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Reid MJ, Tetteh EK, Ingaiza LM, Bradley CD, Dolcini MM, McKay VR. High Impact for Whom? A Qualitative Analysis of Organization Concerns About the Transition to High-Impact Prevention Policy. Health Promot Pract 2023; 24:932-943. [PMID: 35533246 DOI: 10.1177/15248399221091537] [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: 11/17/2022]
Abstract
HIV represents a significant health burden in the United States. In 2012, the Centers for Disease Control and Prevention (CDC) stopped recommending many once-promoted interventions as part of a shift from one HIV intervention policy, Diffusion of Effective Behavioral Interventions (DEBI), to another, High Impact Prevention (HIP). Twenty-nine staff members from 10 organizations were interviewed to explore how organizations reacted to this shift. Three major themes emerged: (1) Personal experience, community assessment, and epidemiological evidence influenced organizations' perceptions of efficacy and preference for earlier interventions. (2) Organizations were concerned that HIP interventions were not a good fit for their priority populations. (3) Organizations were frustrated with the top-down approach by the CDC prioritizing HIP interventions over earlier interventions. These results indicate that organizations continue to see value in and provide DEBI interventions. In addition, a more participatory process incorporating qualitative evidence and organizations' experiences may be necessary to achieve widespread de-implementation of DEBI interventions.
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Affiliation(s)
| | | | | | | | - M Margaret Dolcini
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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2
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Sok P, Mgbere O, Pompeii L, Essien EJ. Evaluation of the Sociodemographic, Behavioral and Clinical Influences on Complete Antiretroviral Therapy Adherence Among HIV-Infected Adults Receiving Medical Care in Houston, Texas. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2021; 13:539-555. [PMID: 34040451 PMCID: PMC8140896 DOI: 10.2147/hiv.s303791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/10/2021] [Indexed: 11/28/2022]
Abstract
Introduction Few studies have estimated complete antiretroviral therapy (ART) adherence following HIV infection since the advent of the new ART guidelines in 2012. This study determined the prevalence and influence of sociodemographic, behavioral, and clinical factors on complete ART adherence among people living with HIV (PLWH) receiving medical care in Houston/Harris County, Texas. Methods Data from the Houston Medical Monitoring Project survey collected from 2009 to 2014 among 1073 participants were used in this study. The primary outcome evaluated was combined adherence, defined as complete, partial, and incomplete combined adherence based on three ART adherence types—dose, schedule, and instruction adherence. The duration living since initial HIV diagnosis was classified as <5, 5–10 and >10 years. Rao–Scott Chi-square test and multivariable proportional-odds cumulative logit regression models were employed to identify the sociodemographic, behavioral, and clinical characteristics of complete combined adherence among the three groups of PLWH living with HIV infection. Results More than one-half (54.4%) of PLWH had complete, 37.4% had partial, and 8.3% had incomplete combined adherence. Among these PLWH, 52.2% had been infected with HIV for >10 years, and 26.5% and 21.4% were infected for <5 years and 5–10 years, respectively. PLWH who were diagnosed <5 and 5–10 years were two times (aOR=1.71, 95% CI=1.13–2.57; aOR=1.69, 95% CI=1.10–2.59; respectively) more likely to experience complete combined adherence than those with >10 years of infection. Multiple sociodemographic, behavioral, and clinical characteristics were significantly associated with complete adherence and varied by the duration of HIV infection. Conclusion Measures of adherence should include all adherence types (dose, schedule, instruction), as utilizing a single adherence type will overestimate adherence level in PLWH receiving medical care. Intervention efforts to maintain adherence should target recently infected PLWH, while those aimed at improving adherence should focus on longer infected PLWH.
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Affiliation(s)
- Pagna Sok
- The University of Texas School of Public Health, Texas Medical Center, Houston, TX, USA.,Department of Pediatrics, Baylor College of Medicine, Texas Medical Center, Houston, TX, USA
| | - Osaro Mgbere
- Disease Prevention and Control Division, Houston Health Department, Houston, TX, USA.,Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, USA
| | - Lisa Pompeii
- The University of Texas School of Public Health, Texas Medical Center, Houston, TX, USA.,Department of Pediatrics, Baylor College of Medicine, Texas Medical Center, Houston, TX, USA
| | - Ekere James Essien
- The University of Texas School of Public Health, Texas Medical Center, Houston, TX, USA.,Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, USA.,Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, TX, USA
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3
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Chen YC, Thio CL, Kamangar F, Cox AL, Wiberg KJ. Evolving trends in the prevalence of hepatitis C virus antibody positivity among HIV-infected men in a community-based primary care setting. J Viral Hepat 2020; 27:1202-1213. [PMID: 32579777 PMCID: PMC7544680 DOI: 10.1111/jvh.13354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 05/04/2020] [Accepted: 05/20/2020] [Indexed: 12/09/2022]
Abstract
Hepatitis C virus (HCV) infections in the United States occurred mostly among those born between 1945 and 1965. However, new infections continue to increase in recent years. To understand the changes in the prevalence and risk factors of HCV infection in different age and risk groups among men living with HIV, we performed a retrospective cross-sectional analyses of 1948 HIV-infected men at a multisite community health centre in urban/suburban and rural Maryland from 2003 through 2014. We used multivariate logistic regression to determine factors associated with HCV antibody (anti-HCV) positivity and restricted cubic spline method to model trends in anti-HCV prevalence over time. The overall anti-HCV prevalence was 24.2%. The annual prevalence declined in the full cohort, from 38% in 2003 to 24% in 2014, and among those ≥ 40 years old. However, the annual prevalence increased initially and then stabilized in the groups of men who were younger (<40 years old) or had injection-drug use and/or sex with men. Among the younger injection-drug users, the prevalence rose from 33% in 2003 to 79% in 2009 and then stabilized. The independent predictors for anti-HCV positivity differed between the men with and without injection-drug use and between those < 40 and ≥ 40 years old. Notably, a high prevalence of anti-HCV was observed among the younger, white injection-drug users residing in rural areas. Thus, the HCV epidemic continued unabated among high-risk individuals in this diverse population of HIV-infected men. The ongoing HCV transmission among young HIV-infected men poses a challenge en route to HCV eradication.
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Affiliation(s)
- Yun-Chi Chen
- Department of Biology, Morgan State University, Baltimore, MD,Corresponding author: Yun-Chi Chen, D.Phil (Oxon). Department of Biology, Morgan State University, 1700 Cold Spring Lane, Baltimore, 21251 MD, Phone: 1-443-885-1997,
| | - Chloe L Thio
- Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Farin Kamangar
- Department of Biology, Morgan State University, Baltimore, MD
| | - Andrea L Cox
- Department of Medicine, Johns Hopkins University, Baltimore, MD
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Thompson J, Onyenaka C, Oduguwa E, Dongarwar D, Gendra S, Coker V, Kutse S, Blanco M, Nwangwu O, King C, Enamorado E, Bakare O, Ajewole VB, Spooner KK, Salemi JL, Aliyu MH, Salihu HM, Olaleye OA. Trends and Racial/Ethnic Disparities in the Rates of Pre-eclampsia by HIV Status in the US. J Racial Ethn Health Disparities 2020; 8:670-677. [PMID: 32754847 DOI: 10.1007/s40615-020-00826-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Preeclampsia and HIV account for a significant proportion of the global burden of disease and pose severe maternal-fetal risks. There is a dearth of literature regarding racial/ethnic disparities in preeclampsia associated with HIV/AIDS in the US. METHODS We retrospectively analyzed data from the National Inpatient Sample (NIS) database from 2002 to 2015 on a cohort of hospitalized pregnant women with or without preeclampsia and HIV. Joinpoint regression models were used to identify trends in the rates of preeclampsia among pregnant women living with or without HIV, stratified by race/ethnicity over the study period. We also assessed the association between preeclampsia and various socio-demographic factors. RESULTS We analyzed over 60 million pregnancy-related hospitalizations, of which 3665 had diagnoses of preeclampsia and HIV, corresponding to a rate of 0.61 per 10,000. There was an increasing trend in the diagnosis of preeclampsia among hospitalized, pregnant women without HIV across each racial/ethnic category. The highest prevalence of preeclampsia was among non-Hispanic (NH) Blacks, regardless of HIV status. CONCLUSION The increase in rates of pre-eclampsia between 2002 and 2015 was mostly noted among pregnant women without HIV. Regardless of HIV status, NH-Blacks experienced the highest discharge prevalence of preeclampsia.
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Affiliation(s)
- Jamalena Thompson
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Collins Onyenaka
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Emmanuella Oduguwa
- Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77098, USA.
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77098, USA
| | - Sumaya Gendra
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Vidella Coker
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Seun Kutse
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Mayra Blanco
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Onyinye Nwangwu
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Charlee King
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Elza Enamorado
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Oluwatoyin Bakare
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Veronica B Ajewole
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Kiara K Spooner
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jason L Salemi
- College of Public Health, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Muktar H Aliyu
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hamisu M Salihu
- Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77098, USA.,Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Omonike A Olaleye
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
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5
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Beltrami J, Gans A, Wozniak M, Murphy J, Puesta B, Kennebrew D, Angie Allen M, OʼConnor K. The Usefulness of Individual-Level HIV Surveillance Data to Initiate Statewide HIV Partner Services: Experiences From Hawaii and New Mexico. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 24:519-525. [PMID: 28763430 DOI: 10.1097/phh.0000000000000643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Partner services are a broad array of services that should be offered to persons with human immunodeficiency virus (HIV) and that are based on a process through which HIV-infected persons are interviewed to elicit information about their sex and needle-sharing partners. Human immunodeficiency virus testing of partners can result in a high yield of newly diagnosed HIV positivity, but despite this yield and the benefits of partners knowing their exposures and HIV status, partner services are often not conducted. OBJECTIVE We sought to determine the newly diagnosed HIV positivity and benefits to 2 health departments that conducted demonstration projects that focused on statewide HIV partner services. DESIGN The main sources of information used for this case study analysis included the health department funding applications, progress reports and final reports submitted to the Centers for Disease Control and Prevention, and records of communications between Centers for Disease Control and Prevention and the health departments. Required quantitative reporting included the number of partners tested and the number of partners with newly diagnosed confirmed HIV infection. Required qualitative reporting included how health departments benefited from their demonstration project activities. SETTING Hawaii and New Mexico. PARTICIPANTS Sex and needle-sharing partners of persons who were newly diagnosed with HIV infection. INTERVENTION The use of HIV surveillance data to initiate statewide HIV partner services. MAIN OUTCOME MEASURE Newly diagnosed HIV positivity. RESULTS During 2012-2015, the newly diagnosed HIV positivity among partners was 18% (78/427): 16% (17/108) in Hawaii and 19% (61/319) in New Mexico. The health departments benefited from improved collaborations among HIV prevention program and surveillance staff and among the health departments, providers, and AIDS service organizations. CONCLUSIONS Hawaii and New Mexico each achieved a high newly diagnosed HIV positivity and benefited from improved local collaborations. As a result of the success of these projects, both health departments have continued the activities since the end of category C funding by securing alternative funding sources.
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Affiliation(s)
- John Beltrami
- US Public Health Service, Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia (Dr Beltrami); New Mexico Department of Health, Santa Fe, New Mexico (Messrs Gans and Murphy); Hawaii Department of Health, Honolulu, Hawaii (Ms Wozniak); Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia (Mr Puesta and Mss Kennebrew and Allen); and Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, Georgia (Mr O'Connor)
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Bauermeister JA, Muessig KE, Flores DD, LeGrand S, Choi S, Dong W, Harper GW, Hightow-Weidman LB. Stigma Diminishes the Protective Effect of Social Support on Psychological Distress Among Young Black Men Who Have Sex With Men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:406-418. [PMID: 30332312 PMCID: PMC6524771 DOI: 10.1521/aeap.2018.30.5.406] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Addressing stigma remains a pressing HIV priority globally. Young Black men who have sex with men (YBMSM, ages 18-30; N = 474) completed an in-person baseline survey and reported their experiences of externalized stigma (i.e., racial and sexuality discrimination), internalized stigma (i.e., homonegativity), social support, and psychological distress (i.e., anxiety and depression symptoms). We used structural equation modeling to test the association between stigma and psychological distress, and examined whether social support mediated the relationship between stigma and psychological distress. Recognizing that these associations may differ by HIV status, we compared our models by self-reported HIV status (n = 275 HIV negative/unknown; n = 199 living with HIV). Our findings suggest that YBMSM who experience stigma are more vulnerable to psychological distress and may have diminished buffering through social support. These effects are accentuated among YBMSM living with HIV, highlighting the need for additional research focused on the development of tailored stigma reduction interventions for YBMSM.
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Affiliation(s)
| | | | | | | | - Seulki Choi
- University of North Carolina, Chapel Hill, North Carolina
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Cunha GHD, Galvão MTG, Pinheiro PNDC, Vieira NFC. Health literacy for people living with HIV/Aids: an integrative review. Rev Bras Enferm 2017; 70:180-188. [PMID: 28226058 DOI: 10.1590/0034-7167-2015-0052] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 08/25/2016] [Indexed: 11/21/2022] Open
Abstract
Objective: to analyze knowledge produced by research about health literacy for adult with HIV/Aids. Method: an integrative literature review, using six databases, was conducted between January and April of 2014. The descriptors aids and Health Literacy were used, in Portuguese, English and Spanish. A total of 130 articles were found and 14 were selected. Three categories were identified: educational technologies and health literacy for HIV/Aids; assessment of health literacy of patients with HIV/Aids; and health literacy and adherence to antiretroviral therapy. Results: analysis of health literacy, socioeconomic status and educational level of people living with HIV/ Aids was essential for implementation of educational strategies that increased adherence to health guidance. Conclusion: this study showed the importance of health literacy for working with people living with HIV/Aids, especially considering individuals who did not possess the minimum necessary for survival, which makes it relevant and encourages further research on the topic.
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8
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Deren S, Naegle M, Hagan H, Ompad DC. Continuing Links Between Substance Use and HIV Highlight the Importance of Nursing Roles. J Assoc Nurses AIDS Care 2017; 28:622-632. [PMID: 28456473 PMCID: PMC5485853 DOI: 10.1016/j.jana.2017.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
Abstract
Links between HIV and substance use were identified early in the U.S. HIV epidemic. People who use drugs are at risk of HIV infection through shared injection equipment and risky sexual behaviors. In addition, substance use has negative health consequences for people living with HIV. The prescription opioid misuse epidemic, linked to injection drug use, hepatitis C infection, and HIV, poses a new threat to declining HIV rates. We reviewed evidence-based interventions that decrease HIV risk in people who use drugs (needle/syringe programs, medication-assisted treatment, engagement in HIV care, and preexposure prophylaxis/postexposure prophylaxis). The critical roles of nurses in HIV prevention/care for this population are described, including applying the principles of harm reduction, screening for substance use, and undertaking implementation and research efforts. As the nation's largest health care profession, nurses are positioned to contribute to the quality of HIV-related prevention/care for people who use drugs and to lead practice initiatives.
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Affiliation(s)
- Sherry Deren
- Senior Research Scientist, Rory Meyers College of Nursing, New York University, and Co-Director, Center for Drug Use and HIV Research, New York, New York, USA
| | - Madeline Naegle
- Professor and Director, WHO Collaborating Center for Geriatric Nursing Education, Rory Meyers College of Nursing, New York University, and Associate Director, Dissemination & Implementation Core, Center for Drug Use and HIV Research, New York, New York, USA
| | - Holly Hagan
- Professor, Rory Meyers College of Nursing, New York University, and Co-Director of the Center for Drug Use and HIV Research, New York, New York, USA
| | - Danielle C. Ompad
- Associate Professor, College of Global Public Health, New York University, and Deputy Director of the Center for Drug Use and HIV Research, New York, New York, USA
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9
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Gao TY, Howe CJ, Zullo AR, Marshall BDL. Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS. VULNERABLE CHILDREN AND YOUTH STUDIES 2016; 12:277-291. [PMID: 29057006 PMCID: PMC5647150 DOI: 10.1080/17450128.2016.1268741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The Centers for Disease Control and Prevention (CDC) has previously recommended that all adolescents undergo HIV testing in the United States (US). Despite these recommendations, national HIV testing among US adolescents has remained low. This study estimated the prevalence of and identified risk factors for not receiving an HIV test among adolescents with a history of sexual intercourse in New York City (NYC), an urban area that has been greatly impacted by the HIV epidemic. Cross-sectional data on 1,199 NYC high school students who completed the 2013 NYC Youth Risk Behavior Survey were used. Modified Poisson regression models were used to assess whether demographic factors, alcohol/drug use, and sexual behaviors were associated with self-report of lack of HIV testing. In the weighted study population, about 72% were ≥16 years old, approximately 35% were African American, and nearly half were male. Sixty percent reported no history of HIV testing. In adjusted analyses, younger age, male gender, White race/ethnicity, heroin use, as well as reporting one prior sexual partner were significantly and positively associated with no prior history of HIV testing. Our findings suggest that among NYC adolescents with a history of sexual intercourse, the prevalence of HIV testing is low. HIV testing may have been low in part because of limited experience with current screening guidelines among clinicians. Furthermore, many of the adolescents identified as being more likely to not be tested, may have not been screened because of inadequate knowledge about HIV, a low perceived HIV risk, or an unstable lifestyle. Therefore, to increase HIV testing among NYC adolescents, interventions that enhance HIV knowledge among adolescents as well as interventions that promote review and application of current screening guidelines among clinicians should be implemented in NYC. Educational interventions should especially be targeted at the adolescents identified in this study.
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Affiliation(s)
- Tina Y Gao
- Centers for Epidemiology and Environmental Health, Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, Rhode Island, USA
| | - Chanelle J Howe
- Centers for Epidemiology and Environmental Health, Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, Rhode Island, USA
| | - Andrew R Zullo
- Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 South Main Street, Providence, Rhode Island, USA
| | - Brandon D L Marshall
- Centers for Epidemiology and Environmental Health, Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, Rhode Island, USA
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10
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Cunha GHD, Galvão MTG, Medeiros CMD, Rocha RP, Lima MAC, Fechine FV. Vaccination status of people living with HIV/AIDS in outpatient care in Fortaleza, Ceará, Brazil. Braz J Infect Dis 2016; 20:487-93. [PMID: 27542868 PMCID: PMC9425449 DOI: 10.1016/j.bjid.2016.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 07/17/2016] [Accepted: 07/24/2016] [Indexed: 11/27/2022] Open
Abstract
Antiretroviral therapy has increased the survival of patients with HIV/AIDS, thus necessitating health promotion practice with immunization. Vaccines are critical components for protecting people living with HIV/AIDS (PLWHA). The purpose of study was to analyze the vaccination status of PLWHA in outpatient care in Fortaleza, Ceará, Brazil. Cross-sectional study performed from June 2014 to June 2015. The screening was done with patients in antiretroviral therapy, 420 patients underwent screening, but only 99 met the inclusion criteria. Data were collected for interviews using forms to characterize sociodemographic, clinical and vaccination situations. Only 14 patients had complete vaccination schedules. The most used vaccines were hepatitis B, influenza vaccine and 23-valent pneumococcal. There was no difference between men and women regarding the proportion of PLWHA with full vaccination schedule or between sex, skin color, marital status, sexual orientation, religion or occupational status. There was no difference between having or not having a complete vaccination schedule and age, years of education, family income or number of hospitalizations. CD4+ T-cells count of patients with incomplete immunization was lower than patients with complete immunization. Health education strategies can be done individually or in groups to explain the importance of vaccination and to remind about doses to be administered. Most patients did not have proper adherence to vaccination schedules, especially due to lack of guidance. Results implied that education in health is important for vaccination adhesion, knowledge of adverse events and continuation of schemes.
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Affiliation(s)
| | | | | | - Ryvanne Paulino Rocha
- Universidade Federal do Ceará (UFC), Departamento de Enfernagem, Fortaleza, CE, Brazil
| | | | - Francisco Vagnaldo Fechine
- Universidade Federal do Ceará (UFC), Centro de Pesquisa e Desenvolvimento de Medicamentos, Fortaleza, CE, Brazil
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11
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Dombrowski JC, Carey JW, Pitts N, Craw J, Freeman A, Golden MR, Bertolli J. HIV provider and patient perspectives on the Development of a Health Department "Data to Care" Program: a qualitative study. BMC Public Health 2016; 16:491. [PMID: 27286654 PMCID: PMC4901404 DOI: 10.1186/s12889-016-3152-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 05/26/2016] [Indexed: 11/20/2022] Open
Abstract
Background U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing “Data to Care” programs to assists persons living with HIV (PLWH) with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Methods Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009–2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. Results PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care program in Seattle-King County was designed to incorporate an HIV-positive peer component and to ensure coordination with HIV care providers in the process of relinking patients to care. Conclusions Health departments can build support for Data to Care efforts by gathering input of key stakeholders, such as HIV medical and social service providers, and coordinating with clinic-based efforts to re-engage patients in care.
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Affiliation(s)
- Julia C Dombrowski
- Department of Medicine, University of Washington, 325 Ninth Ave, Box 359777, Seattle, WA, 98104, USA. .,Public Health - Seattle & King County HIV/STD Program, Seattle, WA, USA.
| | - James W Carey
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Jason Craw
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Arin Freeman
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew R Golden
- Public Health - Seattle & King County HIV/STD Program, Seattle, WA, USA.,Departments of Medicine and Epidemiology, University of Washington, Seattle, WA, USA
| | - Jeanne Bertolli
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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