers (FSWs) receive greater earnings for providing unprotected sex. In 2003, the landscape of the fight against HIV/AIDS dramatically changed in India with the introduction of Avahan, the largest HIV prevention programme implemented globally. Using a unique, cross-sectional bio-behavioural dataset from 3591 FSWs located in the four Indian states where Avahan was implemented, we estimate the economic loss …
Pursuing Authenticity From Process to Outcome in a Community-Based Participatory Research Study of Intimate Partner Violence and HIV Vulnerability in North Karnataka, India
Community-based participatory research has been seen to hold great promise by researchers aiming to bridge research and action in global health programs and practice. However, there is still much debate around whether achieving authenticity in terms of in-depth collaboration between community and academic partners is possible while pursuing academic expectations for quality. This article describes the community-based methodology for a qualitative…
Community Mobilization and Empowerment of Female Sex Workers in Karnataka State, South India
Objectives. We examined the impact of community mobilization (CM) on the empowerment, risk behaviors, and prevalence of HIV and sexually transmitted infection in female sex workers (FSWs) in Karnataka, India. Methods. We conducted behavioral–biological surveys in 2008 and 2011 in 4 districts of Karnataka, India. We defined exposure to CM as low, medium (attended nongovernmental organization meeting or drop-in centre), or high (member of collectiv…
Adolescent Girls and Their Family Members’ Attitudes Around Gendered Power Inequity and Associations with Future Aspirations in Karnataka, India
Intergenerational differences in inequitable gender attitudes may influence developmental outcomes, including education. In rural Karnataka, India, we examined the extent of intergenerational (adolescent girls [AGs] vs. older generation family members) dis/agreement to attitudes around gendered power inequities, including gender roles and violence against women (VAW). Unadjusted and adjusted logistic regression examined associations between inter…
Violence against female sex workers in Karnataka state, south India
This program demonstrates that a structural approach to addressing violence can be effectively delivered at scale. Addressing violence against FSWs is important for the success of HIV prevention programs, and for protecting their basic human rights
An integrated structural intervention to reduce vulnerability to HIV and sexually transmitted infections among female sex workers in Karnataka state, south India
Stigma, discrimination, violence, harassment and social equity issues are critical concerns of FSWs. This report demonstrates that it is possible to address these broader structural factors as part of large-scale HIV prevention programming. Although assessing the impact of the various components of a structural intervention on reducing HIV vulnerability is difficult, addressing the broader structural factors contributing to FSW vulnerability is c…
Prevalence of HIV and sexually transmitted infections among clients of female sex workers in Karnataka, India
This study fills in important gaps in knowledge regarding clients in southern India. The strong association between HIV and HSV-2 infections highlights the complications in designing effective prevention, intervention and management programs of this well-hidden population
Determinants of condom breakage among female sex workers in Karnataka, India
The reported incidence of condom breakage was high in this study, and this is a major concern for HIV/STI prevention programs, for which condom use is a key prevention tool. Younger and more marginalized female sex workers were most vulnerable to condom breakage. Special effort is therefore required to seek out such women and to provide information and skills on correct condom use. More research is also needed on what specific situational paramet…
The feasibility of using mobile phone technology for sexual behaviour research in a population vulnerable to HIV
Sexual behaviour studies are often challenged by sampling, participation and measurement biases, and may be unacceptable to participants. We invited 293 randomly selected female sex workers (FSWs) in Bangalore, India, to participate in a telephone survey, with condom breakage as the main outcome. Free cell phones were supplied and trained interviewers telephoned FSWs daily to ask about all sex acts the previous day. Later, we undertook focus grou…
Female Sex Worker Client Behaviors Lead to Condom Breakage
Differences Between Seven Measures of Self-Reported Numbers of Clients of Female Sex Workers in Southern India
Personal, interpersonal and structural challenges to accessing HIV testing, treatment and care services among female sex workers, men who have sex with men and transgenders in Karnataka state, South I…
BACKGROUND: Despite high HIV prevalence rates among most-at-risk groups, utilisation of HIV testing, treatment and care services was relatively low in Karnataka prior to 2008. The authors aimed to understand the barriers to and identify potential solutions for improving HIV service utilisation. METHODS: Focus group discussions were carried out among homogeneous groups of female sex workers, men who have sex with men and transgenders, and programm…
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…
Relationship between exposure to the Avahan intervention and levels of reported condom use among men who have sex with men in southern India
Direct contact with Avahan program staff is associated with increased reported condom use among men who have sex with men in Bangalore. Reported consistent condom use and condom use at last sex act are associated with contacts involving demonstrations of correct condom use, and with receiving condoms, respectively
Circumstances, experiences and processes surrounding women's entry into sex work in India
Evidence suggests that in India, the early stages of a woman's career as a sex worker may be an important period to target for HIV and sexually transmitted infection prevention. Before such an intervention is designed and implemented, it is necessary to first understand the life circumstances of women at the start of their sex work careers. We performed a review to bring together available literature pertaining to entry into sex work in India and…
Community Mobilization and Empowerment of Female Sex Workers in Karnataka State, South India
Objectives. We examined the impact of community mobilization (CM) on the empowerment, risk behaviors, and prevalence of HIV and sexually transmitted infection in female sex workers (FSWs) in Karnataka, India. Methods. We conducted behavioral–biological surveys in 2008 and 2011 in 4 districts of Karnataka, India. We defined exposure to CM as low, medium (attended nongovernmental organization meeting or drop-in centre), or high (member of collectiv…
Supporting adolescent girls to stay in school, reduce child marriage and reduce entry into sex work as HIV risk prevention in north Karnataka, India
ClinicalTrials.Gov NCT01996241 . 16th November 2013
Pregnancy wastage among HIV infected women in a high HIV prevalence district of India
HIV prevention and care programs need to consider the reproductive health needs of HIV infected married women as a priority area since large proportion of these women reported negative pregnancy outcomes. There is also a need to explore ways to raise the age at marriage in order to stop women getting married before the legal age at marriage
Reducing violence and increasing condom use in the intimate partnerships of female sex workers
Clinical Trials NCT02807259 Jun 24 2016 (retrospectively registered)
Research protocol for an epidemiological study on estimating disease burden of pediatric HIV in Belgaum district, India
There is a need to strengthen existing pediatric HIV estimation methods in India and other developing countries. We hope that the novel methodology emanating from this study would be applicable for estimating the burden of HIV in other settings and it would be adaptable for estimating the burden of other infectious/chronic diseases. Findings from this study will give future direction to the national program for prevention and control of HIV in In…
The barriers and enablers to education among scheduled caste and scheduled tribe adolescent girls in northern Karnataka, South India
This qualitative study explored the barriers and enablers to scheduled caste/scheduled tribe (SC/ST) adolescent girls entering into, and completing secondary education in northern Karnataka, South India. In-depth interviews were conducted with 22 adolescent girls, their respective parent/guardian (n = 22) and 11 teachers, recruited purposively from 11 villages within two districts in northern Karnataka. Multiple barriers were identified to disadv…
Pornography, Sexual Enhancement Products, and Sexual Risk of Female Sex Workers and their Clients in Southern India
Pursuing Authenticity From Process to Outcome in a Community-Based Participatory Research Study of Intimate Partner Violence and HIV Vulnerability in North Karnataka, India
Community-based participatory research has been seen to hold great promise by researchers aiming to bridge research and action in global health programs and practice. However, there is still much debate around whether achieving authenticity in terms of in-depth collaboration between community and academic partners is possible while pursuing academic expectations for quality. This article describes the community-based methodology for a qualitative…
Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
While Kenya has had a long-standing national HIV-prevention program, evidence on the level of exposure to its interventions and related effects on behavioral changes among female sex workers (FSWs) is limited. Using cross-sectional behavioral data collected in 2013 from 1 357 FSWs aged 18 years and above in Nairobi, Kenya, this study explores the relationship between FSW program exposure levels and behavioral outcomes including condom use, sexual…
Estimating early HIV risk among at risk adolescent girls and young women in Dnipro, Ukraine
By 2016, Ukraine had the second largest HIV epidemic in Eastern Europe and Central Asia with 280,358 people living with HIV. Interventions targeted for FSWs are a key component of HIV prevention programs as heterosexual contacts continue to gain higher epidemic significance – the proportion of the sexual way of HIV transmission has steadily increased [...]
Ecologies of security
This paper highlights important environmental dimensions of HIV vulnerability by describing how the sex trade operates in Nairobi, Kenya. Although sex workers there encounter various forms of violence and harassment, as do sex workers globally, we highlight how they do not merely fall victim to a set of environmental risks but also act upon their social environment, thereby remaking it, as they strive to protect their health and financial interes…
Effects of exposure to an intensive HIV-prevention programme on behavioural changes among female sex workers in Nairobi, Kenya
While Kenya has had a long-standing national HIV-prevention programme, evidence on the level of exposure to its interventions and related effects on behavioural changes among female sex workers (FSWs) is limited. Using cross-sectional behavioural data collected in 2013 from 1 357 FSWs aged 18 years and above in Nairobi, Kenya, this study explores the relationship between FSW programme exposure levels and behavioural outcomes including condom use,…
Intervening in masculinity
Although health researchers have begun to examine the forms of violence and power dynamics that play out in the intimate relationships of female sex workers (FSWs) in India, this knowledge has tended to focus on the perspectives of women, leaving men’s motivations and attitudes relatively unexamined. This paper examines the contours of masculinity and gender norms from the perspective of the intimate partners of FSWs. Based on six months of ethno…
Medicine (43 obras) · Environmental health (33 obras) · Demography (29 obras) · Sex work and related issues (28 obras) · HIV, Drug Use, Sexual Risk (27 obras) · Public health (25 obras) · Population (23 obras) · Sociology (23 obras) · HIV/AIDS Research and Interventions (21 obras) · Family medicine (20 obras)