Search

International focus on reducing onward HIV transmission emphasizes the need for routine HIV testing and early uptake of antiretroviral treatment (ART). Strategic targets have been set for 2020 to achieve the goal of 90% of people infected with HIV diagnosed, 90% of identified cases on treatment, and 90% of persons on treatment virally suppressed (90–90–90). It is vital to understand the complexity of factors influencing a person's treatment decisions over time and the context which may enable better adherence. In this paper we present findings from the review of published and gray literature (2003–2013) on the documented factors associated with treatment initiation and adherence in the general adult population of Australia, Canada, and the UK. A framework developed by Begley, McLaws, Ross, and Gold [2008. Cognitive and behavioural correlates of non-adherence to HIV anti-retroviral therapy: Theoretical and practical insight for clinical psychology and health psychology.Clinical Psychologist, 12(1), 9–17] in Australia was adapted to summarize the findings. A systematic database search using keywords and a set of inclusion criteria yielded 17 studies (Australia = 6; Canada = 8; UK = 3). In addition 11 reports were included in the review. We found that a person's abilities and motivations (intrapersonal factors, reported in 7 studies) to start and continue ART are influenced by a host of interconnected factors spanning relationship (interpersonal, 3 studies) and broader structural (extrapersonal, 15 studies) factors that are situated within social determinants of health. People therefore evaluate various costs and benefits of starting and staying on treatment, in which biomedical concerns play an important yet often subsidiary role. In this review the economic barriers to care were found to be significant and under-reported, highlighting the persistent health inequities in terms of access to services. Our understanding of the context around people's use of ART remains poor. Qualitative social research within HIV-positive communities is urgently needed to capture people's lived experiences and may address some of this deficit in understanding. [ABSTRACT FROM AUTHOR]

Canada and the United Kingdom have pedigrees in offering asylum; however, research in both countries has demonstrated widespread poverty amongst asylum seekers and a high risk of homelessness. Focusing on case examples drawn from 60 in-depth interviews with refugees in Toronto and London, this paper shows how national and local structures shape pathways to homelessness, and how refugees interpret their homlessness in the context of their flight from persecution, reception, and settlement. [ABSTRACT FROM AUTHOR]

With the current global focus on strengthening HIV prevention through greater testing and treatment uptake, it is increasingly salient to identify and address barriers to testing. A review of the published, peer-reviewed literature and national reports from Australia, Canada, and the UK (2003–2013) on barriers to HIV testing was conducted to provide new information relevant to Australia and to complement earlier reviews from Canada and the UK. A systematic database search using keywords and a set of inclusion criteria yielded 36 studies (Australia = 13; Canada = 6; and the UK = 17). In addition 17 unpublished reports were included in the review. Our study uses a novel, comprehensive framework to describe barriers to HIV testing, and thus contributes to moving beyond the traditional patient–provider–system categorization. Within that framework, barriers are categorized as either intrapersonal (reported in 15 studies), interpersonal (21), or extrapersonal (16) and conceptualized within wider sociocultural and structural contexts. People's abilities and motivations to test (intrapersonal factors) are influenced by a host of interconnected factors spanning relationship (interpersonal) and broader socioeconomic, political and cultural (extrapersonal) factors. We suggest that the relative effects of interventions targeting barriers to HIV testing at the intrapersonal and interpersonal levels are limited by the extent to which the social determinants of health are addressed. The framework may also lend itself to thinking about the enabling factors for HIV testing, and future research may investigate the application of that framework for strategizing the most effective response. Future studies should also capture the lived experiences of barriers to HIV testing experienced by patients, especially in populations which are hard to reach based on social and geographic distance. Context-specific studies to evaluate the feasibility and effectiveness of various interventions proposed in the literature to address barriers to HIV testing are needed. [ABSTRACT FROM AUTHOR]

This article provides a framing analysis of mainstream press coverage of poverty (offline and online) in Canada and the UK, and compares mainstream news coverage to coverage on alternative news sites. The research questions the extent to which, and how, coverage of children and immigrants presents contemporary constructions of the ‘deserving’ and ‘undeserving poor’. It is argued that rationalizing and individualizing frames dominate coverage of poverty and immigration. The author suggests that the significance of the dominance of these frames is their ability to privilege and embed market-based approaches to poverty and immigration. An analysis of alternative news content reveals the extent to which social justice frames, the very frames that counter market-based approaches, are absent from mainstream news coverage. Overall, these results indicate that challenging problematic representations and approaches to poverty will require changing representations, an expansion of coverage that runs counter to news norms, and structural investments. [ABSTRACT FROM AUTHOR]

This article is a result of a transnational comparison of two broadcast book programs' influence on readers' book choices. Online surveys and focus group interviews in Canada and the UK illustrate active audience participation in the converged era of print books, the internet, television and radio. The analysis examines readers' negotiation of book choices through uses and gratifications theory as informed by a cultural critique of the programs themselves. Readers simultaneously respond to and create a hierarchy of cultural tastes that are bound up in the cultural assumptions that they have about the different media. [ABSTRACT FROM AUTHOR]

The responsibility of the social work profession to be inclusive and equitable in its service provision is reviewed via policies relating to professional training regarding sexual orientation issues. A comparative review of Canada, the United Kingdom (UK) and the United States of America (USA) and international standards regarding sexual orientation issues in social work codes of ethics and curricula standards was undertaken. A consistency exists in the USA between its ethics code and curriculum standards further backed by a mandated approach, but it is weak in the area of ethically principled practice skills. Both Canada and the UK are less consistent and comprehensive and lack a mandated approach. The results speak to where consistencies exist and where they need to be established in order to develop an infrastructure that properly trains social workers in cultural competency for these populations. [ABSTRACT FROM AUTHOR]