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The redefining of human immunodeficiency virus (HIV) from an acute disease to a manageable chronic illness has reshaped the focus of care, emphasising clinical outcomes and sidelining the complex social barriers many people living with HIV (PLHIV) still face. This parallels changes in the location of HIV care in Australia, with many PLHIV seeking care from private general practitioners whose ability to address complex social issues is constrained by limitations of time and resources. In response, peer navigation has emerged as a model of care implemented by some HIV‐based community health organisations seeking to support PLHIV's biomedical and psychosocial needs. However, there is limited understanding of how peer navigation operates in community settings or of the way these programmes integrate with primary care. This paper is the first to explore peer navigation from the perspective of general practitioners (GPs), with experience in treating PLHIV, to understand the role they see for peer navigators (PNs) in supporting PLHIV. Semi‐structured in‐depth interviews were conducted with six GPs (11.5% of specialty HIV GPs in Queensland, Australia) to examine their views and experiences of peer navigation in the context of HIV care. GPs highlighted the complexities of care for PLHIV and the need for additional resources and supports for psychosocial care. GPs valued peer navigation as part of a patient support network and bridge to health and social care systems. PNs normalised HIV, alleviating fear and stigma, educating and translating clinical information for patients. However, a key challenge was the absence of direct communication pathways with PNs. Peer navigation has clear potential in supporting the care of PLHIV, to alleviate constraints in GP settings and expand HIV care beyond the clinic. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.anbehav.2005.04.003 Byline: Helen Simcox, Nick Colegrave, Adel Heenan, Chris Howard, Victoria A. Braithwaite Abstract: We used laboratory and field-based experiments to examine male mate choice in the promiscuous Panamanian bishop Brachyrhaphis episcopi (Poeciliidae) (also referred to as Brachyraphis episcopi). As females of this species can store sperm, males could increase their reproductive success by selectively mating with different females. To test this, males in both the laboratory and field were allowed to choose between a familiar (same tank or pool) and an unfamiliar female (different tank or pool). We compared males from streams and seasonally occurring pools to see whether lack of access to new females in pools promotes male mate choice for unfamiliarity. In addition, we chose streams and pools both with and without predatory fish to examine the influence of predation risk. In both the laboratory and the field, males attempted more matings with unfamiliar than familiar females. Field experiments showed that courtship preferences differed between males from populations with and without predatory fish: males from populations with predators were choosy only when light levels were dim, whereas males from populations without predators were choosy when light levels were brighter. Males from both streams and pools discriminated between familiar and unfamiliar females, but there were no differences in mating preferences between males from each habitat. Although the reasons for a preference for unfamiliar females remain unclear, the plasticity of this behaviour is evident. Differences in male mate choice between populations with and without predators suggest that males may face a trade-off between the costs and benefits of being choosy. Author Affiliation: Institute of Evolutionary Biology, University of Edinburgh, U.K. Article History: Received 12 October 2004; Revised 4 December 2004; Accepted 8 April 2005 Article Note: (miscellaneous) MS. number: 8297

A cascade of care model is central to contemporary approaches to HIV prevention. The model prioritizes strategies to increase rates of HIV testing and promote early and sustained uptake of antiretroviral treatment (ART) among people living with HIV (PLHIV). The model aims to prevent new HIV transmissions by increasing the number of PLHIV who have achieved HIV viral suppression. However, good quality of life (QoL) among PLHIV has been proposed as an additional goal. This prioritizes the basic right of PLHIV to lead meaningful lives and acknowledges the relationship between better QoL and consistent ART use. A better understanding of factors associated with the QoL can thus inform health promotion programmes for PLHIV. In this study, N =465 Australian participants, recruited through social media and various HIV community organizations, completed an online survey that included a measure of QoL and a range of demographic, health-related and social variables. Overall, social factors accounted uniquely for the most variance in QoL (18%), followed by health-related (11%) and demographic factors (2%). Social support, HIV-related discrimination and treatment convenience were among the strongest determinants of QoL. These findings reinforce the importance of a more holistic approach to health promotion among PLHIV. Specifically, our results indicate that to improve the QoL of PLHIV and to boost related public health benefits, community advocates and healthcare professionals must be responsive to the broader psychological, social and functional needs of PLHIV. [ABSTRACT FROM AUTHOR]

The lived experience of HIV for women remains poorly understood. In particular, there has been little attention to the consequences for women living with HIV (WLHIV) of changing social, epidemiological, biomedical and policy contexts, or to the implications of long-term treatment and aging for the current generation of HIV-positive women. We reviewed qualitative research with WLHIV in selected high-income countries (Australia, Canada, New Zealand, the UK and the USA) to identify the most prevalent experiences of HIV for women and trends over time. Our synthesis highlights the relative consistency of experiences of a diverse sample of WLHIV, particularly the enduring prevalence of gendered HIV-related stigma, sociostructural barriers to healthcare and support, and negative encounters with health professionals. We also identified gaps in knowledge. Understanding women's experiences, particularly their changing needs and strategies for coping as they live long-term with HIV, is key to effective support and services for WLHIV. [ABSTRACT FROM AUTHOR]