944 results
Search Results
2. Engagement and partnership with peer mentors in the development of the "Positive and Healthy Living Program": a process paper.
- Author
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Wambua, Grace Nduku, Musindo, Otsetswe, Machuka, Judy, and Kumar, Manasi
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EXPERIENCE , *HIV infections , *PSYCHOLOGY of HIV-positive persons , *INTERPROFESSIONAL relations , *MEDICAL referrals , *MENTORING , *PSYCHOTHERAPY , *SELF-efficacy , *EVIDENCE-based medicine , *AFFINITY groups , *PEERS , *HUMAN services programs , *STAKEHOLDER analysis - Abstract
Partnership and engagement are mediators of change in the efficient uptake of evidence-based patient-centered health interventions. We reflect on our process of engagement and preparation of peer mentors in the development of peer-led psychotherapy intervention for HIV infected adolescents in active care at the Comprehensive Care Centre (CCC) at Kenyatta National Hospital. The program was implemented in two phases, using a Consultation, Involve, Collaboration and Empowerment approach as stepping stones to guide our partnership and engagement process with stakeholders and ten peer mentors embedded in the CCC. Our partnership process promoted equity, power-and-resource sharing including making the peer mentors in-charge of the process and being led by them in manual development. This process of partnership and engagement demonstrated that engaging key stakeholders in projects lead to successful development, implementation, dissemination and sustainment of evidence-based interventions. Feedback and insights bridged the academic and clinical worlds of our research by helping us understand clinical, family, and real-life experiences of persons living with HIV that are often not visible in a research process. Our findings can be used to understand and design mentorship programs targeting lay health workers and peer mentors at community health care levels. [ABSTRACT FROM AUTHOR] more...
- Published
- 2019
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3. Prioritizing recruitment: the benefits to using a disease registry to recruit older adults with HIV and intersecting identities.
- Author
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Weinstein, Elliott R. and Jimenez, Daniel E.
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REPORTING of diseases ,DATABASES ,HUMAN research subjects ,MINORITIES ,PATIENT selection ,HISPANIC Americans ,RACE ,INFORMED consent (Medical law) ,HUMAN services programs ,HIV ,HEALTH promotion - Abstract
The success of a study hinges on its recruitment procedures, however there is a paucity of papers focused on innovative recruitment strategies, especially as it relates to the recruitment and retention of marginalized populations. This paper aims to outline how consent-to-contact databases can be used as an effective tool for recruitment. First, we begin by describing the consent-to-contact databases we used. Then, we offer insight into how a consent-to-contact database was utilized to recruit Latino older adults with HIV participants for an interdisciplinary behavioral and physical health promotion intervention. We outline barriers and challenges to recruitment and research participation with a specific emphasis on the unique hurdles associated with recruiting and retaining racial/ethnic minority older adults with HIV in behavioral health studies. Finally, we provide final recommendations for future researchers interested in how to best employ this type of recruitment tool in their own research. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
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4. Development and evaluation of a web-based assent for adolescents considering an HIV vaccine trial.
- Author
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Blake, Diane R., Lemay, Celeste A., Maranda, Louise S., Fortenberry, J. Dennis, Kearney, Margaret H., and Mazor, Kathleen M.
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HIV prevention ,CHI-squared test ,INFORMED consent (Medical law) ,MEDICAL research ,PSYCHOLOGICAL tests ,QUESTIONNAIRES ,REGRESSION analysis ,RESEARCH funding ,T-test (Statistics) ,VIRAL vaccines ,WORLD Wide Web ,RANDOMIZED controlled trials ,HEALTH literacy ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
HIV vaccine trials with minors will likely require parental permission and informed assent from adolescents. For this to be a valid process, the information needs to be presented in a manner that promotes adolescent comprehension. Previous studies suggest that adolescent comprehension of assent is often insufficient. We developed an interactive web-based assent that included interspersed quiz questions for a hypothetical HIV vaccine trial. Efficacy of the web-based assent was compared to a standard paper assent with and without interspersed questions. One hundred twenty teen participants, ages 15–17 years, from five community organizations were randomized to self-administered web-based assent (n= 60) or investigator-administered paper assent with (n= 29) or without (n= 31) interspersed quiz questions. After reviewing the assent, participants completed a 27-item comprehension test. Comprehension scores were compared between groups. The mean number of correctly answered questions were 21.2 for the full paper group and 21.1 for the web-based group (t118= –0.08,p= 0.94). Scores were 20.2 for the paper without interspersed questions sub-group and 22.1 for the paper with interspersed questions sub-group (t58= 1.96,p= 0.055). Participants in the web-based group performed as well on the comprehension test as those in the paper group, and those in the paper with questions sub-group performed better than those in the paper without questions sub-group, suggesting that interspersed quiz questions may improve understanding of a traditional paper assent. The minimal investigator time and standardized administration of the web-based assent as well as ability to tailor the assent discussion to topics identified by incorrect comprehension test responses are advantages worthy of further investigation. [ABSTRACT FROM AUTHOR] more...
- Published
- 2015
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5. "We did more than survive": lessons learned from studies of risk and resilience of young people growing up with HIV and mental health needs.
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Poku, Ohemaa B., Ahmed, Afifa, Liotta, Lucy, Kluisza, Luke, Robbins, Reuben N., Abrams, Elaine J., and Mellins, Claude A.
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MENTAL illness risk factors , *PSYCHOLOGICAL resilience , *HEALTH services accessibility , *LIFE change events , *MENTAL health , *MENTAL health services , *RESEARCH funding , *SOCIOECONOMIC factors , *HIV infections , *DESCRIPTIVE statistics , *PSYCHOLOGICAL adaptation , *PSYCHOLOGY of HIV-positive persons , *MEDICAL needs assessment , *RESOURCE-limited settings , *SOCIAL support , *COMPARATIVE studies , *SOCIODEMOGRAPHIC factors , *POVERTY , *PATIENTS' attitudes , *SOCIAL stigma , *ADOLESCENCE , *ADULTS - Abstract
Despite advances in HIV-treatment, adolescents and young adults (AYA) with HIV (AYAHIV) face myriad challenges. They are less likely than children and older adults to be virally suppressed and are at higher risk for mental health conditions compared to their peers who do not have HIV. AYA are also developing in the context of numerous biomedical, neurocognitive, and psychosocial developmental changes. Normative challenges during this time can be exacerbated by HIV and can result in significant physical and mental health problems. Yet, many AYAHIV have shown resilience with positive assets and resources and few health or mental health problems. Historically research has had a risk-focused approach to understanding AYAHIV needs. This paper discusses the rationale for a shift from a risk-focused only approach to one that examines AYAHIV needs from both a risk and resilience perspective. This paper presents: (1) epidemiological data on AYAHIV; (2) conceptual models for understanding both risk (e.g., poverty, stress, trauma, limited resources) and resilience/protective factors (e.g., family and peer support, future orientation, problem-solving skills); (3) global data examining risk and protective factors for physical and mental health challenges; and (4) promising interventions that incorporate elements of resilience to improve overall outcomes among AYAHIV. [ABSTRACT FROM AUTHOR] more...
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- 2024
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6. The path towards an HIV-free generation: engaging adolescent boys and young men (ABYM) in sub-Saharan Africa from lessons learned and future directions.
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Makusha, Tawanda and Gittings, Lesley
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HIV prevention , *HEALTH services accessibility , *AIDS education , *MEDICAL technology , *SEX education , *SOCIAL norms , *PSYCHOLOGY of HIV-positive persons , *PRE-exposure prophylaxis , *MEN'S health , *PSYCHOLOGICAL vulnerability , *ADOLESCENCE , *ADULTS - Abstract
This paper highlights the pressing need to address the HIV epidemic among adolescent boys and young men (ABYM) in sub-Saharan Africa. Despite progress in HIV prevention, ABYM still experience low diagnosis rates, treatment adherence, and linkage to care. The paper emphasizes ABYM's vulnerability due to societal norms, limited healthcare access, and economic pressures. It calls for gender-responsive interventions, including comprehensive sexual education, youth-friendly health services, community engagement, and targeted outreach. Comprehensive sexual education is pivotal in HIV prevention for ABYM, providing them with age-appropriate sexual health knowledge and safer sexual practices to reduce HIV incidence. Harmful masculine norms must be countered to promote respectful relationships, benefiting boys, men, and their partners. Inadequate access to youth-friendly health services hampers HIV prevention. Establishing spaces with confidential, non-judgmental care offering testing, counselling, circumcision, and provision of pre-exposure prophylaxis (PrEP) is essential, especially considering ABYM's unique clinic experiences. Engaging communities, leaders, educators, and peers combats stigma and discrimination. ABYM's input in intervention design, targeted outreach, and innovative technology enhances effectiveness of HIV prevention programmes. Economic factors should also be addressed. Comprehensive multi-sectoral interventions, including conditional cash transfers, effective for AGYW, could benefit ABYM. Addressing structural factors alongside behaviour change and social support is key. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
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7. Intersectional stigma among Latino MSM and HIV prevention: barriers to HIV prevention and strategies to overcome the barriers.
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Zhu, Helen, Stadnick, Nicole A., Stockman, Jamila K., Katague, Marina, Moore, Veronica, Torres, Vicente, Cano, Rosalinda, Penninga, Katherine, Aldous, Jeannette, and Tsuyuki, Kiyomi
- Abstract
Latino men, especially Latino men who have sex with men (LMSM), experience disparities in HIV prevention. Lack of attention to key barriers to care, such as stigma, result in inequitable access to HIV prevention and care for LMSM. This paper describes how intersectional stigma and related factors act as barriers to HIV prevention among Latino men and proposes strategies to overcome these barriers. Qualitative data were collected via in-depth interviews (n = 15) with Latino men about HIV prevention services, mobile outreach, peer navigation and care coordination, and analyzed using rapid qualitative methods. Three key themes emerged: (1) HIV stigma as a barrier to HIV testing, (2) sexual minority stigma as a barrier to accessing HIV prevention services and (3) strategies for stigma reduction, such as confidentiality, comprehensive education about HIV and prevention, and empathy and warmth from staff/care providers. Identified stigmas were intersectional. Addressing and reducing stigma is critical to engaging Latino men in HIV prevention and care, and requires strategies sensitive to the Latino cultural context and community. [ABSTRACT FROM AUTHOR] more...
- Published
- 2025
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8. HIV status disclosure in the era of treat-all: the complexities of societal expectations and disclosure in marital relationships in Shinyanga, Tanzania.
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Erio, Tusajigwe, de Klerk, Josien, and Moyer, Eileen
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HIV infection transmission , *PREVENTION of infectious disease transmission , *HIV prevention , *MARRIAGE , *SOCIAL psychology , *ANTIRETROVIRAL agents , *RESEARCH funding , *SEX distribution , *ETHNOLOGY research , *INTERVIEWING , *DESCRIPTIVE statistics , *HIV infections , *PSYCHOLOGY of women , *PSYCHOLOGY of HIV-positive persons , *SOCIAL values , *SELF-disclosure - Abstract
Robust advancements in clinical treatment of people living with HIV (PLHIV) have resulted in the current "treatment as prevention" strategy: the inability to transmit the virus when it is undetectable. Nevertheless, disclosure within marital relationships remains important to adhere optimally to treatment and further limit transmission in the era of treat-all. Disclosure, however, can have serious social repercussions, particularly for women. This paper examines gendered disclosure decisions and their social consequences in marital relationships in Tanzania. Drawing from a 9-month ethnographic study in Shinyanga Region, we explore how Sukuma societal values shape disclosure decisions. In-depth interviews with 103 PLHIV and 19 FGDs inform our analysis. We found that societal values regarding gender and marriage significantly influence disclosure decisions in marital relationships. The HIV treat-all approach, with its focus on early treatment initiation preserved health and inability to transmit allowed men and women to carefully weigh the costs and benefits of disclosure to their marital aspirations. The benefits of antiretroviral treatment for social relations are often overlooked in medical interventions. We conclude that to reduce difficult disclosure decisions for PLHIV, emphasising community awareness of HIV treatment as prevention to mitigate the negative impacts of disclosure is needed. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
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9. Examining HIV pre-exposure prophylaxis (PrEP) acceptability among rural people who inject drugs: predictors of PrEP interest among syringe service program clients.
- Author
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Surratt, Hilary L., Brown, Sarah, Burton, Abby L., Cranford, Will, Green, Christie, Mersch, Stephanie M., Rains, Rebecca, and Westgate, Philip M.
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HIV prevention , *NEEDLE exchange programs , *RESEARCH funding , *SOCIAL determinants of health , *INTERVIEWING , *DESCRIPTIVE statistics , *PRE-exposure prophylaxis , *RURAL conditions , *RESEARCH methodology , *PATIENTS' attitudes , *INTRAVENOUS drug abusers , *PSYCHOSOCIAL factors , *COMMUNITY-based social services , *SOCIAL stigma - Abstract
Rural communities in the US have increasing HIV burden tied to injection drug use, yet engagement in pre-exposure prophylaxis (PrEP) care has been low among people who inject drugs (PWID). Syringe service programs (SSPs) are widely implemented in Kentucky's Appalachian region, presenting an important opportunity to scale PrEP services. This paper examines PrEP awareness, interest and preferences among PWID attending community-based SSPs in Appalachia. Eighty participants were enrolled from two SSP locations. Eligibility included: ≥ 18 years old, current injection drug use and SSP use, and an indication for PrEP as defined by CDC guidelines. Participants completed a structured baseline interview. Predictors of PrEP awareness, interest and formulation preferences were examined. 38.8% reported baseline awareness of PrEP, 50% expressed high interest in PrEP, and 48.1%reported a preference for injectable PrEP. Significant bivariate predictors of PrEP interest included: current worry about health, higher perceived HIV risk, higher community HIV stigma, and higher enacted substance use stigma in the past year; in the adjusted model, enacted substance use stigma remained significant. Findings demonstrate substantial interest in PrEP among rural PWID. Intrapersonal and social determinant factors were associated with PrEP interest, which suggests the importance of multi-level intervention targets to increase PrEP uptake. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
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10. Childhood sexual trauma and opioid use among older adults living with HIV.
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Brown, Monique J., Sunkara, Sravya, Kaur, Amandeep, Addo, Prince Nii Ossah, Amoatika, Daniel, and Crouch, Elizabeth
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SUBSTANCE abuse risk factors , *SUBSTANCE abuse , *RISK assessment , *SELF-evaluation , *RESEARCH funding , *PSYCHOLOGY of adult child abuse victims , *MULTIPLE regression analysis , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *CHILD sexual abuse , *PSYCHOLOGY of HIV-positive persons , *NARCOTICS , *COMPARATIVE studies , *CONFIDENCE intervals , *SOCIODEMOGRAPHIC factors , *SEXUAL trauma , *OLD age - Abstract
Childhood sexual abuse (CSA) has been linked to substance use and substance use disorders in adulthood. However, there have been limited studies examining the relationship between CSA and opioid use among older adults living with HIV (OALH). Therefore, the aim of this study was to determine the association between CSA and opioid use among OALH (n = 91). Data were obtained from an HIV clinic population in South Carolina using paper-and-pen, and online questionnaires. CSA was operationalized using six questions from the Early Trauma Inventory-Self Report Form (Yes vs. No). Opioid use was self-report of the use of opioids including: heroin, fentanyl, Oxycontin, Vicodin, codeine, morphine (used vs. never used). Nested crude and multivariable logistic regression models adjusting for sociodemographic confounders were used to determine the association between CSA and opioid use. After adjusting for race, gender, age, and education, OALH who were CSA survivors were 21 times more likely to currently use opioids compared to OALH who were not exposed to CSA (adjusted OR: 21.1; 95% CI: 1.78–250.0). The association seen between CSA history and opioid use may be due to unresolved trauma among OALH. Trauma-informed interventions addressing CSA may help to reduce opioid use among OALH. [ABSTRACT FROM AUTHOR] more...
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- 2024
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11. Anxiety about HIV criminalisation among people living with HIV in Australia.
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Bourne, Adam, Melendez-Torres, G. J., Thanh Ly, An, Kidd, Paul, Cogle, Aaron, Brown, Graham, Lyons, Anthony, Carman, Marina, Rulee, John, and Power, Jennifer
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WELL-being ,SELF advocacy ,CROSS-sectional method ,CRIME ,MENTAL health ,INFECTIOUS disease transmission ,ANXIETY ,PSYCHOLOGY of HIV-positive persons ,PSYCHOLOGICAL resilience ,GAY people - Abstract
Many countries, including Australia, have laws that enable criminal prosecution of an individual based on reckless or intentional transmission of HIV to another person. Previous research has suggested that criminalisation of HIV may serve to hamper public health efforts by inhibiting HIV status disclosure or testing. Limited research to date has sought to examine the broader impact of criminalisation on the health and wellbeing of people living with HIV, which this paper aims to address. Drawing on cross-sectional data from 895 people living with HIV in Australia, this paper describes associations between standard measures of mental health and resilience with a newly devised scale measuring anxiety about HIV criminalisation. Findings suggest that laws criminalising HIV transmission have a broadly negative impact on wellbeing of people living with HIV, a situation that is exacerbated for gay and bisexual men, and other people living with HIV who may face intersecting forms of marginalisation based on race, gender or class. There is little justification for these laws being applied in Australia and the findings add weight to advocacy seeking to overturn criminalisation across the world. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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12. A global analysis of literature on older adults and lifelong living with HIV.
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Hoang, Chi Linh, Pham, Hai Quang, Phan, Hai Thanh, Tran, Bach Xuan, Latkin, Carl A., Ho, Cyrus S.H., and Ho, Roger C.M.
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GERIATRICS ,BIBLIOMETRICS ,QUANTITATIVE research ,ANTIRETROVIRAL agents ,QUALITATIVE research ,HARM reduction ,QUALITY of life ,DATA analysis software ,SOCIAL skills ,PSYCHOLOGY of HIV-positive persons ,OLD age - Abstract
With the growing number of older people living with HIV, "What is the most effective geriatric care and the research trend of existing literature?" is a compelling question after 30 years since the first paper related to aging and HIV/AIDS published. Our study aims to apply quantitative and qualitative analysis to explore the knowledge gaps and describes the research interest of gerontology research in the field of HIV. A bibliometric analysis was conducted based on the databased of the Web of Science from 1991 to 2019. The major domains of research areas were visualized by using VOSviewer software. Latent Dirichlet Allocation (LDA) was applied to classify the dataset into topics. There was a rising number of publications about this topic over time. Our findings indicated that antiretroviral treatment and evaluating quality of life and harm reduction were the major domains regarding care for OPLWH. In addition, the finding highlights the role of social competence in treatment outcomes. Further research needs to tailor multi-disciplinary programs and flexible interventions to reduce the burden and the mortality rate of HIV/AIDS. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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13. Networking community health workers for service integration: role of social media.
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Li, Li, Lin, Chunqing, Pham, Loc Quang, Nguyen, Diep Bich, and Le, Tuan Anh
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HIV infections ,PATIENT aftercare ,CONFIDENCE ,SOCIAL media ,JOB involvement ,BUSINESS networks ,HEALTH ,INFORMATION resources ,MEDICAL referrals ,INTERPROFESSIONAL relations ,JOB satisfaction ,DESCRIPTIVE statistics ,COMMUNICATION ,RESEARCH funding ,INTEGRATED health care delivery ,PATIENT-professional relations ,GROUP process - Abstract
Community health workers (CHW) can play an active role in providing integrated HIV and harm reduction services. We used social media to create a virtual network among Vietnamese CHW. This paper reports CHW's social media engagement and the relationships with other work-related indicators. Sixty CHW participated in an intervention for integrated HIV/drug use service delivery. Following two in-person sessions, Facebook groups were established for CHW to share information, seek consultation, and refer patients. CHW's levels of online engagements were tracked for six months and linked to their service provision confidence, interaction with patients and other providers, and job satisfaction. The CHW made 181 posts, which received 557 comments and 1,607 reactions during the six months. Among the 60 CHW, 22 (36.6%) had three or more posts, 19 (31.7%) had one or two posts, and 19 (31.7%) had no post. Comparing the baseline and 6-month follow-up data, we observed that those who posted three or more times showed better service provision confidence (p = 0.0081), more interaction with providers in other settings (p = 0.0071), and higher job satisfaction (p = 0.0268). Our study suggests using social media to engage CHW in virtual communications to improve service provision in communities. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
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14. A poetic inquiry: the role of the social sciences and humanities in revitalising AIDS.
- Author
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van Rooyen, Heidi
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AIDS prevention , *HIV prevention , *SOCIAL sciences , *HOLISTIC medicine , *POETRY (Literary form) , *HUMANITIES - Abstract
For the past four decades, biomedical science has transformed clinical outcomes for HIV and AIDS. However, the social, economic and gendered determinants of HIV remain largely intact. The social science and humanities offer concepts and methods for articulating why these remain intractable. I used poetic inquiry – an arts-based, qualitative approach – as I reviewed literature on the "end of AIDS, and post-AIDS". As I did so, I considered what contribution the social sciences and humanities could make in moving us closer to these ideals. Several themes and found poems emerged in this reading: (1) how language oversimplifies complex social realities; (2) the voices of people living with HIV and AIDS must be included; (3) HIV and AIDS intersects with social inequalities; (4) social and structural issues are no barrier to HIV prevention and (5) the need for radical interdisciplinarity. The paper concludes that the end of AIDS requires responses that are integrated, holistic and that radically challenge our silo'd disciplinary boundaries and frames. The social sciences and humanities are key to this charge. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
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15. Perspectives of healthcare professionals and people living with HIV in dialogue: on information sharing to improve communication at the consultation.
- Author
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Claisse, Caroline, Kasadha, Bakita, and Durrant, Abigail C.
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SELF-evaluation , *HOLISTIC medicine , *DATA security , *RESEARCH funding , *QUALITATIVE research , *HEALTH , *QUESTIONNAIRES , *PRIVACY , *INFORMATION resources , *HIV infections , *JUDGMENT sampling , *CONFIDENCE , *CONTINUUM of care , *PSYCHOLOGY of HIV-positive persons , *THEMATIC analysis , *ATTITUDES of medical personnel , *PATIENT-professional relations , *COMMUNICATION , *TRUST , *EMBARRASSMENT , *DELPHI method , *PATIENTS' attitudes , *MEDICAL referrals , *SELF-perception , *SOCIAL stigma , *MEDICAL ethics - Abstract
We report on a qualitative Group Survey study involving four healthcare professionals (HCPs) and eight people living with HIV who were recipients of care in the United Kingdom (UK). The survey aimed to bring participants' perspectives into dialogue and establish consensus about how communication between HCPs delivering HIV care and their patients could be improved in the context of the routine care consultation. Responses from both parties were anonymously collated, thematically analysed, and shared back with participants in two subsequent survey rounds to support consensus-building on matters of concern and identify thematic insights. In this paper, we report three themes for informing future designs of tools and services to support communication between patients and HCPs: Patient-clinician relationship for trusted sharing; Self-reporting psychosocial information to support Whole-person care; and Perceived barriers for online trusted sharing with HCPs. Our findings highlight key areas of concern and further investigation is needed to understand how self-reported information may be meaningfully captured, interpreted and processed by HCPs in ways that are trusted by patients who voice privacy and security concerns. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
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16. "Food engages people, as we know": health care and service providers' experiences of using food as an incentive in HIV care and support in British Columbia, Canada.
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Gagnon, Marilou, Payne, Alayna, Guta, Adrian, and Bungay, Vicky
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HIV-positive persons ,HEALTH services accessibility ,SOCIAL support ,FOOD security ,ATTITUDES of medical personnel ,MOTIVATION (Psychology) ,RESEARCH methodology ,FOOD consumption ,INTERVIEWING ,MEDICAL screening ,QUALITATIVE research ,CASE studies ,DESCRIPTIVE statistics ,RESEARCH funding ,THEMATIC analysis - Abstract
Food insecurity is widely documented among people living with HIV (PLWH) worldwide, and it presents significant challenges across the spectrum of HIV care and support. In North America, the prevalence of food insecurity among PLWH exceeds 50%. In the province of British Columbia (BC), it exceeds 65%. It comes as no surprise that food has become an essential tool in supporting and engaging with PLWH. Over the past decade, however, a shift has taken place, and food has become an incentive to boost uptake and outcomes of prevention, testing, treatment, and support. To explore this practice, we drew on a qualitative case study of incentives in the care and support of PLWH. This paper presents the findings of a targeted analysis of interviews (N = 25) that discuss food incentives and explores two main themes that shed light on this practice: (1) Using food to engage versus to incentivize and (2) Food is more beneficial and more ethical. Providers perceived food more positively than other incentives, despite the goal remaining somewhat the same. Incentives, such as cash or gift cards, were considered ethically problematic and less helpful (and potentially harmful), whereas food addressed a basic need and felt more ethical. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
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17. Country level homophobia and protective sexual health behaviours among HIV negative or untested men who have sex with men in 45 countries.
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Melendez-Torres, G.J., Noori, Teymur, Pharris, Anastasia, Spiteri, Gianfranco, Garner, Alex, Alba, Beatrice, and Bourne, Adam
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HEALTH behavior ,HOMOPHOBIA ,SEXUAL health ,PREVENTIVE medicine ,POPULATION geography ,SURVEYS ,PILOT projects ,MEN who have sex with men ,DESCRIPTIVE statistics ,AIDS serodiagnosis - Abstract
Despite new, effective biomedical technologies to prevent the transmission of HIV, social and structural factors still impact the opportunity for gay, bisexual and other men who have sex with men (GBMSM) to access safe sexual health services. Within this paper we describe findings of a pilot analysis that seeks to identify relationships between country level homophobia, individual-level sexualised drug use and key sexual health protective behaviours in a sample of HIV negative men from 45 countries recruited via a large online survey. Responses to questions relating to HIV and STI testing history, use of pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP) and engagement in sexualised drug use were treated as dependent variables within generalised linear mixed-effects model with logit link analysis, with country level homophobia (drawn from a recently published international index) operating as the dependent variable. In total, data from 9,356 respondents were included for analysis. Overall, uptake of behaviours known to be protective of sexual health overall was significantly lower in countries with high levels of homophobia. This paper is unique in linking a robust measure of country-level homophobia to engagement in health protective behaviours on a large-scale, multi-country level basis. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
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18. AIDSImpact 2019 special issue – Promises to keep and miles to go ...
- Author
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Sherr, Lorraine, Harding, Richard, Davidovich, Udi, Cluver, Lucie, Spire, Bruno, Prince, Bridgette, Hedge, Barbara, and Catalan, Jose
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AIDS ,CONFERENCES & conventions ,PREVENTIVE medicine ,SOCIAL stigma - Abstract
An introduction is presented in which the editor discusses articles in the issue on the topics including papers from 14th AIDSImpact conference with broad range of global considerations; and psychological ramifications of the epidemic need as much understanding as the virological challenge. more...
- Published
- 2020
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19. "I have HIV but I'm not the HIV" – the experiences of heterosexual Chinese men living with HIV in Singapore.
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Ho, Lai Peng Priscilla and Goh, Esther C. L.
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ATTITUDE (Psychology) ,GROUP identity ,PSYCHOLOGY of HIV-positive persons ,INTERVIEWING ,MEN'S health ,SELF-perception ,SOCIAL stigma ,QUALITATIVE research ,THEMATIC analysis ,PATIENTS' attitudes ,ATTITUDES toward illness - Abstract
As HIV is widely acknowledged as a stigmatized chronic condition which impacts the self, it is important to study the experiences of people living with HIV in relation to their selves and identities. According to extant literature on HIV and identity, the incorporation of an HIV identity is essential to adapting to the diagnosis. However, most of the participants in this study reject HIV as an identity. Using qualitative in-depth interviews, this paper explores the experiences of twelve heterosexual Chinese men living with HIV in Singapore. This paper is anchored by identity concepts from identity theory to examine the impact of HIV on self and identities and how various identities are reworked in the face of a stigmatized chronic medical condition. Thematic analysis shows varying impact of HIV on self, the role of normative identities and the location of HIV in their lives. The findings shed light on the importance of normative identities and the manner in which participants locate HIV in their lives. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
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20. Providing telemedicine services to persons living with HIV in an urban community: a demonstration project.
- Author
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Grewal, Reetu, Jones, Ross, Peters, Jessica, Morga, Kristen, Wilkes, Aisha L., Johnston, Marie E., and Webb, Fern
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HUMAN services programs , *RESEARCH funding , *MEDICAL care , *EVALUATION of human services programs , *GOAL (Psychology) , *DESCRIPTIVE statistics , *TELEMEDICINE , *PSYCHOLOGY of HIV-positive persons , *METROPOLITAN areas , *MATHEMATICAL models , *THEORY , *NEEDS assessment , *HEALTH equity , *INTEGRATED health care delivery , *PATIENT participation - Abstract
Although HIV incidence and mortality rates have declined over the past 20 years, HIV health disparities continue to persist among patients living in urban communities. Barriers to proficient health outcomes for persons with HIV (PWH) in urban communities include lack of access to care, resulting from limited transportation or clinic availability. While healthcare systems in rural communities provide telemedicine (TM) services to PWH to eliminate transportation and accessibility barriers, few examples exist regarding TM use for PWH in urban communities. This project's goal was to increase the provision of healthcare services in an urban setting to PWH, using TM. As guided by "Integration of Healthcare Delivery Service" theories and key principles, we created an integration framework comprised of several simultaneous, overlapping activities to include: (1) capacity building (2) clinical standardization (3) community and patient engagement and (4) evaluation performance and measurements. This paper describes major activities involved with developing, implementing and evaluating a TM program for PWH. We discuss results, challenges, and lessons learned from integrating this program into our existing healthcare system. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
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21. Slipping through the cracks: a qualitative study to explore pathways of HIV care and treatment amongst hospitalised patients with advanced HIV in Kenya and the Democratic Republic of the Congo.
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Burns, Rose, Venables, Emilie, Odhoch, Lilian, Kocholla, Lilian, Wanjala, Stephen, Mucinya, Gisele, Bossard, Claire, and Wringe, Alison
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EVALUATION of medical care ,RURAL conditions ,VIRAL load ,PATIENT-centered care ,INTERVIEWING ,QUALITATIVE research ,HIGHLY active antiretroviral therapy ,EXPERIENCE ,HOSPITAL care ,THEMATIC analysis ,PSYCHOLOGY of HIV-positive persons ,PSYCHOLOGICAL stress - Abstract
Advanced HIV causes substantial mortality in sub-Saharan Africa despite widespread antiretroviral therapy coverage. This paper explores pathways of care amongst hospitalised patients with advanced HIV in rural Kenya and urban Democratic Republic of the Congo, with a view to understanding their care-seeking trajectories and poor health outcomes. Thirty in-depth interviews were conducted with hospitalised patients with advanced HIV who had previously initiated first-line antiretroviral therapy, covering their experiences of living with HIV and care-seeking. Interviews were audio-recorded, transcribed and translated before being coded inductively and analysed thematically. In both settings, participants' health journeys were defined by recurrent, severe symptoms and complex pathways of care before hospitalisation. Patients were often hospitalised after multiple failed attempts to obtain adequate care at health centres. Most participants managed their ill-health with limited support networks, lived in fragile economic situations and often experienced stress and other mental health concerns. Treatment-taking was sometimes undermined by strict messaging around adherence that was delivered in health facilities. These findings reveal a group of patients who had "slipped through the cracks" of health systems and social support structures, indicating both missed opportunities for timely management of advanced HIV and the need for interventions beyond hospital and clinical settings. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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22. Economic strengthening for HIV testing and linkage to care: a review of the evidence.
- Author
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Swann, Mandy
- Subjects
DIAGNOSIS of HIV infections ,HIV infections ,THERAPEUTICS ,MEDICAL screening ,ENDOWMENTS ,HIV-positive persons ,MEDICAL care ,MEDICAL care costs ,PATIENTS ,SYSTEMATIC reviews ,TREATMENT effectiveness ,ECONOMICS - Abstract
Delayed HIV diagnosis and enrollment in HIV care can lead to negative health outcomes for individuals and pose major barriers to achieving the UNAIDS 90-90-90 treatment targets. Household economic strengthening (HES) initiatives are increasingly used to alleviate the direct and indirect costs of HIV testing and linkage to care for those who are diagnosed. The evidence linking HES with a range of HIV outcomes is growing, and this evidence review aimed to comprehensively synthesize the research linking 15 types of HES interventions with a range of HIV prevention and treatment outcomes. The review was conducted between November 2015 and October 2016 and consisted of an academic database search, citation tracking of relevant articles, examination of secondary references, expert consultation, and a gray literature search. Given the volume of evidence, the results are presented and discussed in three papers. This is the second paper in the series and focuses on the 20 studies on HIV testing, diagnosis, and enrollment in care. The results indicate that financial incentives are consistently and independently linked with higher testing uptake and yield among adults. Limited evidence indicates they may also be beneficial for enrollment in care. Evidence for other HES interventions is too sparse to identify clear trends. [ABSTRACT FROM AUTHOR] more...
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- 2018
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23. HIV-sensitive social protection services in mitigating the challenges and vulnerability of the children affected by HIV/AIDS in Bangladesh: a qualitative study.
- Author
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Afroz, Tahmina, Camellia, Suborna, Oyewale, Tajudeen, Uddin, M. Ziya, and Mahmud, Ilias
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HIV infections & psychology ,GENDER role ,WELL-being ,PSYCHOLOGY of parents ,SOCIAL support ,COUNSELING ,HEALTH services accessibility ,PSYCHOLOGICAL vulnerability ,RESEARCH methodology ,INTERVIEWING ,SOCIAL stigma ,QUALITATIVE research ,SOCIAL services ,PARENT-child relationships ,POVERTY ,AIDS ,TRANSPORTATION ,CHILDREN ,ADULTS - Abstract
Children are particularly vulnerable to the consequences of HIV/AIDS. This paper reports on the challenges faced by children due to their or their parents' HIV/AIDS status and the role of HIV-sensitive social protection in mitigating these challenges. We conducted 32 semi-structured in-depth interviews – 15 with children affected by HIV/AIDS (aged 13–18 years) and 17 with parents of children aged 10–12 years. We found children face significant challenges associated with poverty, gender norms, stigma, and lack of social support which affect their rights to education, shelter, treatment, and food. HIV-sensitive social protection packages such as conditional cash transfer, counselling, and community sensitization help continuation of education, facilitate access to treatment and social protection services, reduce stigma in the community and improve wellbeing of children. Children's accessibility to these services was limited due to distance, transport expenses, poor health conditions of the parents, gender issues, and stigma. HIV-sensitive social protection is effective in improving children's wellbeing. Continuation and expansion of HIV-sensitive social protection packages including conditional cash transfer, psychosocial counselling, and community sensitization and life skills training to facilitate HIV/AIDS affected children's wellbeing and inclusion is recommended. [ABSTRACT FROM AUTHOR] more...
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- 2022
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24. Structural determinants of health: a qualitative study on female sex workers in Benin.
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Dugas, Marylène, Bédard, Emmanuelle, Kpatchavi, Adolphe C., Guédou, Fernand A., Béhanzin, Luc, and Alary, Michel
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CONCEPTUAL structures ,HIV infections ,HUMAN rights ,INTERVIEWING ,SEX work ,WOMEN'S health ,ETHNOLOGY research ,QUALITATIVE research ,SOCIAL support ,SOCIOECONOMIC factors ,HEALTH & social status - Abstract
The objective of this paper is to expose those socio-structural contexts revealing the social injustice and human rights violations that sub-Saharan women face every day when forced into sex work by unemployment or sickness. Results of a qualitative study highlighting some key structural determinants of sex work and HIV infection among FSWs will be presented and examined through the lens of the WHO conceptual framework for action on the social determinants of health. The results showed that most FSWs had lacked the necessary financial support at some point in their lives. Also, both the socioeconomic and political context failed to provide proper support to prevent involvement in sex work and the consequent risks of HIV. The cultural and societal values placed on the health and well-being of FSWs in Benin appear to depend on the degree to which sexual violence and adultery are perceived as a collective social concern. This portrait of FSWs calls for both long-term interventions through a structural determinant approach to HIV prevention, targeting all the women who could face such a financial situation well before their entry into sex work, while maintaining short and medium-term interventions on the intermediary determinants. [ABSTRACT FROM AUTHOR] more...
- Published
- 2019
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25. Measuring empowerment among people living with HIV: a systematic review of available measures and their properties.
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Cooper, Vanessa, Clatworthy, Jane, Harding, Richard, and Whetham, Jennifer
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HEALTH ,HIV ,PSYCHOMETRICS ,HEALTH self-care ,SELF-efficacy ,UNCERTAINTY ,INFORMATION resources ,PSYCHOLOGY of AIDS patients ,PATIENT participation ,SYSTEMATIC reviews ,INFORMATION-seeking behavior ,HEALTH literacy ,ATTITUDES toward AIDS (Disease) - Abstract
A systematic review was conducted to identify and appraise measures of empowerment used in peer-reviewed research with people living with HIV. Thirty articles reporting on 12 scales were identified via keyword and citation searches of electronic databases and hand searching of reference lists. The instruments captured a wide range of constructs, including self-efficacy, perceived knowledge/information seeking, self-management behaviours, belief in an active patient role and tolerance of uncertainty. While the majority of instruments were focused exclusively on self-efficacy to manage HIV, the Patient Activation Measure (PAM-13 and PAM-22) and the Health Empowerment Inventory were broader in scope. Most of the identified measures had acceptable construct validity, however there were insufficient data to determine the reliability or responsiveness of many of the scales. The findings highlight the need for a more concrete definition of empowerment and for further validation of existing measures with people living with HIV. [ABSTRACT FROM AUTHOR] more...
- Published
- 2019
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- View/download PDF
26. The use of social marketing campaigns to increase HIV testing uptake: a systematic review.
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Olawepo, John O., Pharr, Jennifer R., and Kachen, Axenya
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DIAGNOSIS of HIV infections ,BLACK people ,GAY men ,HEALTH promotion ,HEALTH services accessibility ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,MEDLINE ,ONLINE information services ,POPULATION geography ,SOCIAL marketing ,SYSTEMATIC reviews ,DEVELOPED countries ,MEN who have sex with men ,AIDS serodiagnosis - Abstract
Social marketing campaigns have been increasingly used in HIV prevention efforts to address barriers to HIV testing. The purpose of this review is to evaluate the social marketing campaigns in the past ten years (2008-2017) that have targeted HIV testing or intent to test as an outcome, and synthesize the results to determine which campaigns work or do not work. The search was conducted using PubMed, Scopus, PsycINFO, EMBASE, and ABI/Inform. The quality assessment tool for quantitative studies developed by the Effective Public Health Practice Project was used to assess study quality. The search generated 373 articles, of which 13 articles met the inclusion criteria. These articles were from 13 distinct campaigns carried out in 9 countries, twelve of which were in high income countries. Sixty-nine percent (n = 9) of the campaigns targeted MSM, gay men, or MSMW, 23% (n = 3) targeted the general population, while 8% (n = 1) focused on African-American women. The study designs for evaluating the campaigns were predominantly cross-sectional, with 4 of the articles combining two or three study designs to evaluate their campaign. Overall, 38% (n = 5) of the campaigns had an increase in HIV testing outcomes, 23% (n = 3) reported no change in HIV testing outcomes, and the remaining 38% (n = 5) of the studies reported mixed outcomes. The results of the quality rating showed that 69% (n = 9) of the papers had weak global ratings, while 31% (n = 4) had moderate rating. None of the articles had a strong rating. This review displayed that social marketing campaigns intended to increase HIV testing uptake were effective in some context. Social marketing practitioners will need to come up with a standardized way of communicating the results of campaign exposure and impact so as to enhance comparison among the multitude of campaigns. [ABSTRACT FROM AUTHOR] more...
- Published
- 2019
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27. Anal cancer screening among women with HIV: provider experiences and system-level challenges.
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Higashi, Robin T., Rodriguez, Serena A., Betts, Andrea C., Tiro, Jasmin A., Luque, Amneris E., Rivera, Rachel, and Barnes, Arti
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HIV-positive persons ,OCCUPATIONAL roles ,PROFESSIONS ,ATTITUDES of medical personnel ,RESEARCH methodology ,WORK ,EARLY detection of cancer ,COMMUNITY health services ,INTERVIEWING ,EXECUTIVES ,PAP test ,ANAL tumors ,QUALITATIVE research ,RESPONSIBILITY ,SAFETY-net health care providers ,EXPERIENTIAL learning ,FIELD notes (Science) ,MEDICAL referrals ,COMMUNICATION ,THEMATIC analysis ,ELECTRONIC health records ,WOMEN'S health - Abstract
Women living with HIV (WLWH) are at increased risk of anal cancer compared to women without HIV, often due to persistent human papillomavirus (HPV) infections. This paper describes current practices and challenges conducting anal cancer screening for WLWH at an urban integrated safety-net system and a non-profit community-based HIV clinic. We conducted 25 semi-structured interviews with clinical and administrative stakeholders to assess knowledge, clinic practices and procedures, and experiences with anal cancer screening. Interview transcripts and fieldnotes were thematically analyzed using an iterative deductive and inductive coding scheme. Findings were organized by the Consolidated Framework for Implementation Research (CFIR) domains and constructs. Provider-level barriers to conducting anal cancer screening included limited knowledge of guidelines. System-level barriers included: structural characteristics such as lack of coordination between clinics to discern provider roles and responsibilities; and limitations in available resources such as configuration of electronic health records and infrastructure to manage referrals of abnormal anal Pap results. We conclude that anal cancer screening and follow-up for WLWH requires organization and coordination between multiple care teams, updated clinical information systems to facilitate communication and support anal Pap ordering and result documentation, and infrastructure that includes policies and protocols for management of abnormal results. Trial registration: ClinicalTrials.gov identifier: NCT02135419. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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28. The PEARL study: a prospective two-group pilot PrEP promotion intervention for cisgender female sex workers living in Baltimore, MD, U.S.
- Author
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Pelaez, D., Weicker, N. P., Glick, J., Mesenburg, J. V., Wilson, A., Kirkpatrick, H., Clouse, E., and Sherman, S. G.
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HIV prevention ,PILOT projects ,SEX work ,COMMUNITY health services ,SELF-efficacy ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,HUMAN services programs ,EMTRICITABINE-tenofovir ,PREVENTIVE medicine ,STATISTICAL sampling ,WOMEN'S health ,HEALTH promotion - Abstract
HIV remains elevated among female sex workers (FSW) globally, with a number of structural (e.g., poverty, access to care) factors driving these persistently high rates. Pre-exposure prophylaxis (PrEP), a user-controlled prevention method, is a promising means of empowering vulnerable populations to protect themselves and enhance agency. Yet there is a dearth of PrEP research and interventions targeting cisgender women in the United States, and even fewer aimed to reach FSW. We developed and implemented a multifaceted PrEP pilot intervention, the Promoting Empowerment And Risk Reduction (PEARL) study, to meet this gap. This paper describes the development process and nature of a community-informed intervention for tenofovir/emticitrabine (TDF/FTC) pre-exposure prophylaxis engagement among street-based cisgender FSW in Baltimore, Maryland, U.S. In the course of the study's implementation, structural, programmatic, and medical barriers have already posed significant barriers to full engagement. PEARL implemented a number of strategies in an effort to counter barriers and facilitate increased success of PrEP uptake and maintenance. The study will provide critical insights into the nature of intervention components that could help FSW to initiate PrEP and reduce PrEP care cascade gaps. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
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29. Implementation Science Protocol: evaluating evidence-informed interventions to improve care for people with HIV seen in Ryan White HIV/AIDS program settings.
- Author
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Bourdeau, Beth, Shade, Starley, Koester, Kim, Rebchook, Greg, Dawson-Rose, Carol, Guzé, Mary, Psihopaidas, Demetrios, Cohen, Stacy M., and Myers, Janet
- Subjects
HIV infections ,MATHEMATICAL models ,RESEARCH methodology ,EVIDENCE-based medicine ,TREATMENT effectiveness ,THEORY ,QUALITY assurance - Abstract
In 2017, the Health Resources and Services Administration's HIV/AIDS Bureau funded an Evaluation Center (EC) and a Coordinating Center for Technical Assistance (CCTA) to oversee the rapid implementation of 11 evidence-informed interventions at 26 HIV care and treatment providers across the U.S. This initiative aims to address persistent gaps in HIV-related health outcomes emerging from social determinants of health that negatively impact access to and retention in care. The EC adapted the Conceptual Model of Implementation Research to develop a Hybrid Type III, multi-site mixed-methods evaluation, described in this paper. The results of the evaluation will describe strategies associated with uptake, implementation outcomes, as well as HIV-related health outcomes for clients engaged in the evidence-informed interventions. This approach will allow us to understand in detail the processes that sites undergo to implement these important intervention strategies for high priority populations. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
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30. Resilience, self-esteem, self-efficacy, social support, depression and ART adherence among people living with HIV in Sichuan, China.
- Author
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Wen, Jing, Yeh, Tzu-Pei, Xie, Hong, Yu, Xingli, Tang, Jian, and Chen, Yanhua
- Subjects
MENTAL depression ,CLINICAL drug trials ,HIV infections ,HOSPITALS ,ADAPTABILITY (Personality) ,SOCIAL support ,SELF-perception ,CROSS-sectional method ,ANTIRETROVIRAL agents ,PATIENT compliance ,STATISTICAL sampling ,PSYCHOLOGY of HIV-positive persons ,PSYCHOLOGICAL resilience - Abstract
AIDS has had physical, psychological and social consequences on People living with HIV (PLWH) with the result that the challenges and adversity they face have significantly increased. Resilience helps individuals cope with these adversities and difficulties. For PLWH to face increased challenges and setbacks created by AIDS, they are required to have resilience. This paper presents research carried out in China aiming to examine the relationships among resilience, self-esteem, self-efficacy, social support, depression and antiretroviral therapy (ART) adherence in PLWH. A cross-sectional study using a convenience sample was conducted and 223 PLWH were recruited from 2 hospitals and 1 Center of Disease Control in Sichuan, China, from May to August 2018. The present research found that resilience was positively affected by self-esteem, self-efficacy and social support, and negatively predicted depression and positively predicted ART adherence. Resilience plays a mediating role between influential factors (self-esteem, self-efficacy and social support) and adaptive outcomes (depression and ART adherence). It suggests that resilience should be considered as a factor in intervention designed to reduce PLWH's depression and improve ART adherence. Improving self-esteem, self-efficacy and social support could enhance resilience. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
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31. “There is a chain of connections”: using syndemics theory to understand HIV treatment side effects.
- Author
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Gagnon, Marilou
- Subjects
DIAGNOSIS ,HIV infections ,THERAPEUTICS ,DRUGS ,DRUG side effects ,QUALITY of life ,HIGHLY active antiretroviral therapy - Abstract
Side effects are central to the experience of living longer with HIV but rarely have they been studied alone. Unlike other aspects of that experience, like quality of life, treatment adherence, chronicity, episodic disability, aging, health, and viral load suppression, side effects have not benefited from the same level of empirical and theoretical engagement from qualitative researchers. In this paper, we draw on syndemics theory and 50 qualitative interviews to better understand the experience of HIV treatment side effects. Two main categories were identified in the data: side effects as a product and side effects as a risk factor. The first category suggests that side effects are not just the product of taking antiretroviral drugs. They are also the product of particular conditions and tend to cluster with other health problems. The second category puts forward the idea that side effects can act as a syndemic risk factor by exposing PLWH to a greater risk of developing health problems and creating conditions in which psychosocial issues are more likely to emerge. The paper concludes by calling for more research on the complex nature of side effects and for the development of comprehensive approaches for the assessment and management of side effects. [ABSTRACT FROM AUTHOR] more...
- Published
- 2018
- Full Text
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32. Rebooting resilience: shifts toward dynamic, multi-level, and technology-based approaches for people living with HIV.
- Author
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Harrison, Sayward and Li, Xiaoming
- Subjects
ATTITUDE (Psychology) ,CONCEPTUAL structures ,DISCRIMINATION (Sociology) ,GENDER identity ,GROUP identity ,PSYCHOLOGY of HIV-positive persons ,LIFE change events ,PSYCHOLOGICAL resilience ,SOCIAL networks ,SOCIAL stigma ,TELEMEDICINE - Abstract
Resilience research has often been characterized by a static conceptualization of resilience that focuses on individual-level factors that help people living with HIV (PLHIV) adapt to HIV-related challenges and overcome other life adversities. Early conceptualizations often depicted resilience as a static, stable construct, with limited attention paid to the social context and broader systems that may foster or discourage resilient adaptation across time and place. This special issue seeks to challenge these conventional views by highlighting innovative HIV resilience research across the globe. Far from ignoring socio-cultural contexts, studies presented in this issue directly address systemic stigma and discrimination against PLHIV, as well as sexual and gender minority individuals, and identify unique opportunities to promote resilience through building strong "villages" (i.e., social networks), reducing structural inequities, and enhancing HIV treatment and care systems. In addition, papers included in this issue address the promise and challenges of utilizing mobile Heath (mHealth) technology to build resilience for PLHIV through improving psychosocial and clinical outcomes. [ABSTRACT FROM AUTHOR] more...
- Published
- 2018
- Full Text
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33. Correlation between computerised and standard cognitive testing in people with HIV and HIV-negative individuals.
- Author
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De Francesco, Davide, Underwood, Jonathan, Anderson, Jane, Boffito, Marta, Post, Frank A., Sachikonye, Memory, Mallon, Patrick W.G., Haddow, Lewis, Vera, Jaime H., Kunisaki, Ken M., Sabin, Caroline A., and Winston, Alan more...
- Subjects
COGNITION disorders diagnosis ,STATISTICS ,LIFESTYLES ,SCIENTIFIC observation ,CONFIDENCE intervals ,NEUROPSYCHOLOGICAL tests ,DESCRIPTIVE statistics ,DATA analysis ,PSYCHOLOGY of HIV-positive persons ,LONGITUDINAL method - Abstract
We investigated the correlations and agreement between cognitive assessments made using a computerised (CogState™, six domains) and a standard pen-and-paper battery (five domains) in PWH and lifestyle-similar HIV-negative individuals. Demographically adjusted domain and global T-scores were obtained and used to define cognitive impairment according to the multivariate normative comparison (MNC) criteria. Correlations between T-scores and the agreement between the classifications of cognitive impairment obtained from the two batteries were assessed using the Spearman's rank correlation and Cohen's κ, respectively. The correlation between global T-scores from the two batteries was 0.52 (95% CI 0.44–0.60) in PWH and 0.45 (0.29–0.59) in controls (p = 0.38 for their difference). Correlations were generally stronger between domains within the same battery than between those from different batteries. The agreement between the two batteries in classifying individuals as cognitively impaired or not impaired was fair in PWH (κ = 0.24) and poor in HIV-negative individuals (κ = −0.02). The moderate correlation between overall cognitive function and the modest agreement between binary classifications of cognitive impairment obtained from two different batteries indicate the two batteries may assess slightly different components of cognition. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
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34. Employment trajectories of PLHIV on ART in Lusaka, Zambia: a short report.
- Author
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Reijer, Josien
- Subjects
HIV-positive persons ,CONVALESCENCE ,JOB descriptions ,ANTIRETROVIRAL agents ,HIGHLY active antiretroviral therapy ,EMPLOYMENT ,SYMPTOMS ,EMPLOYMENT reentry - Abstract
The introduction of antiretroviral therapy (ART) has helped mitigate many of the negative consequences of HIV. ART allows people living with HIV (PLHIV) to recover physically and become active members of society. Research thus far is positive about the potential economic impact of ART on household economies. In terms of employment, studies indicate that ART, when initiated early in disease progression, allows PLHIV to maintain their employment and, when initiated late in disease progression, allows PLHIV to return to work once they physically recover. This paper questions the latter by demonstrating that while the employment levels indeed return to normal or baseline levels, the type of employment that PLHIV obtain has undergone a shift. It demonstrates that the type of employment PLHIV are engaged in once they recover is largely less stable and less profitable than what they were doing prior to illness. It additionally demonstrates that PLHIV are engaged in work that is less stable and less profitable than their HIV-negative counterparts. I conclude that a closer inspection of the type of employment that PLHIV are engaged in is needed to provide a more accurate understanding of the impact of ART on the socio-economic status of PLHIV on ART. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
- Full Text
- View/download PDF
35. Economic strengthening for retention in HIV care and adherence to antiretroviral therapy: a review of the evidence.
- Author
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Swann, Mandy
- Subjects
HIV prevention ,ANTIRETROVIRAL agents ,DISEASES ,DRUGS ,ENDOWMENTS ,HIV infections ,PATIENT compliance ,TRANSPORTATION ,SYSTEMATIC reviews - Abstract
To address the economic drivers of poor HIV care and treatment outcomes, household economic strengthening (HES) initiatives are increasingly being implemented with biomedical and behavioral approaches. The evidence linking HES with HIV outcomes is growing, and this evidence review aimed to comprehensively synthesize the research linking 15 types of HES interventions with a range of HIV prevention and treatment outcomes. The review was conducted between November 2015 and October 2016 and consisted of an academic database search, citation tracking of relevant articles, examination of secondary references, expert consultation, and a gray literature search. Given the volume of evidence, the results are presented and discussed in three papers, each focused on a different HIV outcome area. This is the third paper in the series and focuses on the 38 studies on retention in HIV care, ART adherence, morbidity, and HIV-related mortality. Monthly food rations and conditional cash transfers are associated with improvements in care seeking and medication pick-up. Transportation assistance, income generation and microcredit show positive trends for care and treatment, but evidence quality is moderate and based heavily on integrated interventions. Clinical outcomes of CD4 count and viral suppression were not significantly affected in most studies where they were measured. [ABSTRACT FROM AUTHOR] more...
- Published
- 2018
- Full Text
- View/download PDF
36. Economic strengthening for HIV prevention and risk reduction: a review of the evidence.
- Author
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Swann, Mandy
- Subjects
HIV prevention ,HIV infection risk factors ,AIDS education ,CIRCUMCISION ,ENDOWMENTS ,FOOD relief ,RISK-taking behavior ,SEXUALLY transmitted diseases ,SYSTEMATIC reviews ,TREATMENT effectiveness ,DISEASE incidence ,DISEASE prevalence - Abstract
Household economic strengthening (HES) is increasingly implemented alongside HIV programing to address economic drivers of the epidemic. The evidence base on HES for HIV outcomes is growing, and this evidence review aimed to comprehensively consolidate and synthesize the research linking 15 types of HES interventions with a range of HIV prevention and treatment outcomes. The review was conducted between November 2015 and October 2016 and consisted of an academic database search, citation tracking of relevant articles, examination of secondary references, expert consultation, and a gray literature search. Studies were included if they evaluated an HES intervention(s), reported on an HIV outcome(s), were available in English, and were relevant to low-income contexts or vulnerable populations. All evidence was assessed for quality. Over 108 citations were included and a matrix framework was used to map the evidence, linking each HES intervention with each HIV outcome, providing a precise visual depiction of the evidence base. Given the volume of evidence, the results are presented and discussed in three papers, each focused on a different HIV outcome area. This is the first paper in the series and focuses on the 64 studies that reported HIV prevention outcomes. Conditional and unconditional cash transfers, and educational support were each associated with reductions in self-reported risk behaviors, particularly among adolescents. Food assistance in combination with other support also shows a positive trend for adolescent risk reduction. Most studies relied on self-reported behavioral data, and clinical outcomes such as HIV or other sexually transmitted infection (STI) incidence or prevalence were mostly null or underpowered, calling into question the true effectiveness of these interventions in preventing HIV. Limited evidence also supports the effectiveness of financial incentives in increasing voluntary medical male circumcision. Well-designed vocational/entrepreneurial training and savings interventions could bolster HIV prevention efforts for female sex workers, while findings are less conclusive for adolescents. [ABSTRACT FROM AUTHOR] more...
- Published
- 2018
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37. Integrating cardiovascular diseases, hypertension, and diabetes with HIV services: a systematic review.
- Author
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Haldane, Victoria, Legido-Quigley, Helena, Chuah, Fiona Leh Hoon, Sigfrid, Louise, Murphy, Georgina, Ong, Suan Ee, Cervero-Liceras, Francisco, Watt, Nicola, Balabanova, Dina, Hogarth, Sue, Maimaris, Will, Buse, Kent, McKee, Martin, Piot, Peter, and Perel, Pablo more...
- Subjects
CARDIOVASCULAR diseases ,DIABETES ,HIV infections ,HYPERTENSION ,INTEGRATED health care delivery ,SYSTEMATIC reviews - Abstract
Non-communicable diseases (NCDs), including cardiovascular diseases (CVD), hypertension and diabetes together with HIV infection are among the major public health concerns worldwide. Health services for HIV and NCDs require health systems that provide for people’s chronic care needs, which present an opportunity to coordinate efforts and create synergies between programs to benefit people living with HIV and/or AIDS and NCDs. This review included studies that reported service integration for HIV and/or AIDS with coronary heart diseases, chronic CVD, cerebrovascular diseases (stroke), hypertension or diabetes. We searched multiple databases from inception until October 2015. Articles were screened independently by two reviewers and assessed for risk of bias. 11,057 records were identified with 7,616 after duplicate removal. After screening titles and abstracts, 14 papers addressing 17 distinct interventions met the inclusion criteria. We categorized integration models by diseases (HIV with diabetes, HIV with hypertension and diabetes, HIV with CVD and finally HIV with hypertension and CVD and diabetes). Models also looked at integration from micro (patient focused integration) to macro (system level integrations). Most reported integration of hypertension and diabetes with HIV and AIDS services and described multidisciplinary collaboration, shared protocols, and incorporating screening activities into community campaigns. Integration took place exclusively at the meso-level, with no micro- or macro-level integrations described. Most were descriptive studies, with one cohort study reporting evaluative outcomes. Several innovative initiatives were identified and studies showed that CVD and HIV service integration is feasible. Integration should build on existing protocols and use the community as a locus for advocacy and health services, while promoting multidisciplinary teams, including greater involvement of pharmacists. There is a need for robust and well-designed studies at all levels – particularly macro-level studies, research looking at long-term outcomes of integration, and research in a more diverse range of countries. [ABSTRACT FROM PUBLISHER] more...
- Published
- 2018
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38. Community-based antiretroviral therapy (ART) delivery for female sex workers in Tanzania: intervention model and baseline findings.
- Author
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Vu, Lung, Tun, Waimar, Apicella, Louis, Casalini, Caterina, Makyao, Neema, Tsang, Samantha, Michael, Denna, Koppenhaver, Todd, and Mlanga, Erick
- Subjects
DIAGNOSIS of HIV infections ,HIV infection transmission ,COMMUNITY health services ,CONDOMS ,HIV infections ,RESEARCH methodology ,MEDICAL care ,MEDICAL screening ,SEX work ,WOMEN'S health ,ANTIRETROVIRAL agents ,HEALTH literacy - Abstract
To increase linkage to and retention in antiretroviral therapy (ART) care, we piloted a community-based, ART service delivery intervention for female sex workers (FSWs). At baseline, we recruited and collected data from 617 FSWs (intervention: 309; comparison: 308) who were HIV positive and not on ART. This paper presents (1) the description of the intervention model, and (2) key descriptive and bivariate-level findings of the baseline FSW cohort. The data showed more than half of FSWs had a non-paying sex partner, and less than one-third used a condom at last sex with paying and non-paying clients, which suggest potentially high levels of HIV transmission. In addition, there is a gap in HIV testing and treatment because one-third learned about their HIV-positive status only at study enrollment, and among FSWs who had known their status for more than a month, half had not registered in care. This substantiates the importance of timely HIV diagnosis and treatment. A community-based ART program may serve as an important strategy in closing the HIV care and treatment gap for FSWs. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
- Full Text
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39. The impact of common mental disorders among caregivers living with HIV on child cognitive development in Zimbabwe.
- Author
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Mebrahtu, Helen, Sherr, Lorraine, Simms, Victoria, Weiss, Helen A., Chingono, Rudo, Rehman, Andrea M., Ndlovu, Patience, and Cowan, Frances M.
- Subjects
PSYCHOLOGY of caregivers ,CHILD development ,COGNITION in children ,PSYCHOLOGY of HIV-positive persons ,LANGUAGE acquisition ,MARITAL status ,EVALUATION of medical care ,MENTAL illness ,PSYCHOLOGY of mothers ,QUESTIONNAIRES ,EDUCATIONAL attainment ,DISEASE prevalence ,FOOD security - Abstract
This paper aimed to assess the impact of maternal common mental disorders (CMD) among caregivers living with HIV on the cognitive functioning of their child. Data were collected at baseline and 12 months follow-up from mother–child dyads recruited as part of an ongoing trial in Zimbabwe. Symptoms of CMD were assessed using the Shona Symptom Questionnaire. Mixed-effects linear regression was used to assess child cognitive scores at follow-up (using the Mullen Scales of Early Learning) in relation to caregiver CMD prevalence over 12 months. At baseline, caregivers reporting CMD (n = 230; 40.1%) were less likely to have completed higher education (46.9% vs. 56.9%; p = 0.02), more likely to be unmarried (27.8% vs. 16.0%; p < 0.01), and experience food insecurity (50.0% vs. 29.4%; p < 0.01) compared to the group without CMD (n = 344). There were 4 CMD patterns over time: (i) Emerging CMD (n = 101; 19.7% of caregivers) defined as those who were below the cut-off at baseline, and above it at 12 months; (ii) Improving CMD (n = 76; 14.8%) defined as those who reported CMD at baseline, and were below the cut-off by follow-up; (iii) No CMD (n = 206; 40.1%) defined as those who did not report CMD symptoms at either time point; and (iv) Chronic CMD (n = 131; 25.5%) defined as those who reported CMD above the cut-off at both time points. Children of caregivers with chronic CMD (n = 131, 25.5%) had lower receptive language scores (aMD:−2.81, 95%CI −5.1 to −0.6; p = 0.05) compared to the reference group with no CMD (n = 206, 40.1%). Exposure to caregiver CMD over a prolonged period may affect child receptive vocabulary skills. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
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- View/download PDF
40. Children living with HIV-related disabilities in a resource-poor community in South Africa: caregiver perceptions of caring and rehabilitation.
- Author
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Maddocks, Stacy, Moodley, Koobeshan, Hanass-Hancock, Jill, Cobbing, Saul, and Chetty, Verusia
- Subjects
DEVELOPMENTAL disabilities ,EMPLOYMENT ,HEALTH services accessibility ,HEALTH status indicators ,HIV infections ,HIV-positive persons ,HOUSING ,INTERVIEWING ,METROPOLITAN areas ,NEEDS assessment ,SOCIAL security ,QUALITATIVE research ,GOVERNMENT policy ,CHILDREN with disabilities ,SOCIAL support ,WELL-being ,THEMATIC analysis ,BURDEN of care ,CAREGIVER attitudes ,CHILDREN - Abstract
The care offered to children living with HIV (CLHIV) experiencing HIV-related disability is often challenged by caregiver illness, poverty and poor support structures in and around communities. Since caregiver needs directly influences the care offered to CLHIV this paper aimed to explore the experiences of the caregivers of CLHIV in order to inform an appropriate rehabilitation model in South Africa. A qualitative enquiry using in-depth interviews with 14 caregivers (one male and thirteen females) of CLHIV experiencing disability in a peri-urban setting was conducted. Data were analysed using thematic analysis. Four themes emerged from the interviews: understanding of HIV-related disability and rehabilitation, challengers to care and well-being, enablers to care; and perceived needs of caregivers. The study revealed that caregiver burden is influenced by the availability of resources and social support services. Financial constraints, poor access to rehabilitation and reduced support networks challenged the care offered to CLHIV. The perceived needs of the caregivers in this study included appeals for improved social security, housing, accessible rehabilitation and education. Changes in government policy guiding social support, employment, education and rehabilitation interventions are needed to improve the availability of resources, education, health and well-being of CLHIV and their caregiver's in South Africa. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
- Full Text
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41. Self-efficacy and response-efficacy: critical components of sexual and reproductive health interventions targeting condom use intention among American Indian adolescents.
- Author
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Rosenstock, Summer, Chambers, Rachel, Lee, Angelita, Goklish, Novalene, Larzelere, Francene, and Tingey, Lauren
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CONDOMS ,SEXUAL health ,SELF-efficacy ,REPRODUCTIVE health ,ADOLESCENCE - Abstract
The Respecting the Circle of Life (RCL) intervention is a comprehensive, skills-based sexual/reproductive health program shown to be effective for reducing sexual risk among American Indian (AI) adolescents (13-19 years of age). This paper seeks to identify critical program components of the RCL intervention for replication of impacts on condom use intention (CUI) when scaling to additional communities. RCL was tested among AI adolescents through a cluster randomized controlled trial (N = 267) embedded in an 8-day basketball camp. Data were collected at baseline, immediately post-camp, at 6 and 12 months post-camp. Previously established predictors of CUI that were statistically significantly impacted by RCL at the post-camp time point were tested as mediators of RCL impact on CUI. Condom use self-efficacy and response efficacy fully mediated the effect of RCL on CUI. The indirect path through condom use self-efficacy had the greatest effect on CUI, explaining 79% of the direct effect. When stratified by gender, there was only evidence of mediation among girls. Results indicate condom use self-efficacy and response efficacy are critical components of the RCL intervention for AI girls, and sexual/reproductive health programs should include practical skills training to improve these constructs to maximize intervention impact on CUI. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
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42. Knowledge and Acceptability of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Ghana.
- Author
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Ogunbajo, Adedotun, Leblanc, Natalie M., Kushwaha, Sameer, Boakye, Francis, Hanson, Samuel, Smith, Martez D.R., and Nelson, LaRon E.
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HIV prevention ,CONDOMS ,CONTENT analysis ,DRUGS ,FOCUS groups ,PREVENTIVE medicine ,PATIENT compliance ,QUALITATIVE research ,HEALTH literacy ,MEN who have sex with men ,ANTI-HIV agents - Abstract
In Ghana, men who have sex with men (MSM) are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a biomedical intervention that reduces the risk of HIV infection but is not currently available in Ghana. This paper explores knowledge and acceptability of HIV PrEP among Ghanaian MSM. Qualitative content analysis was conducted on 22 focus group discussions (N = 137) conducted between March and June 2012 in Accra, Kumasi, and Manya Krobo. Overall, participants reported low knowledge of PrEP. However, once information about PrEP was provided, there was high acceptability. The primary reason for acceptability was that PrEP provided an extra level of protection against HIV. Acceptability of PrEP was conditioned on it having minimal side effects, being affordable and efficient in preventing HIV infection. No acceptability of PrEP was attributed to limited knowledge of side effects and perceived lack of effectiveness. The reasons provided to utilize PrEP and condoms were that condoms protect against other STIs, and sexual partner factors. This is the first known study to explore PrEP knowledge and acceptability among Ghanaian MSM. It is important that key stakeholders preemptively address potential barriers to PrEP acceptability, uptake, and adherence, especially among MSM, once PrEP becomes available in Ghana. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
- Full Text
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43. Effect of organizational models of provider-initiated testing and counseling (PITC) in health facilities on adult HIV testing coverage in sub-Saharan Africa.
- Author
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Inghels, M., Carillon, S., Desgrees du Lou, A., and Larmarange, J.
- Subjects
DIAGNOSIS of HIV infections ,CONFIDENCE intervals ,COUNSELING ,HEALTH facilities ,META-analysis ,SYSTEMATIC reviews ,HUMAN services programs ,EVALUATION of human services programs ,ODDS ratio - Abstract
The purpose of this paper is to identify which Provider-Initiated HIV Testing and Counseling (PITC) organizational models are the most efficient to maximize testing coverage. We conducted a systematic literature review to identify published articles that evaluated routine PITC programs implemented in adult health facilities in Sub-Saharan Africa. We considered only articles measuring PITC offer, PITC acceptability and PITC coverage. Adjusted meta-regression models were performed to measure the association between PITC offer, acceptability and coverage with PITC organizational model. A total of 30 articles were included in the meta-analysis. Overall, 85.4% [95%CI: 77.2–93.5] of patients were offered a test, and 87.1% [82.4–91.7] accepted the test resulting in a PITC coverage of 74.3% [66–82.6]. Four types of PITC organizational models were identified: PITC initiated and performed during the consultation (model A), PITC initiated before consultation (model B), PITC referred on-site (model C) and PITC referred off-site (model D). Compared to model A, model B had a similar coverage (aOR: 1.02 [0.82–1.26]). However, coverage was lower for model C (aOR: 0.81 [0.68–0.97]) and model D (aOR: 0.58 [0.44–0.77]). Initiating the testing process before or during medical consultation is recommended for maximizing testing coverage among patients. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
- Full Text
- View/download PDF
44. Determinants of livelihood in the era of widespread access to ART.
- Author
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Hanass-Hancock, Jill, Misselhorn, Alison, Carpenter, Bradley, and Myezwa, Hellen
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ANTI-HIV agents ,AGE distribution ,DRUGS ,HEALTH services accessibility ,HEALTH status indicators ,HIV infections ,PSYCHOLOGY of HIV-positive persons ,MARITAL status ,PATIENT compliance ,PEOPLE with disabilities ,QUESTIONNAIRES ,SEX distribution ,STATISTICS ,SOCIOECONOMIC factors ,WELL-being ,CROSS-sectional method ,FOOD security ,DESCRIPTIVE statistics - Abstract
We have only just begun to understand the long-term impact of living with chronic HIV on health and livelihood after a decade of widespread access to treatment in southern Africa. This paper explores health and well-being, disability, and livelihood dynamics among people living with HIV (PLHIV) in a public healthcare setting in South Africa. We undertook a cross-sectional survey among a cohort of 1042 people on ART and explored associations between socio-demographic characteristics, treatment adherence, measures of disability (functional and activity limitations), livelihood resources (capitals) and outcomes, including food security, and exposure to livelihood shocks. A range of dynamic relationships relevant for decision-makers is evident. Age, gender, and marital status all had significant associations with levels of livelihood capitals and outcomes. Those who had been on ART for longer periods of time also had significantly higher aggregate livelihood capital. This was particularly driven by social and financial capital. Livelihoods are built within specific social and health contexts. Of particular importance is that the resources drawn on to build a livelihood differ significantly between men and women, and that different forms of disability also have gender-specific pathways in influencing livelihood and livelihood outcomes. Our results support the need for a gender-sensitive approach to supporting the well-being and livelihoods of PLHIV. Of equal importance is an approach that considers more comprehensively the new experiences of comorbidities and disabilities that may occur with a long life on ART. [ABSTRACT FROM PUBLISHER] more...
- Published
- 2017
- Full Text
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45. Use of antiretroviral treatment among people living with HIV in Australia between 1997 and 2012.
- Author
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Power, J., Lyons, A., Brown, G., Dowsett, G. W., and Lucke, J.
- Subjects
ANTI-HIV agents ,CHI-squared test ,COMPARATIVE studies ,CONFIDENCE intervals ,DRUGS ,EMPLOYMENT ,HEALTH attitudes ,HIV infections ,HIV-positive persons ,INCOME ,PATIENT compliance ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH funding ,SCALE analysis (Psychology) ,T-test (Statistics) ,LOGISTIC regression analysis ,MULTIPLE regression analysis ,SOCIOECONOMIC factors ,CROSS-sectional method ,DATA analysis software ,PATIENTS' attitudes ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Current international targets aim for 90% of people diagnosed with HIV to be on antiretroviral treatment (ART). This paper aims to identify sociodemographic and attitudinal factors associated with ART non-use over time in three samples of Australian people living with HIV (PLHIV). Data for this paper were derived from an Australian cross-sectional survey of PLHIV that was repeated at three different time points: 1997, 2003, and 2012. There were approximately 1000 respondents to each survey (n = 3042 in total). The survey included approximately 250 items related broadly to health and well-being, ART use, and attitudes towards ART use. Univariate and multivariate logistic regression analyses were used. While the proportion of participants using ART increased between 1997 and 2012 (78.8–87.6%,p < .001), there was a decrease between 1997 and 2003 to 70.6% (p < .001). Factors linked to ART non-use remained steady over those 15 years. In all cohorts, people less likely to be using ART were younger and had a more recent diagnosis of HIV. In 2003 and 2012, people in full-time employment were less likely to be using ART, while those whose main source of income was a pension or social security were more likely to be using ART. Multivariate models showed that, at each time point, a belief in the health benefits of delayed ART uptake was associated with non-use. These findings suggest that there may be barriers to ART uptake that have persisted over time despite changes to clinical guidelines that now encourage early uptake. [ABSTRACT FROM PUBLISHER] more...
- Published
- 2017
- Full Text
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46. Caregiver supportive policies to improve child outcomes in the wake of the HIV/AIDS epidemic: an analysis of the gap between what is needed and what is available in 25 high prevalence countries.
- Author
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Kidman, Rachel and Heymann, Jody
- Subjects
AIDS treatment ,THERAPEUTICS ,HIV infections ,CONCEPTUAL structures ,EDUCATION ,EMPLOYEE assistance programs ,INCOME ,SERVICES for caregivers ,EVALUATION of medical care ,MEDICAL needs assessment ,PEDIATRICS ,PUBLIC welfare ,QUALITY assurance ,SOCIAL services ,STUDENT assistance programs ,GOVERNMENT policy ,SOCIAL support - Abstract
In the wake of the HIV/AIDS epidemic, caregivers are struggling to support HIV-affected children. For reasons of equity and efficiency, their needs can be best met through strong social protections and policies. This paper presents a conceptual framework to help address the needs of HIV-affected caregivers and to prioritize policies. We describe the needs that are common across diverse caregiving populations (e.g., economic security); the needs which are intensified (e.g., leave to care for sick children) or unique to providing care to HIV-affected children (e.g., ARV treatment). The paper then explores the types of social policies that would facilitate families meeting these needs. We outline a basic package of policies that would support HIV-affected families, and would meet goals agreed to by national governments. We examine the availability of these policies in 25 highly affected countries in sub-Saharan Africa. The majority of countries guarantee short-term income protection during illness, free primary school, and educational inclusion of children with special needs. However, there are significant gaps in areas critical to family economic security and healthy child development. Fewer than half of the countries we analyzed guarantee a minimum wage that will enable families to escape poverty; only six have eliminated tuition fees for secondary school; and only three offer paid leave to care for sick children. Filling these policy gaps, as well as making mental health and social services more widely available, is essential to support caregiving by families for HIV-affected children. As part of the HIV agenda, the global community can help national governments advance towards their policy targets. This would provide meaningful protection for families affected by HIV, as well as for millions of other vulnerable families and children across the region. [ABSTRACT FROM PUBLISHER] more...
- Published
- 2016
- Full Text
- View/download PDF
47. HIV testing practices among Latina women at risk of getting infected: a five-year follow-up of a community sample in South Florida.
- Author
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Lopez-Quintero, Catalina, Rojas, Patria, Dillon, Frank R., Varga, Leah M., and De La Rosa, Mario
- Subjects
DIAGNOSIS of HIV infections ,AUTOMATIC data collection systems ,CHI-squared test ,CONFIDENCE intervals ,HEALTH behavior ,PSYCHOLOGY of Hispanic Americans ,MEDICAL screening ,QUESTIONNAIRES ,RESEARCH funding ,RISK-taking behavior ,STATISTICAL sampling ,HUMAN sexuality ,T-test (Statistics) ,WOMEN'S health ,LOGISTIC regression analysis ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Latinos are more likely to delay HIV testing, present to care with an AIDS defining illness, and die within one year of learning their HIV-positive status than non-Latino blacks and whites. For this paper, we explore the role of partner-relationship characteristics and health behaviors, in predicting HIV testing among Latina adult women who engaged in risky sexual behaviors (i.e., unprotected vaginal and/or anal sex). Data from a convenience sample of 168 Latina adult women who engaged in risky sexual behavior in the year prior to assessment were analyzed for this paper. Rates and predictors of HIV testing among this sample were assessed after a five-year follow-up. Descriptive and analytical estimates include incidence rates and adjusted odds ratios (AOR) from multilevel models. At five-year follow-up, 63.7% (n = 107) women reported having been tested for HIV, of whom 12.2% (n = 13) were women who never tested before. Main reasons for not having been tested at follow-up included: low risk perception (62.1%) and trusting their partner(s)/being in a monogamous relationship/knowing their partner's HIV status (17.2%). Predictors of HIV testing included: age (AOR: 0.96; 95% CI = 0.92–0.99), provider endorsement of HIV testing (AOR: 4.59; 95% CI = 1.77–11.95), poor quality of their romantic relationships (AOR: 1.12; 95% CI = 1.03–1.26), and knowing the HIV sero-status of sexual partner (AOR: 3.61; 95% CI = 1.46–8.95). This study characterizes a group of Latina women at high risk for HIV infection and their HIV testing behaviors. Our findings underscore the need of increasing access to quality health-care services and HIV behavioral interventions, and to strengthen the adherence to HIV/sexually transmitted disease testing recommendations and guidelines among local health-care providers serving the Latino community in South Florida. [ABSTRACT FROM PUBLISHER] more...
- Published
- 2016
- Full Text
- View/download PDF
48. Longitudinal trajectories of neurocognitive test performance among individuals with perinatal HIV-infection and -exposure: adolescence through young adulthood.
- Author
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Robbins, Reuben N., Zimmerman, R., Korich, R., Raymond, J., Dolezal, C., Choi, C. J., Leu, C. S., Nguyen, N., Malee, K., Wiznia, A., Abrams, E. J., and Mellins, C. A.
- Subjects
DIAGNOSIS of HIV infections ,PSYCHOLOGY of HIV-positive persons ,LONGITUDINAL method ,NEUROPSYCHOLOGICAL tests ,MOTOR ability ,SHORT-term memory ,THOUGHT & thinking ,TASK performance ,EXECUTIVE function ,DESCRIPTIVE statistics ,ADOLESCENCE ,ADULTS ,CHILDREN ,FETUS - Abstract
There are an estimated 2.1 million youth less than 15 years of age living with HIV globally (the majority perinatally HIV-infected [PHIV]) and millions more perinatally HIV-exposed uninfected (PHEU) youth who are expected to survive through adolescence and into adulthood. Transitioning from adolescence to young adulthood requires adaptation to more demanding social interactions, academic pressures, and individual responsibilities which place distinct demands on neurocognitive functions. This study examined longitudinal trajectories of neurocognitive test performance in the domains of processing speed (PS), working memory (WM), and executive functioning (EF) among PHIV and demographically similar PHEU from adolescence through young adulthood. Data for this paper come from four time points, spanning approximately 10 years, within the Child and Adolescent Self-Awareness and Health Study (CASAH). Youth age ranged from 15 to 29 years. Longitudinal linear mixed effect models were computed for each test. Few differences in performance were found on tests of EF and WM between PHIV and PHEU youth as they aged, though PHEU youth showed significantly better PS as they aged than PHIV youth. Future research is needed to understand these vulnerable youth's neurocognitive trajectories as a function of HIV infection and -exposure, biological functions and psychosocial stressors. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
- Full Text
- View/download PDF
49. Sero-status of preschoolers and disclosure to schools.
- Author
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Muhati-Nyakundi, Linet Imbosa
- Subjects
AIDS ,COMMUNICATION ,CONTENT analysis ,EXPERIENCE ,HEALTH education ,PSYCHOLOGY of HIV-positive persons ,PHENOMENOLOGY ,SCHOOLS ,QUALITATIVE research ,DISCLOSURE ,THEMATIC analysis ,HIV seroconversion ,COLLEGE teacher attitudes ,CHILDREN - Abstract
Infants with HIV-infection have longevity due to improved Highly Active Antiretroviral Therapy (HAART), making many realise their developmental progression which includes access to schooling. However, there is scant information that focuses on disclosure of their positive sero-status to schools and how these children understand and communicate their illnesses. This paper reports on a study of experiences of children affected by HIV and AIDS in Kenya. Qualitative phenomenological data from children aged between 5 and 7 years and their teachers in Early Childhood Development and Education (ECDE) centres were collected using multiple methods. Thematic content analysis was utilised with several themes emerging from findings. Obstacles to disclosure, anticipation of exceptional care, accidental disclosures, lack of psychosocial structures, a need for specialised skills training for teachers, and lack of clear guidelines to assist in disclosure processes emerged as some of the challenges faced. The findings also provide insights into teachers' scaffolding efforts to educate children in understanding and communicating their illnesses, and forging support structures through relationships with their siblings and peers for care and management. [ABSTRACT FROM AUTHOR] more...
- Published
- 2019
- Full Text
- View/download PDF
50. Positive religious coping predicts self-reported HIV medication adherence at baseline and twelve-month follow-up among Black Americans living with HIV in the Southeastern United States.
- Author
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Poteat, Tonia and Lassiter, Jonathan Mathias
- Subjects
PSYCHOLOGICAL adaptation ,AGE distribution ,BLACK people ,MENTAL depression ,DRUGS ,HIV-positive persons ,PATIENT aftercare ,PATIENT compliance ,QUESTIONNAIRES ,RELIGION ,SELF-evaluation ,MULTIPLE regression analysis ,HIGHLY active antiretroviral therapy ,DESCRIPTIVE statistics - Abstract
This paper presents the results of secondary data analyses investigating the influence of religious coping on HIV medication adherence across time among 167 Black Americans living with HIV (BALWH) in the Southeastern United States. Participants were recruited from a large urban clinic in Atlanta, GA and completed questionnaires about their religious coping at baseline assessment and about their medication adherence at baseline and 12-month follow-up assessment. Descriptive analyses and multiple linear regression were used to determine the association between religious coping and HIV medication adherence. Findings indicated that after controlling for age and depressive symptoms at baseline, positive religious coping significantly predicted medication adherence at baseline and 12-month follow-up. Negative religious coping was inversely associated with medication adherence at baseline after controlling for age and depressive symptoms but not at 12-month follow-up. The implications of these findings for future research and intervention work related to medication adherence among BALWH are discussed. [ABSTRACT FROM AUTHOR] more...
- Published
- 2019
- Full Text
- View/download PDF
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