3,963 results
Search Results
2. Opinion Paper : Looking back at paediatric HIV treatment in South Africa. My, how we have grown! Special Collection: UNAIDS Targets for 2030
- Author
-
Levin, Leon J., Horak, Juliet L., and Nuttall, James
- Subjects
HIV ,paediatric HIV ,paediatric antiretroviral treatment ,South Africa ,history - Abstract
Antiretroviral treatment has undergone major changes in the last 20 years, from monotherapy, to dual therapy and finally to triple therapy. Lately, more focus has been placed on better, more well-tolerated combinations and formulations. As in most other disciplines in medicine, the development of paediatric HIV dosages and formulations always tends to lag behind adult research. Twenty years ago, it could take several years before data were available to enable the use of life-saving antiretrovirals in children. Paediatricians, being ever resourceful, were not prepared to let their paediatric patients suffer despite the lack of data or formulations and so made a plan. This article describes some of the trials and tribulations that we went through trying to make sure that our paediatric HIV patients not only survived but thrived. Clinicians treating paediatric patients today have it so much easier because of what our colleagues and their patients went through in those early days.
- Published
- 2023
3. Data set accompanying the GitHub repository bartonlab/paper-Bezier-interpolation
- Author
-
Shimagaki, Kai and Barton, John P.
- Subjects
MPL ,HIV ,Wright Fisher process - Abstract
This dataset contains: 1) Binary sequence generated from Wright-Fisher processes, which of source code can be found in the GitHub repository, bartonlab/paper-Bezier-interpolation. 2). HIV nucleotide sequence. The GitHub repository contains source files and data for reproducing the results shown in “B\'ezier interpolation improves the inference of dynamical models from data.” Please see the GitHub repository for more details on the analysis of these data sets.  
- Published
- 2022
- Full Text
- View/download PDF
4. Using qualitative study designs to understand treatment burden and capacity for self-care among patients with HIV/NCD multimorbidity in South Africa: A methods paper.
- Author
-
van Pinxteren, Myrna, Mbokazi, Nonzuzo, Murphy, Katherine, Mair, Frances S, May, Carl, and Levitt, Naomi S
- Subjects
NON-communicable diseases ,EVALUATION of medical care ,RESEARCH ,MIDDLE-income countries ,RESEARCH methodology ,BURDEN of care ,DISEASES ,POPULATION geography ,INTERVIEWING ,QUALITATIVE research ,COMPARATIVE studies ,CONCEPTUAL structures ,LOW-income countries ,EPIDEMICS ,EMPLOYEES' workload ,DECISION making ,RESEARCH funding ,THEMATIC analysis ,HEALTH self-care ,HIV - Abstract
Background: Low- and middle-income countries (LMICs), including South Africa, are currently experiencing multiple epidemics: HIV and the rising burden of non-communicable diseases (NCDs), leading to different patterns of multimorbidity (the occurrence of two or more chronic conditions) than experienced in high income settings. These adversely affect health outcomes, increase patients' perceived burden of treatment, and impact the workload of self-management. This paper outlines the methods used in a qualitative study exploring burden of treatment among people living with HIV/NCD multimorbidity in South Africa. Methods: We undertook a comparative qualitative study to examine the interaction between individuals' treatment burden (self-management workload) and their capacity to take on this workload, using the dual lenses of Burden of Treatment Theory (BoTT) and Cumulative Complexity Model (CuCoM) to aid conceptualisation of the data. We interviewed 30 people with multimorbidity and 16 carers in rural Eastern Cape and urban Cape Town between February-April 2021. Data was analysed through framework analysis. Findings: This paper discusses the methodological procedures considered when conducting qualitative research among people with multimorbidity in low-income settings in South Africa. We highlight the decisions made when developing the research design, recruiting participants, and selecting field-sites. We also explore data analysis processes and reflect on the positionality of the research project and researchers. Conclusion: This paper illustrates the decision-making processes conducting this qualitative research and may be helpful in informing future research aiming to qualitatively investigate treatment burden among patients in LMICs. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
5. Examining barriers to antiretroviral therapy initiation in infants living with HIV in sub‐Saharan Africa despite the availability of point‐of‐care diagnostic testing: a narrative systematic review.
- Author
-
Chapuma, Chikondi Isabel Joana, Sakala, Doreen, Nyang'wa, Maggie Nyirenda, Hosseinipour, Mina C., Mbeye, Nyanyiwe, Matoga, Mitch, Kumwenda, Moses Kelly, Chikweza, Annastarsia, Nyondo‐Mipando, Alinane Linda, and Mwapasa, Victor
- Subjects
ANTIRETROVIRAL agents ,INFANTS ,POINT-of-care testing ,VERTICAL transmission (Communicable diseases) ,DIAGNOSIS methods - Abstract
Introduction: Antiretroviral therapy (ART) initiation in infants living with HIV before 12 weeks of age can reduce the risk of mortality by 75%. Point‐of‐care (POC) diagnostic testing is critical for prompt ART initiation; however, despite its availability, rates of ART initiation are still relatively low before 12 weeks of age. This systematic review describes the barriers to ART initiation in infants before 12 weeks of age, despite the availability of POC. Methods: This systematic review used a narrative synthesis methodology. We searched PubMed and Scopus using search strategies that combined terms of multiple variants of the keywords "early infant initiation on antiretroviral therapy," "barriers" and "sub‐Saharan Africa" (initial search 18th January 2023; final search 1st August 2023). We included qualitative, observational and mixed methods studies that reported the influences of early infant initiation on ART. We excluded studies that reported influences on other components of the Prevention of Mother to Child Transmission cascade. Using a deductive approach guided by the updated Consolidated Framework of Implementation Research, we developed descriptive codes and themes around barriers to early infant initiation on ART. We then developed recommendations for interventions for the identified barriers using the action, actor, target and time framework from the codes. Results: Of the 266 abstracts reviewed, 52 full‐text papers were examined, of which 12 papers were included. South Africa had most papers from a single country (n = 3) and the most reported study design was retrospective (n = 6). Delays in ART initiation beyond 12 weeks in infants 0–12 months were primarily associated with health facility and maternal factors. The most prominent barriers identified were inadequate resources for POC testing (including human resources, laboratory facilities and patient follow‐up). Maternal‐related factors, such as limited male involvement and maternal perceptions of treatment and care, were also influential. Discussion: We identified structural barriers to ART initiation at the health system, social and cultural levels. Improvements in the timely allocation of resources for POC testing operations, coupled with interventions addressing social and behavioural barriers among both mothers and healthcare providers, hold a promise for enhancing timely ART initiation in infants. Conclusions: This paper identifies barriers and proposes strategies for timely ART initiation in infants. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
6. Additive quantile mixed effects modelling with application to longitudinal CD4 count data.
- Author
-
Yirga AA, Melesse SF, Mwambi HG, and Ayele DG
- Subjects
- Adolescent, Adult, Aged, Antiretroviral Therapy, Highly Active methods, CD4 Lymphocyte Count, Female, Follow-Up Studies, HIV Infections epidemiology, HIV Infections virology, Humans, Linear Models, Longitudinal Studies, Middle Aged, Prognosis, Risk Factors, South Africa epidemiology, Treatment Outcome, Viral Load, Young Adult, Anti-HIV Agents therapeutic use, Disease Progression, HIV, HIV Infections drug therapy, HIV Infections immunology
- Abstract
Quantile regression offers an invaluable tool to discern effects that would be missed by other conventional regression models, which are solely based on modeling conditional mean. Quantile regression for mixed-effects models has become practical for longitudinal data analysis due to the recent computational advances and the ready availability of efficient linear programming algorithms. Recently, quantile regression has also been extended to additive mixed-effects models, providing an efficient and flexible framework for nonparametric as well as parametric longitudinal forms of data analysis focused on features of the outcome beyond its central tendency. This study applies the additive quantile mixed model to analyze the longitudinal CD4 count of HIV-infected patients enrolled in a follow-up study at the Centre of the AIDS Programme of Research in South Africa. The objective of the study is to justify how the procedure developed can obtain robust nonlinear and linear effects at different conditional distribution locations. With respect to time and baseline BMI effect, the study shows a significant nonlinear effect on CD4 count across all fitted quantiles. Furthermore, across all fitted quantiles, the effect of the parametric covariates of baseline viral load, place of residence, and the number of sexual partners was found to be major significant factors on the progression of patients' CD4 count who had been initiated on the Highly Active Antiretroviral Therapy study., (© 2021. The Author(s).)
- Published
- 2021
- Full Text
- View/download PDF
7. Overview of virus and cancer relationships. Position paper.
- Author
-
Bouza, Emilio, Martín Jiménez, Miguel, Alemany, Laia, Arribas, Joaquín, Bañares, Rafael, Barragán, Maria Begoña, Eiros Bouza, José María, Felip, Enriqueta, Fernández-Capetillo, Oscar, Gracia, Diego, López-Vélez, Rogelio, Bautista Mollar, Juan, Muñoz, Patricia, Paz-Ares, Luis, Torné, Aureli, Tovar, Javier, Valencia, Eulalia, and Palomo, Esteban
- Subjects
TUMORS ,VIRUSES ,CANCER ,PAPILLOMAVIRUSES ,HEPATITIS B ,HEPATITIS C ,EPSTEIN-Barr virus - Abstract
Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia 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.)
- Published
- 2021
- Full Text
- View/download PDF
8. Modelling HIV/AIDS epidemiological complexity: A scoping review of Agent-Based Models and their application.
- Author
-
Anderle, Rodrigo Volmir, de Oliveira, Robson Bruniera, Rubio, Felipe Alves, Macinko, James, Dourado, Ines, and Rasella, Davide
- Subjects
HIV ,AIDS ,INFECTIOUS disease transmission - Abstract
Objective: To end the AIDS epidemic by 2030, despite the increasing poverty and inequalities, policies should be designed to deal with population heterogeneity and environmental changes. Bottom-up designs, such as the Agent-Based Model (ABM), can model these features, dealing with such complexity. HIV/AIDS has a complex dynamic of structural factors, risk behaviors, biomedical characteristics and interventions. All embedded in unequal, stigmatized and heterogeneous social structure. To understand how ABMs can model this complexity, we performed a scoping review of HIV applications, highlighting their potentialities. Methods: We searched on PubMed, Web of Science, and Scopus repositories following the PRISMA extension for scoping reviews. Our inclusion criteria were HIV/AIDS studies with an ABM application. We identified the main articles using a local co-citation analysis and categorized the overall literature aims, (sub)populations, regions, and if the papers declared the use of ODD protocol and limitations. Results: We found 154 articles. We identified eleven main papers, and discussed them using the overall category results. Most studies model Transmission Dynamics (37/154), about Men who have sex with Men (MSM) (41/154), or individuals living in the US or South Africa (84/154). Recent studies applied ABM to model PrEP interventions (17/154) and Racial Disparities (12/154). Only six papers declared the use of ODD Protocol (6/154), and 34/154 didn't mention the study limitations. Conclusions: While ABM is among the most sophisticated techniques available to model HIV/AIDS complexity. Their applications are still restricted to some realities. However, researchers are challenged to think about social structure due model characteristics, the inclusion of these features is still restricted to case-specific. Data and computational power availability can enhance this feature providing insightful results. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
9. Introducing the NUATEI Consortium: A Mexican Research Program for the Identification of Natural and Synthetic Antimicrobial Compounds for Prevalent Infectious Diseases.
- Author
-
Carrero, Julio César, Espinoza, Bertha, Huerta, Leonor, Silva-Miranda, Mayra, Guzmán-Gutierrez, Silvia-Laura, Dorazco-González, Alejandro, Reyes-Chilpa, Ricardo, Espitia, Clara, and Sánchez, Sergio
- Subjects
COMMUNICABLE diseases ,CONSORTIA ,MEDICAL research ,AMEBIASIS ,SYNTHETIC products ,TUBERCULOSIS - Abstract
The need for new drugs to treat human infections is a global health concern. Diseases like tuberculosis, trypanosomiasis, amoebiasis, and AIDS remain significant problems, especially in developing countries like Mexico. Despite existing treatments, issues such as resistance and adverse effects drive the search for new alternatives. Herein, we introduce the NUATEI research consortium, made up of experts from the Institute of Biomedical Research at UNAM, who identify and obtain natural and synthetic compounds and test their effects against human pathogens using in vitro and in vivo models. The consortium has evaluated hundreds of natural extracts and compounds against the pathogens causing tuberculosis, trypanosomiasis, amoebiasis, and AIDS, rendering promising results, including a patent with potential for preclinical studies. This paper presents the rationale behind the formation of this consortium, as well as its objectives and strategies, emphasizing the importance of natural and synthetic products as sources of antimicrobial compounds and the relevance of the diseases studied. Finally, we briefly describe the methods of the evaluation of the compounds in each biological model and the main achievements. The potential of the consortium to screen numerous compounds and identify new therapeutic agents is highlighted, demonstrating its significant contribution to addressing these infectious diseases. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
10. An Analysis of Approaches to Reduction of HIV Stigma across the World through educational interventions: A Scoping Review.
- Author
-
Ebrahimi, Hamideh, Shoorideh, Foroozan Atashzadeh, Sohrabi, Mohammad Reza, Ebrahimi, Masoumeh, and Hosseini, Meimanat
- Subjects
PATIENT education ,MEDICAL information storage & retrieval systems ,COMMUNITY support ,FEAR ,HIV-positive persons ,CINAHL database ,HIV infections ,TEACHING methods ,FAMILIES ,SYSTEMATIC reviews ,MEDLINE ,HOSPITAL medical staff ,MEDICAL students ,LITERATURE reviews ,MEDICAL databases ,COMMUNITY life ,ONLINE information services ,SHAME ,SOCIAL support ,HEALTH education ,SOCIAL stigma - Abstract
Copyright of Investigacion & Educacion en Enfermeria is the property of Universidad de Antioquia, Facultad de Enfermeria 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.)
- Published
- 2024
- Full Text
- View/download PDF
11. Navigating grey areas in HIV and mental health implementation science.
- Author
-
Harkness, Audrey, Giusto, Ali, Hamilton, Alison B., Hernandez‐Ramirez, Raul U., Spiegelman, Donna, Weiner, Bryan J., Beidas, Rinad S., Larson, Michaela E., Lippman, Sheri A., Wainberg, Milton L., and Smith, Justin D.
- Subjects
MALIGNANT hyperthermia ,HIV ,HIV infection transmission ,MENTAL health ,PSYCHOLOGY ,AIDS - Abstract
Introduction: Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high‐impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, "grey areas," or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research. Discussion: A group of IS experts affiliated with NIMH‐funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH‐related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence‐based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas. Conclusions: HIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high‐impact HIV/MH implementation research. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
12. Understanding the use of co-design methods for research involving older adults living with HIV: A scoping review protocol.
- Author
-
Brown, Paige, Singh, Hardeep, Su, Esther, Sirisegaram, Luxey, Munce, Sarah E. P., Eaton, Andrew D., Zhabokritsky, Alice, McKinlay, Stuart, and Kokorelias, Kristina M.
- Subjects
OLDER people ,PARTICIPATORY design ,RESEARCH methodology ,GREY literature ,RESEARCH questions ,HIV ,OLDER patients ,FRAIL elderly - Abstract
There is a growing population of adults aged 50 years or older living with HIV, facing unique challenges in care due to age, minority status, and stigma. Co-design methodologies, aligning with patient-centered care, have potential for informing interventions addressing the complex needs of older adults with HIV. Despite challenges, co-design has shown promise in empowering older individuals to actively participate in shaping their care experiences. The scoping review outlined here aims to identify gaps in existing co-design work with this population, emphasizing the importance of inclusivity based on PROGRESS-Plus characteristics for future patient-oriented research. This scoping review protocol is informed by the Joanna Briggs Institute Manual to explore co-design methods in geriatric HIV care literature. The methodology encompasses six stages: 1) developing research questions, 2) creating a search strategy, 3) screening and selecting evidence, 4) data extraction, 5) data analysis using content analysis, and 6) consultation with key stakeholders, including community partners and individuals with lived experience. The review will involve a comprehensive literature search, including peer-reviewed databases and gray literature, to identify relevant studies conducted in the past 20 years. The inclusive criteria focus on empirical data related to co-design methods in HIV care for individuals aged 50 or older, aiming to inform future research and co-design studies in geriatric HIV care. The study will be limited by the exclusion of papers not published or translated to English. Additionally, the varied terminology used to describe co-design across different research may result in the exclusion of articles using alternative terms. The consultation with key stakeholders will be crucial for translating insights into meaningful co-design solutions for virtual HIV care, aiming to provide a comprehensive synthesis that informs evidence-based strategies and addresses disparities in geriatric HIV care. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
13. Using Drama Pedagogy to Enhance Understanding of HIV Transmission, Infection, and Prevention Among Third-Year Student Teachers.
- Author
-
Khau, Mathabo
- Subjects
HIV ,AIDS education ,HIV infection transmission ,ARTS in education ,DRAMA in education - Abstract
Thirty-eight years into the HIV and AIDS pandemic, the world is still striving to reduce global HIV infections towards zero new infections and AIDS-related deaths by 2030. Sub-Saharan Africa continues to carry the burden of global HIV infections as governmental and nongovernmental agencies try out different prevention strategies (UNAIDS, 2024b). Several scholars have argued that comprehensive sexuality education (CSE) is the best preventive strategy to reach youth and key populations with factual information regarding HIV and AIDS. This paper draws from the project, Mentoring as a Method to Promote Women's Health in the Context of HIV-Prevention and Unequal Gender Relations, which employed memory work, photo-voice, drama, drawings, and focus group discussions with third-year student teachers in a life orientation module. Focussing on the data generated through drama, I present an arts-based activity that was used to teach about HIV transmission to student teachers in a bid to equip them with alternative ways of teaching school-learners about HIV and AIDS. The findings highlight student teachers' lived experiences and how they have shaped their perceptions of HIV infections and living with AIDS. I argue from the findings, that arts-based pedagogies allow for enhanced understanding of complex phenomena due to their participatory and in-built intervention nature. Thus, I posit that pedagogies that employ participatory, arts-based, and visual methodologies should be extensively employed in teacher-education towards reducing new HIV infections among the youth. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
14. Smoking among people living with HIV/AIDS: a bibliometric analysis (GAPRESEARCH).
- Author
-
Bach Xuan-Tran, Latkin, Carl A., Hai Thanh-Phan, Thi-Nguyen, Huong L., Chi Linh-Hoang, Ho, Cyrus S. H., and Ho, Roger C. M.
- Subjects
HIV-positive persons ,BIBLIOMETRICS ,SMOKING cessation ,AIDS ,EXPLORATORY factor analysis - Abstract
Tobacco smoking undermines the effectiveness of antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) and potentially associates with other health problems. This study aimed to analyze the growth and content of research on smoking among PLWHA on Web of Science Database. Co-occurrence analysis and Jaccard's' similarity index calculation were performed to identify and visualize networks of countries collaboration, keywords co-occurrence, and research topics. Exploratory factor analysis was applied to the abstracts' contents to uncover research domains and landscapes. The number of publications increased by 14.55% annually in the period of 1991-2017, with 74% of total papers published within 2007-2017. A wide range of topics have been covered, notably co-morbidities, interventions on smoking abstinence and cessation, and the enforcing relationship of smoking cessation with antiretroviral treatment adherence. A shortage of studies on smoking among PLWHA in low-and middle-income countries, limited collaborations between countries outside of close geographical proximity and a lack of discussion on local contexts and psychosocial factors were found. Smoking among PLWHA has been being studied more extensively in recent years, enhancing our knowledge and awareness of the significant and specific effects smoking have on PLWHA, which, in turn, assisting the proposals and implementations of suitable solutions. However, more efforts should be made to examine and understand contextualized aspects, including culture and beliefs specific to each nation or smaller sub-population within a country, especially those currently under-researched, as well as psycho-behavioral factors to implement more effective interventions to reduce smoking among PLWHA. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
15. Characterizing the Development of Research Landscapes in Substance Use and HIV/AIDS During 1990 to 2021.
- Author
-
Tham Thi Nguyen, Hien Thu Nguyen, Huyen Phuc Do, Cyrus SH Ho, and Roger CM Ho
- Subjects
HEALTH policy ,HIV infections ,SUBSTANCE abuse ,SERIAL publications ,BIBLIOMETRICS ,MENTAL health ,MEDICAL care ,HUMAN services programs ,QUALITY of life ,HEALTH care teams ,RESEARCH funding ,DESCRIPTIVE statistics ,POLICY sciences ,CONTENT analysis ,HIV ,AIDS ,MEDICAL research ,DATA mining - Abstract
Mitigating the impacts of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and substance use requires comprehensive and systematic thinking in designing interventions and developing policies. This study describes the growth of research publications from 1991 to 2021 in the Web of Science database and points out current research landscapes in the fields of HIV/AIDS and substance use. Latent Dirichlet Allocation was used for classifying 21 359 papers into corresponding topics. The most common topics were HIV transmission, HIV infection, quality of life and mental health of substance users, and the biomedical effect of substance use. Emerging research landscapes include vulnerabilities of people who inject drugs to HIV transmission and related health problems. This study found a lack of research on health services, interdisciplinary and inter-sectoral in combination with clinical evaluation and treatment services. Future investment and implementation of HIV/AIDS and substance use programs should focus on research of health services and clinical evaluation, especially context-specific interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
16. Supporting Retention in HIV Care: Comparing In-Person and Telehealth Visits in a Chicago-Based Infectious Disease Clinic
- Author
-
Arianna I. Boshara, Megan E. Patton, Bijou R. Hunt, Nancy Glick, and Amy K. Johnson
- Subjects
Adult ,Chicago ,Male ,Original Paper ,Social Psychology ,education ,Public Health, Environmental and Occupational Health ,COVID-19 ,HIV ,HIV Infections ,Telemedicine ,Cross-Sectional Studies ,Telehealth ,Infectious Diseases ,Adherence ,Humans ,Pandemics ,health care economics and organizations - Abstract
The COVID-19 pandemic has created increased need for telehealth appointments. To assess differences in appointment adherence for telehealth compared to in-person HIV medical care visits, we conducted a cross-sectional study of patients receiving HIV care in a safety-net hospital-based outpatient infectious disease clinic in a large urban area (Chicago, IL). The sample (N = 347) was predominantly Black (n = 251) and male (62.5%, n = 217); with a mean age of 44.2 years. Appointment attendance was higher for telehealth (78.9%) compared to in-person (61.9%) appointments. Compared to patients without drug use, those with drug use had 19.4 percentage point lower in-person appointment attendance. Compared to those with stable housing, those in unstable housing arrangements had 15.0 percentage point lower in-person appointment attendance. Telehealth as a modality will likely have some staying power as it offers patients newfound flexibility, but barriers to telehealth need to be assessed and addressed.
- Published
- 2022
17. Sauti ya Vijana (SYV; The Voice of Youth): Longitudinal Outcomes of an Individually Randomized Group Treatment Pilot Trial for Young People Living with HIV in Tanzania
- Author
-
Dorothy E. Dow, Karen E. O’Donnell, Laura Mkumba, John A. Gallis, Elizabeth L. Turner, Judith Boshe, Aisa M. Shayo, Coleen K. Cunningham, and Blandina T. Mmbaga
- Subjects
Male ,Original Paper ,Adolescent ,Social Psychology ,Public Health, Environmental and Occupational Health ,HIV ,HIV Infections ,Pilot Projects ,Tanzania ,Young Adult ,Mental Health ,Infectious Diseases ,Anti-Retroviral Agents ,Africa ,Humans ,Female - Abstract
Sauti ya Vijana is a mental health and life skills intervention delivered by young adult group leaders for the improvement of HIV outcomes in young people living with HIV in Tanzania. This pilot randomized controlled trial estimated exploratory intervention effectiveness compared to standard of care. YPLWH (N = 105) were randomized to receive intervention or SOC. The mean age of participants was 18.1 years and 53% were female. Mean scores on mental health measures (Patient Health Questionnaire [PHQ-9], Strengths and Difficulties Questionnaire [SDQ], UCLA Trauma) were asymptomatic to mild in both study arms through 30-month follow-up with a non-significant fluctuation of 1–2 points. The mean self-reported adherence was higher in the intervention arm across all time points (but the confidence interval contained the null at all time points except 6 months). Risk ratio of virologic suppression (HIV RNA
- Published
- 2022
18. Experiences with Telemedicine for HIV Care During the COVID-19 Pandemic: A Mixed-Methods Study
- Author
-
Harsono, Dini, Deng, Yanhong, Chung, Sangyun, Barakat, Lydia A., Friedland, Gerald, Meyer, Jaimie P., Porter, Elizabeth, Villanueva, Merceditas, Wolf, Michael S., Yager, Jessica E., and Edelman, E. Jennifer
- Subjects
Original Paper ,Mixed-methods ,Telehealth ,Infectious Diseases ,Social Psychology ,Privacy ,Public Health, Environmental and Occupational Health ,Humans ,HIV ,COVID-19 ,HIV Infections ,Pandemics ,Telemedicine - Abstract
To characterize perspectives and experiences with telemedicine during the COVID-19 pandemic, we conducted a mixed-methods study in two HIV clinics in the US Northeast. Among surveyed patients with HIV (PWH) who had a telemedicine appointment (n = 205), 42.4% perceived telemedicine visits as useful during the pandemic. PWH and clinical staff identified benefits of telemedicine: (1) ability to engage and re-engage patients in care; (2) perceived patient-centeredness and flexibility; (3) opportunity to engage family and multidisciplinary care team members; and (4) opportunity to enhance telemedicine use proficiency through practice and support. Identified barriers included: (1) technical challenges; (2) privacy concerns; (3) loss of routine clinical experiences and interactions; (4) limited objective patient remote monitoring; and (5) reimbursement concerns. Efforts to optimize telemedicine for HIV care should consider strategies to improve technology support for PWH, flexible options to access care, additional platforms to allow patient remote monitoring, and appropriate billing and reimbursement methods.Para caracterizar las perspectivas sobre y las experiencias con la telemedicina durante la pandemia de COVID-19, realizamos un estudio de métodos mixtos en dos clínicas de VIH en el noreste de los Estados Unidos. Entre los pacientes con VIH (PWH) encuestados que tuvieron una cita de telemedicina (n = 205), el 42.4% percibió las visitas de telemedicina como útiles durante la pandemia. Los PWH y el personal clínico identificaron como beneficios de la telemedicina: 1) la capacidad para involucrar y reinvolucrar a los pacientes en el cuidado; 2) el cuidado centrado en el paciente y flexibilidad percibidos; 3) la oportunidad de involucrar a la familia y miembros del equipo de cuidado multidisciplinario; y 4) la oportunidad de mejorar la capacidad para usar la telemedicina a través de la práctica y el apoyo. Las barreras identificadas incluyeron: 1) retos tecnológicos; 2) preocupaciones sobre la privacidad; 3) falta de experiencias e interacciones clínicas de rutina; 4) limitada monitorización remota objetiva del paciente; y 5) preocupaciones sobre los reembolsos. Los esfuerzos para optimizar la telemedicina para el cuidado del VIH deben considerar estrategias para mejorar el soporte tecnológico para los PWH, opciones flexibles para acceder a el cuidado, plataformas adicionales que permitan el monitoreo remoto del paciente, y métodos apropiados de facturación y reembolso.
- Published
- 2022
19. Race and Sexual Identity Differences in PrEP Continuum Outcomes Among Latino Men in a Large Chicago Area Healthcare Network
- Author
-
Casey D. Xavier Hall, Brian A. Feinstein, Laura Rusie, Gregory Phillips II, and Lauren B. Beach
- Subjects
Chicago ,Male ,Original Paper ,Race ,Social Psychology ,Disparity ,Public Health, Environmental and Occupational Health ,HIV ,HIV Infections ,Hispanic or Latino ,PrEP ,Sexual and Gender Minorities ,Sexual identity ,Infectious Diseases ,Humans ,Pre-Exposure Prophylaxis ,Homosexuality, Male ,Delivery of Health Care - Abstract
U.S. HIV incidence is threefold higher among Latino individuals than non-Latino Whites. Pre-exposure prophylaxis (PrEP) uptake remains low among Latino men. Most HIV studies view Latino communities as a monolithic group, ignoring racial and sexual diversity. This analysis examines PrEP-related outcomes including eligibility, first prescription, and second prescription across race and sexual identity in a sample of Latino cisgender men (n = 8271) who sought services from a healthcare network in Chicago in 2012-2019. Logistic regression was used to calculate adjusted odds ratios. Latino-only participants had lower odds of PrEP eligibility and first prescription compared to White-Latino participants. No other significant differences by race were detected. While bisexual participants had equivalent odds of PrEP eligibility, they had lower odds of first PrEP prescription compared to gay participants. Heterosexual participants also had lower odds of PrEP eligibility and initiation. Future research should address unique factors shaping PrEP-related outcomes among diverse Latino populations.La incidencia del VIH en los EEUU és 3 veces mayor entre las personas latinos que entre los blancos no latinos. La iniciación de la profilaxis previa a la exposición (PrEP) sigue siendo baja entre los hombres latinos. La mayoría de los estudios sobre el VIH ven a las comunidades latinos como un grupo monolítico, ignorando la diversidad racial y sexual. Este análisis examina los resultados relacionados con la PrEP, incluida la elegibilidad, la primera prescripción y la segunda prescripción según la raza y la identidad sexual en una muestra de hombres latinos cisgénero (n = 8.271) que buscaron servicios de una gran red de servicios de salud en Chicago 2012–2019. Se utilizó la regresión logística para calcular las razones de momios ajustadas. Los participantes que solo eran latinos tenían menores probabilidades de ser elegibles para PrEP y de recibir la primera prescripción en comparación con los participantes de blancos-latinos. No se detectaron otras diferencias significativas por raza. Si bien los participantes bisexuales tenían probabilidades equivalentes de ser elegibles para PrEP, tenían probabilidades más bajas de recibir la primera prescripción de PrEP en comparación con los participantes homosexuales. Los participantes heterosexuales también tenían menores probabilidades de ser elegibles y de iniciarse en la PrEP. Las investigaciones futuras deben abordar los factores únicos que dan forma a los resultados relacionados con la PrEP entre las diversas poblaciones latinos.
- Published
- 2022
20. COVID-19 Vaccine Uptake Among People Living with HIV
- Author
-
Timothy W Menza, Michelle Barber, Jeff Capizzi, Amy I. Zlot, and Lea Bush
- Subjects
Original Paper ,Vaccines ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Social Psychology ,business.industry ,Anti-HIV Agents ,Vaccination ,Human immunodeficiency virus (HIV) ,Public Health, Environmental and Occupational Health ,HIV ,COVID-19 ,HIV Infections ,medicine.disease_cause ,Infectious Diseases ,Environmental health ,medicine ,Public health surveillance ,Humans ,business - Abstract
People living with HIV (PLWH) are at greater risk for severe COVID-19 and are a priority population for COVID-19 vaccination. As of June 15, 2021, 61.6% of PLWH in Oregon received ≥ 1 COVID-19 vaccine dose. Younger PLWH, Hispanic/Latinx PLWH and PLWH who inject drugs or reside in rural and frontier areas had low vaccine uptake while PLWH who were engaged in care, enrolled in the AIDS Drug Assistance Program, and vaccinated against influenza had high vaccine uptake. Greater advocacy, education, and care navigation are required to increase COVID-19 vaccine access and uptake among PLWH. Supplementary Information The online version contains supplementary material available at 10.1007/s10461-021-03570-9.
- Published
- 2022
21. Understanding the role of religious beliefs in adherence to antiretroviral therapy among Pentecostal Christians living with HIV in sub-Saharan Africa: a scoping review.
- Author
-
Azia, Ivo Nchendia, Nyembezi, Anam, Carelse, Shernaaz, and Mukumbang, Ferdinand C.
- Subjects
ANTIRETROVIRAL agents ,RELIGIOUS art ,RELIGIOUS literature ,LITERATURE reviews ,HIV - Abstract
Background: Optimum adherence to antiretroviral therapy (ART) is crucial in managing HIV. However, some people's religious beliefs can influence how they deal with HIV and the psychosocial factors influencing their adherence to ART, such as disclosure, acceptance of HIV status, belief in ART, and depression. In sub-Saharan Africa (SSA), the role of religious beliefs in ART adherence is underexplored. We aimed to identify and conceptualize the literature on religious beliefs concerning ART adherence among Pentecostal Christians living with HIV in SSA. Methods: We conducted a scoping review of the literature on religious beliefs and ART adherence. We searched papers from PubMed, Web of Science, Medline, Sabinet, Academic Search Complete, CINAHL Plus, Health Source/Nursing Academic, Scopus, and Google Scholar and published papers from conference proceedings and dissertations. Data were extracted according to a predetermined population, concept, context framework, and eligibility criteria for selecting or rejecting studies. We used a narrative synthesis to summarize the data on evidence and the impact of religious beliefs on ART adherence. Results: Seven papers published between January 2010 and February 2022 met the inclusion criteria. Nineteen aspects of religious beliefs were identified as negatively influencing ART adherence, while eight aspects facilitated optimal adherence. "Being saved" or "born again" enhanced coping strategies for optimal adherence through actions such as less alcohol use, fidelity to a sexual partner(s), disclosure, acceptance of HIV status, reduced depression, and facilitated PLHIV to access social support from church members or other institutions. Conclusion: Religious beliefs are integral to Pentecostal Christians living with HIV and affect their adherence to ART. While some Pentecostal Christians living with HIV on ART use their religious beliefs and practices to access psychosocial support from other church members or organizations and achieve good clinical outcomes, others apply their religious beliefs and practices differently and compromise their commitments to taking ART as prescribed, thus experiencing poor viral suppression and clinical outcomes. However, more research is required to understand and theorize how religious beliefs impact ART adherence among Pentecostals living with HIV to inform guidelines for practitioners. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
22. Implementation of REDCap mobile app in an oral HIV clinical study.
- Author
-
Lucia Seminario, Ana, Karczewski, Ashley E., Stanley, Sara, Huamani, Javier Valencia, José Montenegro, Juan, Tafur, Karla, Julca, Ana Bautista, and Altice, Frederick L.
- Abstract
Background: In Peru, HIV cases are highly concentrated among men who have sex with men (MSM). Despite the availability of anti-retroviral therapy, people living with HIV (PWH) have higher levels of oral diseases. Alcohol use disorder (AUD) is significantly present among PWH. Our overarching goal was to generate foundational evidence on the association of AUD and oral health in MSM with HIV and enhance research capacity for future intersectional research on AUD, oral health and HIV. Our specific aim was to implement an on-site electronic data collection system through the use of a REDCap Mobile App in a low-middle income country (LMIC) setting. Methods: Five validated surveys were utilized to gather data on demographics, medical history, HIV status, alcohol use, HIV stigma, perceived oral health status, and dietary supplement use. These surveys were developed in REDCap and deployed with the REDCap Mobile App, which was installed on ten iPads across two medical HIV clinics in Lima, Peru. REDCap app as well as the protocol for data collection were calibrated with feedback from trial participants and clinical research staff to improve clinical efficiency and participant experience. Results: The mean age of participants (n = 398) was 35.94 ± 9.13y, of which 98.5% identified as male, and 85.7% identified as homosexual. 78.1% of participants binge drank, and 12.3% reported being heavy drinkers. After pilot testing, significant modifications to the structure and layout of the surveys were performed to improve efficiency and flow. The app was successfully deployed to replace cumbersome paper records and collected data was directly stored in a REDCap database. Conclusions: The REDCap Mobile App was successfully used due to its ability to: (a) capture and store data offline, (b) timely translate between multiple languages on the mobile app interface, and (c) provide user-friendly interface with low associated costs and ample support. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
23. Humoral response to SARS-CoV-2 vaccines in people living with HIV
- Author
-
Ariane von Krosigk, Eva Wolf, Carmen Wiese, Silke Heldwein, Farhad Schabaz, Nino Ochana, Rudolf Rasshofer, Sebastian Noe, and Celia Jonsson-Oldenbuettel
- Subjects
Male ,Microbiology (medical) ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Human immunodeficiency virus (HIV) ,HIV Infections ,Antibodies, Viral ,medicine.disease_cause ,Immune system ,Humans ,Medicine ,Retrospective Studies ,Original Paper ,Vaccines, Synthetic ,biology ,SARS-CoV-2 ,business.industry ,COVID-19 ,HIV ,General Medicine ,Middle Aged ,CD4 ,Vaccination ,Infectious Diseases ,Quartile ,Immunology ,Cd4 cell ,biology.protein ,Female ,mRNA Vaccines ,Antibody ,business - Abstract
Purpose To describe the humoral immune response to COVID-19 vaccines in people living with HIV and identify factors associated with the magnitude of anti-SARS-CoV-2 antibody concentrations. Methods Retrospective analysis of electronic patient files in a big single HIV center in Munich, Germany. Non-parametric methods were used for descriptive and comparative statistics. Generalized linear models were used to analyze associations of general and HIV-specific variables with anti-SARS-CoV-2 antibody concentrations after standard vaccination. Result Overall, 665 people living with HIV were included into the analysis (median age: 53 [IQR: 43; 59]), 560 [84.2%] males). Median concentration of anti-SARS-CoV-2-antibodies was 1400 (IQR 664; 2130) BAU/mL. In 18 (2.7%) subjects, antibody concentrations below the threshold of 34 BAU/mL were found. Among PLWH with CD4 cell count
- Published
- 2021
24. HIV and Intersectional Stigma Reduction Among Organizations Providing HIV Services in New York City: A Mixed-Methods Implementation Science Project
- Author
-
Victoria Brock, Karen McKinnon, Cristina Rodriguez-Hart, Courtney Ahmed, Nova West, Theo G. M. Sandfort, Susan Weigl, Jhané Phanor, Francine Cournos, Grace Mackson, Alana Rule, Jorge H Soler, and Dan Belanger
- Subjects
medicine.medical_specialty ,Mixed methods ,Social Psychology ,Social Stigma ,Human immunodeficiency virus (HIV) ,Stigma (botany) ,HIV Infections ,medicine.disease_cause ,medicine ,Humans ,Sociology ,Hiv services ,Acquired Immunodeficiency Syndrome ,Original Paper ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,Public relations ,Stigma reduction ,Mental health ,Stigma ,Health psychology ,Infectious Diseases ,Implementation science ,New York City ,Organizational structure ,business ,Intersectional stigma - Abstract
Stigma remains a pervasive barrier to Ending the HIV Epidemic (EHE) in New York City (NYC). As part of an EHE implementation science planning process, we mapped multi-level HIV-related stigma-reduction activities, assessed their evidence base, and characterized barriers and facilitators. We interviewed and surveyed a convenience sample of 27 HIV prevention and/or treatment services organizations in NYC, March-August, 2020, using an embedded mixed-methods design. The greatest facilitators of stigma reduction included integration of health services, hiring staff who represent the community, and trainings. Intersecting stigmas were primarily addressed through the integration of HIV with mental health and substance use services. Barriers were multilevel, with organizational structure and capacity most challenging. A strong base of stigma-reduction activities was utilized by organizations, but intersectional frameworks and formal evaluation of activities’ impact on stigma were lacking. Effectiveness-implementation hybrid research designs are needed to evaluate and increase the uptake of effective stigma-reduction approaches in NYC. Supplementary Information The online version contains supplementary material available at 10.1007/s10461-021-03498-0.
- Published
- 2021
25. ChimLeish, a new recombinant chimeric protein evaluated as a diagnostic and prognostic marker for visceral leishmaniasis and human immunodeficiency virus coinfection
- Author
-
Amanda S. Machado, Ricardo Andrez Machado-de-Ávila, Grasiele S.V. Tavares, Vívian T. Martins, Daniela P. Lage, Camila S. Freitas, Débora V.C. Mendonça, João A. Oliveira-da-Silva, Myron Christodoulides, Gláucia Fernandes Cota, Unaí Tupinambás, Fernanda Ludolf, Thiago A.R. Reis, Nathalia Sernizon Guimarães, Danniele L. Vale, Fernanda F. Ramos, Eduardo A.F. Coelho, Gabriel Paulino Luiz, Daysiane de Oliveira, Nathália C. Galvani, Ana Thereza Chaves, Maria Victoria Humbert, and Bruna B. Fernandes
- Subjects
Chagas disease ,Recombinant chimera ,medicine.medical_specialty ,Recombinant Fusion Proteins ,Antigens, Protozoan ,HIV Infections ,Serology ,Medical microbiology ,Antigen ,Diagnosis ,medicine ,Humans ,Leishmania infantum ,Visceral leishmaniasis ,General Veterinary ,biology ,Coinfection ,Synthetic peptides ,HIV ,General Medicine ,Prognosis ,medicine.disease ,biology.organism_classification ,Virology ,Infectious Diseases ,Protozoology - Original Paper ,Insect Science ,biology.protein ,Leishmaniasis, Visceral ,ELISA ,Parasitology ,Antibody - Abstract
Visceral leishmaniasis (VL) is a neglected tropical disease of global importance caused by parasites of the genus Leishmania, and coinfection with human immunodeficiency virus (HIV) is common in countries where both diseases are endemic. In particular, widely used immunological tests for VL diagnosis have impaired sensitivity (Se) and specificity (Sp) in VL/HIV coinfected patients and there is also cross-reactivity with other endemic diseases, e.g., Chagas disease, malaria, and tuberculosis. To develop new antigens to improve the diagnosis of VL and VL/HIV coinfection, we predicted eight specific B-cell epitopes of four Leishmania infantum antigens and constructed a recombinant polypeptide chimera antigen called ChimLeish. A serological panel of 195 serum samples was used to compare the diagnostic capabilities of ChimLeish alongside the individual synthetic peptides. ChimLeish reacted with sera from all VL and VL/HIV coinfected patients [Se = 100%; Sp = 100%; area under the curve (AUC) = 1.0]. Peptides showed lower reactivities (Se = 76.8 to 99.2%; Sp = 67.1 to 95.7%; AUC between 0.87 and 0.98) as did a L. infantum antigenic preparation used as an antigen control (Se = 56.8%; Sp = 69.5%: AUC = 0.45). Notably, ChimLeish demonstrated a significant reduction (p < 0.05) of anti-ChimLeish antibodies after treatment and cure of a small number of patients. Although only a limited serological panel was tested, preliminary data suggest that ChimLeish should be evaluated in larger sample studies for the diagnosis of VL and VL/HIV coinfection.
- Published
- 2021
26. Disrupting the Systems: Opportunities to Enhance Methodological Approaches to Address Socio-Structural Determinants of HIV and End the Epidemic Through Effective Community Engagement
- Author
-
Alan E. Greenberg, Lisa Bowleg, Deanna Kerrigan, Yeycy Donastorg, Martha Sichone Cameron, Carlos E. Rodriguez-Diaz, Wendy A. Davis, and Marcia V. Ellis
- Subjects
Original Paper ,medicine.medical_specialty ,Social Psychology ,Community engagement ,business.industry ,Interpretation (philosophy) ,Public health ,Hiv epidemic ,Public Health, Environmental and Occupational Health ,Psychological intervention ,Human immunodeficiency virus (HIV) ,HIV ,HIV Infections ,Public relations ,medicine.disease_cause ,Social determinants of health ,Health psychology ,Infectious Diseases ,medicine ,Humans ,Methodologies ,Sociology ,Epidemics ,business - Abstract
A world without HIV is only possible by addressing the socio-structural determinants of health. Our understanding of socio-structural determinants is constantly changing, and parallel changes must occur with the methodologies used to explain the drivers of the HIV epidemic. We argue for the need to engage communities in the planning, implementation, and dissemination of research on the socio-structural determinants of HIV. Community engagement should cross-cut various types of research including rigorous measurement development of socio-structural determinants and novel analytic techniques to model their role in the trajectory of the epidemic and the impact of interventions. Considering the role of place, we recommend collaboration between scientists and communities in the interpretation of results from studies that map HIV-related behaviors and movement. As we collectively delve into historically oppressive systems with colonial antecedents, we must be ready to challenge these systems and replace them with collaborative models. The success of research-driven HIV policy and programming will best be evaluated with methodologies derived from the insights of the very individuals that these policies and programs aim to serve.Un mundo sin VIH es posible sólo si atendemos los determinantes socio-estructurales de la salud. Nuestra comprensión sobre determinantes socio-estructurales cambia constantemente y cambios similares deben ocurrir en las metodologías utilizadas para explicar los factores que rigen la epidemia del VIH. Argumentamos sobre la necesidad de involucrar las comunidades en la planificación, implementación y diseminación de investigaciones sobre los determinantes socio-estructurales del VIH. La participación comunitaria debe ser transversal en varios tipos de investigaciones, incluyendo el desarrollo riguroso de métricas sobre los determinantes socio-estructurales y técnicas noveles para la modelación de su rol en las trayectorias de la epidemia y el impacto de intervenciones. Considerando el rol que tiene el lugar físico, recomendamos la colaboración de científicos y comunidades en la interpretación de resultados de estudios que crean mapas de las conductas relacionadas al VIH y la movilidad de las personas. En la medida en que examinamos sistemas históricamente opresivos con antecedentes coloniales, debemos estar listos para retar estos sistemas y remplazarlos con modelos colaborativos. El logro de políticas y programas de VIH informados por la investigación sería evaluado mejor si se utilizan metodologías guiadas por el conocimiento de las personas a las cuales estas políticas y programas persiguen servir.
- Published
- 2021
27. PrEP Care Continuum Engagement Among Persons Who Inject Drugs: Rural and Urban Differences in Stigma and Social Infrastructure
- Author
-
Brandon Muncan, John A. Schneider, Brent Van Ham, Valerie A. Earnshaw, Samuel R. Friedman, Jessica Jaiswal, Suzan M. Walters, David M. Frank, and Danielle C. Ompad
- Subjects
medicine.medical_specialty ,Social Psychology ,Anti-HIV Agents ,Social Stigma ,Human immunodeficiency virus (HIV) ,Persons who inject drugs (PWID) ,Stigma (botany) ,Human sexuality ,HIV Infections ,Population health ,medicine.disease_cause ,Pre-exposure prophylaxis (PrEP) ,Social infrastructure ,Drug Users ,Nursing ,medicine ,Third places ,Urban ,Humans ,Rural ,Substance Abuse, Intravenous ,Original Paper ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,Continuity of Patient Care ,Care Continuum ,Health psychology ,Stigma ,Infectious Diseases ,Social Capital ,Pre-Exposure Prophylaxis ,Psychology - Abstract
Pre-exposure prophylaxis (PrEP) is a medication that prevents HIV acquisition, yet PrEP uptake has been low among people who inject drugs. Stigma has been identified as a fundamental driver of population health and may be a significant barrier to PrEP care engagement among PWID. However, there has been limited research on how stigma operates in rural and urban settings in relation to PrEP. Using in-depth semi-structured qualitative interviews (n = 57) we explore PrEP continuum engagement among people actively injecting drugs in rural and urban settings. Urban participants had more awareness and knowledge. Willingness to use PrEP was similar in both settings. However, no participant was currently using PrEP. Stigmas against drug use, HIV, and sexualities were identified as barriers to PrEP uptake, particularly in the rural setting. Syringe service programs in the urban setting were highlighted as a welcoming space where PWID could socialize and therefore mitigate stigma and foster information sharing. Supplementary Information The online version contains supplementary material available at 10.1007/s10461-021-03488-2.
- Published
- 2021
28. Older Adults Vastly Overestimate Both HIV Acquisition Risk and HIV Prevalence in Rural South Africa
- Author
-
Till Bärnighausen, Lisa F. Berkman, Eva van Empel, F. Xavier Gómez-Olivé, Jennifer Manne-Goehler, Livia Montana, Rebecca A de Vlieg, Stephen Tollman, and Kathleen Kahn
- Subjects
Adult ,Male ,Rural Population ,medicine.medical_specialty ,Longitudinal study ,Adolescent ,Agincourt South Africa ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,South Africa ,03 medical and health sciences ,0302 clinical medicine ,Arts and Humanities (miscellaneous) ,Prevalence ,medicine ,Humans ,Longitudinal Studies ,030212 general & internal medicine ,Hiv acquisition ,General Psychology ,Aged ,Original Paper ,030505 public health ,HAALSI ,Public health ,1. No poverty ,HIV ,Middle Aged ,Hiv prevalence ,3. Good health ,HIV transmission ,Risk perception ,Sexual behavior ,Cohort ,HIV risk perception ,Female ,0305 other medical science ,Psychology ,Demography - Abstract
Perceptions of HIV acquisition risk and prevalence shape sexual behavior in sub-Saharan Africa (SSA). We used data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa baseline survey. Data were collected through home-based interviews of 5059 people ≥ 40 years old. We elicited information on perceived risk of HIV acquisition and HIV prevalence among adults ≥ 15 and ≥ 50 years old. We first describe these perceptions in key subgroups and then compared them to actual estimates for this cohort. We then evaluated the relationship between sociodemographic characteristics and accurate perceptions of prevalence in regression models. Finally, we explored differences in behavioral characteristics among those who overestimated risk compared to those who underestimated or accurately estimated risk. Compared to the actual HIV acquisition risk of
- Published
- 2021
29. Optimization of the vertical transmission prevention program in Guinea: impact of the improvement plan on performance indicators at large-cohort sites.
- Author
-
Camara, Soriba, Millimouno, Tamba Mina, Hounmenou, Castro Gbêmêmali, Kolié, Delphin, Kadio, Kadio Jean-Jacques Olivier, Sow, Abdoulaye, Sidibé, Sidikiba, and Delamou, Alexandre
- Subjects
HIV prevention ,POLYMERASE chain reaction ,RETROSPECTIVE studies ,MANN Whitney U Test ,PREGNANT women ,LONGITUDINAL method ,HIGHLY active antiretroviral therapy ,PRE-exposure prophylaxis ,VERTICAL transmission (Communicable diseases) ,RURAL conditions ,MEDICAL records ,ACQUISITION of data ,RESOURCE-limited settings ,EARLY diagnosis ,HEALTH equity - Abstract
Introduction: Vertical transmission of HIV remains a major challenge in Guinea, especially, in low-resource rural areas. This paper presents the results of a pilot project designed to enhance the prevention of vertical transmission through a comprehensive improvement plan implemented across 66 large-cohort sites. Methods: Data from 66 large-cohort of mother to child transmission prevention (PMTCT) sites from 2019 to 2022 were analysed to compare PMTCT metrics before (2019–2020) and after (2021–2022) the improvement initiative. Key indicators were reviewed, and trends were statistically analysed using Mann‒Whitney tests, with a p value less than 0.05 indicating statistical significance. Results: The implementation of this strategy significantly increased the antiretroviral therapy rate among HIV-positive pregnant women from 66 to 94%, and full antiretroviral prophylaxis coverage was achieved in infants. However, early infant diagnosis via polymerase chain reaction testing falls short of the national target, highlighting deficiencies in laboratory and specimen transport capacities. The study also revealed regional disparities in the use of PMTCT services. Conclusion: The improvement plan effectively enhanced antiretroviral therapy and prophylaxis use, demonstrating the benefits of structured interventions and capacity development. Despite improvements, challenges such as insufficient polymerase chain reaction (PCR) testing and uneven access to services remain. Future initiatives should aim to equip PMTCT sites with essential resources and promote community-driven health-seeking behaviours in underserved areas. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
30. The occupational syndemics of miners in South Africa.
- Author
-
Bulled, Nicola and Singer, Merrill
- Subjects
INDUSTRIAL hygiene ,SYNDEMICS ,REPORTING of diseases ,DRUGGED driving ,WORK environment - Abstract
Occupational exposures in the large industrial mining sector contributed significantly to South Africa's high excess death rate due to COVID-19. Historically poor work-protection oversight has perpetuated centuries of risky labor and living conditions within the industry, driving high levels of disease co-morbidities, and supporting enduring social vulnerabilities. In this paper, we offer a syndemic lens to consider the clustering of adversely interacting diseases among mineworkers in South Africa, drawing attention to the complex occupational health crisis and the need to move beyond simply reporting individual diseases or comorbidities among this population. The physically demanding and dangerous working conditions, the lack of adequate changes to crowded and unsanitary working and living situations, the failure to meet social and labor plan targets, the continued precarious nature of working contracts and mines, and the limited access to robust healthcare reflect the historically exploitative nature of industrial mining in South Africa that places miners at increased risk for various syndemics. This assessment of the adverse interactions of diseases and socioeconomic and political conditions highlights the need for focused research and more follow-through in comprehensive occupational reforms. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
31. "We chose PrEP because I wanted to be sure that this child my wife was going to conceive was indeed mine." Factors influencing the choice of safer conception methods and experiences with its use: a qualitative study among HIV sero-discordant couples in Zimbabwe
- Author
-
Brown, Joelle M., Musara, Petina, Gitome, Serah, Chitukuta, Miria, Mataveke, Bismark, Chirenda, Thandiwe, Mgodi, Nyaradzo, Mutero, Prisca, Matubu, Allen, Chareka, Gift, Chasakara, Charles, Murombedzi, Caroline, Makurumure, Tinei, Hughes, Carolyn Smith, Bukusi, Elizabeth, Cohen, Craig R., Shiboski, Stephen, Darbes, Lynae, Rutherford, George W., and Chirenje, Z. Michael
- Subjects
PARCEL post ,UNSAFE sex ,HIV infection transmission ,CONDOMS ,HIV ,COUPLES ,HUMAN artificial insemination - Abstract
Background: Safer conception services are needed to minimize HIV transmission among HIV sero-discordant couples desiring pregnancy. Few studies have evaluated the choices couples make when they are offered multiple safer conception methods or real-world method acceptability. This paper addresses an important knowledge gap regarding factors that influence the choice of safer conception methods, couples' actual experiences using safer conception methods, and why some couples switch safer conception methods. Methods: Between February and June 2019, we conducted semi-structured in-depth interviews among 14 men and 17 women, representing 17 couples who exited the SAFER study—a pilot safer conception study for HIV sero-discordant couples in Zimbabwe that offered couples a choice of ART with monthly viral load monitoring (ART/VL), oral PrEP, vaginal insemination, and semen washing. All couples in SAFER had used at least two safer conception methods. Results: We found that safer conception method choice often centered around a desire for intimacy, condomless sex, and certainty in the conception process, particularly for men. Method-related attributes such as familiarity, perceived ease of use, side effects, and perceived level of effectiveness in preventing HIV and achieving pregnancy influenced method choice, switching, and satisfaction. Concerns were expressed about each safer conception method and couples were willing to try different methods until they found method(s) that worked for them. The majority of participants reported having positive experiences using safer conception, especially those using ART/VL + PrEP, citing that they were able to attempt pregnancy for the first time with peace of mind and experienced joy and satisfaction from being able to achieve pregnancy safely. Conclusions: The differences in method preferences and experiences voiced by participants in this study and in other studies from the region point to the importance of having a variety of safer conception options in the service delivery package and addressing concerns about paternity, intimacy, and method-related attributes to enable HIV sero-discordant couples to safely achieve their reproductive goals. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
32. A citizen science approach to develop a digital intervention to reduce HIV stigma and promote HIV self‐testing among adolescents and young adults: a mixed methods analysis from Kazakhstan.
- Author
-
Davis, Alissa, Rosenthal, Susan L., Tucker, Joseph D., Balabekova, Olga, Nyblade, Laura, Sun, Yihang, Gryazev, Denis, Lunze, Karsten, Landers, Sara E., Tang, Weiming, Kuskulov, Azamat, Gulyayev, Valera, Terlikbayeva, Assel, Primbetova, Sholpan, and Mergenova, Gaukhar
- Subjects
HIV testing kits ,PATIENT self-monitoring ,YOUNG adults ,CITIZEN science ,HIV - Abstract
Introduction: Kazakhstan has one of the fastest‐growing HIV epidemics in the world, with increasing rates among adolescents and young adults (AYA). Innovative strategies are needed to increase HIV testing uptake and decrease HIV stigma among AYA. Citizen science, defined as the active engagement of the general public in scientific research tasks, promotes and facilitates community engagement throughout the research process. This citizen science study used crowdsourcing to engage AYA in Kazakhstan to develop a digital intervention to reduce HIV stigma and promote HIV self‐testing. Our objectives in this paper are to describe the approach used, its feasibility and acceptability, and AYA motivations for and lessons learned collaborating on the study. Methods: From October 2021 to July 2022, in collaboration with a Community Collaborative Research Board and a Youth Advisory Board, we developed an open call requesting multimedia submissions to reduce HIV testing stigma. Eligible submissions were separated by age group (13−19 or 20−29 years) and judged by a panel composed of AYA (n = 23), healthcare professionals (n = 12), and representatives from the local government and non‐governmental organizations (n = 17). Each entry was reviewed by at least four judges and ranked on a 5‐point scale. The top 20 open call contestants were asked to submit self‐recordings sharing their motivation for and experience participating in the contest and lessons learned. Descriptive statistics were calculated for quantitative data. Qualitative data were coded using open coding. Results: We received 96 submissions from 77 youth across Kazakhstan. Roughly, three‐quarters (n = 75/96) of entries met judging eligibility criteria. Of the eligible entries, over half (n = 39/75) scored 3.5 or higher on a 5‐point scale (70.0%). The most frequent types of entries were video (n = 36/96, 37.5%), image (n = 28/96, 29.2%) and text (n = 24/96, 25.0%). AYA's primary motivations for collaborating on the study included a desire to improve society and help youth. The main challenges included creating content to address complex information using simple language, finding reliable information online and technological limitations. Conclusions: Crowdsourcing was feasible and highly acceptable among AYA in Kazakhstan. Citizen science approaches hold great promise for addressing the increasingly complex health and social challenges facing communities today. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
33. "Will you need this health at all? Will you be alive?": using the bioecological model of mass trauma to understand HIV care experiences during the war in Ukraine.
- Author
-
Owczarzak, Jill, Monton, Olivia, Fuller, Shannon, Burlaka, Julia, Kiriazova, Tetiana, Morozova, Olga, and Dumchev, Kostyantyn
- Subjects
RUSSIAN invasion of Ukraine, 2022- ,OPIOID abuse ,MEDICAL personnel ,PUBLIC health infrastructure ,PATIENT compliance ,PRE-exposure prophylaxis ,DRUG abuse treatment - Abstract
Introduction: Russia's invasion of Ukraine in February 2022 has severely impacted the healthcare system, including the provision of HIV care. The ongoing war is a human‐caused mass trauma, a severe ecological and psychosocial disruption that greatly exceeds the coping capacity of the community. The bioecological model of mass trauma builds on Bronfenbrenner's concept of interaction between nested systems to argue that social context determines the impact of life events on the individual and how an individual responds. This paper uses the bioecological model of mass trauma to explore the impact of Russia's aggression against Ukraine and the ongoing war on HIV‐positive people who use drugs in Ukraine, a particularly vulnerable population that may be negatively affected by disruptions to social networks, healthcare infrastructure and economic conditions caused by mass trauma. Methods: Data were collected between September and November 2022. A convenience sample of 18 HIV‐positive people who use drugs were recruited from community organizations that work with people living with HIV, drug treatment programmes, and HIV clinics through direct recruitment and participant referral. A total of nine men and nine women were recruited; the age ranged from 33 to 62 years old (mean = 46.44). Participants completed a single interview that explored how the war had affected their daily lives and access to HIV care and other medical services; their relationships with healthcare providers and social workers; and medication access, supply and adherence. Data were analysed using the Framework Method for thematic analysis. Results: The war had a profound impact on the social, emotional and financial support networks of participants. Changes in social networks, coupled with limited job opportunities and rising prices, intensified financial difficulties for participants. Relocating to different regions of Ukraine, staying at somebody else's home, and losing connections with social workers impacted medication adherence and created lengthy treatment gaps. Participants also experienced a decreased supply of antiretroviral therapy, concerns about accessing medication for opioid use disorder, and overwhelming fears associated with the war, which overshadowed their HIV‐related health concerns and negatively impacted medication adherence. Conclusions: Our analysis reveals the complex impact of war on social networks and healthcare access. Maintaining support networks and competent healthcare providers will be essential amid the ongoing war. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
34. Defining community‐led monitoring and its role in programme‐embedded learning: lessons from the Citizen Science Project in Malawi and South Africa.
- Author
-
Lauer, Krista J., Soboyisi, Melikhaya, Kassam, Carol Ameera, Mseu, Dennis, Oberth, Gemma, and Baptiste, Solange L.
- Subjects
CITIZEN science ,COVID-19 pandemic ,MEDICAL personnel ,COMMUNITY leadership ,WATERSHEDS - Abstract
Introduction: Programme Science (PS) and community‐led monitoring (CLM) intersect in unexpected and promising ways. This commentary examines a CLM initiative in Malawi and South Africa to highlight the crucial role of CLM in bolstering the PS framework. By leveraging data sources often overlooked by conventional research and evaluation approaches, CLM emerges as a pivotal element in enhancing programme effectiveness. This paper delineates the fundamental principles of CLM, presents programme outcomes derived from CLM methodologies and contextualizes these findings within the broader framework of PS. Discussion: The Citizen Science Project implements CLM continuously at 33 health facilities: 14 in Malawi (eight in Kasungu District and six in Dedza District), and 19 in South Africa (all in the West Rand District), representing a total catchment area of 989,848 people. Monitoring indicators are developed in an iterative process with community groups. The indicators are unique to each country, but both focus on the uptake of health services (quantitative) and barriers to access (qualitative). Monthly clinic records surveys capture 34 indicators in Malawi and 20 in South Africa and are supplemented by qualitative interviews with care recipients and healthcare workers. Qualitative interviews provide additional granularity and help confirm and explain the more macro trends in service coverage as described in quantitative data. The resulting data analysis reveals key themes that help stakeholders and decision‐makers to solve problems collaboratively. Noteworthy outcomes include a substantial increase in multi‐month dispensing of antiretroviral therapy (ART) during COVID‐19 (from 6% to 31%) with a subsequent recovery surpassing of HIV service benchmarks in Malawi post‐pandemic. Conclusions: While quantifying direct impact remains challenging due to the project's design, CLM proves to be a robust methodology that generates credible data and produces impactful outcomes. Its potential extends beyond the health sector, empowering community leadership and fostering interventions aligned with community needs. As CLM continues to evolve, its integration into PS promises to improve relevance, quality and impact across diverse disciplines. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
35. Increased Depression during COVID-19 Lockdown Associated with Food Insecurity and Antiretroviral Non-Adherence among People Living with HIV in Uganda
- Author
-
Zachary Wagner, Sebastian Linnemayr, Peter Wabukala, Mahlet Gizaw, Glenn J. Wagner, Uzaib Saya, Barbara Mukasa, and Sarah MacCarthy
- Subjects
Male ,medicine.medical_specialty ,Social Psychology ,Economic ,HIV Infections ,Food Supply ,law.invention ,Randomized controlled trial ,law ,Intervention (counseling) ,Environmental health ,Humans ,Medicine ,Uganda ,Pandemics ,Depression (differential diagnoses) ,Original Paper ,Food insecurity ,Depression ,business.industry ,Public health ,Stressor ,Public Health, Environmental and Occupational Health ,COVID-19 ,HIV ,Patient Health Questionnaire ,Health psychology ,Distress ,Infectious Diseases ,Anti-Retroviral Agents ,Adherence ,Communicable Disease Control ,Female ,business - Abstract
The health and economic threats posed by the COVID-19 pandemic can be sources of great distress among people living with HIV, which in turn can impact the management of their HIV disease. We examined change in depression from pre- to post-lockdown restrictions and correlates of elevated depressive symptoms, including antiretroviral therapy (ART) adherence. Participants enrolled in a randomized controlled trial of an ART adherence intervention in Uganda. The month-12 follow-up assessment was fully administered just prior to the start of the pandemic-related lockdown in March 2020; at the conclusion of the lockdown three months later, we administered a mixed-methods phone-based assessment. ART adherence was electronically monitored throughout the study period, including during and after the lockdown. Depression was assessed with the 8-item Patient health questionnaire (PHQ-8), on which scores > 9 signify a positive screen for elevated depressive symptoms. A sample of 280 participants completed both the month-12 and post-lockdown assessments. Rates of elevated depressive symptoms nearly tripled from month 12 (n = 17, 6.1%) to the post-lockdown assessment (n = 50, 17.9%; McNemar test
- Published
- 2021
36. Automated STI/HIV risk assessments: Testing an online clinical algorithm in Ottawa, Canada
- Author
-
Patrick O'Byrne, Alexandra Musten, Scott Buckingham, and Lauren Orser
- Subjects
Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Sexually Transmitted Diseases ,Human immunodeficiency virus (HIV) ,HIV Infections ,Dermatology ,medicine.disease_cause ,Humans ,Medicine ,Pharmacology (medical) ,Homosexuality, Male ,Hiv transmission ,sexually transmitted infections ,SARS-CoV-2 ,Miscellaneous Paper ,business.industry ,Transmission (medicine) ,Public Health, Environmental and Occupational Health ,COVID-19 ,HIV ,virus diseases ,Clinical algorithm ,Test (assessment) ,Infectious Diseases ,Family medicine ,Scale (social sciences) ,Screening ,business ,Risk assessment ,Algorithms ,self-testing ,online testing - Abstract
Despite the ongoing transmission of sexually transmitted infections (STIs) and HIV, many people became unable to access testing due to COVID-19. To address this, we created a mail-out HIV self-test kit, which could be delivered without restrictions in our region. The uptake and feedback from this project made us realize that comprehensive STI testing was being sought. To ensure testing occurred correctly—that is, it would be targeted at the persons most affected by STIs/HIV—we automated clinical decision-making. We built this model based on a 2-by-2 matrix that plots the risk of STI/HIV transmission and risk of STI/HIV exposure. The intercept of these two measures classifies a person as low, medium, or high risk. After automating this logic, 16 expert clinicians in STI/HIV care tested this system with over 400 test patient cases and refined the algorithm until it yielded the exact outcomes that these clinicians would offer patients based on guidelines. Findings of interest are that the scale of the y-axis is exponential, in that risk factors for exposure do not climb cumulatively but do so according to a quadratic equation. This helps ensure that testing services are targeted at those who are most inequitably burdened by these infections.
- Published
- 2021
37. Behavioral Risk Factors for HIV Infection in Hospitalized Persons Who Co-use Stimulants and Opioids
- Author
-
Jane M. Liebschutz, Michael D. Stein, Bradley J. Anderson, Kristina T. Phillips, Joshua A. Barocas, Catherine Stewart, and Raagini Jawa
- Subjects
medicine.medical_specialty ,Social Psychology ,medicine.medical_treatment ,Human immunodeficiency virus (HIV) ,HIV Infections ,Hiv risk ,medicine.disease_cause ,Behavioral risk ,Risk-Taking ,Risk Factors ,Internal medicine ,medicine ,Humans ,Stimulant use ,Substance Abuse, Intravenous ,HIV risk behaviors ,Original Paper ,Sex risk ,business.industry ,Public Health, Environmental and Occupational Health ,HIV ,Confidence interval ,Stimulant ,Analgesics, Opioid ,Opioid use ,Infectious Diseases ,Cross-Sectional Studies ,Opioid ,Risk assessment ,business ,People who inject drugs ,medicine.drug - Abstract
We investigated the association of 90-day opioid and stimulant co-use and HIV risk behaviors in a cross-sectional analysis of hospitalized HIV-negative people who inject drugs (PWID). We compared those injecting opioids alone to two sub-groups who co-used opioids with (1) cocaine, (2) amphetamine-type stimulants (ATS), on sex and injection drug risk behaviors assessed via the Risk Assessment Battery (RAB), where a higher score indicates a higher risk. Of 197 participants who injected opioids, 53% co-used cocaine only, 5% co-used ATS only, 18% co-used both cocaine and ATS, 24% co-used neither stimulant. PWID who injected opioids alone had a mean RAB drug risk score of 5.98 points and sex risk score of 2.16 points. Compared to PWID who injected opioids alone, PWID who co-used stimulants had higher mean drug risk RAB scores: cocaine, b = 2.84 points [95% confidence interval (CI) 1.01; 4.67]; ATS, b = 3.43 points (95% CI 1.29; 5.57). Compared to PWID who injected opioids alone, cocaine co-use was associated with higher sex RAB scores b = 1.06 points (95% CI 0.32; 1.79). Overall, we found a significant association between stimulant co-use and higher HIV sex and drug risk scores.Investigamos la asociación entre el uso conjunto de opioides y estimulantes durante 90 días y las conductas de riesgo frente al VIH en un análisis transversal de personas hospitalizadas que se inyectan drogas y que son VIH negativas (“PWID” en lo sucesivo). Se comparó a los que consumían únicamente opioides con dos subgrupos que consumían opioides junto con (1) cocaína, (2) estimulantes de tipo anfetamínico (“ATS” en lo sucesivo), en relación con las conductas de riesgo evaluadas mediante la Serie de Pruebas de Evaluación de Riesgos (“RAB” en lo sucesivo). De los 197 participantes, el 53% sólo consumía cocaína, el 5% sólo ATS y el 18% cocaína y ATS; el 24% restante únicamente se inyectaba opiáceos. En comparación con las PWID que únicamente se inyectaban opioides, las PWID que consumían paralelamente estimulantes tenían puntuaciones medias más altas en el RAB de riesgo de drogas: cocaína, b = 2.84 puntos (intervalo de confianza [IC] del 95% 1.01; 4.67); ATS, b = 3.43 puntos (IC del 95% 1.29; 5.57). En comparación con las PWID que únicamente se inyectaban opioides, el co-consumo de cocaína se relacionó con puntuaciones más altas en la RAB en el sexo (1.06 puntos, IC del 95% 0.32; 1.79). En general, se encontró una asociación significativa entre el co-consumo de estimulantes y las puntuaciones más altas de riesgo sexual y de drogas frente al VIH.
- Published
- 2021
38. Survival Among New Yorkers with HIV from 1981 to 2017: Inequities by Race/Ethnicity and Transmission Risk Persist into the Post-HAART Era
- Author
-
Lucia V. Torian, Sarah L. Braunstein, Laura S. Kersanske, Rachael Lazar, and Graham Harriman
- Subjects
Adult ,Male ,medicine.medical_specialty ,Social Psychology ,Survival ,Adolescent ,Population ,Ethnic group ,HIV Infections ,Men who have sex with men ,Sexual and Gender Minorities ,immune system diseases ,Antiretroviral Therapy, Highly Active ,Ethnicity ,Medicine ,Humans ,Mortality ,Homosexuality, Male ,education ,Survival analysis ,education.field_of_study ,Original Paper ,business.industry ,Proportional hazards model ,Public health ,Public Health, Environmental and Occupational Health ,virus diseases ,HIV ,Confidence interval ,Antiretroviral therapy ,Infectious Diseases ,Risk factors ,Cohort ,Female ,business ,Demography - Abstract
Data on long-term survival among people with HIV (PWH) can inform the development of services for this population. An estimated 90,000 PWH live in New York City (NYC). Using HIV surveillance data, we conducted survival analysis of PWH diagnosed in NYC before and after introduction of highly active antiretroviral therapy (HAART) (pre-HAART cohort: 1981–1994; post-HAART cohort: 1995–2016). We created Kaplan–Meier curves by cohort and demographic factors, and Cox proportional hazards models to evaluate adjusted mortality risk by cohort. 205,584 adults and adolescents were diagnosed with HIV in NYC from 1981 to 2016, half each in the pre-HAART and post-HAART eras. The pre-HAART cohort had significantly poorer survival compared with the post-HAART cohort. Adjusted mortality risk in the pre-HAART cohort was almost threefold that in the post-HAART cohort (HR 2.84, 95% confidence interval [CI] 2.80–2.88). In sex- and risk-stratified models, men who have sex with men (MSM) had the largest difference in mortality risk pre-HAART versus post-HAART (HR 5.41, 95% CI 5.23–5.59). Race/ethnic disparities were pronounced among MSM, with Latino/Hispanic and White MSM having lower mortality than Black MSM. Females with heterosexual risk born outside the US had lower mortality than US-born women. The improvement in survival post-HAART was most pronounced for White people. Survival among persons diagnosed with HIV in NYC increased significantly since the introduction of HAART. However, among MSM and among PWH overall, improvements even post-HAART lagged for Black and Latino/Hispanic people, underscoring the need to address structural barriers, including racism, to achieve optimal health outcomes among people with HIV.
- Published
- 2021
39. Perception and utilization of prevention of mother-to-child transmission of human immunodeficiency virus (HIV) services among women living with HIV
- Author
-
Chiemerigo Anne Onyeneho, Anifat O. Saka, and Chizoma M Ndikom
- Subjects
Research design ,medicine.medical_specialty ,media_common.quotation_subject ,Human immunodeficiency virus (HIV) ,utilization ,RT1-120 ,Stigma (botany) ,hiv ,Nursing ,perception ,medicine.disease_cause ,Nonprobability sampling ,Acquired immunodeficiency syndrome (AIDS) ,prevention ,immune system diseases ,Perception ,Maternity and Midwifery ,medicine ,reproductive and urinary physiology ,media_common ,Pregnancy ,business.industry ,Transmission (medicine) ,transmission ,Obstetrics and Gynecology ,virus diseases ,Gynecology and obstetrics ,medicine.disease ,female genital diseases and pregnancy complications ,Family medicine ,Pediatrics, Perinatology and Child Health ,RG1-991 ,mother-to-child ,business ,Research Paper - Abstract
Introduction Mother-to-child transmission is the major route of pediatric Human Immunodeficiency Virus (HIV) infection accounting for 90% of childhood HIV infection. Poor utilization of prevention of mother-to-child transmission (PMTCT) of HIV services has been shown in this situation. Hence, the study assessed the perception and utilization of PMTCT services among Women Living with HIV (WLHIV). Methods A cross-sectional research design was used with a purposive sampling technique to select 182 WLHIV within reproductive age attending President’s Emergency Plan for Acquired Immunodeficiency Syndrome (AIDS) Relief (PEPFAR)/AIDS Prevention Initiative in Nigeria (APIN) clinic in two secondary Health facilities in Ibadan, Oyo State. A validated structured questionnaire was used for data collection. Descriptive and inferential statistics were used for data analysis. Results The mean age of the women was 37.0±6.5 years. Majority (74.2%) of the respondents had good knowledge on PMTCT of HIV, positive perception (89%) towards PMTCT services while only 42.9% of the respondents have utilized PMTCT services during pregnancy. However, some of the challenges to use of PMTCT services identified by the respondents were stigma (16.5%), discrimination (15.4%), financial constraint (11.5%) and non-involvement of partner (8.2%). There was a significant association between level of knowledge and PMTCT services utilization (χ 2 =6.244, p=0.012). Conclusions There is need for improvement of knowledge and perception of HIV, MTCT and PMTCT among women through counseling and antenatal education, thereby increasing PMTCT services uptake. Partner involvement, good quality PMTCT services and lack of discrimination of people living with HIV in our society should be encouraged, hence promoting the utilization of PMTCT services.
- Published
- 2021
40. Tajikistan Country Gender Assessment
- Author
-
World Bank
- Subjects
GENDER RELATIONS ,MIGRANT ,EQUAL OPPORTUNITIES ,RURAL DEVELOPMENT ,ELDERLY MEN ,EARLY MARRIAGE ,FEMALE EDUCATION ,EQUAL ACCESS ,EMPLOYMENT ,EARLY MARRIAGES ,EQUALITY OF MEN ,FUTURE GENERATIONS ,GENDER STUDIES ,NATIONAL LEVEL ,INSTITUTIONAL MECHANISMS ,ENTREPRENEURIAL ACTIVITIES ,INFORMAL SECTOR ,ECONOMIC RESOURCES ,SKILL DEVELOPMENT ,INSTITUTIONAL FRAMEWORK ,MOTHER ,FEMALE STUDENTS ,CULTURAL RIGHTS ,BUSINESS DEVELOPMENT ,FERTILITY RATES ,EARNINGS ,INFORMAL SECTOR EMPLOYMENT ,HIV INFECTIONS ,SOCIAL UNREST ,GENDER POLICIES ,PENSIONS ,SHADOW REPORT ,LOW-INCOME COUNTRIES ,INTERNATIONAL FINANCE ,ECONOMIC OPPORTUNITIES ,FERTILITY ,SECONDARY EDUCATION ,IMPORTANT POLICY ,ECONOMIC SITUATION ,ELDERLY ,HEALTH RISKS ,ID ,GENDER AWARENESS ,SOCIAL NORMS ,DELIVERY CARE ,POLICY IMPLICATIONS ,RIGHTS OF WOMEN ,MATERNAL MORTALITY ,WOMEN'S AGENCY ,FINANCIAL CONSTRAINTS ,ELDERLY WOMEN ,LITERACY RATES ,FINANCIAL LITERACY ,FEMALE EMPLOYMENT ,JOINT LIABILITY ,LABOR FORCE PARTICIPATION ,EMPLOYEE ,EMPLOYMENT STATUS ,EDUCATIONAL CHOICES ,INTRAVENOUS DRUG USE ,MALE INVOLVEMENT ,STATE SUPPORT ,YOUNG WOMEN ,LIFE EXPECTANCY ,HUMAN DEVELOPMENT ,NEW BUSINESSES ,ACCESS TO INFORMATION ,PRINCIPLE OF EQUALITY ,DISCRIMINATION AGAINST WOMEN ,ENDOWMENTS ,EQUAL PAY ,SEXUAL INTERCOURSE ,PREGNANCY ,EDUCATION SYSTEM ,HEALTH SYSTEMS ,HOUSEHOLDS ,RESPECT ,CHILDBIRTH ,GENDER-BASED VIOLENCE ,SECONDARY SCHOOL ,BUSINESS WORKSHOPS ,SOCIAL ASSISTANCE ,UNION ,HOUSEHOLD POVERTY ,MIGRANT HOUSEHOLDS ,FINANCIAL RESOURCES ,UNDP ,POLITICAL RIGHTS OF WOMEN ,PUBLIC LIFE ,POLICY RESEARCH WORKING PAPER ,ENROLLMENT ,INTERNATIONAL ORGANIZATION FOR MIGRATION ,TRADITIONAL GENDER ROLES ,VIOLENCE AGAINST WOMEN ,GENDER EQUALITY ,AGRICULTURAL ACTIVITIES ,CORRUPTION ,HIV ,INCLUSION OF WOMEN ,COVID-19 ,FEMALE WORKERS ,MASS MEDIA ,POLITICAL PARTIES ,SECONDARY ENROLMENT ,COUNTRY GENDER ASSESSMENT ,GENDER ROLES ,MARKET ECONOMY ,RURAL WOMEN ,GENDER ,HUSBANDS ,EDUCATED WOMEN ,GENDER GAP ,UNITED NATIONS DEVELOPMENT FUND FOR WOMEN ,STATE POLICY ,NATIONAL DEVELOPMENT ,LEVELS OF EDUCATION ,WOMEN'S VOICE ,ECONOMIC GROWTH ,EMPLOYERS ,GENDER ANALYSES ,CORONAVIRUS ,CHILD HEALTH ,UNICEF ,FAMILIES ,LABOR MIGRATION ,HEALTH SYSTEM ,ROLE OF WOMEN ,UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT ,RURAL HOUSEHOLDS ,GENDER DISPARITIES ,POPULATION GROWTH ,PROMOTING GENDER EQUALITY ,WORKING CONDITIONS ,MIGRANTS ,SEXUAL VIOLENCE ,PANDEMIC IMPACT ,PRODUCTIVITY ,WORLD POPULATION ,CIVIL WAR ,ECONOMIC CRISIS ,LABOUR MARKET ,ENROLMENT RATES ,EQUALITY IN EDUCATION ,DOMESTIC VIOLENCE ,CIVIL SOCIETY ACTORS ,DISEASES ,MICRO-FINANCE ,GENDER DISCRIMINATION ,VICIOUS CYCLE ,PRIMARY EDUCATION ,LIVING STANDARDS ,REPRODUCTIVE ROLES ,ADOLESCENT GIRLS ,GENDER GAPS ,LEGAL ADVICE ,POPULATION STUDY ,SUPPORT FOR WOMEN ,LIVE BIRTHS ,POLITICAL PARTY ,FEMALE ENTREPRENEURSHIP ,PROGRESS ,LACK OF ACCESS ,SAFETY NET ,LABOR MARKET ,LEGAL RIGHTS ,MORTALITY ,EQUAL RIGHTS ,LACK OF FINANCE ,MATERNAL HEALTH ,GENDER WAGE GAP ,GENDER ASSESSMENT ,NUMBER OF WOMEN ,TERTIARY EDUCATION ,HUMAN RIGHTS ,HEALTH SECTOR ,SOCIAL SECURITY ,INFANT ,HUSBAND ,FEMALE ENTREPRENEURS ,ECONOMIC CHARACTERISTICS ,LABOR MIGRANTS ,DEMOGRAPHIC PROFILES ,UNITED NATIONS DEVELOPMENT PROGRAMME ,FEMALE STAFF ,ECONOMIC ACTIVITY ,NATIONAL STRATEGY ,OLD-AGE ,FEMALE POPULATION ,GENDER STEREOTYPES ,WOMAN ,EQUAL WORK ,GENDER SEGREGATION ,REMITTANCES ,LACK OF COLLATERALS ,UNESCO ,HUMAN CAPITAL ,FEMALE LABOR FORCE PARTICIPATION ,SOCIAL DEVELOPMENT ,SEX ,UNITED NATIONS ,POLITICAL DECISION ,AGRICULTURAL SECTOR ,REPRESENTATION OF WOMEN ,MIGRATION ,SOCIAL EXCLUSION ,FORMS OF DISCRIMINATION ,POLICY RESEARCH ,CHILDBEARING ,LIMITED ACCESS ,GENDER ISSUES ,HOUSEHOLD LEVEL ,TERTIARY LEVEL ,JOURNALISTS ,GENDER MAINSTREAMING ,SCHOLARSHIPS ,POLITICAL RIGHTS ,ELIMINATION OF DISCRIMINATION ,INDIVIDUAL ENTREPRENEURS ,LABOR FORCE ,HEALTH SERVICES ,HIV INFECTION ,DISCRIMINATION ,OUTREACH ,DEMOGRAPHIC CHANGES ,RELIGIOUS PRACTICES ,FOCUS GROUP DISCUSSIONS ,EXPENDITURE - Abstract
The aim of this report is to provide a broad overview of the current state of gender equality in Tajikistan. While the Europe and Central Asia (ECA) region traditionally surpassed many other regions in terms of gender equality, this advantage has been eroding in recent decades. Particularly in Tajikistan, concerns have been raised that men and women have unequally born the consequences of economic, political, and social transitions after independence in 1991. The report examines several dimensions of gender equality both quantitatively and qualitatively. Tajikistan has set up a legal framework that enshrines principles of equality and non-discrimination, but better implementation results require continued efforts. Prevailing social norms and patriarchal systems of decision-making limit women s ability to make effective choices be it at home or at work. The paper is structured along the following lines. The first section introduces the idea of agency that will remain an important issue throughout the report. This is followed by an analysis of disparities in human capital endowment, including health and education. Gender gaps in the Tajik labor market and entrepreneurial activities of men and women are discussed in the fourth and fifth section. The final section concludes with some policy recommendations that might be beneficial for discussions among policy-makers, civil society actors, and development partners.
- Published
- 2021
41. Community engagement group model in basic and biomedical research: lessons learned from the BEAT-HIV Delaney Collaboratory towards an HIV-1 cure.
- Author
-
Dubé, Karine, Peterson, Beth, Jones, Nora L., Onorato, Amy, Carter, William B., Dannaway, Christine, Johnson, Steven, Hayes, Roy, Hill, Marcus, Maddox, Rease, Riley, James L., Shull, Jane, Metzger, David, and Montaner, Luis J.
- Subjects
COMMUNITY organization ,MEDICAL research ,SOCIAL scientists ,HIV ,COMMUNITIES ,NONPROFIT organizations - Abstract
Introduction: Achieving effective community engagement has been an objective of U.S. National Institutes of Health-funded HIV research efforts, including participation of persons with HIV. Community Advisory Boards (CABs) have remained the predominant model for community engagement since their creation in 1989. As HIV cure-directed research efforts have grown into larger academic-industry partnerships directing resources toward both basic and clinical research under the Martin Delaney Collaboratories (MDC), community input models have also evolved. The BEAT-HIV MDC Collaboratory, based at The Wistar Institute in Philadelphia, United States, implemented a three-part model for community engagement that has shown success in providing greater impact for community engagement across basic, biomedical, and social sciences research efforts. Discussion: In this paper, we review the case study of the formation of the BEAT-HIV Community Engagement Group (CEG) model, starting with the historical partnership between The Wistar Institute as a basic research center and Philadelphia FIGHT as a not-for-profit community-based organization (CBO), and culminating with the growth of community engagement under the BEAT-HIV MDC. Second, we present the impact of a cooperative structure including a Community Advisory Board (CAB), CBO, and researchers through the BEAT-HIV CEG model, and highlight collaborative projects that demonstrate the potential strengths, challenges, and opportunities of this model. We also describe challenges and future opportunities for the use of the CEG model. Conclusions: Our CEG model integrating a CBO, CAB and scientists could help move us towards the goal of effective, equitable and ethical engagement in HIV cure-directed research. In sharing our lessons learned, challenges and growing pains, we contribute to the science of community engagement into biomedical research efforts with an emphasis on HIV cure-directed research. Our documented experience with implementing the CEG supports greater discussion and independent implementation efforts for this model to engage communities into working teams in a way we find a meaningful, ethical, and sustainable model in support of basic, clinical/biomedical, social sciences and ethics research. Plain English summary: HIV biomedical research groups have prioritized community support and representation as exemplified by the creation of Community Advisory Boards (CABs). Most CABs bring diverse stakeholders to advise on research objectives as part of their activities. The BEAT-HIV Delaney Collaboratory, based at The Wistar Institute in Philadelphia, is a research program created in 2016 to advance HIV cure research. To better engage communities beyond the CAB, the BEAT-HIV Delaney Collaboratory created a Community Engagement Group (CEG) model composed of three distinct components. First, the involvement of a community-based organization (CBO) introduces the historical know-how and relationship with the community. Philadelphia FIGHT fulfills the CBO role as a provider of primary care, education, advocacy, and research support for persons with HIV. Second, the BEAT-HIV CAB provides individual experiences and community input into HIV cure research and gives updates to the broader community about the status of research. Third, basic, clinical/biomedical, and social scientists implement the scientific goals of the BEAT-HIV Collaboratory. In this paper, we aimed to highlight the strengths, challenges, lessons learned, and opportunities of the BEAT-HIV CEG model. We also present examples of collaborative community engagement projects. Our paper contributes to the literature on novel community engagement approaches beyond the CAB. Based on our experience to date using the CEG, a multi-part community engagement model could help move us towards the goal of inclusive, effective, equitable, and ethical engagement in HIV cure research. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
42. Characterizing the Development of Research Landscapes in Substance Use and HIV/AIDS During 1990 to 2021.
- Author
-
Nguyen, Tham Thi, Nguyen, Hien Thu, Do, Huyen Phuc, Ho, Cyrus SH, and Ho, Roger CM
- Subjects
HIV infections ,SUBSTANCE abuse ,MENTAL health ,MEDICAL care ,QUALITY of life ,RESEARCH funding ,ELECTRONIC publications ,HIV ,AIDS ,MEDICAL research - Abstract
Mitigating the impacts of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and substance use requires comprehensive and systematic thinking in designing interventions and developing policies. This study describes the growth of research publications from 1991 to 2021 in the Web of Science database and points out current research landscapes in the fields of HIV/AIDS and substance use. Latent Dirichlet Allocation was used for classifying 21 359 papers into corresponding topics. The most common topics were HIV transmission, HIV infection, quality of life and mental health of substance users, and the biomedical effect of substance use. Emerging research landscapes include vulnerabilities of people who inject drugs to HIV transmission and related health problems. This study found a lack of research on health services, interdisciplinary and inter-sectoral in combination with clinical evaluation and treatment services. Future investment and implementation of HIV/AIDS and substance use programs should focus on research of health services and clinical evaluation, especially context-specific interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
43. Game Plan—a Brief Web-Based Intervention to Improve Uptake and Use of HIV Pre-exposure Prophylaxis (PrEP) and Reduce Alcohol Use Among Gay and Bisexual Men: Content Analysis
- Author
-
Philip A. Chan, Christopher W. Kahler, John P. Guigayoma, and Tyler B. Wray
- Subjects
Original Paper ,mobile phone ,medicine.medical_specialty ,business.industry ,Human immunodeficiency virus (HIV) ,HIV ,Medicine (miscellaneous) ,Health Informatics ,alcohol use ,medicine.disease_cause ,Computer Science Applications ,Pre-exposure prophylaxis ,mHealth ,Family medicine ,Intervention (counseling) ,medicine ,Web application ,eHealth ,business ,pre-exposure prophylaxis ,intervention - Abstract
Background HIV pre-exposure prophylaxis (PrEP) has considerable potential for reducing incidence among high-risk groups, such as gay, bisexual, and other men who have sex with men (GBM). However, PrEP’s effectiveness is closely linked with consistent use, and a variety of individual-level barriers, including alcohol use, could impede optimal uptake and use. Web-based interventions can encourage medication adherence, HIV prevention behaviors, and responsible drinking and may help support PrEP care, particularly in resource-limited settings. Objective We previously developed a web application called Game Plan that was designed to encourage heavy drinking GBM to use HIV prevention methods and reduce their alcohol use and was inspired by brief motivational interventions. This paper aims to describe the web-based content we designed for integration into Game Plan to help encourage PrEP uptake and consistent use among GBM. In this paper, we also aim to describe this content and its rationale. Methods Similar to the original site, these components were developed iteratively, guided by a thorough user-centered design process involving consultation with subject-matter experts, usability interviews and surveys, and user experience surveys. Results In addition to Game Plan’s pre-existing content, the additional PrEP components provide specific, personal, and digestible feedback to users about their level of risk for HIV without PrEP and illustrate how much consistent PrEP use could reduce it; personal feedback about their risk for common sexually transmitted infections to address low-risk perceptions; content challenging common beliefs and misconceptions about PrEP to reduce stigma; content confronting familiar PrEP and alcohol beliefs; and a change planning module that allows users to select specific goals for starting and strategies for consistent PrEP use. Users can opt into a weekly 2-way SMS text messaging program that provides similar feedback over a 12-week period after using Game Plan and follows up on the goals they set. Conclusions Research preliminarily testing the efficacy of these components in improving PrEP outcomes, including uptake, adherence, sexually transmitted infection rates, and alcohol use, is currently ongoing. If supported, these components could provide a scalable tool that can be used in resource-limited settings in which face-to-face intervention is difficult.
- Published
- 2022
44. Development and evaluation of serological screening based on one dried plasma spot for HIV, syphilis, and HCV.
- Author
-
Ma, Jie-qiong, Ren, Ya-nan, Wen, Shi-yuan, Dong, Ao-bo, Xing, Wen-ge, and Jiang, Yan
- Subjects
HIV ,TREPONEMA pallidum ,MEDICAL screening ,SYPHILIS ,HEPATITIS C virus ,BLOOD volume ,DIAGNOSIS of HIV infections - Abstract
Background: In the effort to prevent and control HIV/AIDS, China has established a national sentinel surveillance system. However, some sentinel sites face limitations in environmental resources and accessibility, prompting the exploration of alternative sample strategies. Dried plasma spots (DPS) samples are viewed as promising alternatives to traditional plasma samples due to their advantages, including sample stability, easy storage, and convenient transport. This study aims to develop a method for screening HIV, Treponema pallidum (TP), and Hepatitis C Virus (HCV) using DPS samples and assess their performance. Methods: Based on existing commercial assay kits, a detection method was established through the optimization of experimental parameters, including the amount of plasma on filter paper, the volume of elution solution applied to dried plasma spots, the size of dried plasma spots, elution solution volume, elution solution components, elution temperature, and elution time. A series of laboratory evaluation panels were constructed for laboratory assessments, including the laboratory basic panel, laboratory interference panel, and laboratory precision panel. Additionally, clinical samples were used for evaluation. Results: Optimal conditions for DPS sample extraction were: plasma volume, 100 µL; DPS size, whole spot; eluent volume, 500 µL; eluent, PBS with 1‰ Tween20; elution time, 2 h; elution temperature, room temperature. A total of 619 paired plasma/DPS samples were tested by both methods. The DPS-based ELISA method exhibited 100% sensitivity/specificity for HIV, 98.6%/100% for TP, and 99.6%/100% for HCV. Kappa values between the plasma samples and DPS samples were 100% for HIV, 99% for TP, and 100% for HCV. The DPS-based ELISA method failed to detect 1 HCV mono-infected sample and TP in 1 HIV/HCV/TP co-infected sample. For the HIV/HCV/TP co-infected sample, the S/CO in the plasma sample was 2.143 and in the DPS sample was 0.5. For HCV, the S/CO (sample OD/cut-off) was 3.049 in the plasma sample and 0.878 in the DPS sample. Conclusions: A single DPS, following one-time standardized processing, can be used to detect HIV, HCV, and TP. Researching and establishing laboratory testing methods better suited for China's sentinel surveillance have significant practical applications in improving HIV testing in resource-constrained environments. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
45. Investigating the articles on HIV/AIDS from Turkey with bibliometric methods.
- Author
-
Alkan, Sevil and Şahinoğlu, Mustafa Serhat
- Subjects
SERIAL publications ,SOCIAL sciences ,HIV ,CITATION analysis ,AUTHORSHIP ,MEDICAL research ,BIBLIOMETRICS ,AIDS - Abstract
Introduction: The purpose of the study was to determine the volume and extent of general human immunodeficiency viruses (HIV)/acquired immunodeficiency syndrome (AIDS) research in Turkey as well as the coverage of national HIV/AIDS research agenda. Material and methods: Web of Science (WoS) Core Collection advanced search engine was applied to conduct bibliometric search. "HIV or AIDS or HIV/AIDS or Human immunodeficiency virus or HIV-1 or HIV-2 or acquired immunodeficiency syndrome" and "Turkey" were used as search key words. In addition, the study included "Language = English", "Document area = medicine" and "Document type = Article". We also selected science citation index expanded (SCI-EXPANDED) and social sciences citation index (SSCI) as Web of Science indexes. The data in WoS improved all information on publications, including fields of study, institutions, group authors, funding agencies, journals, citations, and co-authorship. Results: In total, 313 articles were found. The first document was published in 1996, and 310 (99%) papers were published in the last 20 years. The documents were mostly (62.300%) published in science citation index expanded (SCI-EXPANDED) indexed journals. Most of the publications were from medicine general internal (33.866%) area. The top-ranked affiliations from Turkey in HIV/AIDS research were Istanbul University (19.169%), Ege University (10.863%), University of Health Sciences (9.265%), and Hacettepe University (8.626%). ACTHIV-IST (ACTion against HIV in Istanbul) study group (n = 3, 0.958) was Turkey's most productive HIV/AIDS research group. 87.220% of the studies were not funded. Conclusions: According to the findings, Turkey has limited HIV/AIDS research output. Furthermore, the majority of investigations were conducted by only a few centers. Because the study covered the entire country, and there are more centers that follow HIV/AIDS patients, these centers should also take part in the research. As a result, the current study emphasizes the importance of increasing targeted financing for HIV/AIDS research. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
46. A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial
- Author
-
Dallas Swendeman, Carinne Brody, Sovannary Tuot, Pheak Chhoun, Anne E. Fehrenbacher, Alexander Moran, and Siyan Yi
- Subjects
Gerontology ,Pediatric AIDS ,and promotion of well-being ,Sexual Behavior ,Clinical Trials and Supportive Activities ,Health Informatics ,Reproductive health and childbirth ,Gender-Based Violence ,Medical and Health Sciences ,sexual and reproductive health ,law.invention ,Entertainment ,linkage to services ,7.1 Individual care needs ,Randomized controlled trial ,Clinical Research ,law ,Information and Computing Sciences ,Intervention (counseling) ,Behavioral and Social Science ,Humans ,sexually transmitted infection ,low- and middle-income countries ,Young female ,female sex workers ,Violence Research ,Pediatric ,Peace ,Original Paper ,Sex Workers ,Prevention ,Psychology and Cognitive Sciences ,HIV ,Health Services ,Prevention of disease and conditions ,Justice and Strong Institutions ,Infectious Diseases ,Mental Health ,Good Health and Well Being ,mHealth ,Sexually Transmitted Infections ,HIV/AIDS ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Female ,Management of diseases and conditions ,Sexual Health ,Psychology ,Cambodia ,Medical Informatics - Abstract
Background Female entertainment workers (FEWs) in Cambodia experience a greater prevalence of human immunodeficiency virus (HIV), other sexually transmitted infections (STIs), psychological distress, substance abuse, and gender-based violence (GBV) than the general female population. Reaching FEWs with health education and linking them to services has been difficult because of their hidden and stigmatized status. Objective This study evaluated the efficacy of the Mobile Link intervention in improving FEWs’ health by engaging and connecting them to existing HIV, sexual and reproductive health, and GBV services. Methods A randomized controlled trial was conducted between March 2018 and June 2019 in the capital city and 3 other provinces in Cambodia. FEWs in the intervention arm received automated twice-weekly Short Message Service messages and voice messages with health information and direct links to outreach workers. The control group received the existing standard care, including free HIV and STI counseling and testing and a toll-free helpline staffed by trained counselors. We used a stratified random sampling method to select participants from 5 study sites in the 4 selected provinces. Initially, we randomly selected 600 participants from a list of 4000 FEWs by age group (18-24 and 25-30 years) and study site using a random number generator and enrolled them in person. The primary outcome measures included self-reported HIV and STI testing, condom use, and contraceptive use assessed through a face-to-face structured interview. We also measured secondary outcomes, including contact with outreach workers, escorted referral service use, forced drinking, and GBV experiences. Intervention effects were modeled using repeated measures, multilevel mixed-effects logistic regression. Results A total of 1118 participants were recruited and enrolled in the study. We included 218 FEWs in the intervention arm and 170 FEWs in the control arm in the per protocol analyses after removing 730 dropouts. Evidence of positive intervention effects was detected for the following secondary outcomes: contacting an outreach worker (at 30 weeks: adjusted odds ratio [AOR] 3.29, 95% CI 1.28-8.47), receiving an escorted referral (at 30 weeks: AOR 2.86, 95% CI 1.09-7.52; at 60 weeks: AOR 8.15, 95% CI 1.65-40.25), and never being forced to drink at work (at 60 weeks: AOR 3.95, 95% CI 1.62-9.60). Over time, no significant differences between intervention and control groups were observed for any primary outcomes in the fully adjusted models. Conclusions The Mobile Link intervention effectively connected FEWs with outreach workers and escorted referrals but did not show an effect on primary outcomes. Reduced forced drinking at work was also significantly more extensive in the intervention group than in the control group. Longer-term messaging may increase access to services and impact FEWs’ health outcomes in the future. Trial Registration Clinicaltrials.gov NCT03117842; https://clinicaltrials.gov/ct2/show/NCT03117842 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-018-2614-7
- Published
- 2022
47. Adaptation and Validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) in People Living with HIV in Myanmar
- Author
-
Htun Nyunt Oo, Sai Htun Lin, Thet Wai Nwe, Cheng-Shi Shiu, Min San Tun, Wei-Ti Chen, Yin Thet Nu Oo, and Feifei Huang
- Subjects
Health (social science) ,Mindfulness ,Social Psychology ,Psychometrics ,Clinical Sciences ,Experimental and Cognitive Psychology ,Myanmar ,Social support ,Cronbach's alpha ,Sociology ,Clinical Research ,HIV ,Mindful ,Rasch analysis ,Behavioral and Social Science ,Developmental and Educational Psychology ,Psychology ,Applied Psychology ,Original Paper ,Rasch model ,Construct validity ,Confirmatory factor analysis ,Mental Health ,Scale (social sciences) ,HIV/AIDS ,Clinical psychology - Abstract
ObjectivesValid and reliable instruments for the measurement of mindfulness are crucial for people living with HIV. However, there was no Myanmar version of such an instrument.MethodsWe adapted the English version of the 12-item Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) based on standard cross-cultural procedures. By randomly sampling methods, a sample of 248 eligible people living with HIV was contacted from a closed Myanmar Facebook group; 159 PLHIV completed the initial 12-item version of the adapted survey.ResultsThree items were removed due to low item-to-total correlations of the corrected item-total correlation as well as having infit and outfit mean squares outside the range of 0.6 to 1.4. After deleting the 3 items, the three-factor structure was confirmed by confirmatory factor analysis, which indicated good model fit. The resultant 9-item CAMS-R in Myanmar (CAMS-R-M-2) achieved good internal reliability (Cronbach’sαof 0.75 to 0.87, and the corrected item-total correlation ranged from 0.44 to 0.81). Construct validity of the scale was demonstrated by significant association with self-reported HIV stigma and social support levels (r = 0.63, and − 0.53). In Rasch analysis, the infit and outfit mean squares for each item ranged from 0.49 to 1.24, and the person reliability was 2.17 and the separation index was 0.83.ConclusionsThe 9-item CAMS-R-M-2 with a three-factor structure has good reliability and validity. Higher total scores and subscale score reflected greater mindfulness qualities in people living with HIV in Myanmar.
- Published
- 2022
48. Stay-at-home : the impact of the COVID-19 lockdown on household functioning and ART adherence for people living with HIV in three sub-districts of Cape Town, South Africa
- Author
-
Linda S. Campbell, Caroline Masquillier, Lucia Knight, Anton Delport, Neo Sematlane, Lorraine Tanyaradzwa Dube, and Edwin Wouters
- Subjects
Original Paper ,Social Psychology ,Public Health, Environmental and Occupational Health ,COVID-19 ,HIV ,VIH ,HIV Infections ,tratamiento antiretroviral ,Medication Adherence ,confinamiento ,South Africa ,Infectious Diseases ,Anti-Retroviral Agents ,Sociology ,Adherence ,adhesión ,Lockdown ,Communicable Disease Control ,Humans ,Human medicine ,Biology ,ART - Abstract
In March 2020, the South African government imposed a lockdown to control COVID-19 transmission. Lockdown may affect people living with HIV's (PLWH) antiretroviral therapy (ART) adherence. Data from a cluster randomised control trial was collected from 152 PLWH in Cape Town sub-districts from October 2019-March 2020 when the lockdown halted collection. Subsequently, 83 PLWH were followed-up in June-July 2020. Random effects models were used to analyse: (1) changes between baseline and follow-up and (2) correlates of adherence during lockdown. At follow-up, there was an increase in the odds of being below the poverty line and the odds of experiencing violence decreased. Measures for well-being, household functioning, stigma and HIV competency improved. Violence, depression, food insecurity, and stigma were associated with poorer ART adherence; higher well-being scores were associated with better adherence. During lockdown, governments need to ensure financial support, access to (mental) health services, and services for those experiencing violence.Clinical Trial Number: Pan African Clinical Trial Registry, PACTR201906476052236. Registered on 24 June 2019.En marzo de 2020, el gobierno sudafricano impuso un confinamiento generalizado para controlar la transmisión del COVID-19. Estas medidas pueden afectar la adherencia a la terapia antirretroviral de las personas con VIH. A partir de un ensayo aleatorio grupal se recopilan datos de 152 personas con VIH en los sub-distritos de Ciudad del Cabo entre octubre de 2019 y marzo de 2020 cuando el confinamiento detuvo la recopilación. Posteriormente, se realizó un seguimiento de 83 pacientes entre junio y julio de 2020. Se utilizaron modelos de efectos aleatorios para analizar: 1) los cambios en las variables entre la línea de base y de seguimiento; 2) covariables de adhesión al tratamiento. En el seguimiento se observa que aumentaron las probabilidades de estar por debajo del umbral de pobreza y disminuyeron las probabilidades de sufrir violencia. Las medidas de bienestar, funcionamiento del hogar, estigma e idoneidad en materia de VIH mejoraron entre la línea base y el seguimiento. Por otro lado, la violencia, la depresión, la inseguridad alimentaria y el estigma se asocian a una menor adherencia al tratamiento antirretroviral, mientras la mejora del bienestar se asocia a una mayor adherencia al tratamiento. De tal manera, se observa que durante situaciones de emergencia que requieran de confinamientos es recomendable que los gobiernos garanticen apoyo financiero, atención a la salud física y mental de manera continua, así como servicios especializados hacia quienes sufren violencia.
- Published
- 2022
49. Community Capacity Building for HIV and Addiction Service Integration: An Intervention Trial in Vietnam
- Author
-
Li-Jung Liang, Chunqing Lin, Tuan Anh Nguyen, Diep Bich Nguyen, Li Li, Loc Quang Pham, and Tuan Anh Le
- Subjects
Male ,Service delivery framework ,HIV Infections ,Technical support ,Substance Misuse ,0302 clinical medicine ,Medicine ,030212 general & internal medicine ,media_common ,Community Health Workers ,Capacity building ,Health Services ,Creación de capacidad ,Health psychology ,Infectious Diseases ,Mental Health ,Vietnam ,Research Design ,Public Health and Health Services ,HIV/AIDS ,Female ,Public Health ,0305 other medical science ,Infection ,medicine.medical_specialty ,Social Work ,Capacity Building ,Community health worker ,Social Psychology ,media_common.quotation_subject ,Clinical Trials and Supportive Activities ,Addiction treatment ,03 medical and health sciences ,Trabajador comunitario de salud ,Clinical Research ,Intervention (counseling) ,Behavioral and Social Science ,Humans ,Service (business) ,Original Paper ,030505 public health ,business.industry ,Public health ,Addiction ,Prevention ,Public Health, Environmental and Occupational Health ,VIH ,HIV ,Brain Disorders ,Good Health and Well Being ,Family medicine ,Tratamiento de adicciones ,business ,Drug Abuse (NIDA only) - Abstract
Scientific findings and policy guidelines recommend integrating HIV and drug addiction prevention and care into community-based settings. Systematic capacity-building efforts are warranted to provide technical support for community health workers and improve their confidence in the integrated service provision. An intervention trial was conducted between 2018 and 2019 with 120 community health workers (CHW) from 60 communes in Vietnam's four provinces. The 60 intervention CHW received in-person training to enhance their HIV/addiction-related service knowledge and skills. Online support groups were established between trained CHW and local HIV and addiction specialists. The intervention outcomes were assessed using mixed-effects regression models with the data collected at baseline and every 3 months for 1 year. Adjusted analyses showed that intervention CHW reported a significant increase in the interaction with other treatment providers than the control group at 6 months and remained at the 12-month follow-up. The difference in the improvement of confidence in HIV/addiction-related service delivery between the intervention and control groups was significant at 6-month but became insignificant at the 12-month. Male CHW were more confident in providing services than female CHW at baseline, and gender differences in the changing patterns were observed over time. This capacity-building intervention demonstrated promising outcomes on CHW inter-agency collaborations and confidence in service delivery. Gender divides in healthcare professionals should be attended to in future studies.Los hallazgos científicos y los protocolos recomiendan integrar la prevención del VIH y la adicción a las drogas en entornos comunitarios. Se implementan esfuerzos sistemáticos de creación de capacidad para brindar apoyo técnico a los trabajadores de salud comunitarios y mejorar su confianza en la prestación de servicios integrados. Se realizó una prueba de intervención entre 2018 y 2019 con 120 trabajadores de salud comunitarios (TSC) de 60 comunas en las cuatro provincias de Vietnam. Los 60 TSC de intervención recibieron capacitación en persona para mejorar sus conocimientos y habilidades de servicios relacionados con VIH / adicción. Se establecieron grupos de apoyo en línea entre TSC capacitados y especialistas locales en VIH y adicciones. Los resultados de la intervención se evaluaron mediante modelos de regresión de efectos mixtos con los datos recopilados al inicio del estudio y cada tres meses durante un año. Los análisis ajustados mostraron que la intervención CHW informó un aumento significativo en la interacción con proveedores de tratamiento diferentes al grupo de control a los seis meses que se mantuvo en el seguimiento a los 12 meses. La diferencia en el aumento de la confianza en la prestación de servicios relacionados con VIH / adicción entre los grupos de intervención y control fue significativa a los 6 meses, pero se volvió insignificante a los 12 meses. Los TSC masculinos tenían más confianza en la prestación de servicios que las femeninas al inicio del estudio, y se observaron diferencias de género en el cambio de patrones a lo largo del tiempo. Esta intervención de creación de capacidad demostró resultados prometedores en las colaboraciones interinstitucionales de los TSC y la confianza en la prestación de servicios. Las brechas de género en los profesionales de la salud deben ser atendidas en estudios futuros.
- Published
- 2022
50. Cyclical Longitudinal Ethnography as an Innovative Design for Addressing Sexuality Education in South African Rural Farm Schools.
- Author
-
Mavhandu-Mudzusi, Azwihangwisi Helen
- Subjects
SEX education ,RURAL schools ,ETHNOLOGY ,HIV prevention ,RESEARCH personnel ,HIV - Abstract
Addressing Sexuality Education among learners in rural schools can be challenging when using traditional designs such as ethnography and phenomenology. This paper introduces Cyclical Longitudinal Ethnography as an innovative design for addressing Sexuality Education in South African rural farm schools. This design was developed as part of an engaged scholarship on HIV prevention in rural farm schools in SoutpansbergNorth Circuit, Limpopo Province, South Africa. The paper provides an overview of Sexuality Education at schools and the challenges thereof. It further provides the basics of ethnography and its limitation. The paper then introduces and describes cyclical ethnography as an alternative to original ethnography. The design allows researchers to still have a prolonged engagement with the community without gross disruption of other academic responsibilities such as tuition, academic citizenship, leadership, and administration. The design allows the researcher to visit the area several times over the years, enabling the researcher to observe variations of a phenomenon over time. The Cyclical nature of the design allows data collection, analysis, intervention, monitoring, and evaluation to be conducted iteratively. Though there are primary key informants, the findings could lead to other key informants, settings, and interventions which were not part of the initial plan and objectives. In this study, the target population was educators teaching Sexuality Education, but it ended up involving learners, parents, and community members. The Longitudinal nature of the design enables the researchers to see the impact of the interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.