Search

A growing number of older adults in the USA are contracting new HIV infections, and more persons living with HIV are living longer due to medical treatment advances. New treatments for HIV disease can improve immune functioning and decrease AIDS-related mortality. However, older persons living with HIV may not respond well to treatment and may experience difficulties adhering to complex medication regimens. One hundred and thirteen late middle-aged and older adults living with HIV (aged 47-69 years) were administered measures of demographic, medical and psychological characteristics. Eighty-four of these patients were currently prescribed antiretroviral medication for treatment of HIV, and this sub-set of participants completed brief self-report measures of medication adherence. Nearly one-third (31%) of older adults reported skipping medication doses in the past week. Education level, satisfaction with patient-provider relationships, physical wellbeing, alcohol use, perceptions of life stressor burden, anxiety and somatization distinguished patients reporting consistent versus inconsistent adherence. Less education, poorer relationships with physicians, greater alcohol use and higher levels of somatization uniquely predicted adherence problems in a multivariate model. Reasons for nonadherence most frequently cited by older adults are presented and recommendations are offered regarding adherence-related domains that should be monitored and addressed among older adults receiving HIV care. [ABSTRACT FROM AUTHOR]

The U.S. Food and Drug Administration's (FDA) 2013 decision to lower recommended Ambien dosing for women has been widely cited as a hallmark example of the importance of sex differences in biomedicine. Using regulatory documents, scientific publications, and media coverage, this article analyzes the making of this highly influential and mobile 'sex-difference fact'. As we show, the FDA's decision was a contingent outcome of the drug approval process. Attending to how a contested sex-difference fact came to anchor elite women's health advocacy, this article excavates the role of regulatory processes, advocacy groups, and the media in producing perceptions of scientific agreement while foreclosing ongoing debate, ultimately enabling the stabilization of a binary, biological sex-difference fact and the distancing of this fact from its conditions of construction.

Objectives: We provided oral health care services at 2 sites using a nurse practitioner-dietitian team to increase dental workforce capacity and improve access to care for low-income preschool children., Methods: Our team provided oral health assessments and education, fluoride varnish application, and dentist referrals. The primary endpoint was participants' access to oral health care. Secondary endpoints included increasing the practice scope of registered dietitians through training programs for oral health assessment and the application of fluoride varnishes for children. The oral health and hygiene and dietary habits of the participants were also determined., Results: From 2010 to 2013, 4360 children received fluoride varnishes in 7195 total visits. Although the proportion of children with dental caries at the first visit was greater at the urban site, both sites were similar by visits 2 and 3. The number of caries declined with increased program visits, which coincided with an increase in the proportion of participants visiting a dentist., Conclusions: Progress toward eliminating dental health disparities requires addressing barriers to dental care access. We showed that expanding access to oral health services through nurse practitioner-dietitian cooperation improved access to preventive fluoride varnishing use in low-income children.

Patterns of HIV-status disclosure and social support were examined among 331 HIV-positive men and women. Structured interviews assessed HIV-status disclosure to family and friends, perceived stress of disclosure, social support, and depression. Results showed patterns of selective disclosure, where most participants disclosed to some relationship members and not to others. Rates of disclosure were associated with social support. Friends were disclosed to most often and perceived as more supportive than family members, and mothers and sisters were disclosed to more often than fathers and brothers and perceived as more supportive than other family members. Path analyses tested a model of HIV-status disclosure showing that perceived stress of disclosing HIV was associated with disclosure, and disclosures were related to social support. Disclosure and its association to social support and depression varied for different relationships and these differences have implications for mental health and coping interventions.