Edith Essie Kekawo Clarke

Ministry of Health, Ghana, Akra, Greater Accra, Ghana

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Publications (4)7.39 Total impact

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    ABSTRACT: To assess the acceptability of a daily pill for prevention of HIV acquisition among 400 Ghanaian women in the oral tenofovir disoproxil fumarate (TDF) clinical trial. Structured questionnaires were conducted with women enrolled in the trial at enrollment and at each of the 12 monthly follow-up visits. Growth curve analysis was used to examine adherence patterns over time. Qualitative interviews were carried out with a subsample of the clinical trial population, and thematic analysis was applied to these data. Overall, acceptability of the pill was good. Adherence remained > 82% throughout the 12-month trial. Consistent access to the pill and study assignment were both associated with adherence. Most reported problems diminished over time as women became accustomed to the pill and developed strategies to incorporate pill taking into their daily routines. If daily preexposure prophylaxis (PrEP) for HIV is found to be efficacious and has as few physical side effects as TDF, acceptability of this method among women in the study population may not be problematic. However, future studies must develop better acceptability measures, in order to more fully address the relationship among adherence, safety, and effectiveness.
    Journal of Women's Health 03/2010; 19(4):791-8. DOI:10.1089/jwh.2009.1576 · 1.90 Impact Factor
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    ABSTRACT: One of the concerns raised regarding the introduction of any new HIV-prevention measure, such as PrEP, is the potential for risk disinhibition or sexual risk compensation. The oral tenofovir HIV prevention trial has been the subject of international discussion in this regard. This article maps the changes in sexual risk behavior among women participating in the oral tenofovir HIV prevention trial in Ghana. Content-driven, thematic analysis was carried out on qualitative data obtained from in-depth interviews with study participants. Growth curve analysis was the primary method used to document trends over time in self-reported sexual behavior collected monthly. Overall, the study found that sexual risk behavior did not increase during the trial. Number of sexual partners and rate of unprotected sex acts decreased across the 12-month period of study enrollment. Certain subgroups of women, however, exhibited different growth curves. Data indicate that the HIV prevention counseling associated with the trial was effective. Counseling during the trial was effective. Different types of counseling and messaging may be needed for different subgroups within a population. These findings also have implications for required sample sizes for future HIV prevention trials where seroconversion is the main outcome.
    Sexually transmitted diseases 01/2009; 35(12):1002-8. · 2.75 Impact Factor
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    ABSTRACT: Background: With an effective HIV vaccine years away, attention has been directed to the development and testing of an oral chemo-prophylactic. For any intervention to be effective it must be acceptable within the target population. This paper describes the experiences of Ghanaian women at high risk for HIV enrolled in a safety and efficacy oral tenofovir HIV-prevention trial. Methods: The behavioral study included structured surveys with 364 trial participants at enrollment and 12 monthly clinic visits during the year-long trial. In-depth interviews were conducted with 24 of the study participants midway through the trial. Growth curve analysis was used to analyze various aspects of participants' use of the study pill. Thematic analysis was carried out on the qualitative data. Results: Self-reported pill adherence (last 7 days) exceeded 74% throughout the trial. At month 1, 31% of participants reported a problem with the pill in the survey. This number decreased steadily until month 6, when it stabilized at <4%. The most commonly reported problems were physical (61%) - mainly gastrointestinal issues, fatigue and dizziness and did not differ between placebo/treatment groups (Peterson et al. 2007). Additional problems were: forgetting to take the pill (20%), traveling (8%), and swallowing the pill (5%). Qualitative data confirmed that most problems diminished over time, as side effects eased and women adapted the pill-taking routine into their daily lives. Conclusion: Oral prophylaxis as a strategy for HIV-prevention was acceptable to women at risk for HIV in the study site, and acceptability of the method improved over time.
    136st APHA Annual Meeting and Exposition 2008; 10/2008
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    ABSTRACT: BACKGROUND:: One of the concerns raised regarding the introduction of any new HIV-prevention measure, such as PrEP, is the potential for risk disinhibition or sexual risk compensation. The oral tenofovir HIV prevention trial has been the subject of international discussion in this regard. METHODS:: This article maps the changes in sexual risk behavior among women participating in the oral tenofovir HIV prevention trial in Ghana. Content-driven, thematic analysis was carried out on qualitative data obtained from in-depth interviews with study participants. Growth curve analysis was the primary method used to document trends over time in self-reported sexual behavior collected monthly. RESULTS:: Overall, the study found that sexual risk behavior did not increase during the trial. Number of sexual partners and rate of unprotected sex acts decreased across the 12-month period of study enrollment. Certain subgroups of women, however, exhibited different growth curves. Data indicate that the HIV prevention counseling associated with the trial was effective. CONCLUSIONS:: Counseling during the trial was effective. Different types of counseling and messaging may be needed for different subgroups within a population. These findings also have implications for required sample sizes for future HIV prevention trials where seroconversion is the main outcome.
    Sex Transm Dis 08/2008; 35(12). DOI:10.1097/OLQ.0b013e3181812939 · 2.75 Impact Factor