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Vu T, Quinn M, Womack J, Monin J. 'If I don't take care of me, then I can't be there for others:' a qualitative study of caregiving relationships among older women living with HIV. Aging Ment Health 2024; 28:1304-1315. [PMID: 38327025 DOI: 10.1080/13607863.2024.2313729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE The population of women ages 50 years and older living with HIV is increasing. Yet, little is known about the care networks that older women living with HIV (OWLH) use to manage their health. The goal of this study was to explore the caregiving and care receiving relationships among OWLH and how these relationships impact HIV management. METHODS OWLH aged 50 years and older were recruited from clinics and community-based organizations across the U.S. We conducted semi-structured, in-depth phone interviews and performed content and thematic analysis on transcripts. RESULTS Participants (N = 23) were on average 60 years old and had been living with HIV for an average of 23.7 years. Participants 1) relied on diverse care networks; 2) were caregivers for grandchildren and parents; 3) had pride and joy in being caregivers; and 4) were highly proactive in their own HIV management. Care networks promoted self-love and acceptance. However, concerns about aging with HIV were still highly prevalent. CONCLUSION Being a caregiver and care recipient are sources of meaning and strength to help OWLH manage HIV. Public health programs should consider engaging both OWLH and their care networks in healthcare discussions and educational efforts.
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Affiliation(s)
- Thi Vu
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Marielle Quinn
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Julie Womack
- Yale University School of Nursing, New Haven, CT, USA
| | - Joan Monin
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
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Huang H, Zhang L, Tu L, Zhang X, Zhong H, Liu Q, Liu Y, Chen H. The Impact of Stigma on Self-Management Behavior Among People with HIV in China: The Role of Social Support and Self-Esteem. AIDS Patient Care STDS 2024. [PMID: 39126267 DOI: 10.1089/apc.2024.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024] Open
Abstract
Understanding the psychosocial factors influencing self-management behaviors among people with HIV (PWH) is crucial for effective medical interventions and improving their quality of life. However, there has been limited research exploring the psychosocial mechanisms influencing self-management behaviors among PWH in China. Our study examined the relationship between stigma, social support, self-esteem, and self-management behaviors among PWH, as well as whether social support and self-esteem mediate these relationships. Cross-sectional data were collected from 282 PWH in Sichuan Province, China. Data were collected using four validated self-report measures (HIV Stigma Scale, HIV/AIDS Patient Self-Management Scale, Social Support Rating Scale, and Self-Esteem Scale). Structural equation modeling was used to examine the different pathways influencing self-management behaviors. All the impacts on self-management behavior outcomes were found to be significant. The final mediation model indicated that social support and self-esteem significantly mediated the relationship between stigma and self-management behaviors. These findings underscore the importance of addressing stigma and enhancing social support and self-esteem in interventions aimed at promoting self-management behaviors among PWH.
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Affiliation(s)
- Haitao Huang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Liao Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Ling Tu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaona Zhang
- School of Public Administration, Sichuan University, Chengdu, China
| | - Hua Zhong
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Qianwen Liu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Ying Liu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hong Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Malika N, Bogart LM, Mutchler MG, Goggin K, Klein DJ, Lawrence SJ, Wagner GJ. Loneliness Among Black/African American Adults Living with HIV: Sociodemographic and Psychosocial Correlates and Implications for Adherence. J Racial Ethn Health Disparities 2024; 11:2467-2474. [PMID: 37436685 PMCID: PMC11236909 DOI: 10.1007/s40615-023-01712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 07/13/2023]
Abstract
Loneliness, an emerging public health problem, is higher among people living with HIV and is associated with negative health outcomes. Black/African Americans have a high burden of HIV, and little is known about the characteristics of loneliness among Black adults living with HIV; therefore, this study sought to understand the sociodemographic and psychosocial correlates of Black adults living with HIV who are lonely and the implications of loneliness for their health outcomes. A sample of 304 Black adults living with HIV (73.8% sexual minority men) in Los Angeles County, CA, USA, completed the survey items assessing sociodemographic and psychosocial characteristics, social determinants of health, health outcomes, and loneliness. Antiretroviral therapy (ART) adherence was assessed electronically with the medication event monitoring system. Bivariate linear regressions analysis showed higher loneliness scores among those with higher levels of internalized HIV stigma, depression, unmet needs, and discrimination related to HIV serostatus, race, and sexual orientation. In addition, participants who were married or living with a partner, had stable housing, and reported receiving more social support had lower levels of loneliness. In multivariable regression models controlling for correlates of loneliness, loneliness was found to be a significant independent predictor of worse general physical health, worse general mental health, and greater depression. Loneliness was marginally associated with lower ART adherence. Findings suggest that Black adults living with HIV, who experience multiple intersectional stigmas, require targeted interventions and resources.
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Affiliation(s)
- Nipher Malika
- RAND Corporation, 1776 Main St, Santa Monica, CA, 90401, USA.
| | - Laura M Bogart
- RAND Corporation, 1776 Main St, Santa Monica, CA, 90401, USA
| | - Matt G Mutchler
- APLA Health & Wellness, Los Angeles, CA, USA
- California State University Dominguez Hills, Carson, CA, USA
| | - Kathy Goggin
- Children's Mercy Kansas City and University of Missouri-Kansas City, School of Medicine and Pharmacy, Kansas City, MO, USA
| | - David J Klein
- RAND Corporation, 1776 Main St, Santa Monica, CA, 90401, USA
| | | | - Glenn J Wagner
- RAND Corporation, 1776 Main St, Santa Monica, CA, 90401, USA
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Durevall D, Cowden RG, Beckett S, Kharsany ABM, Lewis L, George G, Cawood C, Khanyile D, Govender K. Associations of Social Support with Sexual Practices, Health Behaviours, and Health Outcomes Among Adolescent Girls and Young Women: Evidence From a Longitudinal Study in KwaZulu-Natal, South Africa. Int J Behav Med 2024; 31:620-630. [PMID: 37477850 PMCID: PMC11269318 DOI: 10.1007/s12529-023-10199-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Several studies have reported on the benefits of social support for health behaviour, including risky sex. Social support may thus be an important resource for promoting individual health and well-being, particularly in regions where HIV rates are high and healthcare resources are scarce. However, prior research on the implications of social support for the health behaviour of young women has yielded mixed and inconclusive findings. Using prospective data from young women in South Africa, this study examines the associations of social support with subsequent sexual practices, health behaviour, and health outcomes. METHOD We used two rounds of longitudinal data from a sample of n = 1446 HIV-negative emerging adult women, aged 18 to 29 years, who participated in a population-based HIV study in KwaZulu-Natal, South Africa. Applying the analytic template for outcome-wide longitudinal designs, we estimated the associations between combinations of social support (i.e. tangible, educational, emotional) and ten HIV risk-related outcomes. RESULTS Combinations of tangible, educational, and emotional support, as well as tangible support by itself, were associated with lower risk for several outcomes, whereas educational and emotional support, by themselves or together, showed little evidence of association with the outcomes. CONCLUSION This study highlights the protective role of tangible support in an environment of widespread poverty, and the additional effect of combining tangible support with non-tangible support. The findings strengthen recent evidence on the benefits of combining support in the form of cash and food with psychosocial care in mitigating risk behaviours associated with HIV and negative health outcomes among young women.
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Affiliation(s)
- Dick Durevall
- Department of Economics, School of Economics, University of Gothenburg, Gothenburg, Sweden.
| | - Richard G Cowden
- Human Flourishing Program, Harvard University, Cambridge, MA, USA
| | - Sean Beckett
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Ayesha B M Kharsany
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
- School of Laboratory Medicine and Medical Science, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Lara Lewis
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Gavin George
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Cherie Cawood
- Epicentre AIDS Risk Management (Pty) Limited, Cape Town, South Africa
| | - David Khanyile
- Epicentre AIDS Risk Management (Pty) Limited, Cape Town, South Africa
| | - Kaymarlin Govender
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
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5
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Hu S, Jing F, Fan C, Dai Y, Xie Y, Zhou Y, Lv H, He X, Wu D, Tucker JD, Tang W. Social network strategies to distribute HIV self-testing kits: a global systematic review and network meta-analysis. J Int AIDS Soc 2024; 27:e26342. [PMID: 39048927 PMCID: PMC11269052 DOI: 10.1002/jia2.26342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 07/11/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION Social network strategies, in which social networks are utilized to influence individuals or communities, are increasingly being used to deliver human immunodeficiency virus (HIV) interventions to key populations. We summarized and critically assessed existing research on the effectiveness of social network strategies in promoting HIV self-testing (HIVST). METHODS Using search terms related to social network interventions and HIVST, we searched five databases for trials published between 1st January 2010 and 30th June 2023. Outcomes included uptake of HIV testing, HIV prevalence and linkage to antiretroviral therapy (ART) or HIV care. We used network meta-analysis to assess the uptake of HIV testing through social network strategies compared with control methods. A pairwise meta-analysis of studies with a comparison arm that reported outcomes was performed to assess relative risks (RR) and their corresponding 95% confidence intervals (CI). RESULTS Among the 4496 manuscripts identified, 39 studies fulfilled the inclusion criteria, including one quasi-experimental study, 22 randomized controlled trials and 16 observational studies. Networks HIVST testing was organized by peers (distributed to known peers, 15 studies), partners (distributed to their sexual partners, 16 studies) and peer educators (distributed to unknown peers, 8 studies). Among social networks, simulating the possibilities of ranking position, peer distribution had the highest uptake of HIV testing (84% probability), followed by partner distribution (80% probability) and peer educator distribution (74% probability). Pairwise meta-analysis showed that peer distribution (RR 2.29, 95% CI 1.54-3.39, 5 studies) and partner distribution (RR 1.76, 95% CI 1.50-2.07, 10 studies) also increased the probability of detecting HIV reactivity during testing within the key population when compared to the control. DISCUSSION All of the three social network distribution strategies enhanced the uptake of HIV testing compared to standard facility-based testing. Linkage to ART or HIV care remained comparable to facility-based testing across the three HIVST distribution strategies. CONCLUSIONS Network-based HIVST distribution is considered effective in augmenting HIV testing rates and reaching marginalized populations compared to facility-based testing. These strategies can be integrated with the existing HIV care services, to fill the testing gap among key populations globally. PROSPERO NUMBER CRD42022361782.
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Affiliation(s)
- Siyue Hu
- Dermatology Hospital of Southern Medical UniversityGuangzhouChina
- School of Public HealthSouthern Medical UniversityGuangzhouChina
- University of North Carolina Project – ChinaGuangzhouChina
| | - Fengshi Jing
- Faculty of Data ScienceCity University of MacauTaipaChina
| | - Chengxin Fan
- University of North Carolina Project – ChinaGuangzhouChina
- School of Public HealthNanjing Medical UniversityNanjingChina
| | - Yifan Dai
- Dermatology Hospital of Southern Medical UniversityGuangzhouChina
- School of Public HealthSouthern Medical UniversityGuangzhouChina
- University of North Carolina Project – ChinaGuangzhouChina
| | - Yewei Xie
- Programme in Health Services and Systems Research, Duke‐NUS Medical SchoolSingapore
| | - Yi Zhou
- Zhuhai Center for Diseases Control and PreventionZhuhaiChina
| | - Hang Lv
- Zhuhai Center for Diseases Control and PreventionZhuhaiChina
| | - Xi He
- Zhuhai Xutong Voluntary Services CenterZhuhaiChina
| | - Dan Wu
- University of North Carolina Project – ChinaGuangzhouChina
- School of Public HealthNanjing Medical UniversityNanjingChina
- London School of Hygiene and Tropical MedicineLondonUK
| | - Joseph D. Tucker
- University of North Carolina Project – ChinaGuangzhouChina
- London School of Hygiene and Tropical MedicineLondonUK
| | - Weiming Tang
- Dermatology Hospital of Southern Medical UniversityGuangzhouChina
- University of North Carolina Project – ChinaGuangzhouChina
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Avallone F, Hickson F. Sexual Health Needs Among Men Who Engage in Transactional Sex with Men in the UK. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2397-2404. [PMID: 38467959 DOI: 10.1007/s10508-024-02838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 12/30/2023] [Accepted: 02/18/2024] [Indexed: 03/13/2024]
Abstract
Men who engage in transactional sex with men (MTSM) are a high-risk population for HIV and other sexually transmitted infections. Epidemiological data have so far included them in the broad category of men who have sex with men (MSM), while research on transactional sex typically focused on female sex workers. The internet has substantially changed sex work practices and earlier findings concerning the sexual health needs of MTSM may no longer be applicable. We analyzed quantitative data from MSM based in the UK (n = 11629) taking part in the European MSM Internet Survey (EMIS-2017). Compared to non-MTSM, MTSM (n = 230; 2%) were younger, more likely to self-identify as an ethnic minority, be single, have lower education levels, struggle financially, and-controlling for age-more likely to be living with diagnosed HIV. Commonly unmet needs among all MSM were a lack of confidence in accessing HIV post-exposure prophylaxis, uncertainty about HIV status, and ignorance of where to access hepatitis vaccinations. Compared with other MSM, MTSM were notably less satisfied with the safety of their sexual practices, less confident in their ability to maintain sexual boundaries, and more likely to engage in risk because of absent precautionary resources. Given their greater opportunity for sexual risk, as well as fewer resources for negotiating safety, our findings suggest that services should prioritize MTSM in HIV prevention and sexual health promotion, including assertiveness and social skills training, in addition to knowledge-based education.
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Affiliation(s)
- Francesco Avallone
- Department of Family Medicine, McGill University, Montreal, QC, H3S 1Z1, Canada.
- Center for Outcomes Research and Evaluation Research Institute, McGill University Health Centre, Montreal, QC, Canada.
| | - Ford Hickson
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Tam C, Wesseling T, Wang L, Salters K, Moore DM, Dawydiuk N, Zhu J, Grieve S, Bingham B, McLinden T, Hogg R, Barrios R. It's all about connection: Determinants of social support and the influence on HIV treatment interruptions among people living with HIV in British Columbia, Canada. BMC Public Health 2023; 23:2524. [PMID: 38104090 PMCID: PMC10725596 DOI: 10.1186/s12889-023-17416-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Social support has previously been found to be associated with improved health outcomes of individuals managing chronic illnesses, including amongst people living with HIV (PLWH). For women and people who use injection drugs who continue to experience treatment disparities in comparison to other PLWH, social support may have potential in facilitating better treatment engagement and retention. In this analysis, we examined determinants of social support as measured by the Medical Outcomes Study - Social Support Survey (MOS-SSS) scale, and quantified the relationship between MOS-SSS and HIV treatment interruptions (TIs) among PLWH in British Columbia, Canada. METHODS Between January 2016 and September 2018, we used purposive sampling to enroll PLWH, 19 years of age or older living in British Columbia into the STOP HIV/AIDS Program Evaluation study. Participants completed a baseline survey at enrolment which included the MOS-SSS scale, where higher MOS-SSS scores indicated greater social support. Multivariable linear regression modeled the association between key explanatory variables and MOS-SSS scores, whereas multivariable logistic regression modeled the association between MOS-SSS scores and experiencing TIs while controlling for confounders. RESULTS Among 644 PLWH, we found that having a history of injection drug use more than 12 months ago but not within the last 12 months, self-identifying as Indigenous, and sexual activity in the last 12 months were positively associated with MOS-SSS, while being single, divorced, or dating (vs. married), experiences of lifetime violence, and diagnosis of a mental health disorder were inversely associated. In a separate multivariable model adjusted for gender, ethnicity, recent homelessness, sexual activity in the last 12 months, and recent injection drug use, we found that higher MOS-SSS scores, indicating more social support, were associated with a lower likelihood of HIV treatment interruptions (adjusted odds ratio: 0.90 per 10-unit increase, 95% confidence interval: 0.83, 0.99). CONCLUSIONS Social support may be an important protective factor in ensuring HIV treatment continuity among PLWH. Future research should examine effective means to build social support among communities that have potential to promote increased treatment engagement.
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Affiliation(s)
- Clara Tam
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada.
| | - Tim Wesseling
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
| | - Lu Wang
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
| | - Kate Salters
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - David M Moore
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Nicole Dawydiuk
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
| | - Julia Zhu
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
| | - Sean Grieve
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
| | - Brittany Bingham
- Centre for Gender & Sexual Health Equity, University of British Columbia, Vancouver, Canada
- Indigenous Health, Vancouver Coastal Health, Vancouver, Canada
| | - Taylor McLinden
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Robert Hogg
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Rolando Barrios
- Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z1Y6, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Hu S, Jing F, Fan C, Dai Y, Xie Y, Zhou Y, Lv H, He X, Wu D, Tucker JD, Tang W. Social Network Strategies to Distribute HIV Self-testing Kits: A Global Systematic Review and Network Meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.05.23298135. [PMID: 37986939 PMCID: PMC10659482 DOI: 10.1101/2023.11.05.23298135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Introduction Social network strategies, in which social networks are utilized to influence individuals or communities, are increasingly being used to deliver human immunodeficiency virus (HIV) interventions to key populations. We summarized and critically assessed existing research on the effectiveness of social network strategies in promoting HIV self-testing (HIVST). Methods Using search terms related to social network interventions and HIVST, we searched five databases for trials published between January 1st, 2010, and June 30th, 2023. Outcomes included uptake of HIV testing, HIV seroconversion, and linkage to antiretroviral therapy (ART) or HIV Care. We used network meta-analysis to assess the uptake of HIV testing through social network strategies compared with control methods. A pairwise meta-analysis of studies with a comparison arm that reported outcomes was performed to assess relative risks (RR) and their corresponding 95% confidence intervals (CI). Results and discussion Among the 3,745 manuscripts identified, 33 studies fulfilled the inclusion criteria, including one quasi-experimental study, 17 RCTs and 15 observational studies. Networks HIVST testing was organized by peers (distributed to known peers, 15 studies), partners (distributed to their sexual partners, 10 studies), and peer educators (distributed to unknown peers, 8 studies). The results showed that all of the three social network distribution strategies enhanced the uptake of HIV testing compared to standard facility-based testing. Among social networks, peer distribution had the highest uptake of HIV testing (79% probability, SUCRA 0.92), followed by partner distribution (72% probability, SUCRA 0.71), and peer educator distribution (66% probability, SUCRA 0.29). Pairwise meta-analysis showed that peer distribution (RR 2.29, 95% CI 1.54-3.39, 5 studies) and partner distribution (RR 1.45, 95% CI 1.05-2.02, 7 studies) also increased the probability of detecting HIV reactivity during testing within the key population when compared to the control. Linkage to ART or HIV Care remained comparable to facility-based testing across the three HIVST distribution strategies. Conclusions Network-based HIVST distribution is considered effective in augmenting HIV testing rates and reaching marginalized populations compared to facility-based testing. These strategies can be integrated with the existing HIV care services, to fill the testing gap among key populations globally.PROSPERO Number: CRD42022361782.
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Affiliation(s)
- Siyue Hu
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
- University of North Carolina Project – China, Guangzhou, China
| | - Fengshi Jing
- Faculty of Data Science, City University of Macau, Taipa, Macao SAR, China
| | - Chengxin Fan
- University of North Carolina Project – China, Guangzhou, China
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yifan Dai
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
- University of North Carolina Project – China, Guangzhou, China
| | - Yewei Xie
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Yi Zhou
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Hang Lv
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Xi He
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | - Dan Wu
- University of North Carolina Project – China, Guangzhou, China
- School of Public Health, Nanjing Medical University, Nanjing, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph D. Tucker
- University of North Carolina Project – China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- University of North Carolina Project – China, Guangzhou, China
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9
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Green HD, Grant JD, Henschel B, Johnson L, Wei X, Wagner KD. Characteristics of Individuals Seen as Sources of Social Support in Populations at Increased Risk for HIV. AIDS Behav 2023; 27:3447-3459. [PMID: 37052786 DOI: 10.1007/s10461-023-04059-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/14/2023]
Abstract
Access to social support from one's social network can serve as a protective factor against HIV infection; however, research exploring the availability of support in diverse populations that include high proportions of people at increased risk for HIV and the characteristics of network members associated with access to such support is limited. Multi-level dyadic analyses of social network data collected from women at risk for HIV and their network members reveal which individual and relationship characteristics of network members are associated with providing emotional, material, and/or health informational support. Results indicate that access to all three types of support was associated with a network member being a friend, a member of a participant's 'core' group, someone whose opinion matters to the respondent, and the respondent trusting them. These findings have implications for interventions designed to increase access to support among individuals at risk for HIV.
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Affiliation(s)
- Harold D Green
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA.
- Department of Applied Health Science, Indiana University School of Public Health, 809 E. 9th St., Room 201, Bloomington, IN, 47405, USA.
| | - Jeffrey D Grant
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - Beate Henschel
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Laura Johnson
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | - Xing Wei
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | - Karla D Wagner
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
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10
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Storholm ED, Reynolds HE, Muthuramalingam S, Nacht CL, Felner JK, Wagner GJ, Stephenson R, Siconolfi DE. Intimate Partner Violence and the Sexual Health of Sexual Minority Men. LGBT Health 2023; 10:S39-S48. [PMID: 37754928 PMCID: PMC10623463 DOI: 10.1089/lgbt.2023.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Purpose: This qualitative study explores the pathways by which various forms of intimate partner violence (IPV) impact the sexual health behaviors of cisgender identified sexual minority men (SMM). Methods: Semi-structured interviews were conducted with 23 racially and ethnically diverse SMM who recently experienced IPV and 10 clinical and social service providers focused on how experiences of IPV directly or indirectly influences sexual risk as well as engagement in HIV prevention behaviors (e.g., pre-exposure prophylaxis [PrEP] use). Applied thematic analysis, including cycles of analytic memo writing and coding, aided the identification of patterns across the data. Results: Analyses yielded three overarching themes: use of condoms, use of PrEP, and HIV and sexually transmitted infections (STIs). Participants described different ways condom use or nonuse was a mechanism by which power and/or control might be asserted by one partner over the other partner. A range of responses to questions about PrEP were identified, including partners encouraging PrEP use, as well as avoidance of conversations about PrEP or actual PrEP use, to prevent experiencing aggression or IPV from partners. Responses regarding HIV/STIs included those ranging from a new diagnosis being a potential trigger for violence to the exploitation of status to control partners. Conclusion: These findings suggest that in relationships with IPV, HIV prevention strategies can be sources of relationship control and trigger abuse. Addressing IPV may help to prevent HIV/STI transmission and promote the health of SMM. In addition, long-acting formulations of PrEP may be a promising strategy for SMM experiencing IPV when oral PrEP medications may be a risk factor for violence.
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Affiliation(s)
- Erik D. Storholm
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Hannah E. Reynolds
- School of Public Health, San Diego State University, San Diego, California, USA
| | | | - Carrie L. Nacht
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Jennifer K. Felner
- School of Public Health, San Diego State University, San Diego, California, USA
| | | | - Rob Stephenson
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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Stoner MCD, Kelly NK, Gomez-Olive FX, Kahn K, Wagner D, Bhushan NL, Aiello AE, Pettifor AE. Relationships Between Stress-Responsive Biomarkers, ART Adherence, and Viral Suppression Among Adolescent Girls and Young Women Living With HIV in South Africa: An HPTN 068 Analysis. J Acquir Immune Defic Syndr 2023; 92:349-358. [PMID: 36729676 PMCID: PMC10006401 DOI: 10.1097/qai.0000000000003149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Adolescent girls and young women (AGYW) living with HIV who have higher stress levels may be at risk of stress-related biological alterations, which could influence HIV progression and adherence to antiretroviral therapy (ART). SETTING We aimed to estimate associations among stress-responsive biomarkers, ART adherence, and viral suppression in AGYW living with HIV in South Africa. We also hypothesized that psychosocial stressors [eg, depression, food insecurity, low socioeconomic status (SES), and HSV-2] would be associated with higher biomarker levels. METHODS We used 2018/2019 data from the HIV Prevention Trials Network 068 cohort to assess associations between stress-responsive biomarkers and viral suppression (<1000 copies/mL) and ART adherence measured using dried blood spot cards. Stress-responsive biomarkers included C-reactive protein, herpes simplex virus type 1, and cytomegalovirus infection and reactivation. Associations were estimated using unadjusted log-binomial or ordinal logistic regression models. RESULTS In 166 AGYW living with HIV, there was no association between stress-responsive biomarkers and viral suppression or ART adherence. However, increased C-reactive protein levels were associated with higher HSV-2 infection [odds ratio (OR) 1.98; 95% confidence interval (CI) 1.11, 3.52], being a government grant recipient (OR 3.21; 95% CI: 1.30, 7.92), lower food insecurity (OR 0.34; 95% CI: 0.13, 0.90), and increased body mass index (OR 1.07; 95% CI: 1.01, 1.14). CONCLUSIONS High prevalence of psychosocial stressors and persistent herpesviruses in AGYW living with HIV has the potential to lead to poorer health outcomes. More research is needed to untangle relationships between economic stability, chronic disease, and chronic stress.
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Affiliation(s)
- Marie C D Stoner
- Women's Global Health Imperative, RTI International, Berkeley, CA
| | - Nicole K Kelly
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC
| | - F Xavier Gomez-Olive
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Danielle Wagner
- Women's Global Health Imperative, RTI International, Berkeley, CA
| | - Nivedita L Bhushan
- Center for Communication Science, RTI International, Research Triangle Park, NC
| | - Allison E Aiello
- Department of Epidemiology, Robert N Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, USA
| | - Audrey E Pettifor
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC
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Bose DL, Hundal A, Singh S, Singh S, Seth K, Hadi SU, Saran A, Joseph J, Goyal K, Salve S. Evidence and gap map report: Social and Behavior Change Communication (SBCC) interventions for strengthening HIV prevention and research among adolescent girls and young women (AGYW) in low- and middle-income countries (LMICs). CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1297. [PMID: 36911864 PMCID: PMC9831290 DOI: 10.1002/cl2.1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Adolescent girls and young women (AGYW), aged 15-24 years, are disproportionately affected by HIV and other sexual and reproductive health (SRH) risks due to varying social, cultural, and economic factors that affect their choices and shape their knowledge, understanding, and practices with regard to their health. Socio-Behavioral Change Communication (SBCC) interventions targeted at strengthening the capabilities of individuals and their networks have supported the demand and uptake of prevention services and participation in biomedical research. However, despite growing global recognition of the domain, high-quality evidence on the effectiveness of SBCC remains scattered. This evidence and gap map (EGM) report characterizes the evidence base on SBCC interventions for strengthening HIV Prevention and Research among AGYW in low- and middle-income countries (LMICs), identifying evidence gaps and outlining the scope of future research and program design. OBJECTIVES The objectives of the proposed EGM are to: (a) identify and map existing EGMs in the use of diverse SBCC strategies to strengthen the adoption of HIV prevention measures and participation in research among AGYW in LMICs and (b) identify areas where more interventions and evidence are needed to inform the design of future SBCC strategies and programs for AGYW engagement in HIV prevention and research. METHODS This EGM is based on a comprehensive search of systematic reviews and impact evaluations corresponding to a range of interventions and outcomes-aimed at engaging AGYW in HIV prevention and research - that were published in LMICs from January 2000 to April 2021. Based on guidance for producing a Campbell Collaboration EGM, the intervention and outcome framework was designed in consultation with a group of experts. These interventions were categorized across four broad intervention themes: mass-media, community-based, interpersonal, and Information Communication and Technology (ICT)/Digital Media-based interventions. They were further sub-categorized into 15 intervention categories. Included studies looked at 23 unique behavioral and health outcomes such as knowledge attitude and skills, relationship dynamics, household dynamics, health care services, and health outcomes and research engagement. The EGM is presented as a matrix in which the rows are intervention categories/sub-categories, and the columns are outcome domains/subdomains. Each cell is mapped to an intervention targeted at outcomes. Additional filters like region, country, study design, age group, funding agency, influencers, population group, publication status, study confidence, setting, and year of publication have been added. SELECTION CRITERIA To be eligible, studies must have tested the effectiveness of SBCC interventions at engaging AGYW in LMICs in HIV prevention and research. The study sample must have consisted of AGYW between the ages of 15-24, as defined by UNAIDS. Both experimental (random assignment) and quasi-experimental studies that included a comparison group were eligible. Relevant outcomes included those at the individual, influencer, and institutional levels, along with those targeting research engagement and prevention-related outcomes. RESULTS This EGM comprises 415 impact evaluations and 43 systematic reviews. Interventions like peer-led interactions, counseling, and community dialogues were the most dominant intervention sub-types. Despite increased digital penetration use of media and technology-driven interventions are relatively less studied. Most of the interventions were delivered by peers, health care providers, and educators, largely in school-based settings, and in many cases are part of sex-education curricula. Evidence across geographies was mostly concentrated in Sub-Saharan Africa (70%). Most measured outcomes focused on disease-related knowledge dissemination and enhancing awareness of available prevention options/strategies. These included messaging around consistent condom use, limiting sexual partners, routine testing, and awareness. Very few studies were able to include psychographic, social, and contextual factors influencing AGYW health behaviors and decisions, especially those measuring the impact of social and gender norms, relationship dynamics, and household dynamics-related outcomes. Outcomes related to engagement in the research were least studied. CONCLUSION This EGM highlights that evidence is heavily concentrated within the awareness-intent spectrum of behavior change and gets lean for outcomes situated within the intent-action and the action-habit formation spectrum of the behavior change continuum. Most of the evidence was concentrated on increasing awareness, knowledge, and building risk perception around SRH domains, however, fewer studies focused on strengthening the agency and self-efficacy of individuals. Similarly, evidence on extrinsic factors-such as strengthening social and community norms, relationships, and household dynamics-that determine individual thought and action such as negotiation and life skills were also found to be less populated. Few studies explore the effectiveness of these interventions across diverse AGYW identities, like pregnant women and new mothers, sex workers, and people living with HIV, leading to limited understanding of the use of these interventions across multiple user segments including key influencers such as young men, partners, families, religious leaders, and community elders was relatively low. There is a need for better quality evidence that accounts for the diversity of experiences within these populations to understand what interventions work, for whom, and toward what outcome. Further, the evidence for use of digital and mass-media tools remains poorly populated. Given the increasing penetration of these tools and growing media literacy on one end, with widening gender-based gaps on the other, it is imperative to gather more high-quality evidence on their effectiveness. Timely evidence generation can help leverage these platforms appropriately and enable intervention designs that are responsive to changing communication ecologies of AGYW. SBCC can play a critical role in helping researchers meaningfully engage and collaborate with communities as equal stakeholders, however, this remains poorly evidenced and calls for investigation and investment. A full list of abbreviations and acronyms are available in Supporting Information: Appendix F.
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13
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Zakimi N, Greer A, Bouchard M, Dhillon A, Ritter A. Sociometric network analysis in illicit drugs research: A scoping review. PLoS One 2023; 18:e0282340. [PMID: 36848370 PMCID: PMC9970099 DOI: 10.1371/journal.pone.0282340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 02/12/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Sociometric or whole network analysis, a method used to analyze relational patterns among social actors, emphasizes the role of social structure in shaping behaviour. Such method has been applied to many aspects of illicit drug research, including in the areas of public health, epidemiology, and criminology. Previous reviews about social networks and drugs have lacked a focus on the use of sociometric network analysis for illicit drugs research across disciplines. The current scoping review aimed to provide an overview of the sociometric network analysis methods used in illicit drugs research and to assess how such methods could be used for future research. METHODS A systematic search of six databases (Web of Science, ProQuest Sociology Collection, Political Science Complete, PubMed, Criminal Justice Abstracts, and PsycINFO) returned 72 relevant studies that met the inclusion criteria. To be included, studies had to mention illicit drugs and use whole social network analysis as one of their methods. Studies were summarized quantitatively and qualitatively using a data-charting form and a description of the studies' main topics. RESULTS Sociometric network analysis in illicit drugs research has grown in popularity in the last decade, using mostly descriptive network metrics, such as degree centrality (72.2%) and density (44.4%). Studies were found to belong to three study domains. The first, drug crimes investigated network resilience and collaboration patterns in drug trafficking networks. The second domain, public health, focused on the social networks and social support of people who use drugs. Finally, the third domain focused on the collaboration networks of policy, law enforcement, and service providers. CONCLUSION Future illicit drugs research using whole network SNA should include more diverse data sources and samples, incorporate mixed and qualitative methods, and apply social network analysis to study drug policy.
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Affiliation(s)
- Naomi Zakimi
- School of Criminology, Simon Fraser University, Burnaby, British Columbia, Canada
- * E-mail:
| | - Alissa Greer
- School of Criminology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Martin Bouchard
- School of Criminology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Arshpreet Dhillon
- School of Criminology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Alison Ritter
- Drug Policy Modelling Program, Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
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14
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Validation of Multidimensional Scale of Perceived Social Support (MSPSS) in Vietnamese Among People Living with HIV/AIDS. AIDS Behav 2023:10.1007/s10461-022-03974-1. [PMID: 36622488 DOI: 10.1007/s10461-022-03974-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 01/10/2023]
Abstract
Social support plays a vital role in the health of HIV/AIDS patients, but there needs to be a validated instrument to measure social support in Vietnam. This cross-sectional study was to validate a Vietnamese translation of the Multidimensional Perceived Social Support Scale (MSPSS). The study had three stages: [1] translation to Vietnamese, [2] pilot testing, and [3] validation of the translation. Stage 1, including forward and backward translation by four independent translators, resulted in a good content validity translation. Pilot testing was done on 30 HIV/AIDS patients: the translation was understandable, and no change was required. Five hundred HIV/AIDS patients were recruited in stage 3. The translation had excellent internal consistency (Cronbach's alpha: 0.90), good test-retest reliability (intra-class correlation coefficient: 0.95), and good concurrent validity. Construct validity was well established by confirmatory factor analysis. The Vietnamese translation of the MSPSS is reliable and valuable for measuring perceived social support.
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Tassiopoulos K, Travers R, Cameron R, Coulombe S, Davis CE, Wilson CL, Woodford MR, Coleman T. Knowledge of viral load, PrEP, and HIV-related sexual risk among men who have sex with men in the Waterloo region. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2022. [DOI: 10.3138/cjhs.2021-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gay, bisexual, and other men who have sex with men (GBMSM) remain most disproportionately affected by HIV in Canada. HIV-related sexual risk behaviours have been linked to high HIV risk among GBMSM, but prior research has not focused on knowledge of viral load, and the risk it presents for HIV acquisition. The purpose of this study was to explore the relationship between HIV-related sexual risk behaviour and knowledge of viral load among GBMSM. A cross-sectional survey was conducted using a convenience sample of individuals age 16 and older who self-identified as LGBTQ and lived, worked, or resided in the Waterloo region, an urban-rural area in southwestern Ontario ( N = 526). Responses were analyzed from those identifying as GBMSM ( N = 269). Logistic regression models were created to explore sociodemographic, outness, social support, and HIV-related sexual risk variables associated with knowledge of viral load. Multivariable regression models were built to explore the same associations while controlling for confounders. HIV risk was not associated with knowledge of viral load in bivariate or multivariable analyses. Point estimates for low/negligible (odds ratio [OR] 1.10; 95% CI 0.46–2.51) and high risk (OR 1.88; 95% CI 0.68–5.20) suggest trends of higher knowledge with increased HIV risk. Men who engage in sexual risk behaviour may have increased sexual health literacy and awareness of biomedical interventions (e.g., pre-exposure prophylaxis, or PrEP) that reduce HIV risk. Policies are needed that promote acceptance of sexual orientation, improve awareness and access to PrEP, and ensure optimal delivery of HIV education to at-risk groups prior to engagement in higher risk activities.
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Affiliation(s)
- Karina Tassiopoulos
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ruth Cameron
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
- AIDS Committee of Cambridge, Kitchener, Waterloo, Kitchener, Ontario, Canada
| | - Simon Coulombe
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Charlie E. Davis
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ciann L. Wilson
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Michael R. Woodford
- Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada
| | - Todd Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
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Ndimande-Khoza MN, Scorgie F, Delany-Moretlwe S, Selin A, Twine R, Kahn K, Pettifor A, MacPhail C. The impact of conditional cash transfers for HIV prevention on peer relationships: perspectives from female recipients and non-recipients in HPTN 068. BMC Public Health 2022; 22:2230. [PMID: 36451178 PMCID: PMC9710134 DOI: 10.1186/s12889-022-14529-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/02/2022] [Indexed: 12/05/2022] Open
Abstract
CCTs are currently being explored for HIV prevention among adolescent girls and young women (AGYW) in Southern Africa. However, little is known about how CCT geared towards adolescents' influence peer relationships, despite evidence that peer relationships form a critical part of development in adolescence. This article presents findings from a qualitative study that explored CCT recipients' and non-recipients' perspectives on the impact of CCTs paid to AGYW on peer relationships.HPTN 068 was a randomised controlled trial that assessed whether providing CCT to AGYW and their households reduces AGYW's risk of acquiring HIV. As part of this trial, we conducted interviews and focus group discussions with sub-samples of AGYW (n = 39), who were both cash recipients and non-recipients. Through content analysis, we explored ways in which the CCT positively or negatively impacted on peer relationships.From the recipients' viewpoint, the CCT improved their social standing within their peer groups. It facilitated peer identity and promoted social connectedness among AGYW receiving the CCT. Receipt of the CCT enabled AGYW to resemble and behave like their peers who had money, allowing their poverty to become "invisible". The CCT facilitated social interactions, information sharing, and instrumental social support among AGYW. CCT recipients experienced an increase in their social capital, evident in their ability to network, share, and reciprocate with others. However, the CCT also evoked negative emotions such as jealousy, anxiety, and resentment among non-recipients and led to a deterioration of personal relationships.CCTs have enormous benefits for AGYW, but they may also have a negative impact on peer relationships. The implementation of HIV prevention interventions focused on structural drivers needs to be conscious of these dynamics and ensure that the negative consequences do not outweigh benefits.
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Affiliation(s)
| | - Fiona Scorgie
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sinead Delany-Moretlwe
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Amanda Selin
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Audrey Pettifor
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, University of North Carolina, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Catherine MacPhail
- Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
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Doan LP, Nguyen LH, Auquier P, Boyer L, Fond G, Nguyen HT, Latkin CA, Vu GT, Hall BJ, Ho CSH, Ho RCM. Social network and HIV/AIDS: A bibliometric analysis of global literature. Front Public Health 2022; 10:1015023. [PMID: 36408016 PMCID: PMC9666395 DOI: 10.3389/fpubh.2022.1015023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
Social networks (SN) shape HIV risk behaviors and transmission. This study was performed to quantify research development, patterns, and trends in the use of SN in the field of HIV/AIDS, and used Global publications extracted from the Web of Science Core Collection database. Networks of countries, research disciplines, and most frequently used terms were visualized. The Latent Dirichlet Allocation method was used for topic modeling. A linear regression model was utilized to identify the trend of research development. During the period 1991-2019, in a total of 5,698 publications, topics with the highest volume of publications consisted of (1) mental disorders (16.1%); (2) HIV/sexually transmitted infections prevalence in key populations (9.9%); and (3) HIV-related stigma (9.3%). Discrepancies in the geographical distribution of publications were also observed. This study highlighted (1) the rapid growth of publications on a wide range of topics regarding SN in the field of HIV/AIDS, and (2) the importance of SN in HIV prevention, treatment, and care. The findings of this study suggest the need for interventions using SN and the improvement of research capacity via regional collaborations to reduce the HIV burden in low- and middle-income countries.
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Affiliation(s)
- Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam,*Correspondence: Linh Phuong Doan
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Pascal Auquier
- Research Center on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Laurent Boyer
- Research Center on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Guillaume Fond
- Research Center on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Giang Thu Vu
- Center of Excellence in Health Services and System Research, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Brian J. Hall
- School of Global Public Health, New York University, New York, NY, United States
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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18
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Tassiopoulos K, Travers R, Cameron R, Coulombe S, Davis CE, Wilson CL, Woodford MR, Coleman T. Knowledge of viral load, PrEP, and HIV-related sexual risk among men who have sex with men in the Waterloo region. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2022. [DOI: 10.3138/cjhs.2022-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Gay, bisexual, and other men who have sex with men (GBMSM) remain most disproportionately affected by HIV in Canada. HIV-
related sexual risk behaviours have been linked to high HIV risk among GBMSM, but prior research has not focused on knowledge of viral load, and the risk it presents for HIV acquisition. The purpose of this study was to explore the relationship between HIV-related sexual risk behaviour and knowledge of viral load among GBMSM. A cross-sectional survey was conducted using a convenience sample of individuals age 16 and older who self-identified as LGBTQ and lived, worked, or resided in the Waterloo region, an urban-rural area in southwestern Ontario ( N = 526). Responses were analyzed from those identifying as GBMSM ( N = 269). Logistic regression models were created to explore sociodemographic, outness, social support, and HIV-related sexual risk variables associated with knowledge of viral load. Multivariable regression models were built to explore the same associations while controlling for confounders. HIV risk was not associated with knowledge of viral load in bivariate or multivariable analyses. Point estimates for low/negligible (odds ratio [OR] 1.10; 95% CI 0.46–2.51) and high risk (OR 1.88; 95% CI 0.68–5.20) suggest trends of higher knowledge with increased HIV risk. Men who engage in sexual risk behaviour may have increased sexual health literacy and awareness of biomedical interventions (e.g., pre-exposure prophylaxis, or PrEP) that reduce HIV risk. Policies are needed that promote acceptance of sexual orientation, improve awareness and access to PrEP, and ensure optimal delivery of HIV education to at-risk groups prior to engagement in higher risk activities.
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Affiliation(s)
- Karina Tassiopoulos
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ruth Cameron
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
- AIDS Committee of Cambridge, Kitchener, Waterloo, Kitchener, Ontario, Canada
| | - Simon Coulombe
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Charlie E. Davis
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ciann L. Wilson
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Michael R. Woodford
- Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada
| | - Todd Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
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Meanley S, Sexton Topper P, Listerud L, Bonett SK, Watson D, Choi SK, Teixeira Da Silva D, Flores DD, James R, Bauermeister JA. Leveraging Resilience-supportive Strategies to Enhance Protective Factors in Young Sexual Minority Men: A Scoping Review of HIV Behavioral Interventions Implemented in High-income Countries. JOURNAL OF SEX RESEARCH 2022; 59:957-983. [PMID: 35080999 DOI: 10.1080/00224499.2021.2024789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Behavioral HIV interventions focused on strengthening young sexual minority men's (SMM) internal (assets) and external (resources) protective factors are promising, yet their evaluation as resilience-supportive strategies to minimize or negate HIV-related risks remain understudied. The objective of this scoping review was to describe resilience-supportive intervention strategies that have been used to achieve desired HIV behavioral outcomes and to identify how these strategies have been evaluated using a resilience analytic framework. Our scoping review uncovered 271 peer-reviewed articles, of which 38 were eligible for inclusion based on our review criteria. The majority of interventions relied on social support strategies as their primary resilience-supportive strategy. A third of interventions reviewed analyzed their findings from a deficits-focused model, another third used compensatory resilience models, and the remaining interventions employed a hybrid (i.e., deficit and compensatory model) strategy. None of the interventions evaluated their intervention effects using a risk-protective model. From our synthesis regarding the current state of research around resilience-informed interventions, we propose strategies to inform the design of resilience-supportive approaches and make recommendations to move the field forward on how to develop, implement, and measure young SMM's resiliency processes.
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Affiliation(s)
- Steven Meanley
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Patrina Sexton Topper
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Louis Listerud
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Stephen K Bonett
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- University of Pennsylvania Leonard Davis Institute of Health Economics
| | - Dovie Watson
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- School of Medicine, Division of Infectious Diseases, University of Pennsylvania Perelman
| | - Seul Ki Choi
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Daniel Teixeira Da Silva
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- University of Pennsylvania Leonard Davis Institute of Health Economics
- School of Medicine National Clinician Scholar, University of Pennsylvania Perelman
| | - Dalmacio D Flores
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | | | - José A Bauermeister
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
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20
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Glick JL, Jivapong B, Russo R, Pelaez D, Piser R, Footer K, Sherman SG. Cultivating PEARL (Promoting Empowerment and Risk Reduction): Formative Research for a PrEP Intervention Among Female Sex Workers in Baltimore, Maryland. AIDS Behav 2022; 26:2664-2675. [PMID: 35124751 PMCID: PMC9885761 DOI: 10.1007/s10461-022-03600-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 02/01/2023]
Abstract
Pre-exposure prophylaxis (PrEP) is a vital component of comprehensive HIV prevention among female sex workers (FSW). There are limited PrEP interventions targeting FSW in the U.S., who have high HIV risk. Formative research was conducted to inform PEARL (Promoting Empowerment And Risk Reduction), a PrEP intervention for FSW in Baltimore, MD, including a community forum, key informant interviews with providers, and focus group discussions with FSW. FSW and providers acknowledged challenges to building rapport and establishing continuity in care settings. FSW reported low PrEP awareness, with high interest once aware. FSW and providers reported uptake barriers including perceived financial issues, lack of PrEP awareness, and mistrust of the pharmaceutical industry. Concerns were raised about substance use and daily PrEP adherence. Developing a tailored PrEP intervention for FSW necessitates multiple perspectives (e.g. FSW, service providers). Resumen La profilaxis preexposición (PrEP) es un componente vital de la prevención integral del VIH para las trabajadoras sexuales (TSF). En los Estados Unidos, hay pocas intervenciones de PrEP dirigidas a las TSF, quienes experiencian un riesgo elevado de contraer el VIH. Se realizó una investigación formativa para informar a PEARL (Promoción del empoderamiento y la reducción de riesgos), una intervención de PrEP para TSF en Baltimore, MD-la cual incluyó un foro comunitario, entrevistas con proveedores de servicios a las TSF y discusiones entre grupos focales de TSF. TSF y proveedores de servicio reconocieron los retos de mantener buenas relaciones y establecer continuidad en los servicios de salud. TSF exhibieron conocimiento limitado sobre la PrEP, pero expresaron gran interés en la PrEP después de estar informadas. TSF y los proveedores de servicios hablaron de barreras aceptando a la PrEP, incluyendo problemas financieros percibidos, falta de conocimiento sobre la PrEP y desconfianza en la industria farmacéutica. Se expresaron preocupaciones sobre el uso de sustancias y la adherencia diaria a la PrEP. El desarrollo de una intervención de PrEP personalizada para TSF requiere varias perspectivas (por ejemplo, TSF, proveedores de servicios).
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Affiliation(s)
- Jennifer L Glick
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Belinda Jivapong
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rienna Russo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Danielle Pelaez
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Rebecca Piser
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Katherine Footer
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Susan G Sherman
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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21
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Low A, Gummerson E, Schwitters A, Bonifacio R, Teferi M, Mutenda N, Ayton S, Juma J, Ahpoe C, Ginindza C, Patel H, Biraro S, Sachathep K, Hakim AJ, Barradas D, Hassani AS, Kirungi W, Jackson K, Goeke L, Philips N, Mulenga L, Ward J, Hong S, Rutherford G, Findley S. Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016-2017). BMJ Open 2022; 12:e058704. [PMID: 35820770 PMCID: PMC9277378 DOI: 10.1136/bmjopen-2021-058704] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To assess the potential bidirectional relationship between food insecurity and HIV infection in sub-Saharan Africa. DESIGN Nationally representative HIV impact assessment household-based surveys. SETTING Zambia, Eswatini, Lesotho, Uganda and Tanzania and Namibia. PARTICIPANTS 112 955 survey participants aged 15-59 years with HIV and recency test results. MEASURES Recent HIV infection (within 6 months) classified using the HIV-1 limited antigen avidity assay, in participants with an unsuppressed viral load (>1000 copies/mL) and no detectable antiretrovirals; severe food insecurity (SFI) defined as having no food in the house ≥three times in the past month. RESULTS Overall, 10.3% of participants lived in households reporting SFI. SFI was most common in urban, woman-headed households, and in people with chronic HIV infection. Among women, SFI was associated with a twofold increase in risk of recent HIV infection (adjusted relative risk (aRR) 2.08, 95% CI 1.09 to 3.97). SFI was also associated with transactional sex (aRR 1.28, 95% CI 1.17 to 1.41), a history of forced sex (aRR 1.36, 95% CI 1.11 to 1.66) and condom-less sex with a partner of unknown or positive HIV status (aRR 1.08, 95% CI 1.02 to 1.14) in all women, and intergenerational sex (partner ≥10 years older) in women aged 15-24 years (aRR 1.23, 95% CI 1.03 to 1.46). Recent receipt of food support was protective against HIV acquisition (aRR 0.36, 95% CI 0.14 to 0.88). CONCLUSION SFI increased risk for HIV acquisition in women by twofold. Heightened food insecurity during climactic extremes could imperil HIV epidemic control, and food support to women with SFI during these events could reduce HIV transmission.
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Affiliation(s)
- Andrea Low
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, New York, New York, USA
| | - Elizabeth Gummerson
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
- Bill and Melinda Gates Institute for Population and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Amee Schwitters
- Strategic Information, Division of Global HIV and Tuberculosis, Ctr Dis Control, Maseru, Lesotho
| | | | - Mekleet Teferi
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, New York, New York, USA
| | - Nicholus Mutenda
- Directorate for Special Programs, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Sarah Ayton
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
| | - James Juma
- The Ministry of Health, Community Development, Gender, Elderly and Children, National AIDS Control Program, Dar es Salaam, United Republic of Tanzania
| | - Claudia Ahpoe
- Needs Assessment and Analysis, World Food Programme, Rome, Italy
| | | | - Hetal Patel
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Samuel Biraro
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Karam Sachathep
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Avi J Hakim
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Danielle Barradas
- Center for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Ahmed Saadani Hassani
- Center for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | | | - Keisha Jackson
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Leah Goeke
- Centers for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania
| | - Neena Philips
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Lloyd Mulenga
- Zambia Ministry of Health, Lusaka, Zambia
- School of Medicine, University of Zambia, Lusaka, Zambia
| | - Jennifer Ward
- Centers for Disease Control and Prevention, Kampala, Uganda
| | - Steven Hong
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | - George Rutherford
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Sally Findley
- Population and Family Health, Mailman School of Public Health, New York, NY, USA
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22
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Bazrafshani A, Panahi S, Sharifi H, Merghati-Khoei E. The role of online social networks in improving health literacy and medication adherence among people living with HIV/AIDS in Iran: Development of a conceptual model. PLoS One 2022; 17:e0261304. [PMID: 35771768 PMCID: PMC9246123 DOI: 10.1371/journal.pone.0261304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
Online social networks have been used to enhance human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) prevention, diagnosis, and treatment programs worldwide. This study aimed to develop a conceptual model of using online social networks in improving health literacy and medication adherence among people living with HIV/AIDS in Iran. This mixed-method sequential exploratory study was conducted in three phases. Firstly, a series of semi-structured interviews with a purposive sample of 29 HIV-positive patients were conducted to investigate the perceptions and experiences of HIV-positive patients about using online social networks to support health literacy and medication adherence. Thematic analysis was used to analyse qualitative interviews, extract potential components, and design a conceptual model. Then, a Delphi study with 27 HIV-positive patients was subsequently conducted to examine the consensus of patients on the proposed model. Finally, the trustworthiness and credibility of the proposed model were reviewed and evaluated by expert panel members from epidemiology and public health. Seven themes and 24 sub-themes emerged from the qualitative interviews. Five themes encompassed components of online social networks that supported communication and information-seeking behaviour of people living with HIV/AIDS. The two other themes encompassed social support and health-related outcomes including medication adherence. The credibility of the proposed conceptual model was confirmed methodologically using the expert panel and Delphi technique. Our findings highlighted that using online social networks has empowered Iranian people living with HIV/AIDS, making them more connected, safe, and able to access HIV/AIDS-related information and services. The role of online social networks in improving health literacy and medication adherence was also demonstrated in a conceptual model to understand the supportive components of online social networks in the HIV care continuum as well as customized interventions to improve the success of antiretroviral therapies.
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Affiliation(s)
- Azam Bazrafshani
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sirous Panahi
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Effat Merghati-Khoei
- Iranian National Centre of Addiction Studies (INCAS), Institute of Risk Reduction, and Sexual & Family Health Division, Brain & Spinal Cord Injury Research Centre (BASIR), Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
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23
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Zhou L, Assanangkornchai S, Shi Z, Jiang F, Yang D, Shi W. Acceptability of Pre-Exposure Prophylaxis and Non-Occupational Post-Exposure Prophylaxis among Men Who Have Sex with Men in Guilin, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3579. [PMID: 35329266 PMCID: PMC8951311 DOI: 10.3390/ijerph19063579] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/15/2022]
Abstract
Pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) are both effective strategies for preventing HIV. There is limited information about the acceptability of these prevention measures in undeveloped areas of China. We aimed to examine the acceptability of PrEP and nPEP and their determinants among men who have sex with men (MSM). 219 MSM were recruited in Guilin, China. In total, 28.6% (95% CI: 20.0-41.0) and 35.9% (95% CI: 27.3-49.5) of the participants had heard of PrEP and nPEP, respectively, while 57.0% (95% CI: 43.1-68.2) and 58.6 (95% CI:44.8-68.8) reported they would be willing to use PrEP and nPEP after the methods were explained. A higher acceptability of PrEP was seen among participants who were previously married (aOR = 3.30; 95% CI: 1.22-9.19), working as a laborer (aOR = 5.13; 95% CI: 1.64-17.59), migrant workers/farmers (aOR = 2.56; 95% CI: 1.15-5.79), government employees (aOR = 4.76; 95%CI: 1.80-13.02), had higher social support (aOR = 1.05; 95% CI: 1.03-1.08), and had been previously tested for HIV (aOR = 2.79; 95% CI: 1.36-5.94). A higher acceptability of nPEP was associated with those having higher social support (aOR = 1.06; 95% CI: 1.04-1.09), not knowing their sexual partner's HIV status (aOR = 2.72; 95% CI: 1.23-6.12), and having a prior HIV test (aOR = 5.53; 95% CI: 2.58-12.51). PrEP and nPEP are acceptable, especially among MSM with higher social support and had received a previous HIV test. Effective education and different dissemination strategies to promote the acceptance of PrEP and nPEP among MSM are needed.
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Affiliation(s)
- Lingmi Zhou
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin 541000, China; (Z.S.); (F.J.); (D.Y.)
| | - Sawitri Assanangkornchai
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;
| | - Zhaohui Shi
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin 541000, China; (Z.S.); (F.J.); (D.Y.)
| | - Fusheng Jiang
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin 541000, China; (Z.S.); (F.J.); (D.Y.)
| | - Dong Yang
- Department of AIDS Control and Prevention, Guilin Center for Disease Control and Prevention, Guilin 541000, China; (Z.S.); (F.J.); (D.Y.)
| | - Wuxiang Shi
- Health Management Unit, Faculty of Humanities and Management, Guilin Medical University, Guilin 541004, China
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24
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Yoo W. Addressing the Social Determinants of Health in South Korea: Moderating Role of mHealth Technologies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031871. [PMID: 35162893 PMCID: PMC8834917 DOI: 10.3390/ijerph19031871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 11/16/2022]
Abstract
Mobile health (mHealth) technologies may reduce or widen health inequalities. Despite the extensive literature in support of both of these contrasting views, little attention has been paid to the role of mHealth technologies with regard to social strata and health in the context of South Korea, a country with one of the highest usages of smartphones worldwide. This study examined the effects of social determinants on health self-efficacy and health status and explored how mHealth technologies moderate the impacts of social determinants on health outcomes. Data were collected via online surveys from 29 July to 3 August 2021. Survey data from 1187 Korean adults showed that men had higher levels of health self-efficacy than women. The higher an individual’s education level, the greater their subjective health status. Individuals with higher levels of monthly household income, social capital, and healthcare quality reported higher levels of health self-efficacy and superior health status. The use of mHealth technologies moderated the associations between social determinants and health outcomes. Specifically, monthly household income and social capital had smaller effects on health self-efficacy and health status among those who used higher levels of mHealth technologies. Among higher users of mHealth technologies, females reported better health status than males, while men showed better health status than women in the low-user group. These findings highlight the effectiveness of mHealth technologies in addressing health disparities.
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Affiliation(s)
- Woohyun Yoo
- Department of Mass Communication & Institute of Social Sciences, Incheon National University, 119 Academy-ro, Yeonsu-gu, Incheon 22012, Korea
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25
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Stigma in a Collectivistic Culture: Social Network of Female Sex Workers in China. AIDS Behav 2022; 26:297-309. [PMID: 34312739 DOI: 10.1007/s10461-021-03383-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
In this egocentric network study, we explored Chinese collectivism in relation to social network characteristics and sex work-related stigma among mid-age female sex workers (FSWs). Respondent-driven sampling was used to recruit 1245 mid-age FSWs from three cities in China. We found that a one standard deviation (SD) increase in FSWs' collectivism was associated with a 0.18 SD decrease in social support (95% CI - 0.32, - 0.04), a 0.20 SD decrease in network effective size (i.e., the diversity of a social network; 95% CI - 0.30, - 0.10), and a 0.21 SD decrease in network betweenness (i.e., the "bridging potential" of egos within their networks; 95% CI - 0.33, - 0.09). Among participants who perceived more sex work stigma, the association between collectivism and FSWs' network betweenness was attenuated. In a collective culture emphasizing group values and honor, belonging to a less interconnected social network may give FSWs a structural advantage to cope with stigma and secure social support.
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26
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Prediction Model for the Risk of HIV Infection among MSM in China: Validation and Stability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19021010. [PMID: 35055826 PMCID: PMC8776241 DOI: 10.3390/ijerph19021010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/08/2022] [Accepted: 01/11/2022] [Indexed: 12/04/2022]
Abstract
The impact of psychosocial factors on increasing the risk of HIV infection among men who have sex with men (MSM) has attracted increasing attention. We aimed to develop and validate an integrated prediction model, especially incorporating emerging psychosocial variables, for predicting the risk of HIV infection among MSM. We surveyed and collected sociodemographic, psychosocial, and behavioral information from 547 MSM in China. The participants were split into a training set and a testing set in a 3:1 theoretical ratio. The prediction model was constructed by introducing the important variables selected with the least absolute shrinkage and selection operator (LASSO) regression, applying multivariate logistic regression, and visually assessing the risk of HIV infection through the nomogram. Receiver operating characteristic curves (ROC), Kolmogorov–Smirnov test, calibration plots, Hosmer–Lemeshow test and population stability index (PSI) were performed to test validity and stability of the model. Four of the 15 selected variables—unprotected anal intercourse, multiple sexual partners, involuntary subordination and drug use before sex—were included in the prediction model. The results indicated that the comprehensive prediction model we developed had relatively good predictive performance and stability in identifying MSM at high-risk for HIV infection, thus providing targeted interventions for high-risk MSM.
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27
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Schafer KR, Tanner AE, Mann-Jackson L, Alonzo J, Song EY, Rhodes SD. Stigma, Social Support, and Substance Use in Diverse Men Who Have Sex With Men and Transgender Women Living with HIV in the US Southeast. South Med J 2022; 115:26-32. [PMID: 34964058 PMCID: PMC8726574 DOI: 10.14423/smj.0000000000001345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Human immunodeficiency virus (HIV) rates in the southeast United States are high and substance use is common among people living with HIV (PLWH). This study used baseline data from the weCare intervention study to examine factors associated with the use of alcohol, tobacco, and marijuana among racially and ethnically diverse young gay, bisexual, and other men who have sex with men (GBMSM) and transgender women in the southeast who were newly diagnosed as having HIV, not linked to care, out of care, and/or not virally suppressed. METHODS Self-reported data were collected from 196 GBMSM and transgender women living with HIV via Audio Computer-Assisted Self-Interview at enrollment. Measures assessed demographics; stigma; social support; basic and clinical service needs; HIV disclosure; social media use; and recent use of alcohol, tobacco, and marijuana. Logistic regression identified correlates of past 30-day substance use. RESULTS In multivariable analysis, increased age and needing basic support services were associated with past 30-day tobacco, cigarette, electronic cigarette, and/or hookah use. Increased HIV-related stigma and needing basic support services were associated with past 30-day marijuana use. Being White and needing clinical support services were associated with infrequent or no past 30-day marijuana use. CONCLUSIONS HIV-related stigma and needing basic support services were associated with substance use among GBMSM and transgender women living with HIV in the southeastern United States. Routine screening for basic needs could identify GBMSM and transgender women living with HIV at risk for substance use and offer insight into intervention leverage points.
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Affiliation(s)
- Katherine R Schafer
- From the Department of Internal Medicine, Section on Infectious Diseases, the Department of Social Sciences and Health Policy, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, North Carolina, the Department of Public Health Education, University of North Carolina, Greensboro, and Health Quality Partners, Doylestown Health, Doylestown, Pennsylvania
| | - Amanda E Tanner
- From the Department of Internal Medicine, Section on Infectious Diseases, the Department of Social Sciences and Health Policy, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, North Carolina, the Department of Public Health Education, University of North Carolina, Greensboro, and Health Quality Partners, Doylestown Health, Doylestown, Pennsylvania
| | - Lilli Mann-Jackson
- From the Department of Internal Medicine, Section on Infectious Diseases, the Department of Social Sciences and Health Policy, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, North Carolina, the Department of Public Health Education, University of North Carolina, Greensboro, and Health Quality Partners, Doylestown Health, Doylestown, Pennsylvania
| | - Jorge Alonzo
- From the Department of Internal Medicine, Section on Infectious Diseases, the Department of Social Sciences and Health Policy, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, North Carolina, the Department of Public Health Education, University of North Carolina, Greensboro, and Health Quality Partners, Doylestown Health, Doylestown, Pennsylvania
| | - Eunyoung Y Song
- From the Department of Internal Medicine, Section on Infectious Diseases, the Department of Social Sciences and Health Policy, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, North Carolina, the Department of Public Health Education, University of North Carolina, Greensboro, and Health Quality Partners, Doylestown Health, Doylestown, Pennsylvania
| | - Scott D Rhodes
- From the Department of Internal Medicine, Section on Infectious Diseases, the Department of Social Sciences and Health Policy, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, North Carolina, the Department of Public Health Education, University of North Carolina, Greensboro, and Health Quality Partners, Doylestown Health, Doylestown, Pennsylvania
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28
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Pullen E, Gupta A, Stockman JK, Green HD, Wagner KD. Association of social network characteristics with HIV knowledge, stigma, and testing: findings from a study of racial and ethnic minority women in a small Western city. AIDS Care 2022; 34:39-46. [PMID: 33856953 PMCID: PMC8517041 DOI: 10.1080/09540121.2021.1913717] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Black and Latina women are disproportionately impacted by HIV/AIDS. Despite existing research linking social networks and HIV risk among men who have sex with men (MSM) and other high-risk populations, little research has examined how ethnic/racial minority women's social networks shape HIV prevention and intervention targets. Using interviews with a sample of 165 predominantly Black and Latina-identifying women from a small city in the Western U.S., this research examines the relationship between egocentric network characteristics and HIV knowledge, attitudes, and testing history. Results reveal that network characteristics play a significant role in shaping HIV-related knowledge, prejudice, and testing intention but not HIV testing history. Individual-level factors like homelessness and perceptions of testing barriers are more salient for explaining testing behaviors than network characteristics. Intervention efforts to improve knowledge and reduce prejudice among Black and Latina women may benefit from mobilizing network ties.
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Affiliation(s)
- Erin Pullen
- Indiana University Network Science Institute (IUNI), Indiana University, Bloomington, Indiana
| | - Akrati Gupta
- Department of Health Administration, Midwestern State University, Wichita Falls, Texas
| | - Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California
| | - Harold D. Green
- Department of Applied Health Sciences, Indiana University, Bloomington, Indiana
| | - Karla D. Wagner
- School of Community Health Sciences, University of Nevada, Reno, Reno, Nevada
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Social Support Associated with Condom Use Behavior Among Female Sex Workers in Iran. Int J Behav Med 2022; 29:321-333. [PMID: 34476736 PMCID: PMC8412856 DOI: 10.1007/s12529-021-10017-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Despite the widespread knowledge about social support and health, there is little information about the association between social support and HIV risk behaviors such as condom use among female sex workers (FSWs) in Iran. This study aimed to determine the association between social support and frequency of condom use among FSWs in Tehran, Iran. METHODS Using mixed sampling methods, we recruited 170 FSWs in Tehran in 2017. We measured self-reported social support by face-to-face interviews using a standardized questionnaire. Linear regression was used to assess the association between socio-demographic characteristics (age, education level, marital status, and place of living), transactional sex characteristics (age at first transactional sex and frequency of transactional sex in the last month), HIV knowledge, social support network characteristics (social network size, duration of tie, intimacy, social support), and condom use behavior. RESULTS Of the total of 1193 persons in FSW's social networks, 615 (51%) were sexual partners, 529 (44%) were peer sex workers, and 36 (5%) were family members. The participants perceived moderate social support from sexual partners, low from peer sex workers, and very low from family members. Adjusted for individual and other network characteristics, peer sex worker social support (b = 0.28, 95%CI 0.06, 0.50), and family support (b = 1.12, 95%CI 0.028, 2.23) were significantly associated with condom use. CONCLUSION Family and peer sex worker social support are associated with condom use, but less strongly than HIV knowledge or place of living. However, very few FSWs are socially connected with families. Interventions to promote condom use among this vulnerable population should also consider social and familial support.
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Miall A, McLellan R, Dong K, Ndung'u T, Saberi P, Sauceda JA, Dubé K. Bringing social context into global biomedical HIV cure-related research: An urgent call to action. J Virus Erad 2021; 8:100062. [PMID: 35169489 PMCID: PMC8829132 DOI: 10.1016/j.jve.2021.100062] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/27/2021] [Indexed: 02/04/2023] Open
Abstract
Advances in science have ushered in a wave of new potential curative and control strategies for HIV that could eliminate the current requirement for life-long antiretroviral therapy (ART) for people living with HIV (PLWH). In this article, we argue that it is critical to consider social contexts in the development of HIV cure trial protocols. The biological and behavioral risk factors for HIV acquisition by study participants are inseparable from the social context in which these participants live. The article discusses an example of a cohort established to further HIV cure research that included social context, called the FRESH Acute HIV study, which combines a sociostructural intervention while conducting HIV prevention, treatment and cure-related research in Durban, South Africa. We make an urgent call to action to include sociobehavioral components as instrumental in future HIV cure trials in global context.
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Affiliation(s)
| | | | - Krista Dong
- Harvard Medical School, MA, USA,Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA,Massachusetts General Hospital, MA, USA
| | - Thumbi Ndung'u
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA,Africa Health Research Institute (AHRI), Durban, South Africa,HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa,Division of Infection and Immunity, University College London, London, UK
| | - Parya Saberi
- Center for AIDS Prevention Studies (CAPS), Division of Prevention Sciences, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - John A. Sauceda
- Center for AIDS Prevention Studies (CAPS), Division of Prevention Sciences, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Karine Dubé
- UNC Gillings School of Global Public Health, Chapel Hill, NC, USA,Corresponding author. UNC Gillings School of Global Public Health, 4108 McGavran-Greenberg Hall, Chapel Hill, NC, USA.
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Jorjoran Shushtari Z, Salimi Y, Hosseini SA, Sajjadi H, Snijders TAB. Determinants of safe sexual behavior of female sex workers in Tehran: the woman, her network, and the sexual partner. BMC Public Health 2021; 21:2219. [PMID: 34872543 PMCID: PMC8647307 DOI: 10.1186/s12889-021-12266-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the steady growth of sexual transmission of HIV, there is little evidence about safe sexual behavior of FSWs, and social network effects on this behavior, in Iran. Our aim in this study was to determine the effect of social network characteristics on condom use among FSWs, considering individual characteristics of the FSWs and of their sexual partners, characteristics of their relationship, and the FSW's personal network. METHODS A cross-sectional ego-centric network survey of 170 FSWs was carried out in Tehran between January and June 2017. A multilevel ordered logistic regression analysis was conducted to examine the effects of individual and relational characteristics simultaneously. RESULTS Condom use in sexual relationships of the FSWs on average was rather low. Important determinants of safe sexual behavior were found both at the level of the individual FSW and at the level of the sexual partner. The main determinants at the level of the individual FSW were FSWs' age and HIV knowledge. At the level of the sexual partner, age and education of sexual partners, as well as intimacy, duration of tie, frequency of contacts with a given partner, frequency of contact, perceived social support, and perceived safe sex norms were significantly associated with condom use. CONCLUSIONS The findings highlighted that considering only the individual characteristics of female sex workers is not sufficient for effectively promoting condom use. Factors at the network and dyadic level should also be considered, especially the role of sexual partners. Network-based interventions may be useful which modify social relationships to create a social environment that can facilitate changes in sexual behavior.
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Affiliation(s)
- Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, P.O Box: 1985713834, Tehran, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Ali Hosseini
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, P.O Box: 1985713834, Tehran, Iran.
| | - Homeira Sajjadi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, P.O Box: 1985713834, Tehran, Iran
| | - Tom A B Snijders
- Department of Sociology, University of Groningen, 9712 TG, Groningen, Netherlands
- Nuffield College, University of Oxford, Oxford, OX1 1NF, UK
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Shuper PA. The Role of Alcohol-Related Behavioral Research in the Design of HIV Secondary Prevention Interventions in the Era of Antiretroviral Therapy: Targeted Research Priorities Moving Forward. AIDS Behav 2021; 25:365-380. [PMID: 33987783 DOI: 10.1007/s10461-021-03302-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 12/17/2022]
Abstract
HIV secondary prevention focuses on averting onward HIV transmission, which can be realized when people living with HIV enact requisite HIV care continuum-related behaviors to achieve viral suppression, and engage in condom-protected sex when virally unsuppressed. Alcohol has been detrimentally linked to all aspects of HIV secondary prevention, and although a growing number of behavioral interventions account for and address alcohol use within this realm, further efforts are needed to fully realize the potential of such initiatives. The present article proposes a series of targeted priorities to inform the future design, implementation, and evaluation of alcohol-related behavioral intervention research within the scope of HIV secondary prevention. These priorities and corresponding approaches account for the challenges of resource-constrained clinic environments; capitalize on technology; and address key comorbidities. This framework provides the foundation for a range of alcohol-related behavioral interventions that could potentially enhance global HIV secondary prevention efforts in the years ahead.
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Affiliation(s)
- Paul A Shuper
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, M5S 2S1, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
- Institute for Collaboration On Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA.
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.
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Hergenrather KC, Emmanuel D, Zeglin RJ, Ruda DJ, Rhodes SD. Men Who Have Sex With Men and HIV Risk Behavior: Exploring the Influence of Masculinity Within the Social Ecological Model. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:511-533. [PMID: 34874760 DOI: 10.1521/aeap.2021.33.6.511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the United States, gay, bisexual men, and men who have sex with men (MSM) represent 86% of new HIV infections among males. Approximately 1 in 7 men with HIV are unaware of their HIV status (CDC, 2017, 2019a, 2020a). To explore influences on MSM HIV risk behavior, the authors performed a systematic review of quantitative studies conducted in the U.S. assessing what is purported as masculinity. From 30 identified studies, significant findings were framed within the Social Ecological Model (SEM) levels (e.g., Individual, Relationship, Community). SEM level themes were applied to create the Masculinity 10, a preliminary 10-item assessment to explore the influence of masculinity on MSM HIV risk behavior. To increase MSM engagement in HIV prevention and treatment, the influences of masculinity (e.g., attitude toward sexual minorities, appearance, emotion, temperament, substance use, sexual activity, social support, intimate relationships, health care) on HIV risk behavior should be further explored.
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Affiliation(s)
| | | | | | - David J Ruda
- The George Washington University, Washington, D.C
| | - Scott D Rhodes
- Wake Forest School of Medicine, Winston-Salem, North Carolina
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Mann‐Jackson L, Alonzo J, Garcia M, Trent S, Bell J, Horridge DN, Rhodes SD. Using community-based participatory research to address STI/HIV disparities and social determinants of health among young GBMSM and transgender women of colour in North Carolina, USA. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e192-e203. [PMID: 33369811 PMCID: PMC8451894 DOI: 10.1111/hsc.13268] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 05/04/2023]
Abstract
Sexually transmitted infections (STIs) and HIV disproportionately affect young persons; gay, bisexual and other men who have sex with men (GBMSM) and transgender women; persons of colour; and the U.S. South. Complex issues contribute to these high STI/HIV rates. Our community-based participatory research (CBPR) partnership conducted a community-driven needs assessment to inform an intervention addressing STI/HIV disparities and related social determinants of health (SDH) among young GBMSM and transgender women of colour in a high-incidence STI/HIV community in North Carolina. In 2018, in-depth interviews were conducted with 21 community members and 29 community organisation representatives to explore needs, priorities and assets. Interview data were analysed using constant comparison, an approach to grounded theory, and an empowerment theory-based planning process was used to develop multilevel intervention strategies based on findings. Thirteen themes emerged from the interviews that were organised into five domains: health (e.g., limited health services use; need for lesbian, gay, bisexual and transgender [LGBT]-friendly providers; prioritisation of mental health and gender transition and limited knowledge of and access to pre-exposure prophylaxis [PrEP] for HIV); employment (e.g., employment as a priority and relying on sex work to 'make ends meet'); education (e.g., barriers to education and needs for training to improve employment opportunities); social support (e.g., few welcoming activities and groups; strong informal support networks and little interaction between GBMSM and transgender women) and discrimination (e.g., frequent experiences of discrimination and the impact of frontline staff on services use). Three strategies - community-based peer navigation, use of social media, and anti-discrimination trainings for organisations - were identified and integrated into a new intervention known as Impact Triad. CBPR was successfully applied to identify needs, priorities and assets and develop a multilevel intervention focused on health disparities and SDH among young GBMSM and transgender women of colour in the U.S. South.
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Affiliation(s)
- Lilli Mann‐Jackson
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
| | - Jorge Alonzo
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
| | - Manuel Garcia
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
| | | | - Jonathan Bell
- University of North Carolina Chapel HillChapel HillNCUSA
| | - Danielle N. Horridge
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
| | - Scott D. Rhodes
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
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Social Support, Relationship Power, and Knowledge of HIV+ Serostatus in Sexual Risk Behavior Among Women in Psychiatric Treatment. J Clin Psychol Med Settings 2021; 28:191-199. [PMID: 32026174 DOI: 10.1007/s10880-020-09701-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study examined social support, perceived relationship power, and knowledge of HIV+ serostatus in relation to frequency of unprotected sex acts and number of partners among women with comorbid psychiatric illness receiving treatment. Data were drawn from an initial assessment of participants enrolled in an HIV risk reduction intervention (N = 284), and two generalized linear models were used to examine the potential associations. Relationship power was significantly associated with fewer unprotected sex acts. This relationship was stronger among those with greater social support. Knowledge of HIV+ serostatus was linked with fewer sexual partners and less unprotected sex. Findings also revealed that the protective nature of support varies by level of perceived relationship power, with higher power indicative of a stronger protective relationship. Study findings suggest that the potential protective benefits of social support may depend on one's perceived relationship power. Implications for HIV prevention intervention for this at-risk group are discussed.
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Zhao PZ, Wang YJ, Cheng HH, Zhang Y, Tang WM, Yang F, Zhang W, Zhou JY, Wang C. Uptake and correlates of chlamydia and gonorrhea testing among female sex workers in Southern China: a cross-sectional study. BMC Public Health 2021; 21:1477. [PMID: 34320978 PMCID: PMC8320049 DOI: 10.1186/s12889-021-11526-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 07/20/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Female sex workers (FSW) are highly susceptible to chlamydia and gonorrhea infection. However, there is limited literature examining their testing uptake to date. This study aimed to assess the uptake and determinants of chlamydia and gonorrhea testing among FSW in Southern China. METHODS A cross-sectional study with convenience sampling was performed in five cities in Southern China. Data on socio-demographic characteristics, sexual behaviors, chlamydia and gonorrhea testing, and the utilization of health care services from participants were collected through face-to-face interviews. Univariate and multivariable logistic regressions were used to determine factors associated with chlamydia and gonorrhea testing, respectively. RESULTS Overall, 1207 FSWs were recruited, with the mean age of 30.7 ± 6.8 years and an average number of clients of 7.0 (4.0-10.0) per week. 65.4% participants constantly used condoms with clients during the past month. Only 7.5 and 10.4% had been tested for chlamydia and gonorrhea in the last year, respectively. Multivariable analysis indicated that FSW who worked at low tiers (adjusted Odds Ratio (aOR) = 2.36, 95%CI:1.23-10.14), had more clients in the last month (aOR = 1.03, 95%CI:1.01-1.05), used condoms consistently (aOR = 1.79, 95%CI:1.12-2.86), had STD symptoms (aOR = 4.09,95%CI:2.62-6.40), had been tested for HIV (aOR = 5.16, 95%CI:3.21-8.30) or syphilis (aOR = 6.90, 95%CI:4.21-11.22) in the last year were more likely to have chlamydia testing. In addition, FSW who had more clients in the past month (aOR = 1.02,95%CI:1.00-1.04), had STD symptoms (aOR = 3.33, 95%CI:2.03-5.46), had been tested for HIV (aOR = 3.94, 95%CI:2.34-6.65) and syphilis (aOR = 3.27, 95%CI:1.96-5.46) in the last year were more likely to have gonorrhea testing. CONCLUSIONS The testing rates of chlamydia and gonorrhea are low among Chinese FSW. Integrating chlamydia and gonorrhea testing into HIV testing promotion programs may help bridge the gap among FSW.
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Affiliation(s)
- Pei Zhen Zhao
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China
| | - Ya Jie Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China
| | - Huan Huan Cheng
- The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ye Zhang
- Kirby Institute, New South Wales University, Sydney, Australia
| | - Wei Ming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Fan Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Wei Zhang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Ji Yuan Zhou
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
| | - Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China.
- Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China.
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Namey E, Lorenzetti L, O'Regan A, Tenaw E, Feleke E, Girima E. The financial lives of female sex workers in Addis Ababa, Ethiopia: Implications for economic strengthening interventions for HIV prevention. AIDS Care 2021; 34:379-387. [PMID: 34180728 DOI: 10.1080/09540121.2021.1944600] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Understanding the financial context of the lives of female sex workers (FSWs) is essential to address structural drivers of HIV risk. We used a financial diary methodology to record daily financial transactions over six weeks from a stratified purposive sample (n = 34) of FSWs in Addis Ababa, Ethiopia. FSWs also provided information on their experience with gender-based violence and condom use. FSWs generated 90.1% of total cash from sex work, with a median weekly income of USD 60.53. They engaged mostly in protected vaginal sex, earning approximately USD 4.57 per act. Food, housing, and clothing represented the largest areas of expenditure. Around 17% of expenses were recorded as costs of sex work (e.g., alcohol). Median weekly expenditures accounted for 62% of median weekly income. Nearly all participants reported depositing money into savings at least once over six weeks, while 71% reported a loan transaction during the six-week period, most as borrowers. Findings suggest that financial literacy and formalized savings activities, with life skills and empowerment training, have potential to build FSW's economic resilience, mitigating a structural driver of sex work and HIV risk.
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Affiliation(s)
- Emily Namey
- Behavioral, Epidemiological, and Clinical Sciences, FHI 360, Durham, NC, USA
| | - Lara Lorenzetti
- Behavioral, Epidemiological, and Clinical Sciences, FHI 360, Durham, NC, USA
| | - Amy O'Regan
- Behavioral, Epidemiological, and Clinical Sciences, FHI 360, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Eskindir Tenaw
- Independent Consultant, FHI 360 Ethiopia, Addis Ababa, Ethiopia
| | - Engdasew Feleke
- Independent Consultant, FHI 360 Ethiopia, Addis Ababa, Ethiopia
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Valente PK, Biello KB, Edeza A, Klasko-Foster L, Kuhns LM, Reisner SL, Garofalo R, Mimiaga MJ. Psychosocial Problems and Vulnerability to HIV in a Multi-City Prospective Cohort of Young Transgender Women in the United States: A Structural Equation Modeling Study. J Acquir Immune Defic Syndr 2021; 86:544-551. [PMID: 33661822 DOI: 10.1097/qai.0000000000002615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/21/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Gender-based stigma contributes to increased HIV prevalence, but little is known about psychosocial mechanisms linking stigma and HIV risk among young transgender women (YTW). SETTING This study uses data from Project LifeSkills, a randomized controlled efficacy trial of an empowerment-based HIV prevention intervention for YTW (N = 233). YTW were recruited in Boston, MA, and Chicago, IL, between 2012 and 2015 and completed study assessment visits at baseline and months 4 and 12. METHODS Using autoregressive structural equation modeling, we examined whether poor social support and psychological distress at 4 months mediate the prospective relationship between gender-based stigma at baseline and condomless anal and vaginal sex (CAVS) acts at 4 and 12 months; all models were adjusted for treatment arm, HIV serostatus, study site, and sociodemographics. RESULTS Gender-based stigma at baseline was directly associated with increased CAVS at 4 months [adjusted incidence rate ratio (aIRR) = 1.18, 95% confidence interval (CI): (1.05 to 1.33)] and 12 months [aIRR = 1.17, 95% CI: (1.02 to 1.34)]. Gender-based stigma was also associated with higher psychological distress at 4 months [b = 0.70, 95% CI: (0.13 to 1.27)], which in turn was marginally associated with increased CAVS at 12 months [aIRR = 1.03, 95% CI: (1.00 to 1.06)]. Contrary to expectations, poor social support at 4 months was associated with decreased CAVS at 12 months [aIRR = 0.40, 95% CI: (0.28 to 0.59)]. CONCLUSIONS Future HIV prevention interventions with YTW should consider addressing experiences of gender-based stigma and the psychological distress that may ensue from gender-based stigma. More research is needed to understand the influence of poor social support on sexual behaviors in this population.
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Affiliation(s)
- Pablo K Valente
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI
| | - Katie B Biello
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
- The Fenway Institute, Fenway Health, Boston, MA
| | - Alberto Edeza
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI
| | - Lynne Klasko-Foster
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI
| | - Lisa M Kuhns
- Division of Adolescent Medicine, Ann and Robert H. Lurie Children's Hospital, Chicago, IL
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, MA
- Brigham and Women's Hospital, Boston, MA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA; and
| | - Robert Garofalo
- Division of Adolescent Medicine, Ann and Robert H. Lurie Children's Hospital, Chicago, IL
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Matthew J Mimiaga
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
- The Fenway Institute, Fenway Health, Boston, MA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA
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Hickson W, Mayers PM. Understanding how young people become motivated to take their human immunodeficiency virus medication (antiretroviral therapy) and how the need for adherence is communicated. Health SA 2021; 25:1458. [PMID: 33391827 PMCID: PMC7756603 DOI: 10.4102/hsag.v25i0.1458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022] Open
Abstract
Background Antiretroviral therapy (ART), the only effective treatment for human immunodeficiency virus (HIV), requires excellent long-term compliance. Poor levels of adherence to ART, especially amongst adolescents and young adults in South Africa, have been reported. Aim This study aimed to explore how young people become motivated to take their HIV medication (ART) and how the need for adherence is communicated. Setting The study was conducted in a peri-urban township in the Western Cape, South Africa. Methods A qualitative grounded theory approach was employed. Eighty young people were purposively recruited. Participant observation, focus groups and semi-structured interviews were utilised to explore how effective ART adherence messages are in motivating adherence amongst young people and how they would like ART adherence to be communicated to them. All interviews and focus groups were transcribed and analysed by using cross-comparison analysis. Measures to ensure trustworthiness were established and ethical considerations were adhered to. Results Young people’s adherence motivation was an outcome of reconnecting to one or more trusted significant other(s) from within their belonging group, who accepted and supported them, which in turn affirmed their prior belonging identities of son, daughter, other family member or close friend. This facilitated reconnection to their present and future hopes, which in turn increased their motivation to live and to adhere to treatment. Conclusion The findings highlight the need for the development of more effective communication strategies, which facilitate and support young people’s reconnection to trusted members of their belonging groups, and also help belonging group members to accept, affirm and support adherence.
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Affiliation(s)
- Warren Hickson
- Department of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Pat M Mayers
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Phillips TR, Medland N, Chow EPF, Maddaford K, Wigan R, Fairley CK, Ong JJ, Bilardi JE. "Moving from one environment to another, it doesn't automatically change everything". Exploring the transnational experience of Asian-born gay and bisexual men who have sex with men newly arrived in Australia. PLoS One 2020; 15:e0242788. [PMID: 33216802 PMCID: PMC7678978 DOI: 10.1371/journal.pone.0242788] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 11/10/2020] [Indexed: 12/02/2022] Open
Abstract
Asian-born gay, bisexual and other men who have sex with men (gbMSM) who are newly arrived in Australia are at a higher risk of acquiring HIV than Australian-born gbMSM. We used a social constructionist framework to explore HIV knowledge and prevention strategies used by newly-arrived Asian-born gbMSM. Twenty four Asian-born gbMSM, aged 20–34 years, attending Melbourne Sexual Health Centre, who arrived in Australia in the preceding five years, participated in semi-structured, face-to-face interviews. Interviews were recorded, transcribed verbatim and analysed thematically. Participants described hiding their sexual identities in their country of origin, particularly from family members, due to fear of judgement and discrimination resulting from exposure to sexual identity and HIV related stigma in their countries of origin, although some were open to friends. Despite feeling more sexual freedom and acceptance in Australia, many were still not forthcoming with their sexual identity due to internalised feelings of stigma and shame. Exposure to stigma in their country of origin led many to report anxiety around HIV testing in Australia due to a fear of testing positive. Some described experiencing racism and lack of acceptance in the gay community in Australia, particularly on dating apps. Fear of discrimination and judgement about their sexual identity can have a significant impact on Asian-born gbMSM living in Australia, particularly in terms of social connectedness. Additionally, HIV-related stigma can contribute to anxieties around HIV testing. Our data highlights the potential discrimination Asian-born gbMSM face in Australia, which has implications for social connectedness, particularly with regard to LGBTQI communities and HIV testing practices. Future studies should determine effective strategies to reduce sexual identity and HIV-related stigma in newly-arrived Asian-born gbMSM.
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Affiliation(s)
- Tiffany R. Phillips
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- * E-mail:
| | - Nicholas Medland
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Eric P. F. Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Kate Maddaford
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
| | - Rebecca Wigan
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jason J. Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jade E. Bilardi
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of General Practice, University of Melbourne, VIC, Australia
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41
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Paykani T, Zimet GD, Esmaeili R, Khajedaluee AR, Khajedaluee M. Perceived social support and compliance with stay-at-home orders during the COVID-19 outbreak: evidence from Iran. BMC Public Health 2020; 20:1650. [PMID: 33148209 PMCID: PMC7609821 DOI: 10.1186/s12889-020-09759-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/25/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Strong evidence demonstrates that social support plays a key role in facilitating preventive health behaviors. The aim of the current study was to assess the effects of perceived social support on compliance with stay-at-home orders in response to a COVID-19 outbreak during the Persian New Year (Nowruz) holydays, since Nowruz holidays of 2020 coincided with the peak of the coronavirus epidemic in Iran. METHODS This cross-sectional survey was carried out based on phone interviews of 1073 adults aged over 18 years from 4 to 12 April 2020 in Mashhad, Khorasan-Razavi Province, as the second largest city of Iran. A systematic random sampling was carried out using fixed phone number lists provided by Telecommunication Company of Khorasan-Razavi Province. Phone interviews were carried out by trained interviewers from the Iranian Students Polling Agency (ISPA) at various times of the day. The survey included sociodemographic questions, perceived social support scale (MSPSS) and questions about self-isolation during the Nowruz holiday. Statistical analysis included Chi-square test, Mann-Whitney test and multivariate logistic regression. RESULTS 20.5% of participants reported poor compliance with stay at home orders during the first 2 weeks of Nowruz. Clear social gradients were not found in stay-at-home compliance. When controlling socio-demographic factors, perceived social support, interestingly, both fostered and hindered people's compliance with stay at home orders, depending on the source of support from family members (OR = .874, 95% CI = .803, .950, p < .005), friends (OR = 1.147, 95% CI = 1.076, 1.222, p < .001) and a significant other person (OR = .926, 95% CI = .849, 1.010, p = .084). CONCLUSIONS Public health messaging may need to emphasize the role that friends and families can play in helping to protect those in their friendship/family groups by promoting compliance with social distancing. Further in-depth studies are recommended to evaluate how this kind of messaging can most effectively encourage people to engage in social distancing practices.
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Affiliation(s)
- Toktam Paykani
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Reza Esmaeili
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Mohammad Khajedaluee
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Addington EL, Javandel S, De Gruttola V, Paul R, Milanini B, Ances BM, Moskowitz JT, Valcour V. Mindfulness-based stress reduction for HIV-associated neurocognitive disorder: Rationale and protocol for a randomized controlled trial in older adults. Contemp Clin Trials 2020; 98:106150. [PMID: 32942053 PMCID: PMC7686285 DOI: 10.1016/j.cct.2020.106150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/29/2022]
Abstract
The symptom burden of HIV-associated neurocognitive disorder (HAND) is high among older individuals, and treatment options are limited. Mindfulness-based stress reduction (MBSR) has potential to improve neurocognitive performance, psychosocial wellbeing, and quality of life, but empirical studies in this growing vulnerable population are lacking. In this trial, participants (N = 180) age 55 and older who are living with HIV infection, are on combination antiretroviral therapy with suppressed viral loads, and yet continue to experience behavioral and cognitive symptoms of HAND, are randomized to MBSR or to a waitlist control arm that receives MBSR following a 16-week period of standard care. Primary outcomes (attention, executive function, stress, anxiety, depression, everyday functioning, quality of life) and potential mediators (affect, mindfulness) and moderators (social support, loneliness) are assessed at baseline and weeks 8, 16, and 48 in both groups, with an additional assessment at week 24 (post-MBSR) in the crossover control group. Assessments include self-report and objective measures (e.g., neuropsychological assessment, neurological exam, clinical labs). In addition, a subset of participants (n = 30 per group) are randomly selected to undergo fMRI to evaluate changes in functional connectivity networks and their relationship to changes in neuropsychological outcomes. Forthcoming findings from this randomized controlled trial have the potential to contribute to a growing public health need as the number of older adults with HAND is expected to rise.
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Affiliation(s)
- Elizabeth L Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Osher Center for Integrative Medicine, Northwestern University, Chicago, IL, USA.
| | - Shireen Javandel
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Victor De Gruttola
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert Paul
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Benedetta Milanini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Osher Center for Integrative Medicine, Northwestern University, Chicago, IL, USA
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
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Multilevel influences of women's empowerment and economic resources on risky sexual behaviour among young women in Zomba district, Malawi. J Biosoc Sci 2020; 53:887-907. [PMID: 33077003 DOI: 10.1017/s0021932020000590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Gender disparities are pronounced in Zomba district, Malawi. Among women aged 15-49 years, HIV prevalence is 16.8%, compared with 9.3% among men of the same age. Complex structural factors are associated with risky sexual behaviour leading to HIV infection. This study's objective was to explore associations between multilevel measures of economic resources and women's empowerment with risky sexual behaviour among young women in Zomba. Four measures of risky sexual behaviour were examined: ever had sex, condom use and two indices measuring age during sexual activity and partner history. Multilevel regression models and regression models with cluster-robust standard errors were used to estimate associations, stratified by school enrolment status. Among the schoolgirl stratum, the percentage of girls enrolled in school at the community level had protective associations with ever having sex (OR = 0.76; 95% CI: 0.60, 0.96) and condom use (OR = 1.06; 95% CI: 1.01, 1.11). Belief in the right to refuse sex was protective against ever having sex (OR = 0.76; 95% CI: 0.60, 0.96). Participants from households with no secondary school education had higher odds of ever having sex (OR = 1.59; 95% CI: 1.14, 2.22). Among the dropout stratum, participants who had not achieved a secondary school level of education had riskier Age Factor and Partner History Factor scores (β = 0.51; 95% CI: 0.23, 0.79, and β = 0.24; 95% CI: 0.07, 0.41, respectively). Participants from households without a secondary school level of education had riskier Age Factor scores (β = 0.26; 95% CI: 0.03, 0.48). Across strata, the most consistent variables associated with risky sexual behaviour were those related to education, including girl's level of education, highest level of education of her household of origin and the community percentage of girls enrolled in school. These results suggest that programmes seeking to reduce risky sexual behaviour among young women in Malawi should consider the role of improving access to education at multiple levels.
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Lee J, Cassels S. Immigrant Generational Differences in Social Support and Sexual Risk Behaviors Among Men Who Have Sex With Men in Seattle, Washington. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:282-295. [PMID: 32897132 PMCID: PMC8055472 DOI: 10.1521/aeap.2020.32.4.282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Different immigrant generations may encounter distinct sexual opportunities with implications for HIV transmission. Yet, few studies have examined how immigrant generational status is associated with sexual risk behaviors among men who have sex with men (MSM). We explored relationships between immigrant generational status, social support, and sexual risk behaviors among English-speaking MSM using data from surveys conducted in Seattle, Washington, in 2014 (n = 323). We compared the sexual risk behaviors and social support of first-generation, second-generation, and third- and higher-generation MSM, and examined whether immigrant generational status and social support were associated with sexual risk behaviors using logistic regression models. Second-generation MSM reported lower friend social support than first- or third- and higher-generation MSM (p < .05). However, immigrant generational status was not associated with sexual risk behavior outcomes, even after accounting for social support. Results suggest that differences in immigration processes such as acculturation may be more predictive of risk behaviors than generational status alone.
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Affiliation(s)
- Jane Lee
- School of Social Work, University of Washington, Seattle, Washington
| | - Susan Cassels
- Department of Geography, University of California, Santa Barbara, California
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45
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Hadi AM, Lee PY, Adibah HI. The implication of stigma on people living with HIV and the role of social support - A case report. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2020; 15:43-45. [PMID: 32843944 PMCID: PMC7430316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Despite the advancements made in the knowledge and treatment of the human immunodeficiency virus (HIV) since it was first discovered, people living with HIV (PLWH) continue to be stigmatized. This paper presents the case of an HIV-infected patient who delayed the necessary treatment due to stigma and ultimately presented with AIDS. Through social support, however, he was able to overcome his internalized stigma; he was finally willing to start on antiretroviral treatment (ART). This case report addresses the effect of stigma on and the role of social support in the management of an individual with HIV.
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Affiliation(s)
- A M Hadi
- MD (UPM), MMed (Family Medicine) (UPM) Department of Family Medicine Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor, Malaysia
| | - P Y Lee
- MBBS (UM), MMed (Family Medicine) (UM) Department of Family Medicine Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Serdang, Selangor, Malaysia
| | - H I Adibah
- MD (USM), MMed (Family Medicine) (USM) Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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46
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Sohler N, Slawek D, Earnshaw V, Jost J, Lee A, Mancini J, Mompremier A, Cunningham CO. Drug use and HIV medication adherence in people living with HIV. Subst Abus 2020; 42:310-316. [PMID: 31951807 PMCID: PMC9181239 DOI: 10.1080/08897077.2019.1706695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Opioid and cocaine use epidemics continue to be substantial in the United States and intersect with the HIV epidemic. Antiretroviral medication (ARV) adherence is critical for optimum HIV outcomes. While previous research explored harm reduction strategies to prevent HIV spread for people who use drugs (PWUD), little is known about strategies used by PWUD living with HIV to maintain ARV adherence. Methods: We explored whether PWUD modify their drug use explicitly to maintain ARV adherence, and identified factors associated with this process. We conducted 23 semi-structured interviews. Data were analyzed using a modified framework analysis approach. Results: Participants had a mean age of 54 years and were predominantly male (70%) and non-Hispanic black (65%). Most described periods of being able to adhere to ARVs while still using drugs, difficulty adhering to ARVs while using drugs, and abstinence/near abstinence from drug use. In exploring factors that influenced changes in drug use and ARV adherence behaviors, we noted consistent acknowledgment of the roles of family, partners, or providers. Conclusions: PWUD living with HIV often modify their drug use to improve ARV adherence. Providers caring for this population might consider family or group education models to encourage harm reduction to improve outcomes.
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Affiliation(s)
- Nancy Sohler
- CUNY School of Medicine, City College of New York, New York, NY, USA
| | - Deepika Slawek
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Valerie Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA
| | - John Jost
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Alice Lee
- CUNY School of Medicine, City College of New York, New York, NY, USA
| | - John Mancini
- CUNY School of Medicine, City College of New York, New York, NY, USA
| | | | - Chinazo O Cunningham
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
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47
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Teixeira da Silva D, Bouris A, Voisin D, Hotton A, Brewer R, Schneider J. Social Networks Moderate the Syndemic Effect of Psychosocial and Structural Factors on HIV Risk Among Young Black Transgender Women and Men who have Sex with Men. AIDS Behav 2020; 24:192-205. [PMID: 31289985 DOI: 10.1007/s10461-019-02575-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The interaction between the cumulative effect of psychosocial and structural factors (i.e. syndemic effect) and social networks among young Black transgender women and men who have sex with men (YBTM) remains understudied. A representative cohort of 16-29 year-old YBTM (n = 618) was assessed for syndemic factors [i.e. substance use; community violence; depression; poverty; justice system involvement (JSI)], social network characteristics, condomless anal sex (CAS), group sex (GS), and HIV-infection. The syndemic index significantly increased the odds of CAS, GS, and HIV-infection, and these effects were moderated by network characteristics. Network JSI buffered the effect on CAS, romantic network members buffered the effect on GS, and network age and proportion of family network members buffered the effect on HIV-infection. The proportion of friend network members augmented the effect on GS and HIV-infection. Future research to prevent HIV among YBTM should consider social network approaches that target both structural and psychosocial syndemic factors.
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Affiliation(s)
- Daniel Teixeira da Silva
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA.
- Department of Combined Internal Medicine and Pediatrics, University of Chicago, 5841 S Maryland Avenue MC 7082, Chicago, IL, 60637, USA.
| | - Alida Bouris
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
| | - Dexter Voisin
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
| | - Anna Hotton
- Chicago Center for HIV Elimination, Chicago, IL, USA
| | | | - John Schneider
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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48
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Fabian KE, Huh D, Kemp CG, Nevin PE, Simoni JM, Andrasik M, Turan JM, Cohn SE, Mugavero MJ, Rao D. Moderating Factors in an Anti-stigma Intervention for African American Women with HIV in the United States: A Secondary Analysis of the UNITY Trial. AIDS Behav 2019; 23:2432-2442. [PMID: 31218545 DOI: 10.1007/s10461-019-02557-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
African American women experience higher rates of HIV than other women in the United States, and stigma has been identified as an important determinant of engagement in HIV care. Our study examined whether key variables moderated the effect of an anti-stigma intervention on outcomes among African American women receiving treatment for HIV. Twelve potential moderators included: age, years lived with HIV, marital status, employment status, education level, PTSD diagnosis, alcohol use, social support, baseline CD4 count, baseline viral load, and number of children. Outcomes included changes in: HIV-related stigma, social support, depressive symptoms, PTSD symptoms, alcohol use, viral load, and engagement in HIV care. Results suggest that the intervention is associated with greater improvement in engagement in care among participants with PTSD or depression at baseline, and may help maintain engagement in care among participants experiencing certain mental health conditions. This provides opportunities to address discriminatory structural barriers that lead to stigma and drop-offs in HIV care.
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49
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Wallace DD, Pack A, Uhrig Castonguay B, Stewart JL, Schalkoff C, Cherkur S, Schein M, Go M, Devadas J, Fisher EB, Golin CE. Validity of Social Support Scales Utilized Among HIV-Infected and HIV-Affected Populations: A Systematic Review. AIDS Behav 2019; 23:2155-2175. [PMID: 30276703 DOI: 10.1007/s10461-018-2294-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Social support enhances self-management and prevention of behaviors and is typically assessed using self-report scales; however, little is known about the validity of these scales in HIV-infected or affected populations. This systematic review aims to identify available validated social support scales used in HIV-infected and HIV-affected populations. A systematic literature search using key search terms was conducted in electronic databases. After rounds abstract screenings, full-text reviews, and data abstraction 17 studies remained, two of which assessed multiple social support scales, which increased number of scales to 19. Most scales assessed positive social support behaviors (n = 18). Most scales assessed perceived social support (n = 14) compared to received social support. Reliability ranged from 0.67 to 0.97. The most common forms of validation reported were content validity and construct validity and the least was criterion-related validity. Future research should seek to build evidence for validation for existing scales used in HIV-infected or HIV-affected populations.
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50
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Gruszczyńska E, Rzeszutek M. Trajectories of Health-Related Quality of Life and Perceived Social Support Among People Living With HIV Undergoing Antiretroviral Treatment: Does Gender Matter? Front Psychol 2019; 10:1664. [PMID: 31396129 PMCID: PMC6664262 DOI: 10.3389/fpsyg.2019.01664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/02/2019] [Indexed: 12/22/2022] Open
Abstract
The study examined the trajectories of health-related quality of life (HRQoL) and perceived social support (PSS) among people living with HIV (PLWH), with a special focus on gender differences. The participants included 252 PLWH (18% female) undergoing antiretroviral therapy. HRQoL (WHO Quality of Life-BREF; WHOQOL Group, 1998) and PSS (Berlin Social Support Scales; Schulz and Schwarzer, 2003) were measured three times at six-month intervals. Using a univariate approach, three trajectories of HRQoL and four trajectories of PSS were identified. Gender and relationship status were significant covariates for PSS only, with overrepresentation of single women in the increasing trajectory. The dual trajectory approach revealed a match in the decrease of HRQoL and PSS, but only for 31% of the sample. In fact, decreasing PSS co-occurred with increasing as well as stable HRQoL. There was no significant gender effect in this regard. Although a clear correspondence for decreasing trajectories exists, the findings also highlight a discrepancy between HRQoL and PSS changes that are unrelated to gender.
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Affiliation(s)
- Ewa Gruszczyńska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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