5 results on '"Darisheva M"'
Search Results
2. Attitudes towards people living with HIV and people who inject drugs: A mixed method study of stigmas within harm reduction programs in Kazakhstan.
- Author
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Stringer KL, Mukherjee T, McCrimmon T, Terlikbayeva A, Primbetovac S, Darisheva M, Hunt T, Gilbert L, and El-Bassel N
- Subjects
- Adult, Female, Focus Groups, Harm Reduction, Humans, Kazakhstan, Male, Middle Aged, Needle-Exchange Programs, Qualitative Research, Young Adult, Attitude of Health Personnel, HIV Infections psychology, Health Personnel psychology, Patient Acceptance of Health Care psychology, Stereotyping, Substance Abuse, Intravenous psychology
- Abstract
Background: High levels of stigma towards people who inject drugs (PWID) and people living with HIV (PLWH) exist in Kazakhstan, yet little is known about the role of stigma in harm reduction service settings. In this paper, we use a mixed method design to explore and describe the actionable drivers and facilitators of stigma among harm reduction service providers. Additionally, we describe the manifestations of stigma among PWID who are living with HIV (PWID/LWH), and the impact that stigma has on harm reduction and healthcare service utilization., Methods: Eight focus groups with 57 PWID/LWH were convened between March 2016 and July 2016 to describe manifestations of stigma from the perspective of syringe exchange program (SEP) clients. Additionally, we surveyed 80 nurses, social workers, outreach workers, and providers of HIV care at SEPs between January 2017 and July 2017 to assess stigmatizing attitudes among staff within the SEP environment. Joint displays were used to integrate quantitative and qualitative data., Results: The actionable drivers of stigma identified in this study include negative opinions and moral judgements towards PWID/LWH. Facilitators identified included stigmatization as a social norm within the service provision environment, a lack of awareness of anti-discrimination policies, and lack of enforcement of anti-discrimination policies. Qualitative findings highlight manifestations of stigma in which PWID/LWH experienced denial of services, perceived negative attitudes, and avoidance from service provision staff. PWID/LWH also described segregation in healthcare settings, the use of unnecessary precautions by providers, and unauthorized disclosure of HIV status., Conclusions: This paper highlights the urgent need to address stigma in the harm reduction and HIV service settings in Kazakhstan. These findings have implications for informing an actionable model for stigma reduction for providers who deliver services to PWID/LWH in Kazakhstan. Drivers, facilitators, and manifestations of stigma are multifaceted and addressing them will require a multilevel approach., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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3. Individual, social, and structural factors affecting antiretroviral therapy adherence among HIV-positive people who inject drugs in Kazakhstan.
- Author
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Davis A, McCrimmon T, Dasgupta A, Gilbert L, Terlikbayeva A, Hunt T, Primbetova S, Wu E, Darisheva M, and El-Bassel N
- Subjects
- Acquired Immunodeficiency Syndrome epidemiology, Acquired Immunodeficiency Syndrome psychology, Acquired Immunodeficiency Syndrome virology, Adult, Drug Users statistics & numerical data, Female, HIV Infections epidemiology, Humans, Kazakhstan, Male, Middle Aged, Qualitative Research, Social Stigma, Substance Abuse, Intravenous epidemiology, Substance Abuse, Intravenous psychology, Anti-HIV Agents therapeutic use, Anti-Retroviral Agents administration & dosage, Drug Users psychology, HIV Infections drug therapy, Medication Adherence psychology, Substance Abuse, Intravenous virology
- Abstract
Background: HIV-infected people who inject drugs (PWID) are particularly vulnerable to suboptimal ART adherence. The fastest-growing HIV epidemics globally are driven by injection drug use, but only a small percentage of HIV-positive PWID have achieved viral suppression. Virally suppressed individuals have better HIV-related health outcomes and effectively no risk of transmitting HIV to others. Hence, ART adherence is important for both HIV treatment and HIV prevention. There is a paucity of data on barriers and facilitators of ART adherence among PWID in low and middle income countries, which is problematic given the growing HIV epidemics among PWID in these countries., Methods: Using the Theory of Triadic Influence, this paper examines individual, interpersonal, and structural barriers and facilitators of ART adherence among HIV-positive PWID in four cities in Kazakhstan. Eight focus groups were conducted (two in each city) with a total of 57 participants. Data were coded and analyzed by three researchers., Results: We found a number of barriers and facilitators to ART adherence among PWID at the individual, interpersonal, and structural levels. Individual barriers to ART adherence include misperceptions about ART, forgetfulness due to the effects of illicit drug use, and medication side effects. Interpersonal facilitators of ART adherence include social support and good relationships with healthcare providers. Structural barriers include poverty, legal challenges, disruptions in the ART supply, and stigma and discrimination., Conclusion: The paper highlights important factors related to ART adherence for HIV-positive PWID and identifies potential strategies for intervention efforts, including couple-based interventions, electronic reminders, linkage to drug treatment services, and patient navigation. Effectively enhancing adherence to ART among PWID will likely require multi-level approaches and strategies. Further research should be conducted on potential methods and interventions for improving ART adherence among this vulnerable population., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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4. Tuberculosis report among injection drug users and their partners in Kazakhstan.
- Author
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Hermosilla S, El-Bassel N, Aifah A, Terlikbayeva A, Zhumadilov Z, Berikkhanova K, Darisheva M, Gilbert L, Schluger N, and Galea S
- Subjects
- Adult, Age Distribution, Cross-Sectional Studies, Female, Humans, Kazakhstan epidemiology, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prisoners statistics & numerical data, Risk Factors, Sex Distribution, Social Support, Time Factors, Tuberculosis, Multidrug-Resistant epidemiology, Vulnerable Populations, Drug Users statistics & numerical data, Sexual Partners psychology, Substance Abuse, Intravenous epidemiology, Tuberculosis epidemiology
- Abstract
Objectives: Tuberculosis (TB) is a major threat to global public health. Kazakhstan has the second highest percentage of multidrug-resistant tuberculosis (MDR-TB) cases among incident tuberculosis cases in the world (WHO 2013). A high burden of MDR-TB suggests TB prevention, control, and treatment programs are failing. This study provides an epidemiologic profile of TB among injection drug users (IDUs), a high-risk and chronically underserved population, in Kazakhstan., Study Design: Cross-sectional study., Methods: The authors studied the characteristics and risk environment of IDUs with self-reported previous active TB and their primary sexual partners in Almaty, Kazakhstan. 728 individuals (364 couples) participated in a couple-based study in 2009., Results: 16.75% of participants reported at least one positive TB test (x-ray) in their lifetime. In a multivariable logistic regression adjusting for couple-based sampling, persons with positive TB test were significantly more likely to be older (odds ratio (OR) 7.26, 95% confidence interval (CI): 1.73, 30.43), male (OR 5.53, 95% CI: 2.74, 11.16), have a shorter duration of injection drug use (OR 0.17, 95% CI: 0.04, 0.65), have received high social support from their significant other (OR 2.13, 95% CI: 1.03, 4.40) and more likely (non-significantly) to have been incarcerated (OR 7.03, 95% CI: 0.64, 77.30)., Conclusions: Older men with a history of incarceration and recent injection drug use were more likely to have positive TB test in Kazakhstan. Social network support, while potentially positive for many aspects of population health, may increase risk of TB among IDUs in this context. Public health policies that target high-risk populations and their at-risk networks may be necessary to stem the rise of MDR-TB in Central Asia., (Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2015
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5. Tuberculosis, drug use and HIV infection in Central Asia: an urgent need for attention.
- Author
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Schluger NW, El-Bassel N, Hermosilla S, Terlikbayeva A, Darisheva M, Aifah A, and Galea S
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- Asia epidemiology, Comorbidity, HIV Infections drug therapy, Humans, Prevalence, Tuberculosis drug therapy, Tuberculosis, Multidrug-Resistant drug therapy, Anti-HIV Agents therapeutic use, Antitubercular Agents therapeutic use, HIV Infections epidemiology, Substance-Related Disorders epidemiology, Tuberculosis epidemiology, Tuberculosis, Multidrug-Resistant epidemiology
- Abstract
Introduction: Rates of tuberculosis in Central Asia are extremely high, and even more alarming are the very high rates of multidrug-resistant tuberculosis (MDR-TB) in Kazakhstan, Uzbekistan, Tajikistan and Kyrgyzstan. In addition, rates of HIV infection related to injection drug use seems to be rising as well, thus creating conditions for a potentially devastating co-epidemic of TB/HIV and MDR-TB/HIV which would have terrible consequences for public health in these countries., Current Status: In many countries of Central Asia, diagnosis of tuberculosis still rests on clinical grounds or simple technologies such as chest radiograph and sputum smear examination. Modern molecular techniques such as GenExpert are being introduced in Kazakhstan and Uzbekistan, and perhaps soon in Kyrgyzstan. Treatment of TB is still often centered around prolonged inpatient stay at TB hospitals. Only a minority of patients with HIV infection are receiving ART, and TB and HIV services are not well integrated. Needle exchange programs are becoming increasingly available, but opioid substitution therapy is rarely used in Central Asia. TB, drug treatment and HIV services are generally not well-integrated., Conclusions: To combat this developing storm, integration of TB services, HIV care, and substance abuse treatment programs is needed urgently to allow efficient and effective diagnosis and treatment of these conditions in a coordinated manner., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2013
- Full Text
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