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13. HIV risk and barriers to care for African-born immigrant women: a sociocultural outlook.

Author

Okoro, Olihe N. and Whitson, Shanasha O.

Subjects
*REPRODUCTIVE health, *INTIMATE partner violence, *AFRICAN American women, *SOCIOCULTURAL factors, *HIV infection transmission
Abstract

Background: Data from the Minnesota Department of Health (MDH) HIV/AIDS Surveillance Report 2015 show that African-born (AB) women continue to be disproportionately affected by HIV. In 2015, these women accounted for more than half (54%) of all new cases of HIV reported among females in Minnesota and 34% of all known female cases in the state. This study was a needs assessment for HIV pre-exposure prophylaxis (PrEP) in vulnerable subgroups within the AB population and adequacy of HIV care for AB persons. The primary objective of this study was to gain an insight into the strategies that will limit the spread of HIV infection and enhance HIV care among AB immigrants. Methods: Community advocates, community-based organizations (CBOs), clinicians, and other HIV-related service providers were invited to participate in a focus group, structured interview or complete an assessment tool using the same questionnaire about HIV and PrEP among AB persons. A thematic analysis was then conducted on the open-ended questions addressing perceived barriers. Results: Findings suggest the following gender-specific sociocultural factors that drive HIV transmission and constitute barriers to HIV treatment for AB women: domestic/intimate partner violence, gender-biased stigma, discriminatory cultural beliefs and normative values/expectations, unprotected sex with husbands who have sex with other men, gender discordance in health care (preference for female provider), and sexual/reproductive health illiteracy. Recommendation: Based on recommendations, a community-based sexual and reproductive health education is being initiated with a curriculum that will be 1) broad (inclusive but not limited to HIV), 2) culturally sensitive/responsive, and 3) at appropriate literacy level for all women, including those who have little or no formal education. [ABSTRACT FROM AUTHOR]

Published
2017
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14. Awareness of state legislation on naloxone accessibility associated with willingness to prescribe naloxone

Author

Okoro, Olihe N., Bastianelli, Karen M., Wen, Ya-Feng, Bilden, Elisabeth F., Konowalchuk, Brian K., and Schneiderhan, Mark E.

Abstract

ABSTRACTBackground: Increasing rates of opioid-related deaths, state naloxone legislation changes, and negativity prompted investigation of predictive factors associated with willingness to prescribe naloxone to populations at risk of overdose, including knowledge of risk factors, assessment of persons at risk, awareness of legislative changes, perceptions of professional responsibility, and confidence around naloxone prescribing and distribution. Methods: Cross-sectional, Web-based, anonymous, voluntary survey to prescribers of 2 regional health care systems serving urban and rural North Dakota, northern Minnesota, and northwestern Wisconsin. Human subject research was approved by university and health care systems' institutional review boards. Results: Overall, 203 of 1586 prescribers responded; however, not all prescribers completed each survey item. A majority (89.4%, n= 127/142) of respondents had never prescribed naloxone for overdose prevention. Willingness to prescribe naloxone for 4 patient care scenarios involving substantial opioid overdose risk ranged from 43.4% to 70.5%. Knowledge mean score was 15.5 (SD = 2.9) out of 22 with median 15 (range: 5–22). Naloxone legislation awareness score was 8.8 (SD = 3.8) out of 15 with median 8 (range: 3–15). There was a statistically significant but modest correlation between willingness to prescribe naloxone and the other variables, including awareness of state naloxone-related legislation (r= 0.43, P< .0001), level of self-confidence about dosing, prescribing, and writing protocols for naloxone (r= 0.37, P< .0001), general knowledge (r= 0.24, P= .0032), and perception of professional responsibility (r= 0.19, P= .03). Multivariate regression analysis indicated willingness to prescribe naloxone was associated with statistically significant predictors, including awareness of the naloxone laws (P= .0016) and self-confidence about dosing, prescribing, and writing protocols (P= .0011). Conclusions: Prescribers who are more aware of state laws regarding naloxone and confident in their knowledge of dosing, administration, and writing protocols may be more willing to prescribe naloxone.

Published
2018
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