33 results on '"Beaver, Kerrigan"'
Search Results
2. Strategies for Recruiting Women Living with Human Immunodeficiency Virus in Community-Based Research: Lessons from Canada
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Webster, Kath, Carter, Allison, Proulx-Boucher, Karène, Dubuc, Danièle, Nicholson, Valerie, Beaver, Kerrigan, Gasingirwa, Claudine, Ménard, Brigitte, O'Brien, Nadia, Mitchell, Kayla, Bajard, Micaela Pereira, Ding, Erin, de Pokomandy, Alexandra, Loutfy, Mona, and Kaida, Angela
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- 2018
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3. A Journey of Doing Research “In a Good Way” : Partnership, Ceremony, and Reflections Contributing to the Care and Wellbeing of Indigenous Women Living with HIV in Canada
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Peltier, Doris, Martin, Carrie, Masching, Renée, Standup, Mike, Cardinal, Claudette, Nicholson, Valerie, Kazemi, Mina, Kaida, Angela, Warren, Laura, Jaworsky, Denise, Gervais, Laverne, de Pokomandy, Alexandra, Bruce, Sharon, Greene, Saara, Becker, Marissa, Cotnam, Jasmine, Larkin, Kecia, Beaver, Kerrigan, Bourassa, Carrie, and Loutfy, Mona
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- 2020
4. Racism Experiences of Urban Indigenous Women in Ontario, Canada : “We All Have That Story That Will Break Your Heart”
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Benoit, Anita C., Cotnam, Jasmine, O'Brien-Teengs, Doe, Greene, Saara, Beaver, Kerrigan, Zoccole, Art, and Loutfy, Mona
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- 2019
5. Adapting stigma mechanism frameworks to explore complex pathways between intersectional stigma and HIV-related health outcomes among women living with HIV in Canada
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Logie, Carmen H., Williams, Charmaine C., Wang, Ying, Marcus, Natania, Kazemi, Mina, Cioppa, Lynne, Kaida, Angela, Webster, Kath, Beaver, Kerrigan, de Pokomandy, Alexandra, and Loutfy, Mona
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- 2019
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6. Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada
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Anema, Aranka, Becker, Denise, Brotto, Lori, Carter, Allison, Cardinal, Claudette, Colley, Guillaume, Ding, Erin, Duddy, Janice, Gataric, Nada, Hogg, Robert S., Howard, Terry, Jabbari, Shahab, Jones, Evin, Kestler, Mary, Langlois, Andrea, Lima, Viviane, Lloyd-Smith, Elisa, Medjuck, Melissa, Miller, Cari, Money, Deborah, Nicholson, Valerie, Ogilvie, Gina, Patterson, Sophie, Pick, Neora, Roth, Eric, Salters, Kate, Sanchez, Margarite, Sas, Jacquie, Sereda, Paul, Summers, Marcie, Tom, Christina, Wang, Clara, Webster, Kath, Zhang, Wendy, Abdul-Noor, Rahma, Angel, Jonathan, Barry, Fatimatou, Bauer, Greta, Beaver, Kerrigan, Benoit, Anita, Bertozzi, Breklyn, Borton, Sheila, Bourque, Tammy, Brophy, Jason, Burchell, Ann, Carlson, Allison, Cioppa, Lynne, Cohen, Jeffrey, Conway, Tracey, Cooper, Curtis, Cotnam, Jasmine, Cousineau, Janette, Desbiens, Marisol, Fraleigh, Annette, Gagnier, Brenda, Gasingirwa, Claudine, Greene, Saara, Hart, Trevor, Islam, Shazia, Kaushic, Charu, Kennedy, Logan, Kerr, Desiree, Kwaramba, Gladys, Leonard, Lynne, Lewis, Johanna, Logie, Carmen, Margolese, Shari, Muchenje, Marvelous, Ndung'u, Mary (Muthoni), O’Brien, Kelly, Ouellette, Charlene, Powis, Jeff, Quan, Corinna, Raboud, Janet, Rachlis, Anita, Ralph, Edward, Rourke, Sean, Rueda, Sergio, Sandre, Roger, Smaill, Fiona, Smith, Stephanie, Tigere, Tsitsi, Tharao, Wangari, Walmsley, Sharon, Wobeser, Wendy, Yee, Jessica, Yudin, Mark, Bakombo, Dada Mamvula, Baril, Jean-Guy, Boucher, Marc, Boucoiran, Isabelle, Burke, Nora Butler, Clément, Pierrette, Côté, José, Dayle, Janice, Dubuc, Danièle, Fernet, Mylène, Gagnon, Marilou, Groleau, Danielle, Hot, Aurélie, Kiboyogo, Maxime, Klein, Marina, Lacasse, Gary, Lamarre, Valérie, Martin, Carrie, Massie, Lyne, Ménard, Brigitte, Monteith, Ken, O'Brien, Nadia, Otis, Joanne, Peltier, Doris, Pierre, Alie, Proulx-Boucher, Karène, Rouleau, Danielle, Rouleau, Geneviève, Savoie, Édénia, Tremblay, Cécile, Trottier, Benoit, Trottier, Sylvie, Tsoukas, Christos, Gahagan, Jacqueline, Hankins, Catherine, Masching, Renee, Ogunnaike-Cooke, Susanna, Kaufman, Elaina, Ennabil, Nourane, Andersson, Neil, Loutfy, Mona, de Pokomandy, Alexandra, and Kaida, Angela
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- 2017
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7. Increased mortality among Indigenous persons in a multisite cohort of people living with HIV in Canada
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Benoit, Anita C., Younger, Jaime, Beaver, Kerrigan, Jackson, Randy, Loutfy, Mona, Masching, Renée, Nobis, Tony, Nowgesic, Earl, O’Brien-Teengs, Doe, Whitebird, Wanda, Zoccole, Art, Hull, Mark, Jaworsky, Denise, Benson, Elizabeth, Rachlis, Anita, Rourke, Sean B., Burchell, Ann N., Cooper, Curtis, Hogg, Robert S., Klein, Marina B., Machouf, Nima, Montaner, Julio S.G., Tsoukas, Chris, and Raboud, Janet
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- 2017
8. Experiences of chronic stress and mental health concerns among urban Indigenous women
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Benoit, Anita C., Cotnam, Jasmine, Raboud, Janet, Greene, Saara, Beaver, Kerrigan, Zoccole, Art, O’Brien-Teengs, Doe, Balfour, Louise, Wu, Wei, and Loutfy, Mona
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- 2016
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9. Pathways From HIV-Related Stigma to Antiretroviral Therapy Measures in the HIV Care Cascade for Women Living With HIV in Canada
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Logie, Carmen H., Lacombe-Duncan, Ashley, Wang, Ying, Kaida, Angela, Conway, Tracey, Webster, Kath, de Pokomandy, Alexandra, Loutfy, Mona R., Anema, Aranka, Becker, Denise, Brotto, Lori, Carter, Allison, Cardinal, Claudette, Colley, Guillaume, Ding, Erin, Duddy, Janice, Gataric, Nada, Hogg, Robert S., Hosward, Terry, Jabbari, Shahab, Jones, Evin, Kestler, Mary, Langlois, Andrea, Lima, Viviane, Lloyd-Smith, Elisa, Medjuck, Melissa, Miller, Cari, Money, Deborah, Nicholson, Valerie, Ogilvie, Gina, Patterson, Sophie, Pick, Neora, Roth, Eric, Salters, Kate, Sanchez, Margarite, Sas, Jacquie, Sereda, Paul, Summers, Marcie, Tom, Christina, Wang, Lu, Webster, Kath, Zhang, Wendy, Abdul-Noor, Rahma, Angel, Jonathan, Barry, Fatimatou, Bauer, Greta, Beaver, Kerrigan, Benoit, Anita, Bertozzi, Breklyn, Borton, Sheila, Bourque, Tammy, Brophy, Jason, Burchell, Ann, Carlson, Allison, Cioppa, Lynne, Cohen, Jeffrey, Conway, Tracey, Cooper, Curtis, Cotnam, Jasmine, Cousineau, Janette, Fraleigh, Annette, Gagnier, Brenda, Gasingirwa, Claudine, Greene, Saara, Hart, Trevor, Islam, Shazia, Kaushic, Charu, Kennedy, Logan, Kerr, Desiree, Kiboyogo, Maxime, Kwaramba, Gladys, Leonard, Lynne, Lewis, Johanna, Logie, Carmen, Margolese, Shari, Muchenje, Marvelous, Ndungʼu, Mary, OʼBrien, Kelly, Ouellette, Charlene, Powis, Jeff, Quan, Corinna, Raboud, Janet, Rachlis, Anita, Ralph, Edward, Rourke, Sean, Rueda, Sergio, Sandre, Roger, Smaill, Fiona, Smith, Stephanie, Tigere, Tsitsi, Tharao, Wangari, Walmsley, Sharon, Wobeser, Wendy, Yee, Jessica, Yudin, Mark, Baril, Jean-Guy, Burke, Nora Butler, Clément, Pierrette, Dayle, Janice, Dubuc, Danièle, Fernet, Mylène, Groleau, Danielle, Hot, Aurélie, Klein, Marina, Martin, Carrie, Massie, Lyne, Ménard, Brigitte, OʼBrien, Nadia, Otis, Joanne, Peltier, Doris, Pierre, Alie, Proulx-Boucher, Karène, Rouleau, Danielle, Savoie, Édénia, Tremblay, Cécile, Trottier, Benoit, Trottier, Sylvie, Tsoukas, Christos, Gahagan, Jacqueline, Hankins, Catherine, Masching, Renee, and Ogunnaike-Cooke, Susanna
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- 2018
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10. Chapter 8: A Community-Based Research Approach to Developing an hiv Education and Training Module for Child and Family Service Workers in Ontario
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Greene, Saara, primary, O’Brien-Teengs, Doe, additional, Dumbrill, Gary, additional, Ion, Allyson, additional, Beaver, Kerrigan, additional, Porter, Megan, additional, and Desbiens, Marisol, additional
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- 2016
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11. A longitudinal study of associations between HIV-related stigma, recent violence and depression among women living with HIV in a Canadian cohort study
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Logie, Carmen H., Marcus, Natania, Wang, Ying, Kaida, Angela, O'Campo, Patricia, Ahmed, Uzma, O'Brien, Nadia, Nicholson, Valerie, Conway, Tracey, Pokomandy, Alexandra, Fernet, Mylène, Loutfy, Mona, Anema, Aranka, Becker, Denise, Brotto, Lori, Carter, Allison, Cardinal, Claudette, Colley, Guillaume, Ding, Erin, Duddy, Janice, Gataric, Nada, Hogg, Robert S., Howard, Terry, Jabbari, Shahab, Jones, Evin, Kestler, Mary, Langlois, Andrea, Lima, Viviane, Lloyd?Smith, Elisa, Medjuck, Melissa, Miller, Cari, Money, Deborah, Ogilvie, Gina, Patterson, Sophie, Pick, Neora, Roth, Eric, Salters, Kate, Sanchez, Margarite, Sas, Jacquie, Sereda, Paul, Summers, Marcie, Tom, Christina, Wang, Lu, Webster, Kath, Zhang, Wendy, Abdul?Noor, Rahma, Angel, Jonathan, Barry, Fatimatou, Bauer, Greta, Beaver, Kerrigan, Benoit, Anita, Bertozzi, Breklyn, Borton, Sheila, Bourque, Tammy, Brophy, Jason, Burchell, Ann, Carlson, Allison, Cioppa, Lynne, Cohen, Jeffrey, Cooper, Curtis, Cotnam, Jasmine, Cousineau, Janette, Gagnier, Brenda, Gasingirwa, Claudine, Greene, Saara, Hart, Trevor, Islam, Shazia, Kennedy, Logan, Kerr, Desiree, Kiboyogo, Maxime, Kwaramba, Gladys, Leonard, Lynne, Lewis, Johanna, Margolese, Shari, Muchenje, Marvelous, O'Brien, Kelly, Ouellette, Charlene, Powis, Jeff, Quan, Corinna, Raboud, Janet, Rachlis, Anita, Ralph, Edward, Rourke, Sean, Rueda, Sergio, Sandre, Roger, Smaill, Fiona, Smith, Stephanie, Tigere, Tsitsi, Tharao, Wangari, Walmsley, Sharon, Wobeser, Wendy, Yee, Jessica, Yudin, Mark, Bakombo, Dada Mamvula, Baril, Jean?Guy, Burke, Nora Butler, Clément, Pierrette, Dayle, Janice, Dubuc, Danièle, Groleau, Danielle, Hot, Aurélie, Klein, Marina, Martin, Carrie, Massie, Lyne, Ménard, Brigitte, Otis, Joanne, Peltier, Doris, Pierre, Alie, Proulx?Boucher, Karène, Rouleau, Danielle, Savoie, Édénia, Tremblay, Cécile, Trottier, Benoit, Trottier, Sylvie, Tsoukas, Christos, Gahagan, Jacqueline, Hankins, Catherine, Masching, Renee, and Ogunnaike?Cooke, Susanna
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Women -- Health aspects ,Discrimination against AIDS virus carriers -- Prevention ,HIV patients -- Care and treatment ,Stigma (Social psychology) -- Analysis ,Family violence -- Demographic aspects -- Prevention ,Health - Abstract
: Introduction: Women living with HIV (WLHIV) experience stigma and elevated exposure to violence in comparison with HIV‐negative women. We examined the mediating role of experiencing recent violence in the relationship between stigma and depression among WLHIV in Canada. Methods: We conducted a cohort study with WLHIV in three Canadian provinces. Recent violence was assessed through self‐reported experiences of control, physical, sexual or verbal abuse in the past three months. At Time 1 (2013‐2015) three forms of stigma were assessed (HIV‐related, racial, gender) and at Time 2 (2015‐2017) only HIV‐related stigma was assessed. We conducted structural equation modelling (SEM) using the maximum likelihood estimation method with Time 1 data to identify direct and indirect effects of gender discrimination, racial discrimination and HIV‐related stigma on depression via recent violence. We then conducted mixed effects regression and SEM using Time 1 and Time 2 data to examine associations between HIV‐related stigma, recent violence and depression. Results: At Time 1 (n = 1296), the direct path from HIV‐related stigma (direct effect: β = 0.200, p < 0.001; indirect effect: β = 0.014, p < 0.05) to depression was significant; recent violence accounted for 6.5% of the total effect. Gender discrimination had a significant direct and indirect effect on depression (direct effect: β = 0.167, p < 0.001; indirect effect: β = 0.050, p < 0.001); recent violence explained 23.15% of the total effect. Including Time 1 and Time 2 data (n = 1161), mixed‐effects regression results indicate a positive relationship over time between HIV‐related stigma and depression (Acoef: 0.04, 95% CI: 0.03, 0.06, p < 0.001), and recent violence and depression (Acoef: 1.95, 95% CI: 0.29, 4.42, p < 0.05), controlling for socio‐demographics. There was a significant interaction between HIV‐related stigma and recent violence with depression (Acoef: 0.04, 95% CI: 0.01, 0.07, p < 0.05). SEM analyses reveal that HIV‐related stigma had a significant direct and indirect effect on depression over time (direct effect: β = 0.178, p < 0.001; indirect effect: β = 0.040, p < 0.001); recent violence experiences accounted for 51% of the total effect. Conclusions: Our findings suggest that HIV‐related stigma is associated with increased experiences of recent violence, and both stigma and violence are associated with increased depression among WLHIV in Canada. There is an urgent need for trauma‐informed stigma interventions to address stigma, discrimination and violence., Introduction Gender‐based violence (GBV) disproportionately impacts and compromises the wellbeing of women and girls across the world. A global participatory survey among women living with HIV (WLHIV) found that 89% [...]
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- 2019
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12. Help-Seeking to Cope With Experiences of Violence Among Women Living With HIV in Canada
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Gormley, Rebecca, primary, Nicholson, Valerie, additional, Parry, Rebeccah, additional, Lee, Melanie, additional, Webster, Kath, additional, Sanchez, Margarite, additional, Cardinal, Claudette, additional, Li, Jenny, additional, Wang, Lu, additional, Balleny, Rosa, additional, de Pokomandy, Alexandra, additional, Loutfy, Mona, additional, Kaida, Angela, additional, Abdul-Noor, Rahma, additional, Anema, Aranka, additional, Angel, Jonathan, additional, Bakombo, Dada Mamvula, additional, Barry, Fatimatou, additional, Bauer, Greta, additional, Beaver, Kerrigan, additional, Boucher, Marc, additional, Boucoiran, Isabelle, additional, Brophy, Jason, additional, Brotto, Lori, additional, Burchell, Ann, additional, Carter, Allison, additional, Cioppa, Lynne, additional, Conway, Tracey, additional, Côté, José, additional, Cotnam, Jasmine, additional, d’Ambrumenil, Cori, additional, Dayle, Janice, additional, Ding, Erin, additional, Dubuc, Danièle, additional, Duddy, Janice, additional, Fernet, Mylène, additional, Fraleigh, Annette, additional, Frank, Peggy, additional, Gagnier, Brenda, additional, Gagnon, Marilou, additional, Gahagan, Jacqueline, additional, Gasingirwa, Claudine, additional, Gataric, Nada, additional, Gormley, Rebecca, additional, Greene, Saara, additional, Groleau, Danielle, additional, Guerlotté, Charlotte, additional, Hart, Trevor, additional, Hankins, Catherine, additional, Hawa, Roula, additional, Heer, Emily, additional, Hogg, Robert S., additional, Howard, Terry, additional, Islam, Shazia, additional, Jean-Gilles, Joseph, additional, Jefferis, Hermione, additional, Jones, Evin, additional, Kaushic, Charu, additional, Kazemi, Mina, additional, Kestler, Mary, additional, Kiboyogo, Maxime, additional, Klein, Marina, additional, Kronfli, Nadine, additional, Kwaramba, Gladys, additional, Lacasse, Gary, additional, Lacombe-Duncan, Ashley, additional, Lee, Rebecca, additional, Lima, Viviane, additional, Lloyd-Smith, Elisa, additional, Logie, Carmen, additional, Maan, Evelyn, additional, Martel-Lafrenière, Valérie, additional, Martin, Carrie, additional, Masching, Renee, additional, Massie, Lyne, additional, Medjuck, Melissa, additional, Ménard, Brigitte, additional, Miller, Cari L., additional, Mitchell, Judy, additional, Mondragon, Gerardo, additional, Money, Deborah, additional, Monteith, Ken, additional, Muchenje, Marvelous, additional, Mukandamutsa, Florida, additional, Ndung’u, Mary, additional, O’Brien, Kelly, additional, O’Brien, Nadia, additional, Ogilvie, Gina, additional, Ogunnaike-Cooke, Susanna, additional, Otis, Joanne, additional, Patterson, Sophie, additional, Paul, Angela, additional, Peltier, Doris, additional, Pick, Neora, additional, Pierre, Alie, additional, Powis, Jeff, additional, Proulx-Boucher, Karène, additional, Quan, Corinna, additional, Rana, Jesleen, additional, Roth, Eric, additional, Rouleau, Danielle, additional, Rouleau, Geneviève, additional, Rueda, Sergio, additional, Salters, Kate, additional, Sandre, Roger, additional, Sas, Jacquie, additional, Savoie, Édénia, additional, Sereda, Paul, additional, Smith, Stephanie, additional, Summers, Marcie, additional, Tharao, Wangari, additional, Tom, Christina, additional, Tremblay, Cécile, additional, Trigg, Jason, additional, Trottier, Sylvie, additional, Underhill, Angela, additional, Wagner, Anne, additional, Walmsley, Sharon, additional, Wang, Clara, additional, Wobeser, Wendy, additional, Wozniak, Denise, additional, Yudin, Mark, additional, Zhang, Wendy, additional, and Zhu, Julia, additional
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- 2021
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13. Indigenizing our Research
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Nicholson, Valerie, primary, Bratu, Andreea, additional, McClean, Alison R, additional, Jawanda, Simran, additional, Aran, Niloufar, additional, Hillstrom, Knighton, additional, Hennie, Evelyn, additional, Cardinal, Claudette, additional, Benson, Elizabeth, additional, Beaver, Kerrigan, additional, Benoit, Anita C, additional, Hogg, Bob, additional, Jaworsky, Denise, additional, and Research Team, Building More Bridges, additional
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- 2021
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14. Social Determinants of Health and Retention in HIV Care Among Recently Incarcerated Women Living with HIV in Canada
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Gormley, Rebecca, Lin, Sally Y., Carter, Allison, Nicholson, Valerie, Webster, Kath, Martin, Ruth Elwood, Milloy, M. J., Pick, Neora, Howard, Terry, Wang, Lu, de Pokomandy, Alexandra, Loutfy, Mona, Kaida, Angela, Abdul-Noor, Rahma, Anema, Aranka, Angel, Jonathan, Bakombo, Dada Mamvula, Barry, Fatimatou, Bauer, Greta, Beaver, Kerrigan, Boucher, Marc, Boucoiran, Isabelle, Brophy, Jason, Brotto, Lori, Burchell, Ann, Cardinal, Claudette, Cioppa, Lynne, Conway, Tracey, Côté, José, Cotnam, Jasmine, d’Ambrumenil, Cori, Dayle, Janice, Ding, Erin, Dubuc, Danièle, Duddy, Janice, Fernet, Mylène, Fraleigh, Annette, Frank, Peggy, Gagnier, Brenda, Gagnon, Marilou, Gahagan, Jacqueline, Gasingirwa, Claudine, Gataric, Nada, Greene, Saara, Groleau, Danielle, Guerlotté, Charlotte, Hart, Trevor, Hankins, Catherine, Global Health, and APH - Global Health
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Adult ,Canada ,medicine.medical_specialty ,Social Psychology ,CHIWOS ,Incarceration ,Human immunodeficiency virus (HIV) ,Post-incarceration ,HIV Infections ,medicine.disease_cause ,Indigenous ,Medication Adherence ,03 medical and health sciences ,Social determinants of health ,0302 clinical medicine ,5. Gender equality ,medicine ,Humans ,Women ,030212 general & internal medicine ,Multinomial logistic regression ,Sex work ,Ontario ,030505 public health ,British Columbia ,business.industry ,Prisoners ,Public health ,Quebec ,Public Health, Environmental and Occupational Health ,HIV ,Health psychology ,Cross-Sectional Studies ,Infectious Diseases ,Adherence ,Female ,Residence ,0305 other medical science ,business ,Demography - Abstract
Women living with HIV (WLWH) are over-represented in corrections in Canada, yet little is known about women’s experiences post-release. We used CHIWOS cross-sectional data from WLWH to estimate associations between social determinants of health and HIV-related care outcomes among WLWH with recent (within past year) or ever (before past year) incarceration experience. Lifetime incarceration prevalence was 36.9% (6.5% recent; 30.4% ever), with significant differences by province of residence (British Columbia: 10% recent; 52% ever; Ontario: 5%; 24%; Quebec: 6%; 22%; p < 0.001). In adjusted multinomial logistic regression analyses, compared with never incarcerated, recent incarceration was associated with Indigenous ancestry, lower annual income (< $20,000 CAD), unstable housing, current sex work, injection drug use (IDU), and sub-optimal antiretroviral therapy (ART) adherence, while ever incarceration was associated with current sex work, IDU, and experiencing adulthood violence. Our findings have implications regarding supports needed by WLWH in the post-release period, including ART adherence and achieving health and social goals.
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- 2020
15. Help-Seeking to Cope With Experiences of Violence Among Women Living With HIV in Canada.
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Gormley, Rebecca, Nicholson, Valerie, Parry, Rebeccah, Lee, Melanie, Webster, Kath, Sanchez, Margarite, Cardinal, Claudette, Li, Jenny, Wang, Lu, Balleny, Rosa, de Pokomandy, Alexandra, Loutfy, Mona, Kaida, Angela, Abdul-Noor, Rahma, Anema, Aranka, Angel, Jonathan, Bakombo, Dada Mamvula, Barry, Fatimatou, Bauer, Greta, and Beaver, Kerrigan
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FRIENDSHIP ,STATISTICS ,SOCIAL support ,HEALTH services accessibility ,SEXISM ,CONFIDENCE intervals ,DOMESTIC violence ,HELP-seeking behavior ,FAMILIES ,COMMUNITY health services ,FISHER exact test ,MANN Whitney U Test ,SOCIOECONOMIC factors ,QUESTIONNAIRES ,CHI-squared test ,PSYCHOLOGICAL adaptation ,STATISTICAL correlation ,LOGISTIC regression analysis ,ODDS ratio ,DATA analysis software ,PSYCHOLOGY of HIV-positive persons ,MENTAL illness ,SECONDARY analysis - Abstract
Using baseline data from a community-collaborative cohort of women living with HIV in Canada, we assessed the prevalence and correlates of help-seeking among 1,057 women who reported experiencing violence in adulthood (≥16 years). After violence, 447 (42%) sought help, while 610 (58%) did not. Frequently accessed supports included health care providers (n = 313, 70%), family/friends (n = 244, 55%), and non-HIV community organizations (n = 235, 53%). All accessed supports were perceived as helpful. Independent correlates of help-seeking included reporting a previous mental health diagnosis, a history of injection drug use, experiencing childhood violence, and experiencing sexism. We discuss considerations for better supporting women who experience violence. [ABSTRACT FROM AUTHOR]
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- 2022
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16. Sexual inactivity and sexual satisfaction among women living with HIV in Canada in the context of growing social, legal and public health surveillance
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Kaida, Angela, Carter, Allison, de Pokomandy, Alexandra, Patterson, Sophie, Proulx-Boucher, Karene, Nohpal, Adriana, Sereda, Paul, Colley, Guillaume, O'Brien, Nadia, Thomas-Pavanel, Jamie, Beaver, Kerrigan, Nicholson, Valerie J., Tharao, Wangari, Fernet, Mylene, Otis, Joanne, Hogg, Robert S., and Loutfy, Mona
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HIV patients -- Sexual behavior ,HIV infections -- Research -- Development and progression ,Women -- Sexual behavior ,Health - Abstract
Introduction: Women represent nearly one-quarter of the 71,300 people living with HIV in Canada. Within a context of widespread HIV-related stigma and discrimination and on-going risks to HIV disclosure, little is known about the influence of growing social, legal and public health surveillance of HIV on sexual activity and satisfaction of women living with HIV (WLWH). Methods: We analyzed baseline cross-sectional survey data for WLWH (>16 years, self-identifying as women) enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a multisite, longitudinal, community-based research study in British Columbia (BC), Ontario (ON) and Quebec (QC). Sexual inactivity was defined as no consensual sex (oral or penetrative) in the prior six months, excluding recently postpartum women ( Results: Of 1213 participants (26% BC, 50% ON, 24% QC), median age was 43 years (IQR: 35, 50). 23% identified as Aboriginal, 28% as African, Caribbean and Black, 41% as White and 8% as other ethnicities. Heterosexual orientation was reported by 87% of participants and LGBTQ by 13%. In total, 82% were currently taking antiretroviral therapy (ART), and 77% reported an undetectable viral load (VL Conclusions: Approximately half of WLWH in this study reported being sexually inactive. Associations with sexual dissatisfaction and high HIV-related stigma suggest that WLWH face challenges navigating healthy and satisfying sexual lives, despite good HIV treatment outcomes. As half of sexually inactive women reported being satisfied with their sex lives, additional research is required to determine whether WLWH are deliberately choosing abstinence as a means of resisting surveillance and disclosure expectations associated with sexual activity. Findings underscore a need for interventions to de-stigmatize HIV, support safe disclosure and re-appropriate the sexual rights of WLWH. Keywords: HIV; women; Canada; sexual and reproductive health; sexual abstinence; sexual satisfaction; community-based research; antiretroviral therapy; CHIWOS., Introduction Globally, women account for over half of all adults living with HIV [1]. In Canada, approximately one-quarter of the 71,300 people living with HIV (PLWH) are women, nearly double [...]
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- 2015
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17. P069 Do cannabis use and social support mediate the relationship between intersectional stigma and bodily pain and functioning?
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Logie, Carmen, primary, Wang, Ying, additional, Kazemi, Mina, additional, Gagnier, Brenda, additional, Conway, Tracey, additional, Islam, Shazia, additional, Lee, Melanie, additional, Beaver, Kerrigan, additional, Kaida, Angela, additional, Pokomandy, Alexandra De, additional, and Loutfy, Mona, additional
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- 2019
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18. P276 A national action plan to advance the sexual and reproductive health and rights of women living with HIV in canada
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Kaida, Angela, primary, Conway, Tracey, additional, Tharao, Wangari, additional, Masching, Renee, additional, Danforth, Jessica, additional, Pick, Neora, additional, Nicholson, Valerie, additional, Beaver, Kerrigan, additional, Godoy, Sandra, additional, Gormley, Rebecca, additional, Kazemi, Mina, additional, Watt, Sarah, additional, May, Ados, additional, Loutfy, Mona, additional, and Narasimhan, Manjulaa, additional
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- 2019
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19. Sexual Anxiety Among Women Living with HIV in the Era of Antiretroviral Treatment Suppressing HIV Transmission.
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Carter, Allison, Patterson, Sophie, Kestler, Mary, de Pokomandy, Alexandra, Hankins, Catherine, Gormley, Becky, Nicholson, Valerie, Lee, Melanie, Wang, Lu, Greene, Saara, Loutfy, Mona, Kaida, Angela, on behalf of the CHIWOS Research Team, Abdul-Noor, Rahma, Anema, Aranka, Angel, Jonathan, Baril, QC-Jean-Guy, Barry, Fatimatou, Bauer, Greta, and Beaver, Kerrigan
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HIV-positive women ,HIV infection transmission ,ANXIETY ,SEXUAL consent ,SEXUAL intercourse - Abstract
Introduction: Sustained undetectable viral loads (UDVLs) on antiretroviral therapy (ART) eliminate sexual HIV transmission. We measured prevalence and correlates of sexual anxiety among women living with HIV. Methods: We used questionnaire data collected between August 2013 and May 2015 from 1422 women ≥ 16 years in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study. Among women reporting consensual sex in the past month (n = 474), we determined the proportion who reported high anxiety ("always/usually became anxious or inhibited during sexual activity with a partner"), low anxiety ("sometimes/seldom"), and no anxiety. Logistic regression identified medical, psychological, relational, and social correlates, including awareness of ART prevention benefits (i.e., "makes the risk of transmitting HIV a lot lower"). Results: Cohort diversity is reflected in age (range 17–66; median 39), gender (5.7% trans), ethnicity (41.6% White, 24.5% Indigenous, 27.0% African/Caribbean/Black), sexual orientation (14.2% lesbian/queer), and time living with HIV (range 18 days–30 years.). Overall, 58.6% reported feeling no sexual anxiety, while the remainder said that they always/usually (14.6%) or sometimes/seldom (26.8%) became anxious or inhibited during sex. Current sex work, previous illicit drug use, and depression were associated with higher adjusted odds of sexual anxiety, while greater emotional closeness and more equitable relationship power were associated with lower odds. There was no correlation between awareness of ART prevention benefits and sexual anxiety. Conclusions: Relatively few women reported high anxiety during sex with a partner. This was more socially and relationally influenced than linked to understanding ART prevention benefits. Policy Implications: Women living with HIV should be supported to have great sex, free from worry, by tackling unequal power in women's intimate relationships, lack of access to resources, and mental health difficulties. [ABSTRACT FROM AUTHOR]
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- 2020
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20. Validating A Self-Report Measure Of HIV Viral Suppression: An Analysis of Linked Questionnaire and Clinical Data from the Canadian HIV Women’s Sexual And Reproductive Health Cohort Study
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Carter, Allison, de Pokomandy, Alexandra, Loutfy, Mona, Ding, Erin, Sereda, Paul, Webster, Kath, Nicholson, Valerie, Beaver, Kerrigan, Hogg, Robert S., Kaida, Angela, and On Behalf of the CHIWOS Research Team
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Background We assessed the validity of a self-report measure of undetectable viral load (VL) among women with HIV in British Columbia (BC), Canada. Questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study was linked with population-based clinical data from the BC Centre for Excellence in HIV/AIDS. Self-reported undetectable VL was assessed by the question: “What was your most recent VL, undetectable (i.e.
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- 2017
21. Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario.
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Benoit, Anita C., Burchell, Ann N., O'Brien, Kelly K., Raboud, Janet, Gardner, Sandra, Light, Lucia, Beaver, Kerrigan, Cotnam, Jasmine, Conway, Tracey, Price, Colleen, Rourke, Sean B., Rueda, Sergio, Hart, Trevor A., and Loutfy, Mona
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HIV-positive women ,ANTIRETROVIRAL agents ,ALCOHOLISM ,ALCOHOL drinking ,HIV ,HISTORY in art - Abstract
Background: We aimed to identify the association between stress and antiretroviral therapy (ART) adherence among women in HIV care in Toronto, Ontario participating in the Ontario HIV Treatment Network Cohort Study (OCS) between 2007 and 2012. Materials and methods: We conducted cross-sectional analyses with women on ART completing the AIDS Clinical Trial Group (ACTG) Adherence Questionnaire. Data closest to, or at the last completed interview, were collected from medical charts, through record linkage with Public Health Ontario Laboratories, and from a standardized self-reported questionnaire comprised of socio-demographic and psycho-socio-behavioral measures (Center for Epidemiologic Studies Depression Scale (CES-D), Alcohol Use Disorders Identification Test (AUDIT)), and stress measures (National Population Health Survey). Logistic regression was used to quantify associations with optimal adherence (=95% adherence defined as missing = one dose of ART in the past 4 weeks). Results: Among 307 women, 65.5% had optimal adherence. Women with suboptimal compared to optimal adherence had higher median total stress scores (6.0 [interquartile range (IQR): 3.0-8.1] vs. 4.1 [IQR: 2.0-7.1], p = 0.001), CES-D scores (16 [IQR: 6-28] vs. 12 [IQR: 3-22], p = 0.008) and reports of hazardous and harmful alcohol use (31.1% vs. 17.9%, p = 0.008). In our multivariable model, we found an increased likelihood of optimal adherence with the absence of hazardous and harmful alcohol use (Adjusted Odds Ratio (AOR)=2.20, 95% confidence interval (CI): 1.12-4.32) and a decreased likelihood of optimal adherence with more self-reported stress (AOR = 0.56, 95% CI: 0.33-0.94). Conclusions: Interventions supporting optimal ART adherence should address stress and include strategies to reduce or eliminate hazardous and harmful alcohol use for women living with HIV. [ABSTRACT FROM AUTHOR]
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- 2020
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22. A Latent Class Analysis of the Social Determinants of Health Impacting Heavy Alcohol Consumption Among Women Living with HIV in Canada: The Canadian HIV Women's Sexual and Reproductive Health Cohort Study.
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Shokoohi, Mostafa, Bauer, Greta R., Kaida, Angela, Logie, Carmen H., Carter, Allison, Lacombe-Duncan, Ashley, Loutfy, Mona, the CHIWOS Research Team, Abdul-Noor, Rahma, Anema, Aranka, Angel, Jonathan, Baril, Jean-Guy, Barry, Fatimatou, Beaver, Kerrigan, Becker, Denise, Benoit, Anita, Brophy, Jason, Brotto, Lori, Burchell, Ann, and Cardinal, Claudette
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ALCOHOLISM ,DISCRIMINATION (Sociology) ,HIV-positive persons ,SEXUAL health ,LATENT structure analysis ,LONGITUDINAL method ,SOCIAL stigma ,WOMEN'S health ,REPRODUCTIVE health ,LOGISTIC regression analysis ,SOCIOECONOMIC factors ,HEALTH & social status - Abstract
Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
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23. Issue 1: “It’s Better Late Than Never”: A Community-Based HIV Research and Training Response to Supporting Mothers Living with HIV Who Have Child Welfare Involvement (Part I)
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Greene, Saara, primary, Ion, Allyson, additional, Dumbrill, Gary, additional, Teengs, Doe O'Brien, additional, Beaver, Kerrigan, additional, and Vaccaro, Mary-Elizabeth, additional
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- 2018
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24. Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada
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O'Brien, Nadia, primary, Greene, Saara, additional, Carter, Allison, additional, Lewis, Johanna, additional, Nicholson, Valerie, additional, Kwaramba, Gladys, additional, Ménard, Brigitte, additional, Kaufman, Elaina, additional, Ennabil, Nourane, additional, Andersson, Neil, additional, Loutfy, Mona, additional, de Pokomandy, Alexandra, additional, Kaida, Angela, additional, Anema, Aranka, additional, Becker, Denise, additional, Brotto, Lori, additional, Cardinal, Claudette, additional, Colley, Guillaume, additional, Ding, Erin, additional, Duddy, Janice, additional, Gataric, Nada, additional, Hogg, Robert S., additional, Howard, Terry, additional, Jabbari, Shahab, additional, Jones, Evin, additional, Kestler, Mary, additional, Langlois, Andrea, additional, Lima, Viviane, additional, Lloyd-Smith, Elisa, additional, Medjuck, Melissa, additional, Miller, Cari, additional, Money, Deborah, additional, Ogilvie, Gina, additional, Patterson, Sophie, additional, Pick, Neora, additional, Roth, Eric, additional, Salters, Kate, additional, Sanchez, Margarite, additional, Sas, Jacquie, additional, Sereda, Paul, additional, Summers, Marcie, additional, Tom, Christina, additional, Wang, Clara, additional, Webster, Kath, additional, Zhang, Wendy, additional, Abdul-Noor, Rahma, additional, Angel, Jonathan, additional, Barry, Fatimatou, additional, Bauer, Greta, additional, Beaver, Kerrigan, additional, Benoit, Anita, additional, Bertozzi, Breklyn, additional, Borton, Sheila, additional, Bourque, Tammy, additional, Brophy, Jason, additional, Burchell, Ann, additional, Carlson, Allison, additional, Cioppa, Lynne, additional, Cohen, Jeffrey, additional, Conway, Tracey, additional, Cooper, Curtis, additional, Cotnam, Jasmine, additional, Cousineau, Janette, additional, Desbiens, Marisol, additional, Fraleigh, Annette, additional, Gagnier, Brenda, additional, Gasingirwa, Claudine, additional, Hart, Trevor, additional, Islam, Shazia, additional, Kaushic, Charu, additional, Kennedy, Logan, additional, Kerr, Desiree, additional, Leonard, Lynne, additional, Logie, Carmen, additional, Margolese, Shari, additional, Muchenje, Marvelous, additional, Ndung'u, Mary (Muthoni), additional, O’Brien, Kelly, additional, Ouellette, Charlene, additional, Powis, Jeff, additional, Quan, Corinna, additional, Raboud, Janet, additional, Rachlis, Anita, additional, Ralph, Edward, additional, Rourke, Sean, additional, Rueda, Sergio, additional, Sandre, Roger, additional, Smaill, Fiona, additional, Smith, Stephanie, additional, Tigere, Tsitsi, additional, Tharao, Wangari, additional, Walmsley, Sharon, additional, Wobeser, Wendy, additional, Yee, Jessica, additional, Yudin, Mark, additional, Bakombo, Dada Mamvula, additional, Baril, Jean-Guy, additional, Boucher, Marc, additional, Boucoiran, Isabelle, additional, Burke, Nora Butler, additional, Clément, Pierrette, additional, Côté, José, additional, Dayle, Janice, additional, Dubuc, Danièle, additional, Fernet, Mylène, additional, Gagnon, Marilou, additional, Groleau, Danielle, additional, Hot, Aurélie, additional, Kiboyogo, Maxime, additional, Klein, Marina, additional, Lacasse, Gary, additional, Lamarre, Valérie, additional, Martin, Carrie, additional, Massie, Lyne, additional, Monteith, Ken, additional, O'Brien, Nadia, additional, Otis, Joanne, additional, Peltier, Doris, additional, Pierre, Alie, additional, Proulx-Boucher, Karène, additional, Rouleau, Danielle, additional, Rouleau, Geneviève, additional, Savoie, Édénia, additional, Tremblay, Cécile, additional, Trottier, Benoit, additional, Trottier, Sylvie, additional, Tsoukas, Christos, additional, Gahagan, Jacqueline, additional, Hankins, Catherine, additional, Masching, Renee, additional, and Ogunnaike-Cooke, Susanna, additional
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- 2017
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25. Human rights and the sexual and reproductive health of women living with HIV – a literature review
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Narasimhan, Manjulaa, Loutfy, Mona, Khosla, Rajat, Bras, Marlène, Amin, Avni, Van Belle, Nuna, Temmerman, Marleen, Kumar, Shubha, Gruskin, Sofia, Kaida, Angela, Carter, Allison, de Pokomandy, Alexandra, Patterson, Sophie, Proulx-Boucher, Karène, Nohpal, Adriana, Sereda, Paul, Colley, Guillaume, O'Brien, Nadia, Thomas-Pavanel, Jamie, Beaver, Kerrigan, Nicholson, Valerie J, Tharao, Wangari, Fernet, Mylène, Otis, Joanne, Hogg, Robert S, Huchko, Megan J, Maloba, May, Nakalembe, Miriam, Cohen, Craig R, Heffron, Renee, Davies, Natasha, Cooke, Ian, Mergler, Reid, van der Poel, Sheryl, Mmeje, Okeoma, Matheson, Rebecca, Moses-Burton, Suzette, Hsieh, Amy C, Dilmitis, Sophie, Happy, Margaret, Sinyemu, Eunice, Brion, Sophie O, Sharma, Aditi, Orza, Luisa, Bewley, Susan, Logie, Carmen H, Crone, Elizabeth Tyler, Moroz, Svetlana, Strachan, Sophie, Vazquez, Marijo, Welbourn, Alice, Chung, Cecilia, Crone, E Tyler, Nagadya, Hajjarah, Kennedy, Caitlin E, Haberlen, Sabina, Baggaley, Rachel, Chandra-Mouli, Venkatraman, Armstrong, Alice, and Ferguson, Jane
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intimate partner violence ,PMTCT ,integration ,Review Article ,reproductive rights ,community-based research ,violence ,adolescents living with HIV ,cervical cancer prevention ,gender-based violence ,systematic ,gender ,values ,low- and middle-income countries ,adherence ,fertility ,couples ,values and preferences ,implementation science ,Sexual and reproductive health and human rights of women living with HIV ,healthcare ,Supplement 5 ,Editorial ,evidence base ,sexual abstinence ,women ,pregnancy ,disclosure ,mental health ,Research Article ,Canada ,retention ,CHIWOS ,antiretroviral therapy ,sexual health ,review ,human rights ,sexual and reproductive health ,equity ,adolescent girls ,survey ,women living with HIV ,reproductive health ,laws ,HIV ,women's health ,stigma ,eMTCT ,Commentary ,vertical transmission ,gender inequalities ,sexual satisfaction ,qualitative research ,discrimination - Abstract
Introduction Many women living with HIV can have safe, healthy and satisfying sexual and reproductive health, but there is still a long way to go for this to be a reality, especially for the most vulnerable amongst them who face repeated violations of their rights. Discussion The contributions in this Supplement from researchers, clinicians, programme managers, policy makers, and women living with HIV demands an important appreciation that the field of sexual and reproductive health and human rights for women living with HIV is complex on many levels, and women living with HIV form a very diverse community. Conclusions The manuscripts emphasize that attention must be paid to the following critical dimensions: 1) Placing human rights and gender equality at the centre of a comprehensive approach to health programming, in particular in relation to sexuality and sexual health; 2) Ensuring health systems responsiveness to minimizing inequalities in access to health care and quality of care that often do not meet the needs of women living with HIV; 3) Engaging and empowering women living with HIV in the development of policies and programmes that affect them; and 4) Strengthening monitoring, evaluation and accountability procedures to provide good quality data and ensuring remedies for violations of health and human rights of women living with HIV., Introduction Globally, women constitute 50% of all persons living with HIV. Gender inequalities are a key driver of women's vulnerabilities to HIV. This paper looks at how these structural factors shape specific behaviours and outcomes related to the sexual and reproductive health of women living with HIV. Discussion There are several pathways by which gender inequalities shape the sexual and reproductive health and wellbeing of women living with HIV. First, gender norms that privilege men's control over women and violence against women inhibit women's ability to practice safer sex, make reproductive decisions based on their own fertility preferences and disclose their HIV status. Second, women's lack of property and inheritance rights and limited access to formal employment makes them disproportionately vulnerable to food insecurity and its consequences. This includes compromising their adherence to antiretroviral therapy and increasing their vulnerability to transactional sex. Third, with respect to stigma and discrimination, women are more likely to be blamed for bringing HIV into the family, as they are often tested before men. In several settings, healthcare providers violate the reproductive rights of women living with HIV in relation to family planning and in denying them care. Lastly, a number of countries have laws that criminalize HIV transmission, which specifically impact women living with HIV who may be reluctant to disclose because of fears of violence and other negative consequences. Conclusions Addressing gender inequalities is central to improving the sexual and reproductive health outcomes and more broadly the wellbeing of women living with HIV. Programmes that go beyond a narrow biomedical/clinical approach and address the social and structural context of women's lives can also maximize the benefits of HIV prevention, treatment, care and support., Introduction The right to sexual and reproductive health (SRH) is an essential part of the right to health and is dependent upon substantive equality, including freedom from multiple and intersecting forms of discrimination that result in exclusion in both law and practice. Nonetheless, general and specific SRH needs of women living with HIV are often not adequately addressed. For example, services that women living with HIV need may not be available or may have multiple barriers, in particular stigma and discrimination. This study was conducted to review United Nations Human Rights Council, Treaty Monitoring Bodies and Special Rapporteur reports and regional and national mechanisms regarding SRH issues of women living with HIV. The objective is to assess areas of progress, as well as gaps, in relation to health and human rights considerations in the work of these normative bodies on health and human rights. Methods The review was done using keywords of international, regional and national jurisprudence on findings covering the 2000 to 2014 period for documents in English; searches for the Inter-American Commission on Human Rights and national judgments were also conducted in Spanish. Jurisprudence of UN Treaty Monitoring Bodies, regional mechanisms and national bodies was considered in this regard. Results and discussion In total, 236 findings were identified using the search strategy, and of these 129 were selected for review based on the inclusion criteria. The results highlight that while jurisprudence from international, regional and national bodies reflects consideration of some health and human rights issues related to women living with HIV and SRH, the approach of these bodies has been largely ad hoc and lacks a systematic integration of human rights concerns of women living with HIV in relation to SRH. Most findings relate to non-discrimination, accessibility, informed decision-making and accountability. There are critical gaps on normative standards regarding the human rights of women living with HIV in relation to SRH. Conclusions A systematic approach to health and human rights considerations related to women living with HIV and SRH by international, regional and national bodies is needed to advance the agenda and ensure that policies and programmes related to SRH systematically take into account the health and human rights of women living with HIV., Introduction Even as the number of women living with HIV around the globe continues to grow, realization of their sexual and reproductive health and human rights remains compromised. The objective of this study was to review the current state of knowledge on the sexual and reproductive health and human rights of women living with HIV to assess evidence and gaps. Methods Relevant databases were searched for peer-reviewed and grey literature. Search terms included a combination of MeSH terms and keywords representing women, HIV/AIDS, ART, human rights, sexual and reproductive health. We included both qualitative and quantitative literature published in English, French, or Spanish between July 2011 and December 2014. Results and discussion The search yielded 2228 peer-reviewed articles, of which 40 met the inclusion criteria in the final review. The grey literature search yielded 2186 documents of which seven met the inclusion criteria in the final review. Of the articles and documents reviewed, not a single peer-reviewed article described the explicit implementation of rights in programming, and only two documents from the grey literature did so. With one possible exception, no articles or documents were found which addressed rights comprehensively, or addressed the majority of relevant rights (i.e. equality; non-discrimination; participation; privacy and confidentiality; informed decision making; availability, accessibility, acceptability and quality (3AQ) of services individually or in their totality; and accountability). Additional findings indicate that the language of rights is used most often to describe the apparent neglect or violation of human rights and what does exist only addresses a few rights in the context of a few areas within sexual and reproductive health. Conclusions Findings from this review suggest the need to better integrate rights into interventions, particularly with attention to provider training, service delivery, raising awareness and capacity building among the community of women living with HIV. Further research is urgently needed to support the sexual and reproductive health and rights of women living with HIV, to identify what works and to inform future programming and policies to improve care, treatment and support for women living with HIV., Introduction Women represent nearly one-quarter of the 71,300 people living with HIV in Canada. Within a context of widespread HIV-related stigma and discrimination and on-going risks to HIV disclosure, little is known about the influence of growing social, legal and public health surveillance of HIV on sexual activity and satisfaction of women living with HIV (WLWH). Methods We analyzed baseline cross-sectional survey data for WLWH (≥16 years, self-identifying as women) enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a multisite, longitudinal, community-based research study in British Columbia (BC), Ontario (ON) and Quebec (QC). Sexual inactivity was defined as no consensual sex (oral or penetrative) in the prior six months, excluding recently postpartum women (≤6 months). Satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women. Multivariable logistic regression analysis examined independent correlates of sexual inactivity. Results Of 1213 participants (26% BC, 50% ON, 24% QC), median age was 43 years (IQR: 35, 50). 23% identified as Aboriginal, 28% as African, Caribbean and Black, 41% as White and 8% as other ethnicities. Heterosexual orientation was reported by 87% of participants and LGBTQ by 13%. In total, 82% were currently taking antiretroviral therapy (ART), and 77% reported an undetectable viral load (VL, Introduction HIV and cervical cancer are intersecting epidemics that disproportionately affect one of the most vulnerable populations in the world: women in low- and middle-income countries (LMICs). Historically, the disparity in cervical cancer risk for women in LMICs has been due to the lack of organized screening and prevention programmes. In recent years, this risk has been augmented by the severity of the HIV epidemic in LMICs. HIV-positive women are at increased risk for developing cervical precancer and cancer, and while the introduction of antiretroviral therapy has dramatically improved life expectancies among HIV-positive women it has not been shown to improve cancer-related outcomes. Therefore, an increasing number of HIV-positive women are living in LMICs with limited or no access to cervical cancer screening programmes. In this commentary, we describe the gaps in cervical cancer prevention, the state of evidence for integrating cervical cancer prevention into HIV programmes and future directions for programme implementation and research. Discussion Despite the biologic, behavioural and demographic overlap between HIV and cervical cancer, cervical cancer prevention has for the most part been left out of sexual and reproductive health (SRH) services for HIV-positive women. Lower cost primary and secondary prevention strategies for cervical cancer are becoming more widely available in LMICs, with increasing evidence for their efficacy and cost-effectiveness. Going forward, cervical cancer prevention must be considered a part of the essential package of SRH services for HIV-positive women. Effective cervical cancer prevention programmes will require a coordinated response from international policymakers and funders, national governments and community leaders. Leveraging the improvements in healthcare infrastructure created by the response to the global HIV epidemic through integration of services may be an effective way to make an impact to prevent cervical cancer among HIV-positive women, but more work remains to determine optimal approaches. Conclusions Cervical cancer prevention is an essential part of comprehensive HIV care. In order to ensure maximal impact and cost-effectiveness, implementation strategies for screening programmes must be adapted and rigorously evaluated through a framework that includes equal participation with policymakers, programme planners and key stakeholders in the target communities., Introduction HIV-affected women and couples often desire children and many accept HIV risk in order to attempt pregnancy and satisfy goals for a family. Risk reduction strategies to mitigate sexual and perinatal HIV transmission include biomedical and behavioural approaches. Current efforts to integrate HIV and reproductive health services offer prime opportunities to incorporate strategies for HIV risk reduction during pregnancy attempts. Key client and provider values about services to optimize pregnancy in the context of HIV risk provide insights for the design and implementation of large-scale “safer conception” programmes. Discussion Through our collective experience and discussions at a multi-disciplinary international World Health Organization–convened workshop to initiate the development of guidelines and an algorithm of care to support the delivery of services for HIV-affected women and couples attempting pregnancy, we identified four values that are key to the implementation of these programmes: (1) understanding fertility care and an ability to identify potential fertility problems; (2) providing equity of access to resources enabling informed decision-making about reproductive choices; (3) creating enabling environments that reduce stigma associated with HIV and infertility; and (4) creating enabling environments that encourage disclosure of HIV status and fertility status to partners. Based on these values, recommendations for programmes serving HIV-affected women and couples attempting pregnancy include the following: incorporation of comprehensive reproductive health counselling; training to support the transfer and exchange of knowledge between providers and clients; care environments that reduce the stigma of childbearing among HIV-affected women and couples; support for safe and voluntary disclosure of HIV and fertility status; and increased efforts to engage men in reproductive decision-making at times that align with women's desires. Conclusions Programmes, policies and guidelines that integrate HIV treatment and prevention, sexual and reproductive health and fertility care services in a manner responsive to user values and preferences offer opportunities to maximize demand for and use of these services. For HIV-affected women and couples attempting pregnancy, the provision of comprehensive services using available tools – and the development of new tools that are adaptable to many settings and follow consensus recommendations – is a public health imperative. The impetus now is to design and deliver value-driven inclusive programming to achieve the greatest coverage and impact to reduce HIV transmission during pregnancy attempts., Introduction In 2011, the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive was launched to scale up efforts to comprehensively end vertical HIV transmission and support mothers living with HIV in remaining healthy. Amidst excitement around using treatment as prevention, Malawi's Ministry of Health conceived Option B+, a strategy used to prevent vertical transmission by initiating all pregnant and breastfeeding women living with HIV on lifelong antiretroviral therapy, irrespective of CD4 count. In 2013, for programmatic and operational reasons, the WHO officially recommended Option B+ to countries with generalized epidemics, limited access to CD4 testing, limited partner testing, long breastfeeding duration or high fertility rates. Discussion While acknowledging the opportunity to increase treatment access globally and its potential, this commentary reviews the concerns of women living with HIV about human rights, community-based support and other barriers to service uptake and retention in the Option B+ context. Option B+ intensifies many of the pre-existing challenges of HIV prevention and treatment programmes. As women seek comprehensive services to prevent vertical transmission, they can experience various human rights violations, including lack of informed consent, involuntary or coercive HIV testing, limited treatment options, termination of pregnancy or coerced sterilization and pressure to start treatment. Yet, peer and community support strategies can promote treatment readiness, uptake, adherence and lifelong retention in care; reduce stigma and discrimination; and mitigate potential violence stemming from HIV disclosure. Ensuring available and accessible quality care, offering food support and improving linkages to care could increase service uptake and retention. With the heightened focus on interventions to reach pregnant and breastfeeding women living with HIV, a parallel increase in vigilance to secure their health and rights is critical. Conclusion The authors conclude that real progress towards reducing vertical transmission and achieving viral load suppression can only be made by upholding the human rights of women living with HIV, investing in community-based responses, and ensuring universal access to quality healthcare. Only then will the opportunity of accessing lifelong treatment result in improving the health, dignity and lives of women living with HIV, their children and families., Introduction Women living with HIV experience a disproportionate burden of mental health issues. To date, global guidelines contain insufficient guidance on mental health support, particularly regarding perinatal care. The aim of this article is to describe the extent and impact of mental health issues as experienced by women living with HIV on their sexual and reproductive health and human rights (SRH&HR). Methods A global, mixed-methods, user-led and designed survey on SRH&HR of women living with HIV was conducted using snowball sampling, containing an optional section exploring mental health issues. Statistical quantitative data analysis included descriptive statistics, correlation and multiple linear regression analysis for the mental health responses. Thematic analysis of open free-text responses was performed for qualitative data. Results A total of 832 respondents from 94 countries participated in the online survey with 489 responses to the optional mental health section. Of the respondents, 82% reported depression symptoms and 78% rejection. One-fifth reported mental health issues before HIV diagnosis. Respondents reported experiencing a 3.5-fold higher number of mental health issues after diagnosis (8.71 vs 2.48, t[488]=23.00, p, Introduction Women living with HIV are vulnerable to gender-based violence (GBV) before and after diagnosis, in multiple settings. This study's aim was to explore how GBV is experienced by women living with HIV, how this affects women's sexual and reproductive health (SRH) and human rights (HR), and the implications for policymakers. Methods A community-based, participatory, user-led, mixed-methods study was conducted, with women living with HIV from key affected populations. Simple descriptive frequencies were used for quantitative data. Thematic coding of open qualitative responses was performed and validated with key respondents. Results In total, 945 women living with HIV from 94 countries participated in the study. Eighty-nine percent of 480 respondents to an optional section on GBV reported having experienced or feared violence, either before, since and/or because of their HIV diagnosis. GBV reporting was higher after HIV diagnosis (intimate partner, family/neighbours, community and health settings). Women described a complex and iterative relationship between GBV and HIV occurring throughout their lives, including breaches of confidentiality and lack of SRH choice in healthcare settings, forced/coerced treatments, HR abuses, moralistic and judgemental attitudes (including towards women from key populations), and fear of losing child custody. Respondents recommended healthcare practitioners and policymakers address stigma and discrimination, training, awareness-raising, and HR abuses in healthcare settings. Conclusions Respondents reported increased GBV with partners and in families, communities and healthcare settings after their HIV diagnosis and across the life-cycle. Measures of GBV must be sought and monitored, particularly within healthcare settings that should be safe. Respondents offered policymakers a comprehensive range of recommendations to achieve their SRH and HR goals. Global guidance documents and policies are more likely to succeed for the end-users if lived experiences are used., Introduction Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. Methods We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violence. Articles, conference abstracts and programme reports were included if they reported post-intervention evaluation results and were published before 1 April 2015. Searching was conducted through electronic databases for peer-reviewed articles and conference abstracts, reviewing websites of relevant organizations for grey literature, hand searching reference lists of included studies and contacting experts. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with the Cochrane risk of bias tool. Results Two interventions met the inclusion criteria: the Safe Homes and Respect for Everyone cluster-randomized trial of combination HIV and intimate partner violence (IPV) services in Rakai, Uganda, and the South Africa HIV/AIDS Antenatal Post-Test Support study individual randomized trial of an enhanced counselling intervention for pregnant women undergoing HIV testing and counselling. Both programmes integrated screening for IPV into HIV testing services and trained counsellors to facilitate discussions about disclosure based on a woman's risk of violence. However, both were implemented as part of multiple-component interventions, making it impossible to isolate the impact of the safer disclosure components. Conclusions The existing evidence base for interventions to facilitate safe HIV serostatus disclosure for women who experience or fear violence is limited. Development and implementation of new approaches and rigorous evaluation of safe disclosure outcomes is needed to guide programme planners and policy makers., Introduction This commentary provides the rationale and makes a call for greater investment and effort to meet the sexual and reproductive health (SRH) problems of adolescent girls living with HIV in low- and middle-income countries (LMIC). Discussion Adolescent girls in LMIC are at a greater risk of acquiring HIV infection than their male peers. They also face a number of other serious SRH problems – early pregnancy, pregnancy- and childbirth-related complications, unsafe abortions, sexual abuse and intimate partner violence and sexually transmitted infections. While many LMIC have made notable progress in preventing HIV in children and adults and in improving the access of these population groups to HIV treatment and care, adolescents in general and adolescent girls in particular have not received the same effort and investment. Conclusions Much more needs to be done to implement proven approaches to prevent new HIV infections in adolescent girls in LMIC and to meet the needs of those living with HIV.
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- 2015
26. Health-related quality-of-life and receipt of women-centered HIV care among women living with HIV in Canada.
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Carter, Allison, Loutfy, Mona, de Pokomandy, Alexandra, Colley, Guillaume, Zhang, Wendy, Sereda, Paul, O’Brien, Nadia, Proulx-Boucher, Karène, Nicholson, Valerie, Beaver, Kerrigan, Kaida, Angela, and on behalf of the CHIWOS Research Teamϒ
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HIV infections ,THERAPEUTICS ,BLACK people ,CONFIDENCE intervals ,HEALTH facilities ,HIV-positive persons ,INDIGENOUS peoples ,MEDICAL care ,MENTAL health ,MULTIVARIATE analysis ,PATIENTS ,QUALITY of life ,REGRESSION analysis ,SCALE analysis (Psychology) ,WHITE people ,PSYCHOLOGY of women ,WOMEN'S health services ,DESCRIPTIVE statistics - Abstract
We measured health-related quality of life (HRQOL) using the SF-12 among women living with HIV (WLWH) in Canada between August 2013 and May 2015. We investigated differences by perceived receipt of women-centered HIV care (WCHC), assessed using an evidence-based definition with a 5-point Likert item: “Overall, I think that the care I have received from my HIV clinic in the last year has been women-centered” (dichotomized into agree vs. disagree/neutral). Of 1308 participants, 26.3 percent were from British Columbia, 48.2 percent from Ontario, and 25.5 percent from Québec. The median age was 43 years (interquartile range = 36-51). Most (42.2 percent) were White, 29.4 percent African/Caribbean/Black, and 21.0 percent Indigenous. Overall, 53.4 percent perceived having received WCHC. Mean physical and mental HRQOL scores were 43.8 (standard deviation [SD] = 14.4) and 41.7 (SD = 14.2), respectively. Women perceiving having received WCHC had higher mean physical (44.7; SD = 14.0) and mental (43.7; SD = 14.1) HRQOL scores than those not perceiving having received WCHC (42.9; SD = 14.8 and 39.5; SD = 14.0, respectively; p < .001). In multivariable linear regression, perceived WCHC was associated with higher mental (β = 3.48; 95 percent confidence interval: 1.90, 5.06) but not physical HRQOL. Improving HRQOL among Canadian WLWH, which was lower than general population estimates, is needed, including examining the potential of WCHC as an effective model of clinical care. [ABSTRACT FROM AUTHOR]
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- 2018
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27. Cohort profile: The Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS).
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Loutfy, Mona, de Pokomandy, Alexandra, Kennedy, V. Logan, Carter, Allison, O’Brien, Nadia, Proulx-Boucher, Karène, Ding, Erin, Lewis, Johanna, Nicholson, Valerie, Beaver, Kerrigan, Greene, Saara, Tharao, Wangari, Benoit, Anita, Dubuc, Danièle, Thomas-Pavanel, Jamie, Sereda, Paul, Jabbari, Shahab, Shurgold, Jayson H., Colley, Guillaume, and Hogg, Robert S.
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HIV-positive women ,REPRODUCTIVE health ,PREGNANCY ,WOMEN'S health ,CANADIANS ,HEALTH - Abstract
Globally, women are at increased vulnerability to HIV due to biological, social, structural, and political reasons. Women living with HIV also experience unique issues related to their medical and social healthcare, which makes a clinical care model specific to their needs worthy of exploration. Furthermore, there is a dearth of research specific to women living with HIV. Research for this population has often been narrowly focused on pregnancy-related issues without considering their complex structural inequalities, social roles, and healthcare and biological needs. For these reasons, we have come together, as researchers, clinicians and community members in Canada, to develop the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) to investigate the concept of women-centred HIV care (WCHC) and its impact on the overall, HIV, women’s, mental, sexual, and reproductive health outcomes of women living with HIV. Here, we present the CHIWOS cohort profile, which describes the cohort and presents preliminary findings related to perceived WCHC. CHIWOS is a prospective, observational cohort study of women living with HIV in British Columbia (BC), Ontario, and Quebec. Two additional Canadian provinces, Saskatchewan and Manitoba, will join the cohort in 2018. Using community-based research principles, CHIWOS engages women living with HIV throughout the entire research process meeting the requirements of the ‘Greater Involvement of People living with HIV/AIDS’. Study data are collected through an interviewer-administered questionnaire that uses a web-based platform. From August 2013 to May 2015, a total of 1422 women living with HIV in BC, Ontario, and Quebec were enrolled and completed the baseline visit. Follow-up interviews are being conducted at 18-month intervals. Of the 1422 participants at baseline, 356 were from BC (25%), 713 from Ontario (50%), 353 from Quebec (25%). The median age of the participants at baseline was 43 years (range, 16–74). 22% identified as Indigenous, 30% as African, Caribbean or Black, 41% as Caucasian/White, and 7% as other ethnicities. Overall, 83% of women were taking antiretroviral therapy at the time of the baseline interview and of them, 87% reported an undetectable viral load. Of the 1326 women who received HIV medical care in the previous year and responded to corresponding questions, 57% (95% CI: 54%-60%) perceived that the care they received from their primary HIV doctor had been women-centred. There were provincial and age differences among women who indicated that they received WCHC versus not; women from BC or Ontario were more likely to report WCHC compared to participants in Quebec. They were also more likely to be younger. CHIWOS will be an important tool to develop care models specific for women living with HIV. Moreover, CHIWOS is collecting extensive information on socio-demographics, social determinants of health, psychological factors, and sexual and reproductive health and offers an important platform to answer many relevant research questions for and with women living with HIV. Information on the cohort can be found on the study website (). [ABSTRACT FROM AUTHOR]
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- 2017
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28. Establishing the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS): Operationalizing Community-based Research in a Large National Quantitative Study.
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Loutfy, Mona, Greene, Saara, Kennedy, V. Logan, Lewis, Johanna, Thomas-Pavanel, Jamie, Conway, Tracey, de Pokomandy, Alexandra, O'Brien, Nadia, Carter, Allison, Tharao, Wangari, Nicholson, Valerie, Beaver, Kerrigan, Dubuc, Danièle, Gahagan, Jacqueline, Proulx-Boucher, Karène, Hogg, Robert S., Kaida, Angela, and CHIWOS Research Team
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REPRODUCTIVE health ,SEXUAL health ,WOMEN'S health ,PUBLIC health research ,HEALTH ,HIV infection epidemiology ,HEALTH attitudes ,HIV infections ,LONGITUDINAL method ,MEDICAL care research ,RESEARCH funding ,HUMAN sexuality ,WOMEN'S health services - Abstract
Background: Community-based research has gained increasing recognition in health research over the last two decades. Such participatory research approaches are lauded for their ability to anchor research in lived experiences, ensuring cultural appropriateness, accessing local knowledge, reaching marginalized communities, building capacity, and facilitating research-to-action. While having these positive attributes, the community-based health research literature is predominantly composed of small projects, using qualitative methods, and set within geographically limited communities. Its use in larger health studies, including clinical trials and cohorts, is limited. We present the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a large-scale, multi-site, national, longitudinal quantitative study that has operationalized community-based research in all steps of the research process. Successes, challenges and further considerations are offered.Discussion: Through the integration of community-based research principles, we have been successful in: facilitating a two-year long formative phase for this study; developing a novel survey instrument with national involvement; training 39 Peer Research Associates (PRAs); offering ongoing comprehensive support to PRAs; and engaging in an ongoing iterative community-based research process. Our community-based research approach within CHIWOS demanded that we be cognizant of challenges managing a large national team, inherent power imbalances and challenges with communication, compensation and volunteering considerations, and extensive delays in institutional processes. It is important to consider the iterative nature of community-based research and to work through tensions that emerge given the diverse perspectives of numerous team members.Conclusions: Community-based research, as an approach to large-scale quantitative health research projects, is an increasingly viable methodological option. Community-based research has several advantages that go hand-in-hand with its obstacles. We offer guidance on implementing this approach, such that the process can be better planned and result in success. [ABSTRACT FROM AUTHOR]- Published
- 2016
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29. A Comparison of Virological Suppression and Rebound between Indigenous and Non-Indigenous Persons Initiating Combination Antiretroviral Therapy in a Multisite Cohort of Individuals Living with HIV in Canada
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Benoit, Anita C, Younger, Jaime, Beaver, Kerrigan, Jackson, Randy, Loutfy, Mona, Masching, Renée, Nobis, Tony, Nowgesic, Earl, O'Brien-Teengs, Doe, Whitebird, Wanda, Zoccole, Art, Hull, Mark, Jaworsky, Denise, Rachlis, Anita, Rourke, Sean, Burchell, Ann N, Cooper, Curtis, Hogg, Robert, Klein, Marina B, Machouf, Nima, Montaner, Julio, Tsoukas, Chris, and Raboud, Janet
- Abstract
Background This study compared time to virological suppression and rebound between Indigenous and non-Indigenous individuals living with HIV in Canada initiating combination antiretroviral therapy (cART).Methods Data were from the Canadian Observational Cohort collaboration; eight studies of treatment-naive persons with HIV initiating cART after 1/1/2000. Fine and Gray models were used to estimate the effect of ethnicity on time to virological suppression (two consecutive viral loads [VLs] <50 copies/ml at least 3 months apart) after adjusting for the competing risk of death and time until virological rebound (two consecutive VLs >200 copies/ml at least 3 months apart) following suppression.Results Among 7,080 participants were 497 Indigenous persons of whom 413 (83%) were from British Columbia. The cumulative incidence of suppression 1 year after cART initiation was 54% for Indigenous persons, 77% for Caucasian and 80% for African, Caribbean or Black (ACB) persons. The cumulative incidence of rebound 1 year after suppression was 13% for Indigenous persons, 6% for Caucasian and 7% for ACB persons. Indigenous persons were less likely to achieve suppression than Caucasian participants (aHR=0.58, 95% CI 0.50, 0.68), but not more likely to experience rebound (aHR=1.03, 95% CI 0.84, 1.27) after adjusting for age, gender, injection drug use, men having sex with men status, province of residence, baseline VL and CD4+T-cell count, antiretroviral class and year of cART initiation.Conclusions Lower suppression rates among Indigenous persons suggest a need for targeted interventions to improve HIV health outcomes during the first year of treatment when suppression is usually achieved.
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- 2017
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30. Validating a self-report measure of HIV viral suppression: an analysis of linked questionnaire and clinical data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study
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Carter, Allison, De Pokomandy, Alexandra, Loutfy, Mona, Ding, Erin, Sereda, Paul, Webster, Kath, Nicholson, Valerie, Beaver, Kerrigan, Hogg, Robert S, and Kaida, Angela
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3. Good health - Abstract
Background: We assessed the validity of a self-report measure of undetectable viral load (VL) among women with HIV in British Columbia (BC), Canada. Questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study was linked with population-based clinical data from the BC Centre for Excellence in HIV/AIDS. Self-reported undetectable VL was assessed by the question: “What was your most recent VL, undetectable (i.e.
31. Indigenizing our research: indigenous community leadership in HIV epidemiology research.
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Nicholson V, Bratu A, McClean AR, Jawanda S, Aran N, Hillstrom K, Hennie E, Cardinal C, Benson E, Beaver K, Benoit AC, Hogg B, and Jaworsky D
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- Community-Based Participatory Research, Humans, Indigenous Peoples, Population Groups, HIV Infections epidemiology, Leadership
- Abstract
The use of data intensive health research has allowed for greater understandings of population health. When conducting data intensive health research, engaging and involving the community is essential for conducting meaningful research that is responsive to the public's needs. Particularly, when engaging Indigenous communities in research, there is a need to understand historical and ongoing impacts of colonialism and recognize the strengths in Indigenous Peoples' knowledges and experiences while supporting Indigenous leadership and self-determination in research. This article describes the approach our research team/organization used to engage and involve Indigenous people living with HIV in three research projects using large, linked datasets and looking at HIV outcomes of Indigenous populations in Canada. The foundation of these projects was simultaneously: 1) supporting Indigenous people living with HIV to be involved as research team members, 2) developing research questions to answer with available datasets, and 3) integrating Indigenous and Western ways of knowing. We have identified important considerations and suggestions for engaging and involving Indigenous communities and individuals in the generation of research ideas and analysis of linked data using community-based participatory research approaches through our work. These include engaging stakeholders at the start of the project and involving them throughout the research process, honouring Indigenous ways of knowing, the land, and local protocols and traditions, prioritizing Indigenous voices, promoting co-learning and building capacity, and focusing on developing longitudinal relationships. We describe keys to success and learnings that emerged. Importantly, the methodology practiced and presented in this manuscript is not a qualitative study design whereby research subjects are surveyed about their experiences or beliefs. Rather, the study approach described herein is about engaging people with living experience to co-lead as researchers. Our approach supported Indigenous people to share research that addresses their research priorities and responds to issues relevant to Indigenous Peoples and communities., Competing Interests: Statement on conflicts of interest: No conflicts of interest
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- 2021
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32. Pathways From HIV-Related Stigma to Antiretroviral Therapy Measures in the HIV Care Cascade for Women Living With HIV in Canada.
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Logie CH, Lacombe-Duncan A, Wang Y, Kaida A, Conway T, Webster K, de Pokomandy A, Loutfy MR, Anema A, Becker D, Brotto L, Carter A, Cardinal C, Colley G, Ding E, Duddy J, Gataric N, Hogg RS, Hosward T, Jabbari S, Jones E, Kestler M, Langlois A, Lima V, Lloyd-Smith E, Medjuck M, Miller C, Money D, Nicholson V, Ogilvie G, Patterson S, Pick N, Roth E, Salters K, Sanchez M, Sas J, Sereda P, Summers M, Tom C, Wang L, Webster K, Zhang W, Abdul-Noor R, Angel J, Barry F, Bauer G, Beaver K, Benoit A, Bertozzi B, Borton S, Bourque T, Brophy J, Burchell A, Carlson A, Cioppa L, Cohen J, Conway T, Cooper C, Cotnam J, Cousineau J, Fraleigh A, Gagnier B, Gasingirwa C, Greene S, Hart T, Islam S, Kaushic C, Kennedy L, Kerr D, Kiboyogo M, Kwaramba G, Leonard L, Lewis J, Logie C, Margolese S, Muchenje M, Ndungʼu M, OʼBrien K, Ouellette C, Powis J, Quan C, Raboud J, Rachlis A, Ralph E, Rourke S, Rueda S, Sandre R, Smaill F, Smith S, Tigere T, Tharao W, Walmsley S, Wobeser W, Yee J, Yudin M, Baril JG, Burke NB, Clément P, Dayle J, Dubuc D, Fernet M, Groleau D, Hot A, Klein M, Martin C, Massie L, Ménard B, OʼBrien N, Otis J, Peltier D, Pierre A, Proulx-Boucher K, Rouleau D, Savoie É, Tremblay C, Trottier B, Trottier S, Tsoukas C, Gahagan J, Hankins C, Masching R, and Ogunnaike-Cooke S
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- Adult, Antiretroviral Therapy, Highly Active, Canada, Cross-Sectional Studies, Female, Humans, Middle Aged, Anti-Retroviral Agents therapeutic use, HIV Infections drug therapy, HIV Infections psychology, Medication Adherence psychology, Social Stigma
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Background: Associations between HIV-related stigma and reduced antiretroviral therapy (ART) adherence are widely established, yet the mechanisms accounting for this relationship are underexplored. There has been less attention to HIV-related stigma and its associations with ART initiation and current ART use. We examined pathways from HIV-related stigma to ART initiation, current ART use, and ART adherence among women living with HIV in Canada., Methods: We used baseline survey data from a national cohort of women living with HIV in Canada (n = 1425). Structural equation modeling using weighted least squares estimation methods was conducted to test the direct effects of HIV-related stigma dimensions (personalized, negative self-image, and public attitudes) on ART initiation, current ART use, and 90% ART adherence, and indirect effects through depression and HIV disclosure concerns, adjusting for sociodemographic factors., Results: In the final model, the direct paths from personalized stigma to ART initiation (β = -0.104, P < 0.05) and current ART use (β = -0.142, P < 0.01), and negative self-image to ART initiation (β = -0.113, P < 0.01) were significant, accounting for the mediation effects of depression and HIV disclosure concerns. Depression mediated the pathways from personalized stigma to ART adherence, and negative self-image to current ART use and ART adherence. Final model fit indices suggest that the model fit the data well [χ(25) = 90.251, P < 0.001; comparative fit index = 0.945; root-mean-square error of approximation = 0.044]., Conclusions: HIV-related stigma is associated with reduced likelihood of ART initiation and current ART use, and suboptimal ART adherence. To optimize the benefit of ART among women living with HIV, interventions should reduce HIV-related stigma and address depression.
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- 2018
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33. Validating a self-report measure of HIV viral suppression: an analysis of linked questionnaire and clinical data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study.
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Carter A, de Pokomandy A, Loutfy M, Ding E, Sereda P, Webster K, Nicholson V, Beaver K, Hogg RS, and Kaida A
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- Adult, Anti-HIV Agents therapeutic use, British Columbia, Canada, Cohort Studies, Female, HIV Infections drug therapy, HIV-1 drug effects, Host-Pathogen Interactions drug effects, Humans, Middle Aged, Reproducibility of Results, Viral Load drug effects, Women's Health statistics & numerical data, HIV Infections virology, HIV-1 physiology, Reproductive Health statistics & numerical data, Self Report standards, Sexual Behavior statistics & numerical data, Viral Load statistics & numerical data
- Abstract
Background: We assessed the validity of a self-report measure of undetectable viral load (VL) among women with HIV in British Columbia (BC), Canada. Questionnaire data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study was linked with population-based clinical data from the BC Centre for Excellence in HIV/AIDS. Self-reported undetectable VL was assessed by the question: "What was your most recent VL, undetectable (i.e. <50 copies/mL) or detectable (i.e. ≥50 copies/mL)?" Laboratory measurements of VL <50 copies/mL (closest to/before study visit) were the criterion for validity analyses. We measured positive and negative predictive values (PPV, NPV) and likelihood ratios (LR+, LR-)., Results: Of 356 participants, 99% were linked to clinical data. Those unlinked (n = 1), missing self-report VL (n = 18), or missing self-report and laboratory VL (n = 1) were excluded. Among the remaining 336: median age was 44 (IQR 37-51); 96% identified as cis-gender; 84% identified as heterosexual; and 45% identified as Indigenous, 40% White, 8% African, Caribbean, or Black, and 8% other/multiple ethnicities. Overall, 85% self-reported having an undetectable VL while 82% had clinical data indicating viral suppression. The PPV was 93.7 (95% CI 90.2-96.2) indicating that 94% of women who self-reported being undetectable truly were. The NPV was 80.4 (95% CI 66.9-90.2). LR+ was 3.2 (2.1-4.6) and LR- was 0.05 (0.03-0.10)., Conclusions: Our self-report measure assessing undetectable VL strongly predicted true viral suppression among Canadian women with HIV. This measure can be used in research settings without laboratory data in regions with high rates of VL testing and suppression.
- Published
- 2017
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