Integration of WASH interventions into HIV/AIDS programmes in sub-Saharan Africa
People living with HIV (PLHIV) have compromised immune systems and are highly susceptible to diarrhoeal diseases. Water, sanitation, and hygiene (WASH) interventions have been proven to be effective in reducing diarrhoeal diseases among PLHIV, yet little information exists on how integration of WASH into HIV/AIDS programmes occurs. The goals of this study were to: 1) identify specific WASH activities that have been integrated into HIV/AIDS programmes; 2) characterize the behavioural change techniques used to improve WASH-related behaviours; 3) identify WASH indicators used to evaluate WASH activities; and 4) discuss implementation challenges and potential ways to move the sector forward. A semi-structured questionnaire was used to obtain information from six organizations integrating WASH into HIV/AIDS programmes. Additionally, in-depth interviews were conducted with four of those six organizations. Each of the organizations integrated at least one of the three key WASH interventions into their HIV/AIDS programme, including: 1) household water treatment and safe storage; 2) hand washing with soap; and 3) safe handling and disposal of faeces. No organization integrated all three interventions. Sanitation interventions were least common among the programmes, highlighting the neglect of sanitation.Abebe, L.S., Smith, J.A., Narkiewicz, S., Oyandedel-Craver, V., Conaway, M., Singo, A., Amidou, S., Mojapelo, P., Brant, J. and Dillingham, R. (2013) ‘Ceramic water filters impregnated with silver nanoparticles as a point-of-use water-treatment intervention for HIV-positive individuals in Limpopo province, South Africa: a pilot study of technological performance and human health benefits’, Journal of Water and Health (in press) <http://dx.doi.org/10.2166/wh.2013.185≯.
Abraham, C. and Michie, S. (2008) ‘A taxonomy of behavior change techniques used in interventions’, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 27(3): 379–87
Abraham, C. and Michie, S. (2008) ‘A taxonomy of behavior change techniques used in interventions’, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 27(3): 379–87 <http://dx.doi.org/10.1037/0278-6133.27.3.379≯.
Barzilay, E.J., Aghoghovbia, T.S., Blanton, E.M., Akinpelumi, A.A., Coldiron, M.E., Akinfolayan, O. and Quick, R. (2011) ‘Diarrhea prevention in people living with HIV: an evaluation of a point-of-use water quality intervention in Lagos, Nigeria’, AIDS Care 23(3): 330–39 <http://dx.doi.org/10.1080/09540121.2010.507749≯.
Beyene, H. and Hailu, D. (2013) ‘Assessment of knowledge, attitude and practice regarding water, sanitation and hygiene for people living with HIV/AIDS’, Journal of Water, Sanitation and Hygiene for Development 3(1): 81–5 <http://dx.doi.org/10.2166/washdev.2013.022≯.
Bushen, O.Y., Davenport, J.A., Lima, A.B., Piscitelli, S.C., Uzgiris, A.J., Silva, T.M., Leite, R., Kosek, M., Dillingham, R.A., Girao, A., Lima, A.A. and Guerrant, R.L. (2004) ‘Diarrhea and reduced levels of antiretroviral drugs: improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil’, Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 38(12): 1764–70 <http://dx.doi.org/10.1086/421394≯.
Colford Jr, J.M., Saha, S.R., Wade, T.J., Wright, C.C., Vu, M., Charles, S., Jensen, P., Hubbard, A., Levy, D.A. and Eisenberg, J.N. (2005) ‘A pilot randomized, controlled trial of an in-home drinking water intervention among HIV + persons,’ Journal of Water and Health 3(2): 173–84.
Curtis, V. and Cairncross, S. (2003) ‘Effect of washing hands with soap on diarrhoea risk in the community: a systematic review’, The Lancet Infectious Diseases 3: 275–81 <http://dx.doi.org/10.1016/S1473-3099(03)00606-6≯.
Fewtrell, L., Kaufmann, R.B., Kay, D., Enanoria, W., Haller, L. and Colford, J.M. (2005) ‘Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’, The Lancet Infectious Diseases 5: 42–52 <http://dx.doi.org/10.1016/S1473-3099(04)01253-8≯.
Harris, J.R., Greene, S.K., Thomas, T.K., Ndivo, R., Okanda, J., Masaba, R., Nyangau, I., Thigpen, M.C., Hoekstra, R.M. and Quick, R.E. (2009) ‘Effect of a point-of-use water treatment and safe water storage intervention on diarrhea in infants of HIV-infected mothers’, The Journal of Infectious Diseases 200(8): 1186–93 <http://dx.doi.org/10.1086/605841≯.
Huang, D.B. and Zhou, J. (2007) ‘Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study’, Journal of Medical Microbiology 56(5): 659–63 <http://dx.doi.org/10.1099/jmm.0.46867-0≯.
Kamminga, E. and Wegelin-Schuringa, M. (2003) HIV/AIDS and Water, Sanitation and Hygiene. Thematic Overview Paper, Delft, the Netherlands: IRC International Water and Sanitation Centre.
Lule, J.R., Mermin, J., Ekwaru, J.P., Malamba, S., Downing, R., Ransom, R., Nakanjako, D., Wafula, W., Hughes, P., Bunnell, R., Kaharuza, F., Coutinho, A., Kigozi, A. and Quick, R. (2005) ‘Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda’, The American Journal of Tropical Medicine and Hygiene 73(5): 926–33.
Meier, A.S., Bukusi, E.A., Cohen, C.R. and Holmes, K.K. (2006) ‘Independent association of hygiene, socioeconomic status, and circumcision with reduced risk of HIV infection among Kenyan men’, Journal of Acquired Immune Deficiency Syndromes (1999) 43(1): 117–8 <http://dx.doi.org/10.1097/01.qai.0000224973.60339.35≯.
Peletz, R.L., Mahin, T., Elliot, M., Harris, M.S., Chan, K.S., Cohen, M.S. and Clasen, T.F. (2013) ‘Water, sanitation, and hygiene interventions to improve health among people living with HIV/ AIDS: a systematic review’, AIDS Care <http://dx.doi.org/10.1097/QAD.0b013e3283633a5f≯.
Pickering, A.J. and Davis, J. (2012) ‘Freshwater availability and water fetching distance affect child health in sub-Saharan Africa’, Environmental Science & Technology 46(4): 2391–7 <http://dx.doi.org/10.1021/es203177v≯.
Potgieter, N., Barnard, T.G., Brown, J. and Sobsey, M.D. (2011) Impact of a Ceramic Pot Pointof- Use Water Treatment Device on Rural People Living with HIV and AIDS, WRC Report 1653/1/11, Johannesburg, South Africa: South African Water Research Commission.
Thea, D.M., St Louis, M.E., Atido, U., Kanjinga, K., Kembo, B., Matondo, M., Tshiamala, T., Kamenga, C., Davachi, F. and Brown, C. (1993) ‘A prospective study of diarrhea and HIV-1 infection among 429 Zairian infants’, The New England Journal of Medicine 329(23): 1696–1702.
UNAIDS (2011) ‘World Overview’ [website], <www.unaids.org/en/dataanalysis/datatools/aidsinfo/≯ [accessed 10 November 2013]. www.unaids.org/en/dataanalysis/datatools/aidsinfo/
USAID/WHO (2010) How to Integrate Water, Sanitation and Hygiene into HIV Programmes [pdf] <http://whqlibdoc.who.int/publications/2010/9789241548014_eng.pdf≯ [accessed 10 November 2013]. http://whqlibdoc.who.int/publications/2010/9789241548014_eng.pdf
Walson, J.L., Sangaré, L.R., Singa, B.O., Naulikha, J.M., Piper, B.K.S., Yuhas, K., Onchiri, F.M., Otieno, P.A., Mermin, J., Zeh, C., Richardson, B.A. and John-Stewart, G. (2013) ‘Evaluation of impact of long-lasting insecticide-treated bed nets and point-of-use water filters on HIV-1 disease progression in Kenya’, AIDS 27(9): 1493–501 <http://dx.doi.org/10.1097/QAD.0b013e32835ecba9≯.
Wang, X. and Hunter, P. (2010) ‘A systematic review and meta-analysis of the association between self-reported diarrheal disease and distance from home to water source’, The American Journal of Tropical Medicine and Hygiene 83(3): 582 <http://dx.doi.org/10.4269/ajtmh.2010.10-0215≯.
Abebe, L.S., Smith, J.A., Narkiewicz, S., Oyandedel-Craver, V., Conaway, M., Singo, A., Amidou, S., Mojapelo, P., Brant, J. and Dillingham, R. (2013) ‘Ceramic water filters impregnated with silver nanoparticles as a point-of-use water-treatment intervention for HIV-positive individuals in Limpopo province, South Africa: a pilot study of technological performance and human health benefits’, Journal of Water and Health (in press) <http://dx.doi.org/10.2166/wh.2013.185≯.
Abraham, C. and Michie, S. (2008) ‘A taxonomy of behavior change techniques used in interventions’, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 27(3): 379–87
Abraham, C. and Michie, S. (2008) ‘A taxonomy of behavior change techniques used in interventions’, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 27(3): 379–87 <http://dx.doi.org/10.1037/0278-6133.27.3.379≯.
Barzilay, E.J., Aghoghovbia, T.S., Blanton, E.M., Akinpelumi, A.A., Coldiron, M.E., Akinfolayan, O. and Quick, R. (2011) ‘Diarrhea prevention in people living with HIV: an evaluation of a point-of-use water quality intervention in Lagos, Nigeria’, AIDS Care 23(3): 330–39 <http://dx.doi.org/10.1080/09540121.2010.507749≯.
Beyene, H. and Hailu, D. (2013) ‘Assessment of knowledge, attitude and practice regarding water, sanitation and hygiene for people living with HIV/AIDS’, Journal of Water, Sanitation and Hygiene for Development 3(1): 81–5 <http://dx.doi.org/10.2166/washdev.2013.022≯.
Bushen, O.Y., Davenport, J.A., Lima, A.B., Piscitelli, S.C., Uzgiris, A.J., Silva, T.M., Leite, R., Kosek, M., Dillingham, R.A., Girao, A., Lima, A.A. and Guerrant, R.L. (2004) ‘Diarrhea and reduced levels of antiretroviral drugs: improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil’, Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 38(12): 1764–70 <http://dx.doi.org/10.1086/421394≯.
Colford Jr, J.M., Saha, S.R., Wade, T.J., Wright, C.C., Vu, M., Charles, S., Jensen, P., Hubbard, A., Levy, D.A. and Eisenberg, J.N. (2005) ‘A pilot randomized, controlled trial of an in-home drinking water intervention among HIV + persons,’ Journal of Water and Health 3(2): 173–84.
Curtis, V. and Cairncross, S. (2003) ‘Effect of washing hands with soap on diarrhoea risk in the community: a systematic review’, The Lancet Infectious Diseases 3: 275–81 <http://dx.doi.org/10.1016/S1473-3099(03)00606-6≯.
Fewtrell, L., Kaufmann, R.B., Kay, D., Enanoria, W., Haller, L. and Colford, J.M. (2005) ‘Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’, The Lancet Infectious Diseases 5: 42–52 <http://dx.doi.org/10.1016/S1473-3099(04)01253-8≯.
Harris, J.R., Greene, S.K., Thomas, T.K., Ndivo, R., Okanda, J., Masaba, R., Nyangau, I., Thigpen, M.C., Hoekstra, R.M. and Quick, R.E. (2009) ‘Effect of a point-of-use water treatment and safe water storage intervention on diarrhea in infants of HIV-infected mothers’, The Journal of Infectious Diseases 200(8): 1186–93 <http://dx.doi.org/10.1086/605841≯.
Huang, D.B. and Zhou, J. (2007) ‘Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study’, Journal of Medical Microbiology 56(5): 659–63 <http://dx.doi.org/10.1099/jmm.0.46867-0≯.
Kamminga, E. and Wegelin-Schuringa, M. (2003) HIV/AIDS and Water, Sanitation and Hygiene. Thematic Overview Paper, Delft, the Netherlands: IRC International Water and Sanitation Centre.
Lule, J.R., Mermin, J., Ekwaru, J.P., Malamba, S., Downing, R., Ransom, R., Nakanjako, D., Wafula, W., Hughes, P., Bunnell, R., Kaharuza, F., Coutinho, A., Kigozi, A. and Quick, R. (2005) ‘Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda’, The American Journal of Tropical Medicine and Hygiene 73(5): 926–33.
Meier, A.S., Bukusi, E.A., Cohen, C.R. and Holmes, K.K. (2006) ‘Independent association of hygiene, socioeconomic status, and circumcision with reduced risk of HIV infection among Kenyan men’, Journal of Acquired Immune Deficiency Syndromes (1999) 43(1): 117–8 <http://dx.doi.org/10.1097/01.qai.0000224973.60339.35≯.
Peletz, R.L., Mahin, T., Elliot, M., Harris, M.S., Chan, K.S., Cohen, M.S. and Clasen, T.F. (2013) ‘Water, sanitation, and hygiene interventions to improve health among people living with HIV/ AIDS: a systematic review’, AIDS Care <http://dx.doi.org/10.1097/QAD.0b013e3283633a5f≯.
Pickering, A.J. and Davis, J. (2012) ‘Freshwater availability and water fetching distance affect child health in sub-Saharan Africa’, Environmental Science & Technology 46(4): 2391–7 <http://dx.doi.org/10.1021/es203177v≯.
Potgieter, N., Barnard, T.G., Brown, J. and Sobsey, M.D. (2011) Impact of a Ceramic Pot Pointof- Use Water Treatment Device on Rural People Living with HIV and AIDS, WRC Report 1653/1/11, Johannesburg, South Africa: South African Water Research Commission.
Thea, D.M., St Louis, M.E., Atido, U., Kanjinga, K., Kembo, B., Matondo, M., Tshiamala, T., Kamenga, C., Davachi, F. and Brown, C. (1993) ‘A prospective study of diarrhea and HIV-1 infection among 429 Zairian infants’, The New England Journal of Medicine 329(23): 1696–1702.
UNAIDS (2011) ‘World Overview’ [website], <www.unaids.org/en/dataanalysis/datatools/aidsinfo/≯ [accessed 10 November 2013]. www.unaids.org/en/dataanalysis/datatools/aidsinfo/
USAID/WHO (2010) How to Integrate Water, Sanitation and Hygiene into HIV Programmes [pdf] <http://whqlibdoc.who.int/publications/2010/9789241548014_eng.pdf≯ [accessed 10 November 2013]. http://whqlibdoc.who.int/publications/2010/9789241548014_eng.pdf
Walson, J.L., Sangaré, L.R., Singa, B.O., Naulikha, J.M., Piper, B.K.S., Yuhas, K., Onchiri, F.M., Otieno, P.A., Mermin, J., Zeh, C., Richardson, B.A. and John-Stewart, G. (2013) ‘Evaluation of impact of long-lasting insecticide-treated bed nets and point-of-use water filters on HIV-1 disease progression in Kenya’, AIDS 27(9): 1493–501 <http://dx.doi.org/10.1097/QAD.0b013e32835ecba9≯.
Wang, X. and Hunter, P. (2010) ‘A systematic review and meta-analysis of the association between self-reported diarrheal disease and distance from home to water source’, The American Journal of Tropical Medicine and Hygiene 83(3): 582 <http://dx.doi.org/10.4269/ajtmh.2010.10-0215≯.
Abebe, L.S., Smith, J.A., Narkiewicz, S., Oyandedel-Craver, V., Conaway, M., Singo, A., Amidou, S., Mojapelo, P., Brant, J. and Dillingham, R. (2013) ‘Ceramic water filters impregnated with silver nanoparticles as a point-of-use water-treatment intervention for HIV-positive individuals in Limpopo province, South Africa: a pilot study of technological performance and human health benefits’, Journal of Water and Health (in press) <http://dx.doi.org/10.2166/wh.2013.185≯.
Abraham, C. and Michie, S. (2008) ‘A taxonomy of behavior change techniques used in interventions’, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 27(3): 379–87
Abraham, C. and Michie, S. (2008) ‘A taxonomy of behavior change techniques used in interventions’, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 27(3): 379–87 <http://dx.doi.org/10.1037/0278-6133.27.3.379≯.
Barzilay, E.J., Aghoghovbia, T.S., Blanton, E.M., Akinpelumi, A.A., Coldiron, M.E., Akinfolayan, O. and Quick, R. (2011) ‘Diarrhea prevention in people living with HIV: an evaluation of a point-of-use water quality intervention in Lagos, Nigeria’, AIDS Care 23(3): 330–39 <http://dx.doi.org/10.1080/09540121.2010.507749≯.
Beyene, H. and Hailu, D. (2013) ‘Assessment of knowledge, attitude and practice regarding water, sanitation and hygiene for people living with HIV/AIDS’, Journal of Water, Sanitation and Hygiene for Development 3(1): 81–5 <http://dx.doi.org/10.2166/washdev.2013.022≯.
Bushen, O.Y., Davenport, J.A., Lima, A.B., Piscitelli, S.C., Uzgiris, A.J., Silva, T.M., Leite, R., Kosek, M., Dillingham, R.A., Girao, A., Lima, A.A. and Guerrant, R.L. (2004) ‘Diarrhea and reduced levels of antiretroviral drugs: improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil’, Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 38(12): 1764–70 <http://dx.doi.org/10.1086/421394≯.
Colford Jr, J.M., Saha, S.R., Wade, T.J., Wright, C.C., Vu, M., Charles, S., Jensen, P., Hubbard, A., Levy, D.A. and Eisenberg, J.N. (2005) ‘A pilot randomized, controlled trial of an in-home drinking water intervention among HIV + persons,’ Journal of Water and Health 3(2): 173–84.
Curtis, V. and Cairncross, S. (2003) ‘Effect of washing hands with soap on diarrhoea risk in the community: a systematic review’, The Lancet Infectious Diseases 3: 275–81 <http://dx.doi.org/10.1016/S1473-3099(03)00606-6≯.
Fewtrell, L., Kaufmann, R.B., Kay, D., Enanoria, W., Haller, L. and Colford, J.M. (2005) ‘Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’, The Lancet Infectious Diseases 5: 42–52 <http://dx.doi.org/10.1016/S1473-3099(04)01253-8≯.
Harris, J.R., Greene, S.K., Thomas, T.K., Ndivo, R., Okanda, J., Masaba, R., Nyangau, I., Thigpen, M.C., Hoekstra, R.M. and Quick, R.E. (2009) ‘Effect of a point-of-use water treatment and safe water storage intervention on diarrhea in infants of HIV-infected mothers’, The Journal of Infectious Diseases 200(8): 1186–93 <http://dx.doi.org/10.1086/605841≯.
Huang, D.B. and Zhou, J. (2007) ‘Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study’, Journal of Medical Microbiology 56(5): 659–63 <http://dx.doi.org/10.1099/jmm.0.46867-0≯.
Kamminga, E. and Wegelin-Schuringa, M. (2003) HIV/AIDS and Water, Sanitation and Hygiene. Thematic Overview Paper, Delft, the Netherlands: IRC International Water and Sanitation Centre.
Lule, J.R., Mermin, J., Ekwaru, J.P., Malamba, S., Downing, R., Ransom, R., Nakanjako, D., Wafula, W., Hughes, P., Bunnell, R., Kaharuza, F., Coutinho, A., Kigozi, A. and Quick, R. (2005) ‘Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda’, The American Journal of Tropical Medicine and Hygiene 73(5): 926–33.
Meier, A.S., Bukusi, E.A., Cohen, C.R. and Holmes, K.K. (2006) ‘Independent association of hygiene, socioeconomic status, and circumcision with reduced risk of HIV infection among Kenyan men’, Journal of Acquired Immune Deficiency Syndromes (1999) 43(1): 117–8 <http://dx.doi.org/10.1097/01.qai.0000224973.60339.35≯.
Peletz, R.L., Mahin, T., Elliot, M., Harris, M.S., Chan, K.S., Cohen, M.S. and Clasen, T.F. (2013) ‘Water, sanitation, and hygiene interventions to improve health among people living with HIV/ AIDS: a systematic review’, AIDS Care <http://dx.doi.org/10.1097/QAD.0b013e3283633a5f≯.
Pickering, A.J. and Davis, J. (2012) ‘Freshwater availability and water fetching distance affect child health in sub-Saharan Africa’, Environmental Science & Technology 46(4): 2391–7 <http://dx.doi.org/10.1021/es203177v≯.
Potgieter, N., Barnard, T.G., Brown, J. and Sobsey, M.D. (2011) Impact of a Ceramic Pot Pointof- Use Water Treatment Device on Rural People Living with HIV and AIDS, WRC Report 1653/1/11, Johannesburg, South Africa: South African Water Research Commission.
Thea, D.M., St Louis, M.E., Atido, U., Kanjinga, K., Kembo, B., Matondo, M., Tshiamala, T., Kamenga, C., Davachi, F. and Brown, C. (1993) ‘A prospective study of diarrhea and HIV-1 infection among 429 Zairian infants’, The New England Journal of Medicine 329(23): 1696–1702.
UNAIDS (2011) ‘World Overview’ [website], <www.unaids.org/en/dataanalysis/datatools/aidsinfo/≯ [accessed 10 November 2013]. www.unaids.org/en/dataanalysis/datatools/aidsinfo/
USAID/WHO (2010) How to Integrate Water, Sanitation and Hygiene into HIV Programmes [pdf] <http://whqlibdoc.who.int/publications/2010/9789241548014_eng.pdf≯ [accessed 10 November 2013]. http://whqlibdoc.who.int/publications/2010/9789241548014_eng.pdf
Walson, J.L., Sangaré, L.R., Singa, B.O., Naulikha, J.M., Piper, B.K.S., Yuhas, K., Onchiri, F.M., Otieno, P.A., Mermin, J., Zeh, C., Richardson, B.A. and John-Stewart, G. (2013) ‘Evaluation of impact of long-lasting insecticide-treated bed nets and point-of-use water filters on HIV-1 disease progression in Kenya’, AIDS 27(9): 1493–501 <http://dx.doi.org/10.1097/QAD.0b013e32835ecba9≯.
Wang, X. and Hunter, P. (2010) ‘A systematic review and meta-analysis of the association between self-reported diarrheal disease and distance from home to water source’, The American Journal of Tropical Medicine and Hygiene 83(3): 582 <http://dx.doi.org/10.4269/ajtmh.2010.10-0215≯.
Abebe, L.S., Smith, J.A., Narkiewicz, S., Oyandedel-Craver, V., Conaway, M., Singo, A., Amidou, S., Mojapelo, P., Brant, J. and Dillingham, R. (2013) ‘Ceramic water filters impregnated with silver nanoparticles as a point-of-use water-treatment intervention for HIV-positive individuals in Limpopo province, South Africa: a pilot study of technological performance and human health benefits’, Journal of Water and Health (in press) <http://dx.doi.org/10.2166/wh.2013.185≯.
Abraham, C. and Michie, S. (2008) ‘A taxonomy of behavior change techniques used in interventions’, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 27(3): 379–87
Abraham, C. and Michie, S. (2008) ‘A taxonomy of behavior change techniques used in interventions’, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association 27(3): 379–87 <http://dx.doi.org/10.1037/0278-6133.27.3.379≯.
Barzilay, E.J., Aghoghovbia, T.S., Blanton, E.M., Akinpelumi, A.A., Coldiron, M.E., Akinfolayan, O. and Quick, R. (2011) ‘Diarrhea prevention in people living with HIV: an evaluation of a point-of-use water quality intervention in Lagos, Nigeria’, AIDS Care 23(3): 330–39 <http://dx.doi.org/10.1080/09540121.2010.507749≯.
Beyene, H. and Hailu, D. (2013) ‘Assessment of knowledge, attitude and practice regarding water, sanitation and hygiene for people living with HIV/AIDS’, Journal of Water, Sanitation and Hygiene for Development 3(1): 81–5 <http://dx.doi.org/10.2166/washdev.2013.022≯.
Bushen, O.Y., Davenport, J.A., Lima, A.B., Piscitelli, S.C., Uzgiris, A.J., Silva, T.M., Leite, R., Kosek, M., Dillingham, R.A., Girao, A., Lima, A.A. and Guerrant, R.L. (2004) ‘Diarrhea and reduced levels of antiretroviral drugs: improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil’, Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 38(12): 1764–70 <http://dx.doi.org/10.1086/421394≯.
Colford Jr, J.M., Saha, S.R., Wade, T.J., Wright, C.C., Vu, M., Charles, S., Jensen, P., Hubbard, A., Levy, D.A. and Eisenberg, J.N. (2005) ‘A pilot randomized, controlled trial of an in-home drinking water intervention among HIV + persons,’ Journal of Water and Health 3(2): 173–84.
Curtis, V. and Cairncross, S. (2003) ‘Effect of washing hands with soap on diarrhoea risk in the community: a systematic review’, The Lancet Infectious Diseases 3: 275–81 <http://dx.doi.org/10.1016/S1473-3099(03)00606-6≯.
Fewtrell, L., Kaufmann, R.B., Kay, D., Enanoria, W., Haller, L. and Colford, J.M. (2005) ‘Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis’, The Lancet Infectious Diseases 5: 42–52 <http://dx.doi.org/10.1016/S1473-3099(04)01253-8≯.
Harris, J.R., Greene, S.K., Thomas, T.K., Ndivo, R., Okanda, J., Masaba, R., Nyangau, I., Thigpen, M.C., Hoekstra, R.M. and Quick, R.E. (2009) ‘Effect of a point-of-use water treatment and safe water storage intervention on diarrhea in infants of HIV-infected mothers’, The Journal of Infectious Diseases 200(8): 1186–93 <http://dx.doi.org/10.1086/605841≯.
Huang, D.B. and Zhou, J. (2007) ‘Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study’, Journal of Medical Microbiology 56(5): 659–63 <http://dx.doi.org/10.1099/jmm.0.46867-0≯.
Kamminga, E. and Wegelin-Schuringa, M. (2003) HIV/AIDS and Water, Sanitation and Hygiene. Thematic Overview Paper, Delft, the Netherlands: IRC International Water and Sanitation Centre.
Lule, J.R., Mermin, J., Ekwaru, J.P., Malamba, S., Downing, R., Ransom, R., Nakanjako, D., Wafula, W., Hughes, P., Bunnell, R., Kaharuza, F., Coutinho, A., Kigozi, A. and Quick, R. (2005) ‘Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda’, The American Journal of Tropical Medicine and Hygiene 73(5): 926–33.
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