Browsing by Author "Moodley, J R"

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    Challenges to cervical screening in the Western Cape province
    (2003) Smith, N; Moodley, J R; Hoffman, M
    Carcinoma of the cervix is the second most common cancer among South African women, with 1 in 41 women developing the disease in her lifetime.1 Although population-based screening programmes using Pap smears can substantially decrease the incidence of the disease, such programmes remain remarkably difficult to implement. Lack of resources and available treatment, low community awareness, poor quality of Pap smears, and inadequate rates of follow-up are foremost among the documented obstacles to successful cytological screening.2,3 In South Africa, work to develop a nationwide screening programme has been ongoing, culminating in 1999 in the release of a national cervical screening policy.4 The screening protocol is based on World Health Organisation (WHO) recommendations for regions with limited resources5 and models of the natural history of the disease.6 The incidence of invasive cancer in South Africa begins to rise for women between the ages of 35 and 39 years, with 87% of cases occurring in women over 35.1 A lifetime total of three Pap smears, taken at 10-year intervals, is to be made available free to all women aged over 30 years, with follow-up and treatment for abnormal tests also free. The goal is to screen 70% of women in the target age group within 10 years of initiating the programme. Screening and treatment based on this model should theoretically decrease cancer incidence by 64%.
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    Fertility Intentions and Reproductive Health Care needs of People Living with HIV in Cape Town, South Africa: Implications for Intergrating reproductive Health and HIV Care Services
    (2009) Cooper, D D; Moodley, J R; Zweigenthal, V; Bekker, L; Shah, I; Myer, L
    Tailoring sexual and reproductive health services to meet the needs of people living with the human immuno-deficiency virus (HIV) is a growing concern but there are few insights into these issues where HIV is most prevalent. This cross-sectional study investigated the fertility intentions and associated health care needs of 459 women and men, not sampled as intimate partners of each other, living with HIV in Cape Town, South Africa. An almost equal proportion of women (55%) and men (43%) living with HIV, reported not intending to have children as were open to the possibility of having children (45 and 57%, respectively). Overall, greater intentions to have children were associated with being male, having fewer children, living in an informal settlement and use of antiretroviral therapy. There were important gender differences in the determinants of future childbearing intentions, with being on HAART strongly associated with women’s fertility intentions. Gender differences were also apparent in participants’ key reasons for wanting children. A minority of participants had discussed their reproductive intentions and related issues with HIV health care providers. There is an urgent need for intervention models to integrate HIV care with sexual and reproduction health counseling and services that account for the diverse reproductive needs of these populations.