1,315 results on '"Parker, Deborah"'
Search Results
2. Bronzino’s Dante
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Parker, Deborah
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- 2018
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3. Future policy and research for advance care planning in dementia: consensus recommendations from an international Delphi panel of the European Association for Palliative Care.
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Nakanishi, Miharu, Martins Pereira, Sandra, Van den Block, Lieve, Parker, Deborah, Harrison-Dening, Karen, Di Giulio, Paola, In der Schmitten, Jürgen, Larkin, Philip, Mimica, Ninoslav, Sudore, Rebecca, Holmerová, Iva, Korfage, Ida, and van der Steen, Jenny
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Humans ,Advance Care Planning ,Advance Directives ,Consensus ,Delphi Technique ,Dementia ,Europe ,Health Policy ,Palliative Care - Abstract
Advance care planning (ACP) is increasingly recognised in the global agenda for dementia care. The European Association for Palliative Care (EAPC) Taskforce on ACP in Dementia aimed to provide recommendations for policy initiatives and future research. We conducted a four-round Delphi study with a 33-country panel of 107 experts between September, 2021, and June, 2022, that was approved by the EAPC Board. Consensus was achieved on 11 recommendations concerning the regulation of advance directives, equity of access, and dementia-inclusive approaches and conversations to express patients values. Identified research gaps included the need for an evidence-based dementia-specific practice model that optimises engagement and communication with people with fluctuating and impaired capacity and their families to support decision making, while also empowering people to adjust their decisions if their goals or preferences change over time. Policy gaps included insufficient health services frameworks for dementia-inclusive practice. The results highlight the need for more evidence and policy development that support inclusive ACP practice models.
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- 2024
4. Microbial Translocation and Gut Damage Are Associated With an Elevated Fast Score in Women Living With and Without HIV.
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Duarte, Maria, Tien, Phyllis, Kardashian, Ani, Ma, Yifei, Hunt, Peter, Kuniholm, Mark, Adimora, Adaora, Fischl, Margaret, French, Audrey, Topper, Elizabeth, Konkle-Parker, Deborah, Minkoff, Howard, Ofotokun, Ighovwerha, Plankey, Michael, Sharma, Anjali, and Price, Jennifer
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HIV-associated liver disease ,MASLD ,microbiome ,steatohepatitis ,steatotic liver disease - Abstract
BACKGROUND: Steatohepatitis is common in persons living with HIV and may be associated with gut microbial translocation (MT). However, few studies have evaluated the gut-liver axis in persons living with HIV. In the Womens Interagency HIV Study, we examined the associations of HIV and circulating biomarkers linked to MT and gut damage using the FibroScan-aspartate aminotransferase (FAST) score, a noninvasive surrogate for steatohepatitis with advanced fibrosis. METHODS: Among 883 women with HIV and 354 without HIV, we used multivariable regression to examine the associations of HIV and serum biomarkers linked to MT and gut damage (kynurenine and tryptophan ratio, intestinal fatty acid-binding protein, soluble CD14, and soluble CD163) with a log-transformed FAST score after adjusting for key covariates. We used a path analysis and mediation models to determine the mediating effect of each biomarker on the association of HIV with FAST. RESULTS: HIV infection was associated with a 49% higher FAST score. MT biomarker levels were higher in women with HIV than women without HIV (P < .001 for each). MT biomarkers mediated 13% to 32% of the association of HIV and FAST score. CONCLUSIONS: Biomarkers linked to MT and gut damage are associated with a higher FAST score and mediate the association of HIV with a higher FAST score. Our findings suggest that MT may be an important mechanism by which HIV increases the risk of steatohepatitis with advanced fibrosis.
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- 2024
5. Consensus definition of advance care planning in dementia: A 33-country Delphi study.
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Harrison Dening, Karen, Parker, Deborah, Mimica, Ninoslav, Holmerova, Iva, Larkin, Philip, Martins Pereira, Sandra, Rietjens, Judith, Korfage, Ida, van der Steen, Jenny, Nakanishi, Miharu, Van den Block, Lieve, Di Giulio, Paola, Gonella, Silvia, In der Schmitten, Jürgen, and Sudore, Rebecca
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advance care planning ,conceptualization ,decision-making ,dementia ,palliative care ,Humans ,Consensus ,Delphi Technique ,Dementia ,Advance Care Planning ,Terminal Care - Abstract
INTRODUCTION: Existing advance care planning (ACP) definitional frameworks apply to individuals with decision-making capacity. We aimed to conceptualize ACP for dementia in terms of its definition and issues that deserve particular attention. METHODS: Delphi study with phases: (A) adaptation of a generic ACP framework by a task force of the European Association for Palliative Care (EAPC); (B) four online surveys by 107 experts from 33 countries, September 2021 to June 2022; (C) approval by the EAPC board. RESULTS: ACP in dementia was defined as a communication process adapted to the persons capacity, which includes, and is continued with, family if available. We identified pragmatic boundaries regarding participation and time (i.e., current or end-of-life care). Three interrelated issues that deserve particular attention were capacity, family, and engagement and communication. DISCUSSION: A communication and relationship-centered definitional framework of ACP in dementia evolved through international consensus supporting inclusiveness of persons with dementia and their family. HIGHLIGHTS: This article offers a consensus definitional framework of advance care planning in dementia. The definition covers all stages of capacity and includes family caregivers. Particularly important are (1) capacity, (2) family, (3) engagement, and communication. Fluctuating capacity was visualized in relation to roles and engaging stakeholders.
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- 2024
6. Intersectional Stigma, Fear of Negative Evaluation, Depression, and ART Adherence Among Women Living with HIV Who Engage in Substance Use: A Latent Class Serial Mediation Analysis
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Stringer, Kristi Lynn, Norcini Pala, Andrea, Cook, Robert L., Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E., Tien, Phyllis C., Wingood, Gina, Neilands, Torsten B., Johnson, Mallory O., Logie, Carmen H., Weiser, Sheri D., Turan, Janet M., and Turan, Bulent
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- 2024
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7. Illuminating Botticelli’s Chart of Hell
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Parker, Deborah
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- 2013
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8. Distributed Medical Education (DME) in psychiatry: perspectives on facilitators, obstacles, and factors affecting psychiatrists' willingness to engage in teaching activities
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da Luz Dias, Raquel, Hazelton, Lara, Esliger, Mandy, Brown, Peggy Alexiadis, Tibbo, Philip G., Sinha, Nachiketa, Njoku, Anthony, Satyendra, Satyanarayana, Siddhartha, Sanjay, Rahman, Faisal, Maguire, Hugh, Gray, Gerald, Bosma, Mark, Parker, Deborah, Connolly, Owen, Raji, Adewale, Manning, Alexandra, Bagnell, Alexa, Shalaby, Reham, and Agyapong, Vincent Israel Opoku
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- 2024
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9. Vasari’s Ritratto di sei poeti toscani: A Visible Literary History
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Parker, Deborah
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- 2012
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10. [Untitled]
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Parker, Deborah
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- 2008
11. Dante and Renaissance Florence (review)
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Parker, Deborah
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- 2008
12. Comento sopra la Comedia (review)
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Parker, Deborah
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- 2008
13. Mapping Implementation Science with Expert Recommendations for Implementing Change (MIS-ERIC): Strategies to Improve PrEP Use among Black Cisgender Women Living in Mississippi
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Arnold, Trisha, Whiteley, Laura, Elwy, Rani A., Ward, Lori M., Konkle-Parker, Deborah J., Brock, James B., Giorlando, Kayla K., Barnett, Andrew P., Sims-Gomillia, Courtney, Craker, Lacey K., Lockwood, Khadijra R., Leigland, Avery, and Brown, Larry K.
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- 2023
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14. Resilience and Optimism as Moderators of the Negative Effects of Stigma on Women Living with HIV
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Turan, Bulent, Budhwani, Henna, Yigit, Ibrahim, Ofotokun, Igho, Konkle-Parker, Deborah J, Cohen, Mardge H, Wingood, Gina M, Metsch, Lisa R, Adimora, Adaora A, Taylor, Tonya N, Wilson, Tracey E, Weiser, Sheri D, Kempf, Mirjam-Colette, Brown-Friday, Janet, Gange, Stephen, Kassaye, Seble, Pence, Brian W, and Turan, Janet M
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Health Services and Systems ,Public Health ,Health Sciences ,Behavioral and Social Science ,Sexually Transmitted Infections ,Mental Health ,HIV/AIDS ,Women's Health ,Infectious Diseases ,Mental Illness ,Depression ,Brain Disorders ,Good Health and Well Being ,Female ,Humans ,Cross-Sectional Studies ,HIV Infections ,Social Stigma ,Surveys and Questionnaires ,HIV ,stigma ,resilience ,depression ,trust ,optimism ,moderation ,provider ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Resilience and optimism may not only have main effects on health outcomes, but may also moderate and buffer negative effects of stressors. We examined whether dispositional resilience and optimism moderate the associations between HIV-related stigma in health care settings and health-related outcomes (trust in HIV health care providers and depression symptoms) among women living with HIV (WLHIV). One thousand four hundred five WLHIV in nine US cities completed validated questionnaires for cross-sectional analyses. Higher self-reported experienced and anticipated stigma and lower resilience and optimism were associated with higher depression symptoms and with lower trust in HIV providers. Importantly, resilience moderated the effects of experienced stigma (but not of anticipated stigma): When resilience was high, the association of experienced stigma with higher depression symptoms and lower trust in HIV providers was weaker compared with when resilience was low. Further, significant moderation effects suggested that when optimism was high, experienced and anticipated stigma was both less strongly associated with depression symptoms and with lower trust in one's HIV care providers compared with when optimism was low. Thus, the effects of experienced stigma on depression symptoms and provider trust were moderated by both resilience and optimism, but the effects of anticipated stigma were moderated only by optimism. Our findings suggest that in addition to their main effects, resilience and optimism may function as buffers against the harmful effects of stigma in health care settings. Therefore, optimism and resilience may be valuable intervention targets to reduce depression symptoms or improve trust in providers among populations that experience or anticipate stigma, such as WLHIV.
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- 2022
15. Intersectional stigmas are associated with lower viral suppression rates and antiretroviral therapy adherence among women living with HIV
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Pala, Andrea Norcini, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E, Tien, Phyllis C, Wingood, Gina, Neilands, Torsten B, Johnson, Mallory O, Weiser, Sheri D, Logie, Carmen H, Turan, Janet M, and Turan, Bulent
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Medical Microbiology ,Biomedical and Clinical Sciences ,Health Sciences ,Mental Health ,Behavioral and Social Science ,Social Determinants of Health ,HIV/AIDS ,Infectious Diseases ,Health Disparities ,Sexually Transmitted Infections ,Clinical Research ,Infection ,Anti-Retroviral Agents ,Bayes Theorem ,Cross-Sectional Studies ,Female ,HIV Infections ,Humans ,Medication Adherence ,Social Stigma ,Viral Load ,antiretroviral therapy ,HIV ,intersectional stigmas ,women with HIV ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectivesTo explore the associations between intersectional poverty, HIV, sex, and racial stigma, adherence to antiretroviral therapy (ART), and viral suppression among women with HIV (WHIV).DesignWe examined intersectional stigmas, self-report ART adherence, and viral suppression using cross-sectional data.MethodsParticipants were WHIV ( N = 459) in the Women's Adherence and Visit Engagement, a Women's Interagency HIV Study substudy. We used Multidimensional Latent Class Item Response Theory and Bayesian models to analyze intersectional stigmas and viral load adjusting for sociodemographic and clinical covariates.ResultsWe identified five intersectional stigma-based latent classes. The likelihood of viral suppression was approximately 90% lower among WHIV who experienced higher levels of poverty, sex, and racial stigma or higher levels of all intersectional stigmas compared with WHIV who reported lower experiences of intersectional stigmas. ART adherence accounted for but did not fully mediate some of the associations between latent intersectional stigma classes and viral load.ConclusionThe negative impact of intersectional stigmas on viral suppression is likely mediated, but not fully explained, by reduced ART adherence. We discuss the research and clinical implications of our findings.
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- 2022
16. Association between BMI and periodontitis in women living with or at risk for HIV
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Janorkar, Deepti A, Long, Dustin M, Weber, Kathleen M, Sharma, Anjali, Lin, Guo‐Hao, D'Souza, Gypsyamber, Edmonds, Andrew, Kassaye, Seble, Lahiri, Cecile D, and Konkle‐Parker, Deborah
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Biomedical and Clinical Sciences ,Dentistry ,Nutrition ,Prevention ,Obesity ,Dental/Oral and Craniofacial Disease ,Clinical Research ,Good Health and Well Being ,Body Mass Index ,Female ,HIV Infections ,Humans ,Male ,Overweight ,Periodontitis ,Risk Factors ,United States ,BMI ,HIV ,obesity ,periodontal disease - Abstract
AimsCurrently, there is no data available assessing the association between body mass index (BMI) and periodontitis among women living with HIV (WLWH). This study aims to investigate this association among WLWH and women at risk for HIV (WRH) in the United States.Methods and resultsData from 351 WLWH and 52 WRH participants from the Women's Interagency HIV Study having pocket depths and clinical periodontal attachment loss assessments in 2003-2004 were included. Multinomial logistic regression analyses in the full sample assessed the relationship between BMI (underweight/normal, overweight, or obese) and periodontitis by severity (mild, moderate, severe), adjusting for study sites, age, education, annual household income, smoking, alcohol consumption, and diabetes. Overall, 75.2% women (76.0% WLWH; 69.0% WRH) had periodontitis. Moreover, 75.0% obese and 75.3% overweight women were affected by periodontitis. In the full sample, adjusted odds ratio (aOR) of having mild, moderate, and severe periodontitis in obese women were: 1.14 (95% confidence interval [CI]: 0.51-2.52), 1.02 (95% CI: 0.46-2.29), and 0.24 (95% CI: 0.06-1.07), respectively, and in overweight women: 0.70 (95% CI: 0.31-1.58), 0.85 (95% CI: 0.38-1.90), and 0.31 (95% CI: 0.08-1.15), respectively.ConclusionsEven with high prevalence of periodontitis among women with or without HIV infection in this cohort, this study does not provide evidence of an association between BMI and periodontitis.
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- 2022
17. Internalized HIV-Related Stigma and Neurocognitive Functioning Among Women Living with HIV
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Thompson, Emma C, Muhammad, Josh N, Adimora, Adoara A, Chandran, Aruna, Cohen, Mardge H, Crockett, Kaylee B, Goparaju, Lakshmi, Henderson, Emmett, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Kwait, Jennafer, Mimiaga, Matthew, Ofotokun, Igho, Rubin, Leah, Sharma, Anjala, Teplin, Linda A, Vance, David E, Weiser, Sheri D, Weiss, Deborah J, Wilson, Tracey E, Turan, Janet M, and Turan, Bulent
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Health Services and Systems ,Health Sciences ,Sexually Transmitted Infections ,Clinical Research ,Basic Behavioral and Social Science ,Infectious Diseases ,Behavioral and Social Science ,HIV/AIDS ,Mental Health ,Neurosciences ,Women's Health ,Brain Disorders ,Black or African American ,Female ,HIV Infections ,Humans ,Social Stigma ,United States ,Viral Load ,HIV ,stigma ,neurocognitive function ,cognitive decline ,women ,aging ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
The prevalence of HIV-associated neurocognitive impairment persists despite highly effective antiretroviral therapy (ART). In this study we explore the role of internalized stigma, acceptance of negative societal characterizations, and perceptions about people living with HIV (PLWH) on neurocognitive functioning (executive function, learning, memory, attention/working memory, psychomotor speed, fluency, motor skills) in a national cohort of women living with HIV (WLWH) in the United States. We utilized observational data from a multicenter study of WLWH who are mostly African American living in low-resource settings. Neurocognitive function was measured using an eight-test battery. A multiple linear regression model was constructed to investigate the relationship between internalized stigma and overall neurocognitive functioning (mean of all neurocognitive domain standardized T-scores), adjusting for age, education, race, previous neuropsychological battery scores, illicit drug use, viral load, and years on ART. Our analysis revealed that internalized HIV-related stigma is significantly associated with worse performance on individual domain tests and overall neurocognitive performance (B = 0.27, t = 2.50, p = 0.01). This suggests HIV-related internalized stigma may be negatively associated with neurocognitive functioning for WLWH. This finding highlights a specific psychosocial factor associated with poor neurocognitive function that may be targeted to better promote the health of PLWH. Future research on the longitudinal relationship between these variables and the effects of other stigma dimensions on poor neurocognitive function would provide further insights into the pathways explaining the relationship between internalized stigma and neurocognition.
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- 2022
18. Impacts of Medicaid Expansion on Health Insurance and Coverage Transitions among Women with or at Risk for HIV in the United States
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Edmonds, Andrew, Belenky, Nadya, Adedimeji, Adebola A, Cohen, Mardge H, Wingood, Gina, Fischl, Margaret A, Golub, Elizabeth T, Johnson, Mallory O, Merenstein, Daniel, Milam, Joel, Konkle-Parker, Deborah, Wilson, Tracey E, and Adimora, Adaora A
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Public Health ,Health Sciences ,Clinical Research ,Infectious Diseases ,Prevention ,Clinical Trials and Supportive Activities ,HIV/AIDS ,Good Health and Well Being ,Female ,HIV Infections ,Health Services Accessibility ,Humans ,Insurance Coverage ,Insurance ,Health ,Medicaid ,Patient Protection and Affordable Care Act ,United States ,Paediatrics and Reproductive Medicine ,Public Health and Health Services ,Midwifery ,Public health ,Policy and administration - Abstract
BackgroundAs employment, financial status, and residential location change, people can gain, lose, or switch health insurance coverage, which may affect care access and health. Among Women's Interagency HIV Study participants with HIV and participants at risk for HIV attending semiannual visits at 10 U.S. sites, we examined whether the prevalence of coverage types and rates of coverage changes differed by HIV status and Medicaid expansion in their states of residence.MethodsGeocoded addresses were merged with dates of Medicaid expansion to indicate, at each visit, whether women lived in Medicaid expansion states. Age-adjusted rate ratios (RRs) and rate differences of self-reported insurance changes were estimated by Poisson regression.ResultsFrom 2008 to 2018, 3,341 women (67% Black, 71% with HIV) contributed 43,329 visits at aged less than 65 years (27% under Medicaid expansion). Women with and women without HIV differed in their proportions of visits at which no coverage (14% vs. 19%; p
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- 2022
19. How Does Poverty Stigma Affect Depression Symptoms for Women Living with HIV? Longitudinal Mediating and Moderating Mechanisms
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Turan, Bulent, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wilson, Tracey E., Tien, Phyllis C., Wingood, Gina, Neilands, Torsten B., Johnson, Mallory O., Logie, Carmen H., Weiser, Sheri D., and Turan, Janet M.
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- 2023
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20. Patient Health Literacy and Communication with Providers Among Women Living with HIV: A Mixed Methods Study
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Budhwani, Henna, Gakumo, C Ann, Yigit, Ibrahim, Rice, Whitney S, Fletcher, Faith E, Whitfield, Samantha, Ross, Shericia, Konkle-Parker, Deborah J, Cohen, Mardge H, Wingood, Gina M, Metsch, Lisa R, Adimora, Adaora A, Taylor, Tonya N, Wilson, Tracey E, Weiser, Sheri D, Sosanya, Oluwakemi, Goparaju, Lakshmi, Gange, Stephen, Kempf, Mirjam-Colette, Turan, Bulent, and Turan, Janet M
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Health Services and Systems ,Public Health ,Health Sciences ,Clinical Research ,HIV/AIDS ,Behavioral and Social Science ,Health Services ,7.1 Individual care needs ,Management of diseases and conditions ,8.1 Organisation and delivery of services ,Health and social care services research ,Infection ,Generic health relevance ,Good Health and Well Being ,Anti-Retroviral Agents ,Communication ,Female ,HIV Infections ,Health Literacy ,Humans ,Trust ,United States ,Health communication ,Health literacy ,HIV ,African American ,Latina ,Public Health and Health Services ,Social Work ,Public health - Abstract
In this mixed-methods study, we examine the relationship between provider communication and patient health literacy on HIV continuum of care outcomes among women living with HIV in the United States. We thematically coded qualitative data from focus groups and interviews (N = 92) and conducted mediation analyses with quantitative survey data (N = 1455) collected from Women's Interagency HIV Study participants. Four qualitative themes related to provider communication emerged: importance of respect and non-verbal cues; providers' expressions of condescension and judgement; patient health literacy; and unclear, insufficient provider communication resulting in diminished trust. Quantitative mediation analyses suggest that higher health literacy is associated with higher perceived patient-provider interaction quality, which in turn is associated with higher levels of trust in HIV providers, improved antiretroviral medication adherence, and reduced missed clinical visits. Findings indicate that enhancing provider communication and bolstering patient health literacy could have a positive impact on the HIV continuum of care.
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- 2022
21. Multisite prospective Liver Disease and Reproductive Ageing (LIVRA) study in US women living with and without HIV
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Price, Jennifer, Ma, Yifei, Adimora, Adaora, Fischl, Margaret, French, Audrey L, Golub, Elizabeth T, Konkle-Parker, Deborah, Kuniholm, Mark H, Ofotokun, Ighovwerha, Plankey, Michael, Sharma, Anjali, and Tien, Phyllis C
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Medical Microbiology ,Biomedical and Clinical Sciences ,Chronic Liver Disease and Cirrhosis ,Digestive Diseases ,Hepatitis ,HIV/AIDS ,Infectious Diseases ,Liver Disease ,Hepatitis - C ,Emerging Infectious Diseases ,Clinical Research ,Infection ,Good Health and Well Being ,Aging ,Child ,Digestive System Diseases ,Disease Progression ,Elasticity Imaging Techniques ,Fatty Liver ,Female ,HIV Infections ,Hepacivirus ,Hepatitis C ,Humans ,Liver ,Liver Cirrhosis ,Liver Diseases ,Non-alcoholic Fatty Liver Disease ,Prospective Studies ,hepatology ,infectious diseases ,HIV & AIDS ,Clinical Sciences ,Public Health and Health Services ,Other Medical and Health Sciences ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
PurposeThe Liver Disease and Reproductive Ageing (LIVRA) study leverages the infrastructure of the decades-long multicentre prospective Women's Interagency HIV Study (WIHS) to examine the contributions of HIV, hepatitis C virus (HCV) and ageing to liver disease progression in women.ParticipantsFrom 2013 to 2018, LIVRA enrolled 1576 participants (77 HCV-seropositive only, 248 HIV/HCV-seropositive, 868 HIV-seropositive only and 383 HIV/HCV-seronegative) who underwent vibration controlled transient elastography (VCTE). A VCTE quality assurance programme was established to ensure consistency and accuracy for longitudinal assessment of steatosis (fatty liver) via the controlled attenuation parameter (CAP) and fibrosis via liver stiffness (LS). Demographic, lifestyle factors, anthropometry, clinical and medication history, host genetics, immune markers and hormone levels were collected as part of the WIHS.Findings to dateAt baseline, 737 of 1543 women with CAP measurements had steatosis (CAP ≥248 dB/m) and 375 of 1576 women with LS measurements had significant fibrosis (LS ≥7.1 kPa), yielding a prevalence of 48% and 24%, respectively. On multivariable analysis, waist circumference (WC) and insulin resistance were independently associated with higher CAP (17.8 dB/m per 10 cm (95% CI:16.2 to 19.5) and 1.2 dB/m per doubling (95% CI:0.8 to 1.6), respectively). By contrast, HIV/HCV seropositivity and HCV seropositivity alone were associated with less steatosis compared with HIV/HCV-seronegative women, although the latter did not reach statistical significance (-9.2 dB/m (95% CI:-18.2 to -0.3) and -10.4 dB/m (95% CI: -23.8 to 3.1), respectively). Factors independently associated with higher LS were age (4.4% per 10 years (95% CI: 0.4% to 8.4%)), WC (5.0% per 10 cm (95% CI: 3.3% to 6.6%)), CAP steatosis (0.6% per 10 dB/m (95% CI: 0.1% to 1.0%)), HIV/HCV seropositivity (33% (95% CI: 24% to 44%)) and HCV seropositivity alone (43% (95% CI: 28% to 60%)). Excluding scans that were invalid based on traditional criteria for unreliability did not affect the results.Future plansEnrolled women undergo VCTE at 3-year intervals unless LS is ≥9.5 kPa, indicating advanced fibrosis, in which case VCTE is performed annually. Participants also undergo VCTE every 6 months until 18 months after HCV treatment initiation. Analysis of the data collected will provide insights into the impact of ageing/ovarian function, host genetics, immune function and contemporary HIV and HCV treatments on liver disease progression.
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- 2022
22. Complementing the United States Household Food Security Survey Module with Items Reflecting Social Unacceptability
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Frongillo, Edward A, Bethancourt, Hilary J, Norcini Pala, Andrea, Maya, Sigal, Wu, Katherine C, Kizer, Jorge R, Tien, Phyllis C, Kempf, Mirjam-Colette, Hanna, David B, Appleton, Allison A, Merenstein, Daniel, D’Souza, Gypsyamber, Ofotokun, Igho, Konkle-Parker, Deborah, Michos, Erin D, Krier, Sarah, Stosor, Valentina, Turan, Bulent, and Weiser, Sheri D
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- 2024
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23. The impact of business model workforce configurations on value creation and value appropriation in the Australian aged care sector
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Brown, David A, Ma, Nelson, Yang, Jin Sug, Sutton, Nicole, McAllister, Gillian, Parker, Deborah, Rawlings-Way, Olivia, and Lewis, Rachael L
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- 2023
24. Medieval Italy (review)
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Parker, Deborah
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- 2008
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25. La "Comedia" di Dante Aligiehri con la nova esposizione (review)
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Parker, Deborah
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- 2008
26. Who cares for the carers? carerhelp: development and evaluation of an online resource to support the wellbeing of those caring for family members at the end of their life
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Tieman, Jennifer, Hudson, Peter, Thomas, Kristina, Saward, Di, and Parker, Deborah
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- 2023
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27. Dual trajectories of antiretroviral therapy adherence and polypharmacy in women with HIV in the United States
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Elbur, Abubaker Ibrahim, Ghebremichael, Musie, Konkle-Parker, Deborah, Jones, Deborah L, Collins, Shelby, Adimora, Adaora A., Schneider, Michael F., Cohen, Mardge H., Tamraz, Bani, Plankey, Michael, Wilson, Tracey, Adedimeji, Adebola, Haberer, Jessica E., and Jacobson, Denise L.
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- 2023
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28. Short-term binge drinking, marijuana, and recreational drug use trajectories in a prospective cohort of people living with HIV at the start of COVID-19 mitigation efforts in the United States
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Meanley, Steven, Choi, Seul Ki, Thompson, Azure B, Meyers, Jacquelyn L, D'Souza, Gypsyamber, Adimora, Adaora A, Mimiaga, Matthew J, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Cohen, Mardge H, Teplin, Linda A, Murchison, Lynn, Rubin, Leah H, Rubtsova, Anna A, Weiss, Deborah Jones, Aouizerat, Brad, Friedman, Mackey R, Plankey, Michael W, and Wilson, Tracey E
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Biomedical and Clinical Sciences ,Clinical Sciences ,Behavioral and Social Science ,Mental Health ,Drug Abuse (NIDA only) ,Prevention ,HIV/AIDS ,Pediatric ,Substance Misuse ,Clinical Research ,Infectious Diseases ,Good Health and Well Being ,Binge Drinking ,COVID-19 ,Cannabis ,Cohort Studies ,HIV Infections ,Humans ,Male ,Pandemics ,Prospective Studies ,Recreational Drug Use ,SARS-CoV-2 ,Substance-Related Disorders ,United States ,HIV ,Substance use ,Longitudinal ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Substance Abuse ,Biochemistry and cell biology ,Pharmacology and pharmaceutical sciences ,Epidemiology - Abstract
BackgroundAt the start of the COVID-19 pandemic, HIV experts suggested that an increase in mental health diagnoses and substance use among people living with HIV (PLHIV) may be an unintended consequence of COVID-19 mitigation efforts (e.g., limiting social contact). We evaluated short-term trajectories in binge drinking, marijuana, and recreational drug use in a prospective cohort of PLHIV.MethodsData (N = 2121 PLHIV) consist of survey responses on substance use behaviors from two pre-COVID-19 (October 2018-September 2019) and one COVID-19-era (April 2020-September 2020) timepoints within the MACS/WIHS Combined Cohort Study (MWCCS). We conducted group-based trajectory models, triangulated with generalized linear mixed models, to assess changes in binge drinking, daily marijuana use, and recreational drug use at the start of the pandemic. Controlling for age and race/ethnicity, we tested whether trajectories differed by sex and early-pandemic depressive symptoms, loneliness, and social support.ResultsGroup-based trajectory models yielded two trajectory groups for binge drinking (none vs. any), marijuana (none/infrequent vs. daily), and recreational drug use (none vs. any). Binge drinking and recreational drug use decreased at the beginning of the pandemic. Generalized linear mixed model supported these trends. Consistent with prior research, male sex and having depressive symptoms early pandemic were positively associated with each substance use outcomes. Social support was inversely associated with recreational drug use.ConclusionsContrary to hypotheses, problematic substance use behaviors decreased from pre-pandemic to the post-pandemic follow-up in our sample of PLHIV. Ongoing surveillance is needed to assess whether this pattern persists as the pandemic continues.
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- 2022
29. Multidimensional Evaluation of Screening Brief Intervention and Referral to Treatment Training for Medical Students
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McAfee, Nicholas W., Schumacher, Julie A., Williams, Daniel C., Madson, Michael B., Bagge, Courtney L., Konkle-Parker, Deborah, Paul, Ian A., Houston, L. Joy, and Young, Kathleen M.
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- 2023
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30. Integrase Inhibitors are Associated with Neuropsychiatric Symptoms in Women with HIV
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Rubin, Leah H., O’Halloran, Jane A., Williams, Dionna W., Li, Yuliang, Fitzgerald, Kathryn C., Dastgheyb, Raha, Damron, Alexandra L., Maki, Pauline M., Spence, Amanda B., Sharma, Anjali, Gustafson, Deborah R., Milam, Joel, Weber, Kathleen M., Adimora, Adaora A., Ofotokun, Igho, Fischl, Margaret A., Konkle-Parker, Deborah, and Xu, Yanxun
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- 2023
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31. Examining the Relationships Between Experienced and Anticipated Stigma in Health Care Settings, Patient–Provider Race Concordance, and Trust in Providers Among Women Living with HIV
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Budhwani, Henna, Yigit, Ibrahim, Ofotokun, Igho, Konkle-Parker, Deborah J, Cohen, Mardge H, Wingood, Gina M, Metsch, Lisa R, Adimora, Adaora A, Taylor, Tonya N, Wilson, Tracey E, Weiser, Sheri D, Kempf, Mirjam-Colette, Sosanya, Oluwakemi, Gange, Stephen, Kassaye, Seble, Turan, Bulent, and Turan, Janet M
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Health Services and Systems ,Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Health Services ,HIV/AIDS ,Clinical Research ,Infection ,Good Health and Well Being ,Anti-Retroviral Agents ,Female ,HIV Infections ,Humans ,Medication Adherence ,Social Stigma ,Trust ,HIV ,health equity ,race ,women living with HIV ,moderation analysis ,WIHS ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Stigma in health care settings can have negative consequences on women living with HIV, such as increasing the likelihood of missed visits and reducing trust in their clinical providers. Informed by prior stigma research and considering knowledge gaps related to the effect of patient-provider race concordance, we conducted this study to assess if patient-provider race concordance moderates the expected association between HIV-related stigma in health care settings and patients' trust in their providers. Moderation analyses were conducted using Women's Interagency HIV Study data (N = 931). We found significant main effects for patient-provider race concordance. Higher experienced stigma was associated with lower trust in providers in all patient-provider race combinations [White-White: B = -0.89, standard error (SE) = 0.14, p = 0.000, 95% confidence interval, CI (-1.161 to -0.624); Black patient-White provider: B = -0.19, SE = 0.06, p = 0.003, 95% CI (-0.309 to -0.062); and Black-Black: B = -0.30, SE = 0.14, p = 0.037, 95% CI (-0.575 to -0.017)]. Higher anticipated stigma was also associated with lower trust in providers [White-White: B = -0.42, SE = 0.07, p = 0.000, 95% CI (-0.552 to -0.289); Black patient-White provider: B = -0.17, SE = 0.03, p = 0.000, 95% CI (-0.232 to -0.106); and Black-Black: B = -0.18, SE = 0.06, p = 0.002, 95% CI (-0.293 to -0.066)]. Significant interaction effects indicated that the negative associations between experienced and anticipated HIV-related stigma and trust in providers were stronger for the White-White combination compared with the others. Thus, we found that significant relationships between HIV-related experienced and anticipated stigma in health care settings and trust in providers exist and that these associations vary across different patient-provider race combinations. Given that reduced trust in providers is associated with antiretroviral medication nonadherence and higher rates of missed clinical visits, interventions to address HIV-related stigma in health care settings may improve continuum of care outcomes.
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- 2021
32. Common antiretroviral combinations are associated with somatic depressive symptoms in women with HIV
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Parra-Rodriguez, Luis, O’Halloran, Jane, Wang, Yuezhe, Jin, Wei, Dastgheyb, Raha M., Spence, Amanda B., Sharma, Anjali, Gustafson, Deborah R., Milam, Joel, Weber, Kathleen M., Adimora, Adaora A., Ofotokun, Igho, Fischl, Margaret A., Konkle-Parker, Deborah, Maki, Pauline M., Xu, Yanxun, and Rubin, Leah H.
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- 2024
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33. Low-Burden Universal Substance Use Screening in a Primary Care Clinic to Lower Implementation Barriers
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Konkle-Parker, Deborah, Williams, Daniel, McAfee, Nicholas, Schumacher, Julie A., and Parker, Jefferson
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- 2023
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34. Food insecurity and frailty among women with and without HIV in the United States: a cross‐sectional analysis
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Tan, Judy Y, Sheira, Lila A, Frongillo, Edward A, Gustafson, Deborah, Sharma, Anjali, Merenstein, Daniel, Cohen, Mardge H, Golub, Elizabeth, Edmonds, Andrew, Ofotokun, Igho, Fischl, Margaret, Konkle‐Parker, Deborah, Neilands, Torsten, Tien, Phyllis, and Weiser, Sheri D
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Clinical Research ,Infectious Diseases ,HIV/AIDS ,Prevention ,Aetiology ,2.3 Psychological ,social and economic factors ,Zero Hunger ,Aged ,Cross-Sectional Studies ,Female ,Food Insecurity ,Food Supply ,Frailty ,HIV Infections ,Humans ,United States ,Food insecurity ,frailty ,HIV ,women ,Clinical Sciences ,Public Health and Health Services ,Other Medical and Health Sciences ,Clinical sciences ,Epidemiology ,Public health - Abstract
IntroductionFrailty is frequently observed among people with HIV, and food insecurity is associated with frailty in the general population. Evidence is scarce on the associations between food insecurity and frailty among women with HIV who may be particularly vulnerable to the impacts of food insecurity. The goal of this study was to assess associations between food insecurity and frailty among women with and without HIV.MethodsThere were 1265 participants from the Women's Interagency HIV Study who participated in frailty assessments in 2017. Frailty was measured using the Fried Frailty Phenotype, and women were subsequently categorized as robust, pre-frail or frail. Food insecurity was assessed using the U.S. Household Food Security Survey Module, with women categorized as having high, marginal, low or very low food security. Multinomial logistic regression models were conducted to examine cross-sectional associations between food insecurity and frailty while adjusting for socio-demographic, behavioural and HIV status covariates.Results and discussionApproximately one-third (31.9%) of the women had marginal, low or very low food security, and the proportions of women who met the criteria for frailty or pre-frailty were 55.6% and 12.4% respectively. In the adjusted model, the relative risk ratio (RRR) of frailty for women with very low food security versus women with high food security was 3.37 (95% CI [1.38 to 8.24], p
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- 2021
35. The Language of Devotion in Michelangelo’s Letters
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Parker, Deborah, primary
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- 2023
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36. Quality of care for Black and Latina women living with HIV in the U.S.: a qualitative study
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Rice, Whitney S, Fletcher, Faith E, Akingbade, Busola, Kan, Mary, Whitfield, Samantha, Ross, Shericia, Gakumo, C Ann, Ofotokun, Igho, Konkle-Parker, Deborah J, Cohen, Mardge H, Wingood, Gina M, Pence, Brian W, Adimora, Adaora A, Taylor, Tonya N, Wilson, Tracey E, Weiser, Sheri D, Kempf, Mirjam-Colette, Turan, Bulent, and Turan, Janet M
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Health Services and Systems ,Public Health ,Health Sciences ,Clinical Research ,Clinical Trials and Supportive Activities ,Behavioral and Social Science ,Health Services ,Health and social care services research ,8.1 Organisation and delivery of services ,Generic health relevance ,Infection ,Good Health and Well Being ,Adult ,Black or African American ,Attitude ,Attitude of Health Personnel ,Consumer Behavior ,Female ,Focus Groups ,HIV Infections ,Health Equity ,Hispanic or Latino ,Humans ,Middle Aged ,Midwestern United States ,New England ,Patient Participation ,Patient Safety ,Qualitative Research ,Quality of Health Care ,Southeastern United States ,Women's Health ,Quality of health care ,Patient satisfaction ,Women living with HIV ,Engagement in care ,HIV ,AIDS ,Qualitative ,African American ,Black ,Hispanic ,HIV/AIDS ,Public Health and Health Services ,Sociology ,Health services and systems ,Public health ,Policy and administration - Abstract
BackgroundEnding the HIV epidemic requires that women living with HIV (WLWH) have access to structurally competent HIV-related and other health care. WLWH may not regularly engage in care due to inadequate quality; however, women's perspectives on the quality of care they receive are understudied.MethodsWe conducted 12 focus groups and three in-depth interviews with Black (90%) and Latina (11%) WLWH enrolled in the Women's Interagency HIV Study in Atlanta, GA, Birmingham, AL, Brooklyn, NY, Chapel Hill, NC, Chicago, IL, and Jackson, MS from November 2017 to May 2018 (n = 92). We used a semi-structured format to facilitate discussions about satisfaction and dissatisfaction with health care engagement experiences, and suggestions for improvement, which were audio-recorded, transcribed, and coded using thematic analysis.ResultsThemes emerged related to women's health care satisfaction or dissatisfaction at the provider, clinic, and systems levels and across Institute of Medicine-defined quality of care domains (effectiveness, efficiency, equity, patient-centeredness, safety and timeliness). Women's degree of care satisfaction was driven by: 1) knowledge-based care resulting in desired outcomes (effectiveness); 2) coordination, continuity and necessity of care (efficiency); 3) perceived disparities in care (equity); 4) care delivery characterized by compassion, nonjudgment, accommodation, and autonomous decision-making (patient-centeredness); 5) attention to avoiding side effects and over-medicalization (safety); and 6) limited wait time (timeliness).ConclusionsQuality of care represents a key changeable lever affecting engage in care among WLWH. The communities most proximally affected by HIV should be key stakeholders in HIV-related quality assurance. Findings highlight aspects of the health care experience valued by WLWH, and potential participatory, patient-driven avenues for improvement.
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- 2020
37. Food insecurity and neurocognitive function among women living with or at risk for HIV in the United States
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Tan, Judy Y, A Sheira, Lila, Frongillo, Edward A, A Adimora, Adaora, Tien, Phyllis C, Konkle-Parker, Deborah, Golub, Elizabeth T, Merenstein, Daniel, Levin, Susanna, Cohen, Mardge, Ofotokun, Igho, A Fischl, Margaret, Rubin, Leah H, and Weiser, Sheri D
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Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Clinical Sciences ,Minority Health ,Prevention ,Health Disparities ,Social Determinants of Health ,Sexually Transmitted Infections ,Infectious Diseases ,Mental Health ,Behavioral and Social Science ,Clinical Research ,Neurosciences ,Women's Health ,Basic Behavioral and Social Science ,HIV/AIDS ,Zero Hunger ,Adult ,Cross-Sectional Studies ,Food Insecurity ,HIV Infections ,HIV-1 ,Humans ,Middle Aged ,Neurocognitive Disorders ,Socioeconomic Factors ,United States ,food insecurity ,HIV ,neurocognitive function ,neurocognitive impairment ,women ,Engineering ,Medical and Health Sciences ,Nutrition & Dietetics ,Clinical sciences ,Nutrition and dietetics - Abstract
BackgroundNeurocognitive impairment (NCI) persists among women living with HIV. Food insecurity is also common among women and may be an important modifiable contributor of NCI.ObjectiveThe goal of this study was to determine the association of food insecurity with neurocognitive function among women living with or without HIV.MethodsFrom 2013 to 2015, we analyzed data from a cross-sectional sample from the Women's Interagency HIV Study (WIHS). Measures included food insecurity and a comprehensive neuropsychological test battery assessing executive function, processing speed, attention/working memory, learning, memory, fluency, and motor function. We conducted multivariable linear regressions to examine associations between food insecurity and domain-specific neurocognitive performance, adjusting for relevant sociodemographic, behavioral, and clinical factors.ResultsParticipants (n = 1,324) were predominantly HIV seropositive (68%), Black/African-American (68%) or Hispanic (16%), and low income (48% reported
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- 2020
38. Metabolic Changes Associated With the Use of Integrase Strand Transfer Inhibitors Among Virally Controlled Women.
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Summers, Nathan A, Lahiri, Cecile D, Angert, Christine D, Aldredge, Amalia, Mehta, C Christina, Ofotokun, Ighovwerha, Kerchberger, Anne M, Gustafson, Deborah, Weiser, Sheri D, Kassaye, Seble, Konkle-Parker, Deborah, Sharma, Anjali, Adimora, Adaora A, Bolivar, Hector, Cocohoba, Jennifer, French, Audrey L, Golub, Elizabeth T, and Sheth, Anandi N
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Diabetes ,Prevention ,Clinical Research ,Cardiovascular ,Nutrition ,Obesity ,Metabolic and endocrine ,Adult ,Cohort Studies ,Female ,HIV Infections ,HIV Integrase Inhibitors ,HIV-1 ,Humans ,Middle Aged ,Retrospective Studies ,HIV ,INSTI ,ART ,diabetes mellitus ,BP ,hypertension ,Clinical Sciences ,Public Health and Health Services ,Virology - Abstract
BackgroundIntegrase strand transfer inhibitors (INSTIs) have been associated with weight gain among women living with HIV. We aimed to investigate the association between INSTIs and change in cardiometabolic risk indicators.SettingRetrospective cohort.MethodsData from 2006 to 2017 were analyzed from women living with HIV enrolled in the longitudinal Women's Interagency HIV Study who were virally controlled on antiretroviral therapy (ART) for ≥5 consecutive semiannual visits. Women who switched/added an INSTI to ART (INSTI group) were compared with women who remained on non-INSTI ART (non-INSTI group). Outcomes included changes in fasting lipids and glucose, hemoglobin A1c (HbA1c), blood pressure (BP), and incident diabetes, hypertension, and insulin resistance. Outcomes were measured 6-12 months before and 6-18 months after INSTI switch/add in the INSTI group with comparable visits in the non-INSTI group. Longitudinal linear regression models compared change over time in each outcome by the study group.ResultsOne thousand one hundred eighteen participants (234 INSTI, 884 non-INSTI) were followed for a median 2.0 (Q1 1.9, Q3 2.0) years. Participants were median age 49 years, 61% Black, and 73% overweight or obese (body mass index ≥25 kg/m). Compared with non-INSTI, the INSTI group experienced greater increases in HbA1c (+0.05 vs. -0.06 mg/dL, P = 0.0318), systolic BP (+3.84 vs. +0.84 mm Hg, P = 0.0191), and diastolic BP (+1.62 vs. -0.14 mm Hg, P = 0.0121), with greatest change in HbA1c among women on INSTIs with ≥5% weight gain.ConclusionsINSTI use was associated with unfavorable changes in HbA1c and systolic and diastolic BP during short-term follow-up. Further research is needed to understand long-term cardiometabolic effects of INSTI use.
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- 2020
39. ELDAC: End of Life direction for aged care
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Yates, Patsy, Tieman, Jennifer, Parker, Deborah, and Clifton, Karen
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- 2022
40. Resilience and HIV Treatment Outcomes Among Women Living with HIV in the United States: A Mixed-Methods Analysis
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Fletcher, Faith E, Sherwood, Nicholas R, Rice, Whitney S, Yigit, Ibrahim, Ross, Shericia N, Wilson, Tracey E, Weiser, Sheri D, Johnson, Mallory O, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Turan, Janet M, and Turan, Bulent
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Prevention ,Mental Health ,Depression ,Mental Illness ,Minority Health ,HIV/AIDS ,Behavioral and Social Science ,Women's Health ,Clinical Research ,Infectious Diseases ,Substance Misuse ,Brain Disorders ,Social Determinants of Health ,Health Disparities ,Sexually Transmitted Infections ,Good Health and Well Being ,Adaptation ,Psychological ,Adult ,Anxiety ,Depressive Disorder ,Discrimination ,Psychological ,Female ,HIV Infections ,Humans ,Medication Adherence ,Minority Groups ,Resilience ,Psychological ,Social Stigma ,Substance-Related Disorders ,Treatment Outcome ,United States ,HIV ,resilience ,women living with HIV ,mixed methods ,HIV outcomes ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Resilience is defined as the ability and process to transform adversity into opportunities for growth and adaptation. Resilience may be especially important for people living with HIV (PLWH), who are susceptible to anxiety and depressive disorders, which are commonly linked to risk behaviors (i.e., alcohol and drug abuse), poor adherence to medical regimens, increased risk of morbidity and mortality, and related stigma and discrimination. To date, few studies have examined the impact of resilience on health-related behaviors and outcomes among PLWH, particularly among minority women living with HIV (WLWH) who are dealing with multiple stressors impacting their health. This study used a convergent parallel mixed-methods design to collect, analyze, and integrate qualitative and quantitative data from a subsample of WLWH enrolled in the Women's Interagency HIV Study (WIHS). The aims of the study were to (1) qualitatively examine the resilience perspectives of 76 marginalized WLWH, and; (2) quantitatively assess the associations of resilience with HIV health outcomes-adherence to antiretroviral therapy and viral suppression-in the context of differing levels of internalized HIV-related stigma and depressive symptoms (n = 420). Findings from this mixed-methods study suggest that resilience is an important resource that can aid WLWH in coping constructively with adversity by capitalizing on intrapersonal traits and states, interpersonal and institutional resources, and spiritual and/or religious practices. Given the complex medical and social needs of marginalized WLWH, intervention strategies should focus on mitigating psychosocial burdens of stigma and depression, in addition to building resilience.
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- 2020
41. Weight Gain Associated With Integrase Stand Transfer Inhibitor Use in Women
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Kerchberger, Anne Marie, Sheth, Anandi N, Angert, Christine D, Mehta, C Christina, Summers, Nathan A, Ofotokun, Ighovwerha, Gustafson, Deborah, Weiser, Sheri D, Sharma, Anjali, Adimora, Adaora A, French, Audrey L, Augenbraun, Michael, Cocohoba, Jennifer, Kassaye, Seble, Bolivar, Hector, Govindarajulu, Usha, Konkle-Parker, Deborah, Golub, Elizabeth T, and Lahiri, Cecile D
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Biomedical and Clinical Sciences ,Clinical Sciences ,Obesity ,Aging ,Infectious Diseases ,HIV/AIDS ,Clinical Research ,Prevention ,Body Mass Index ,Female ,HIV Infections ,HIV Integrase ,HIV Integrase Inhibitors ,Humans ,Integrases ,Middle Aged ,Weight Gain ,integrase strand transfer inhibitors ,weight gain ,HIV positive ,women ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundIntegrase strand-transfer inhibitor (INSTI)-based antiretroviral therapy (ART) is recommended for human immunodeficiency virus (HIV) management. Although studies have suggested associations between INSTIs and weight gain, women living with HIV (WLHIV) have been underrepresented in research. We evaluated the effect of switching or adding INSTIs among WLHIV.MethodsWomen enrolled in the Women's Interagency HIV Study (WIHS) from 2006-2017 who switched to or added an INSTI to ART (SWAD group) were compared to women on non-INSTI ART (STAY group). Body weight, body mass index (BMI), percentage body fat (PBF), and waist, hip, arm, and thigh circumferences were measured 6-12 months before and 6-18 months after the INSTI switch/add in SWAD participants, with comparable measurement time points in STAY participants. Linear regression models compared changes over time by SWAD/STAY group, adjusted for age, race, WIHS site, education, income, smoking status, and baseline ART regimen.ResultsWe followed 1118 women (234 SWAD and 884 STAY) for a mean of 2.0 years (+/- 0.1 standard deviation [SD]; mean age 48.8 years, SD +/- 8.8); 61% were Black. On average, compared to the STAY group, the SWAD group experienced mean greater increases of 2.1 kg in body weight, 0.8 kg/m2 in BMI, 1.4% in PBF, and 2.0, 1.9, 0.6, and 1.0 cm in waist, hip, arm, and thigh circumference, respectively (all P values < .05). No differences in magnitudes of these changes were observed by INSTI type.ConclusionsIn WLHIV, a switch to INSTI was associated with significant increases in body weight, body circumferences, and fat percentages, compared to non-INSTI ART. The metabolic and other health effects of these changes deserve further investigation.
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- 2020
42. Longitudinal assessment of abnormal Papanicolaou test rates among women with HIV.
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Massad, Leslie S, Xie, Xianhong, Minkoff, Howard, Kassaye, Seble, Karim, Roksana, Darragh, Teresa M, Golub, Elizabeth T, Adimora, Adaora, Wingood, Gina, Fischl, Margaret, Konkle-Parker, Deborah, and Strickler, Howard D
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Reproductive Medicine ,Biomedical and Clinical Sciences ,HIV/AIDS ,Prevention ,Clinical Research ,Infectious Diseases ,Aetiology ,2.4 Surveillance and distribution ,Adult ,Colposcopy ,Comorbidity ,Female ,HIV Infections ,Humans ,Logistic Models ,Longitudinal Studies ,Middle Aged ,Multivariate Analysis ,Papanicolaou Test ,Papillomavirus Infections ,Prevalence ,Prospective Studies ,Risk Factors ,United States ,Uterine Cervical Neoplasms ,Vaginal Smears ,Uterine Cervical Dysplasia ,HIV infection in women ,Papanicolaou test ,Women's Interagency HIV Study ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveTo describe longitudinal changes in the prevalence of abnormal Papanicolau testing among women living with HIV.DesignProspective cohort study with sequential enrollment subcohorts.MethodsFour waves of enrollment occurred in the Women's Interagency HIV Study, the US women's HIV cohort (1994-1995, 2001-2002, 2011-2012, 2013-2015). Pap testing was done at intake, with colposcopy prescribed for any abnormality. Rates of abnormal Pap test results (atypical squamous cells of uncertain significance or worse) and cervical intraepithelial neoplasia grade 2 (CIN2) or worse were calculated. Logistic regression models assessed changes in prevalence across cohorts after controlling for severity of HIV disease and other risk factors for abnormal Pap tests.ResultsThe unadjusted prevalence of any Pap abnormality was 679/1769 (38%) in the original cohort, 195/684 (29%) in the 2001-2002 cohort, 46/231 (20%) in the 2011-2012 cohort, and 71/449 (16%) in the 2013-2015 cohort. In multivariable analysis, compared with risk in the 1994-1995 cohort, the adjusted risk in the 2001-2002 cohort was 0.79 (95% CI 0.59-1.05), in the 2011-2012 cohort was 0.67 (95% CI 0.43-1.04), and in the 2013-2015 cohort was 0.41 (95% CI 0.27-0.62) with P for trend less than 0.0001.ConclusionRates of abnormal cytology among women with HIV have fallen during the past two decades.
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- 2020
43. “Oh, older people, it's boring”: Nurse academics’ reflections on the challenges in teaching older person's care in Australian undergraduate nursing curricula
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Rayner, Jo-Anne, Fetherstonhaugh, Deirdre, Beattie, Elizabeth, Harrington, Ann, Jeon, Yun-Hee, Moyle, Wendy, and Parker, Deborah
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- 2023
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44. Australian nursing students’ clinical experiences in residential aged care: Reports from nurse academics
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Rayner, Jo-Anne, Fetherstonhaugh, Deirdre, Beattie, Elizabeth, Harrington, Ann, Jeon, Yun-Hee, Moyle, Wendy, and Parker, Deborah
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- 2023
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45. Teaching the care of older people in Australian nursing schools: Survey findings
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Fetherstonhaugh, Deirdre, Rayner, Jo-Anne, Solly, Kane, Beattie, Elizabeth, Harrington, Ann, Jeon, Yun-Hee, Moyle, Wendy, and Parker, Deborah
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- 2022
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46. Doré's Dante
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Parker, Deborah, primary
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- 2022
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47. Poverty stigma is associated with suboptimal HIV care and treatment outcomes among women living with HIV in the U.S.
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Leddy, Anna M, Turan, Janet M, Johnson, Mallory O, Neilands, Torsten B, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Tien, Phyllis C, Wilson, Tracey E, Logie, Carmen H, Weiser, Sheri D, and Turan, Bulent
- Subjects
Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Infectious Diseases ,Behavioral and Social Science ,Health Disparities ,Sexually Transmitted Infections ,HIV/AIDS ,Clinical Research ,Prevention ,Infection ,Adult ,Anti-Retroviral Agents ,CD4 Lymphocyte Count ,Cross-Sectional Studies ,Drug Utilization ,Female ,HIV Infections ,Humans ,Middle Aged ,Poverty ,Prospective Studies ,Social Stigma ,Sustained Virologic Response ,Treatment Outcome ,United States ,Viral Load ,HIV care and treatment ,poverty stigma ,women living with HIV ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveTo examine whether experienced poverty stigma is associated with worse HIV care and treatment outcomes.DesignWe analyzed cross-sectional data from 433 women living with HIV enrolled in the Women's Adherence and Visit Engagement substudy of the Women's Interagency HIV Study.MethodsExposure was experienced poverty stigma, measured using the Perceived Stigma of Poverty Scale. Outcomes were viral suppression, CD4 cell count at least 350 cells/μl, and attending all HIV care visits in the past 6 months. Multivariable logistic regression models adjusted for income, age, race/ethnicity, education, substance use, months taking antiretroviral therapy (ART), number of antiretroviral pills in ART regimen, unstable housing, relationship status, and exchanging sex for money, drugs, or shelter. We also explored whether self-reported at least 95% ART adherence mediated the relationship between poverty stigma and viral suppression and CD4 cell count at least 350 cells/μl.ResultsExperienced poverty stigma was associated with lower adjusted odds of viral suppression [adjusted odds ratio (aOR) 0.76; 95% confidence interval (CI) 0.61-0.96], CD4 cell count at least 350 cells/μl (aOR 0.69; 95% CI 0.52-0.91), and attending all HIV care visits (aOR 0.73; 95% CI: 0.54-0.98). Exploratory mediation analysis suggests that at least 95% ART adherence significantly mediates the relationship between experienced poverty stigma and viral suppression and CD4 cell count at least 350 cells/μl.ConclusionLongitudinal research should assess these relationships over time. Findings support interventions and policies that seek to reduce poverty stigma among people living with HIV.
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- 2019
48. Neighborhood Racial Diversity, Socioeconomic Status, and Perceptions of HIV-Related Discrimination and Internalized HIV Stigma Among Women Living with HIV in the United States
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Crockett, Kaylee B, Edmonds, Andrew, Johnson, Mallory O, Neilands, Torsten B, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Tien, Phyllis C, Cohen, Mardge, Wilson, Tracey E, Logie, Carmen H, Sosanya, Oluwakemi, Plankey, Michael, Golub, Elizabeth, Adimora, Adaora A, Parish, Carrigan, Weiser, Sheri D, Turan, Janet M, and Turan, Bulent
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Public Health ,Health Sciences ,Women's Health ,Clinical Research ,Basic Behavioral and Social Science ,Behavioral and Social Science ,Pediatric ,Mental Health ,Infectious Diseases ,Health Disparities ,Prevention ,Social Determinants of Health ,HIV/AIDS ,Sexually Transmitted Infections ,Adult ,Aged ,Anti-HIV Agents ,Cross-Sectional Studies ,Discrimination ,Psychological ,Female ,Geographic Mapping ,HIV Infections ,Humans ,Male ,Middle Aged ,Race Factors ,Residence Characteristics ,Social Class ,Social Isolation ,Social Stigma ,United States ,geocoding ,racial diversity ,HIV ,internalized stigma ,discrimination ,women ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Relationships that traverse sociodemographic categories may improve community attitudes toward marginalized groups and potentially protect members of those groups from stigma and discrimination. The present study evaluated whether internalized HIV stigma and perceived HIV-related discrimination in health care settings differ based on individual- and neighborhood-level characteristics of women living with HIV (WLHIV). We also sought to extend previous conceptual and empirical work to explore whether perceived HIV-related discrimination mediated the association between neighborhood racial diversity and internalized HIV stigma. A total of 1256 WLHIV in the Women's Interagency HIV Study (WIHS) attending 10 sites in metropolitan areas across the United States completed measures of internalized HIV stigma and perceived HIV-related discrimination in health care settings. Participants also provided residential information that was geocoded into Federal Information Processing Standard (FIPS) codes and linked with census-tract level indicators. In cross-sectional analyses, greater neighborhood racial diversity was associated with less internalized HIV stigma and less perceived HIV-related discrimination regardless of individual race. Neighborhood median income was positively associated with internalized HIV stigma and perceived discrimination, while individual income was negatively associated with perceptions of stigma and discrimination. In an exploratory mediation analysis, neighborhood racial diversity had a significant indirect effect on internalized HIV stigma through perceived HIV-related discrimination. An indirect effect between neighborhood income and internalized stigma was not supported. These findings suggest that greater neighborhood racial diversity may lessen HIV stigma processes at the individual level and that HIV stigma-reduction interventions may be most needed in communities that lack racial diversity.
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- 2019
49. A Mixed Methods Study of Anticipated and Experienced Stigma in Health Care Settings Among Women Living with HIV in the United States
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Rice, Whitney S, Turan, Bulent, Fletcher, Faith E, Nápoles, Tessa M, Walcott, Melonie, Batchelder, Abigail, Kempf, Mirjam-Colette, Konkle-Parker, Deborah J, Wilson, Tracey E, Tien, Phyllis C, Wingood, Gina M, Neilands, Torsten B, Johnson, Mallory O, Weiser, Sheri D, and Turan, Janet M
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Health Services and Systems ,Public Health ,Health Sciences ,Behavioral and Social Science ,Prevention ,Sexually Transmitted Infections ,HIV/AIDS ,Mental Health ,Women's Health ,Infectious Diseases ,Clinical Research ,7.1 Individual care needs ,Management of diseases and conditions ,Infection ,Good Health and Well Being ,Adaptation ,Psychological ,Aged ,Anti-Retroviral Agents ,Depression ,Fear ,Female ,HIV Infections ,Humans ,Interviews as Topic ,Medication Adherence ,Middle Aged ,Patient Compliance ,Qualitative Research ,Social Stigma ,Surveys and Questionnaires ,United States ,Young Adult ,HIV ,AIDS ,antiretroviral therapy ,mixed methods ,adherence ,stigma ,mental health ,Public Health and Health Services ,Virology ,Clinical sciences ,Public health - Abstract
Among places where people living with HIV experience and anticipate HIV-related stigma, stigma in health care settings may be particularly harmful. Utilizing an exploratory sequential mixed methods approach, we conducted interviews (n = 76) and questionnaires (N = 460) with older adult women living with HIV enrolled in the Women's Interagency HIV Study in Birmingham, AL; Jackson, MS; Atlanta, GA; and San Francisco, CA. Interviews addressed facilitators and barriers to HIV treatment adherence, including HIV-related stigma. Qualitative data were coded using thematic analysis. Questionnaires assessed self-reported antiretroviral therapy (ART) adherence and experienced and anticipated HIV-related stigma from various sources (i.e., health care personnel, family, partner, and community). Covariate-adjusted logistic regression analyses examined total and mediated effects of stigma on ART adherence. Interviewees described fears and experiences of stigma in health care settings; including privacy violations, disrespect for patient autonomy, and reproductive coercion; and how these influenced their adherence to HIV treatment recommendations. Experienced and anticipated HIV-related stigma in health care settings were associated with suboptimal (or
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- 2019
50. Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV
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Turan, Bulent, Rice, Whitney S, Crockett, Kaylee B, Johnson, Mallory, Neilands, Torsten B, Ross, Shericia N, Kempf, Mirjam-Colette, Konkle-Parker, Deborah, Wingood, Gina, Tien, Phyllis C, Cohen, Mardge, Wilson, Tracey E, Logie, Carmen H, Sosanya, Oluwakemi, Plankey, Michael, Golub, Elizabeth, Adimora, Adaora A, Parish, Carrigan, Weiser, Sheri D, and Turan, Janet M
- Subjects
Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Mental Health ,Pediatric ,HIV/AIDS ,Clinical Research ,Depression ,Behavioral and Social Science ,Adult ,Anti-Retroviral Agents ,Female ,HIV Infections ,Humans ,Longitudinal Studies ,Medication Adherence ,Middle Aged ,Social Stigma ,United States ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveWe investigated whether internalized HIV-related stigma predicts adherence to antiretroviral therapy (ART) longitudinally in women living with HIV in the United States, and whether depression symptoms mediate the relationship between internalized stigma and suboptimal ART adherence.DesignObservational longitudinal study utilizing data from the Women's Interagency HIV Study cohort.MethodsA measure of internalized HIV-related stigma was added to the battery of Women's Interagency HIV Study measures in 2013. For current analyses, participants' first assessment of internalized HIV-related stigma and assessments of other variables at that time were used as baseline measures (Time one or T1, visit occurring in 2013/14), with outcomes measured approximately 2 years later (T3, 2015/16; n = 914). A measure of depression symptoms, assessed approximately 18 months after the baseline (T2, 2014/15), was used in mediation analyses (n = 862).ResultsHigher internalized HIV-related stigma at T1 predicted lower odds of optimal ART adherence at T3 (adjusted odds ratio = 0.61, P = 0.001, 95% confidence interval [0.45, 0.82]). Results were similar when ART adherence at T1 was added as a control variable. Mediation analysis revealed a significant indirect effect of internalized HIV stigma at T1 on ART adherence at T3 through depression symptoms at T2 (while controlling for depression symptoms and ART adherence at T1; B = -0.05, SE = 0.03, 95% confidence interval [-0.11, -0.006]).ConclusionThese results provide strong longitudinal support for the hypothesis that internalized HIV-related stigma results in suboptimal ART adherence in a large sample of women living with HIV in the United States, working through the pathway of increased depression symptoms.
- Published
- 2019
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