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Balvanz P, Olvera RG, McGladrey M, Booty M, Beard D, Ellison S, McClay C, Nouvong M, Oser CB, Yamoah O, Martinez LS. Leveraging local knowledge to contextualize the opioid epidemic within HEALing Communities Study communities: A Photovoice protocol. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 165:209460. [PMID: 39067764 DOI: 10.1016/j.josat.2024.209460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/10/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
Since its inception 30 years ago, Photovoice has gained increasing popularity as a research method and more recently has been incorporated within randomized controlled trial (RCT) designs. Photovoice is a participatory action research method that pairs photography with focus group discussions to record community strengths and concerns, build critical consciousness, and reach policymakers. Adherence of Photovoice implementation to these original tenets of Photovoice varies. This article provides the Photovoice protocol developed by the authors to improve the methodological rigor of Photovoice integration into RCTs and help contextualize the landscape for the HEALing Communities Study (HCS: NCT04111939), a greater than $350 million investment by the National Institute on Drug Abuse along with the Substance Abuse and Mental Health Services Administration to reduce opioid overdose deaths in 67 of the hardest-hit communities in four states (Kentucky, Massachusetts, New York, and Ohio). The product of a cross-state collaboration, this HCS Photovoice protocol provides ethical and methodological tools for incorporating Photovoice into RCT designs to enhance community engagement, communication campaigns, and data-driven decision-making about evidence-based practice selection and implementation.
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Affiliation(s)
- Peter Balvanz
- General Internal Medicine, Boston Medical Center, Boston, MA, United States of America.
| | - Ramona G Olvera
- CATALYST, The Ohio State University, College of Medicine, Columbus, OH, United States of America.
| | - Margaret McGladrey
- Department of Health Management and Policy, College of Public Health, UK.
| | - Marisa Booty
- Department of Sociology, University of Kentucky, Lexington, KY, United States of America.
| | - Dacia Beard
- Boston University School of Public Health, Boston, MA, United States of America.
| | - Sylvia Ellison
- HEALing Communities Study, The Ohio State University, College of Medicine, Columbus, OH, United States of America.
| | - Craig McClay
- General Internal Medicine, Boston Medical Center, Boston, MA, United States of America.
| | - Monica Nouvong
- General Internal Medicine, Boston Medical Center, Boston, MA, United States of America.
| | - Carrie B Oser
- Department of Sociology, University of Kentucky, Lexington, KY, United States of America.
| | - Owusua Yamoah
- Swetland Center for Environmental Health, Case Western Reserve University, Cleveland, OH, United States of America.
| | - Linda Sprague Martinez
- Health Disparities Institute, University of Connecticut School of Medicine, UConn Health, Hartford Connecticut, United States of America.
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Kamila A, Widyawati W, Hasanbasri M, Hakimi M. Capturing the HIV-related social exclusion practices experienced by key populations through photovoice: an interpretative phenomenological study. Reprod Health 2024; 21:107. [PMID: 39004733 PMCID: PMC11247771 DOI: 10.1186/s12978-024-01832-y] [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: 08/31/2023] [Accepted: 06/16/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Key populations are defined as groups that are susceptible to HIV, including Men Sex with Men (MSM), Transgender (TG), Persons who Inject Drug (PID), and Female Sex Worker (FSW). These key populations groups are among the fastest-growing populations in Indonesia. These vulnerable groups are ostracized by society and health services, which makes it difficult to get treatment. This project was carried out to investigate the different experiences and perspectives of these key populations in facing and addressing social and spiritual exclusion. METHODS A qualitative phenomenological study using photovoice was carried out from July to December 2022. Key populations comprising MSM, TG, PID, and FSW were recruited from community-based peer groups in West Bandung Regency using snowball sampling. This was followed by the Photovoice stages, from workshops to focus group discussions and interviews with audio recordings. Furthermore, thematic data analysis was carried out by interpretative participant narratives and photographs supported by Atlas.ti software. RESULT Eighteen participants comprising four MSM, five TG, four PIDs, and five FSWs participated in this research. Among these eighteen participants, six were HIV-negative, including 3 PIDs and 3 FSWs, while the remaining were positive. The analysis of the collected data identified four main themes: 1) limited access like unequal treatment, disadvantage, and harassment, 2) social and spiritual impact, 3) coping mechanisms, and 4) self-reflection through photovoice. These results showed that social exclusion occurred in an environment where community values, beliefs, and norms dehumanised these key populations, and where removal of support and care was prominent. Despite these challenges, participant resilience was evidenced by using internal resources and peer support as coping mechanisms. The participants considered photovoice as a tool to foster self-confidence and self-awareness through a reflective process. CONCLUSIONS The findings of this study highlight the emphasis on participants' openness in sharing their experiences, which can build empathy and promote a more inclusive community in HIV prevention efforts. This research findings can be used to inform HIV policy and practice and inclusion of these key populations in the community. We advocate making the photovoice efforts accessible to a wider audience through exhibitions and various media.
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Affiliation(s)
- Ami Kamila
- Doctoral Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Health Science, Universitas 'Aisyiyah Bandung, Bandung, West Java, Indonesia
| | - Widyawati Widyawati
- Pediatric and Maternity Nursing Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Mubasysyir Hasanbasri
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mohammad Hakimi
- Obstetrics and Gynecology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Yang T, Qing L, Wang Y, Bu Q, Zhang M, Tan B, Chen X, Deng D. Influence of HIV/AIDS knowledge on HIV testing behavior among young students (14-27 years) with a history of sexual activity: chain mediation analysis of social discrimination, self-efficacy, and sexual behavior characteristics. AIDS Care 2024; 36:561-568. [PMID: 38088933 DOI: 10.1080/09540121.2023.2280460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/31/2023] [Indexed: 03/08/2024]
Abstract
This study used a self-administered questionnaire to investigate the relationship between HIV/AIDS knowledge, social discrimination, HIV self-efficacy, sexual behavioral characteristics and HIV testing behavior among young students with a history of sexual activity in Chongqing. Propensity score matching was used to construct a control group with similar demographic characteristics to the HIV testing group, only without HIV testing behaviors. Structural equation modeling was used to conduct chain-mediated effect analysis. The HIV testing rate among young students with a history of sexual behavior was 17.16%. Young students with HIV testing behavior had higher levels of HIV/AIDS knowledge, lower social discrimination, better self-efficacy, and no difference in sexual behavior characteristic scores between the two groups (P = 0.062). The mediated effect values of social discrimination and self-efficacy were 0.022 and 0.063, respectively, while their chain mediated effect value was 0.007. There was no mediated effect of sexual behavior characteristics. The level of young students' HIV/AIDS knowledge does not directly influence their HIV testing behavior but plays a complete chain mediating effect on HIV testing behavior through social discrimination and self-efficacy. HIV testing behavior should be promoted through the perspectives of enhancing HIV/AIDS knowledge level, reducing social discrimination, and improving self-efficacy.
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Affiliation(s)
- Tong Yang
- Shapingba District Center for Disease Control and Prevention, Chongqing, People's Republic of China
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Liyuan Qing
- Jiulongpo District Center for Disease Control and Prevention, Chongqing, People's Republic of China
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yunna Wang
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Qingqing Bu
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Meng Zhang
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Bo Tan
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xinrui Chen
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Dan Deng
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
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Ng CG, Ting SQ, Saifi RA, Kamarulzaman AB. Ethical Issues in Photovoice Studies involving Key Populations: A Scoping Review. Asian Bioeth Rev 2024; 16:109-129. [PMID: 38213991 PMCID: PMC10776538 DOI: 10.1007/s41649-023-00264-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 01/13/2024] Open
Abstract
Photovoice, a community-based participatory research method, employs images and words to convey participants' needs, concerns, and desires. It proves particularly valuable in researching marginalized communities who face elevated health risks, disease transmission, and social and health disparities. This paper seeks to investigate the ethical considerations inherent in photovoice research projects. We conducted an extensive literature review spanning four databases to identify pertinent photovoice studies. Ethical issues from the selected articles were identified, categorized, and summarized. Our analysis of twenty-five photovoice studies uncovered various ethical concerns, which had been grouped into informed consent, participant safety and disclosure, privacy and confidentiality, misrepresentation, power dynamics, and compensation. In essence, our findings underscore the importance of addressing these ethical concerns to uphold the rights and autonomy of participants, even as photovoice research strives for authenticity, inclusivity, and empowerment.
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Affiliation(s)
- Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sing Qin Ting
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rumana Akhter Saifi
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Adeeba Bt Kamarulzaman
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Restall G, Ukoli P, Mehta P, Hydesmith E, Payne M. Resisting and disrupting HIV-related stigma: a photovoice study. BMC Public Health 2023; 23:2062. [PMID: 37864144 PMCID: PMC10590010 DOI: 10.1186/s12889-023-16741-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/12/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The stigma associated with human immunodeficiency virus (HIV) is a significant global public health concern. Health care providers and policy makers continue to struggle with understanding and implementing strategies to reduce HIV-related stigma in particular contexts and at the intersections of additional oppressions. Perspectives and direction from people living with HIV are imperative. METHODS In this project we amplified the voices of people living with HIV about their experiences of HIV-related stigma in Manitoba, Canada. We used an arts-based qualitative case study research design using photovoice and narrative interviews. Adults living with HIV participated by taking pictures that represented their stigma experiences. The photos were a catalyst for conversations about HIV and stigma during follow-up individual narrative interviews. Journaling provided opportunities for participants to reflect on their experiences of, and resistance to, stigma. Interviews were audio recorded and transcribed. Photos, journals, and transcribed interviews were analyzed using inductive qualitative methods RESULTS: Through pictures and dialogue, participants (N = 11; 64% women) expressed the emotional and social impacts of stigmas that were created and supported by oppressive structures and interpersonal attitudes and behaviours. These experiences were compounded by intersecting forms of oppression including racism, sexism, and homophobia. Participants also relayed stories of their personal strategies and transitions toward confronting stigma. Strategies were themed as caring for oneself, caring for children and pets, reconstituting social support networks, and resisting and disrupting stigma. Participants made important recommendations for system and policy change. CONCLUSIONS These stories of oppression and resistance can inspire action to reduce HIV-related stigma. People living with HIV can consider the strategies to confront stigma that were shared in these stories. Health care providers and policy makers can take concerted actions to support peoples' transitions to resisting stigmas. They can facilitate supportive and anti-oppressive health and social service systems that address medical care as well as basic needs for food, shelter, income, and positive social and community connections.
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Affiliation(s)
- Gayle Restall
- Department of Occupational Therapy, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada.
| | - Patricia Ukoli
- Faculty of Social Work, University of Manitoba, Winnipeg, MB, Canada
| | - Punam Mehta
- Department of Community Health Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Elizabeth Hydesmith
- Department of Anthropology, Faculty of Arts, University of Manitoba, Winnipeg, MB, Canada
| | - Mike Payne
- Nine Circles Community Health Centre, Winnipeg, MB, Canada
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Sommer S, Barroso J. A qualitative metasynthesis of stigma in women living with HIV in the United States. Int J Equity Health 2023; 22:158. [PMID: 37605194 PMCID: PMC10441719 DOI: 10.1186/s12939-023-01969-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/19/2023] [Indexed: 08/23/2023] Open
Abstract
Our goal was to synthesize qualitative studies on HIV-related stigma as experienced by women living with HIV (WLWH) in the U.S. Qualitative metasynthesis techniques as developed by Sandelowski et al. (Res Nurs Health 30(1):99-111, 2007) were used to integrate and update findings on stigma in WLWH in the U.S. in 43 reports of qualitative studies conducted between 2004 and 2023 with 1118 participants. Developed themes explored a collective narrative of women first surviving the intersectionality of multiple sources of stigma, discovering non-linear pathways to transcend their stigma, and finally experiencing resilience through their transcendence of stigma. While this metasynthesis revealed similarities to an earlier metasynthesis in the ubiquity and persistence of stigma, they differ primarily in women's abilities to find agency in managing and opposing their stigma. This cognitive reframing of their stigma helped women to redefine stigma as ignorance and move towards a more positive assessment of the self. In doing so, they separated themselves from their stigma and the damaging effects of it. Findings from this metasynthesis may serve as a useful tool for the development of stigma reduction interventions specific to the needs and experiences of WLWH in the U.S.
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Affiliation(s)
- Sadie Sommer
- School of Nursing, Vanderbilt University, 461 21st Ave, S, Nashville, TN, 37240, USA.
| | - Julie Barroso
- School of Nursing, Vanderbilt University, 461 21st Ave, S, Nashville, TN, 37240, USA
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Ruiz-Burga E, Tariq S, Touloumi G, Gill J, Nicholls EJ, Sabin C, Mussini C, Meyer L, Volny Anne A, Carlander C, Grabar S, Jarrin I, Van der Valk M, Wittkop L, Spire B, Pantazis N, Burns FM, Porter K. CASCADE protocol: exploring current viral and host characteristics, measuring clinical and patient-reported outcomes, and understanding the lived experiences and needs of individuals with recently acquired HIV infection through a multicentre mixed-methods observational study in Europe and Canada. BMJ Open 2023; 13:e070837. [PMID: 37169505 DOI: 10.1136/bmjopen-2022-070837] [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] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Despite the availability of pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART), 21 793 people were newly diagnosed with HIV in Europe in 2019. The Concerted action on seroconversion to AIDS and death in Europe study aims to understand current drivers of the HIV epidemic; factors associated with access to, and uptake of prevention methods and ART initiation; and the experiences, needs and outcomes of people with recently acquired HIV. METHODS AND ANALYSIS This longitudinal observational study is recruiting participants aged ≥16 years with documented laboratory evidence of HIV seroconversion from clinics in Canada and six European countries. We will analyse data from medical records, self-administered questionnaires, semistructured interviews and participatory photography. We will assess temporal trends in transmitted drug resistance and viral subtype and examine outcomes following early ART initiation. We will investigate patient-reported outcomes, well-being, and experiences of, knowledge of, and attitudes to HIV preventions, including PrEP. We will analyse qualitative data thematically and triangulate quantitative and qualitative findings. As patient public involvement is central to this work, we have convened a community advisory board (CAB) comprising people living with HIV. ETHICS AND DISSEMINATION All respective research ethics committees have approval for data to contribute to international collaborations. Written informed consent is required to take part. A dissemination strategy will be developed in collaboration with CAB and the scientific committee. It will include peer-reviewed publications, conference presentations and accessible summaries of findings on the study's website, social media and via community organisations.
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Affiliation(s)
- Elisa Ruiz-Burga
- Institute for Global Health, University College London, London, UK
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
- Central and Northwest London NHS Foundation Trust, Mortimer Market Centre, London, UK
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - John Gill
- Southern Alberta HIV Clinic, Calgary, Alberta, Canada
| | | | - Caroline Sabin
- Institute for Global Health, University College London, London, UK
| | - Cristina Mussini
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, University of Modena and Reggio Emilia, Modena, Italy
| | - Laurence Meyer
- INSERM CESP U1018, APHP Hôpital de Bicêtre, Le Kremlin-Bicêtre, Paris-Saclay University, Gif-sur-Yvette, France
| | | | - Christina Carlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Sophie Grabar
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, AP-HP, Hôpital St Antoine, Paris, France
| | - Inma Jarrin
- National Centre of Epidemiology, Carlos III Health Institute, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Infecciosas, Madrid, Spain
| | - Marc Van der Valk
- Department of Infectious Diseases, Amsterdam Infection & Immunity Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, Netherlands
| | - Linda Wittkop
- INSERM, BPH, U1219, CIC-EC 1401, Universite Bordeaux, Bordeaux, France
- INRIA SISTM Team, Talence, France
| | - Bruno Spire
- Inserm, IRD, SESSTIM, ISSPAM, Aix-Marseille Université, Marseille, France
| | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Fiona M Burns
- Institute for Global Health, University College London, London, UK
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
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Majid U, Kandasamy S. The rationales for and challenges with employing arts-based health services research (ABHSR): a qualitative systematic review of primary studies. MEDICAL HUMANITIES 2021; 47:266-273. [PMID: 32958530 DOI: 10.1136/medhum-2020-011845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
Health services research (HSR) is an interdisciplinary field that investigates and improves the design and delivery of health services from individual, group, organisational and system perspectives. HSR examines complex problems within health systems. Qualitative research plays an important role in aiding us to develop a nuanced understanding of patients, family, healthcare providers, teams and systems. However, the overwhelming majority of HSR publications using qualitative research use traditional methods such as focus groups and interviews. Arts-based research-artistic and creative forms of data collection such as dance, drama and photovoice-have had limited uptake in HSR due to the lack of clarity in the methods, their rationales and potential impacts. To address this uncertainty, we conducted a qualitative systematic review of studies that have employed arts-based research in HSR topics. We searched four databases for peer-reviewed, primary HSR studies. Using conventional content analysis, we analysed the rationales for using arts-based approaches in 42 primary qualitative studies. We found four rationales for using arts-based approaches for HSR: (1) Capture aspects of a topic that may be overlooked, ignored or not conceptualised by other methods (ie, quantitative and interview-based qualitative methods). (2) Allow participants to reflect on their own experiences. (3) Generate valuable community knowledge to inform intervention design and delivery. (4) Formulate research projects that are more participatory in nature. This review provides health services researchers with the tools, reasons, rationales and justifications for using arts-based methods. We conclude this review by discussing the practicalities of making arts-based approaches commensurable to HSR.
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Affiliation(s)
- Umair Majid
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sujane Kandasamy
- Health Research Methods, Evidence & Impact, Health Research Methdology PhD Program, McMaster University, Hamilton, Ontario, Canada
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Posada-Abadía CI, Marín-Martín C, Oter-Quintana C, González-Gil MT. Women in a situation of homelessness and violence: a single-case study using the photo-elicitation technique. BMC WOMENS HEALTH 2021; 21:216. [PMID: 34022870 PMCID: PMC8141249 DOI: 10.1186/s12905-021-01353-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 05/11/2021] [Indexed: 02/08/2023]
Abstract
Background Violence against women places them in a vulnerable position with regard to homelessness. Although sometimes invisible, women’s homelessness is a complex reality shrouded in dramatic biographies that should be sensitively addressed to avoid revictimization. Methods With the aim of understanding the chaotic discourse of homeless women’s experiences of violence, a qualitative single-case study was conducted using the photo-elicitation technique. Data were analyzed in accordance with grounded theory. Results The participant’s discourse could be summarized in the following categories: “Living in a spiral of violence”, “Confronting vulnerability and violence”, “Being a strong woman”, “New family networks”, “Re-building mother–child relationships”, and “Nurturing spiritual wellbeing”. Conclusions Supporting homelessness women requires an approach that focuses on the prevention of re-victimization and the consequences of violence in terms of physical and mental health. Shelters are spaces of care for recovery and represent referential elements for the re-construction of self.
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Affiliation(s)
| | - Carolina Marín-Martín
- Department of Personality, Evaluation, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
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Overstreet NM, Cheeseborough T. Examining the Effect of Internalized HIV-Related Stigma on Perceptions of Research Participation among HIV-Positive African American Women. TRANSLATIONAL ISSUES IN PSYCHOLOGICAL SCIENCE 2020; 6:223-234. [PMID: 34761075 PMCID: PMC8577417 DOI: 10.1037/tps0000271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
HIV-related stigma may influence ethical concerns in health disparity populations, particularly groups with histories of race, gender, and class oppression in medical research such as African American women. However, a dearth of research has examined how HIV-related stigma influences perceptions of the research process among African American women who participate in health research. The goal of the current study was to examine whether HIV-related stigma experienced on the micro-level, specifically internalized HIV-related stigma, is associated with reactions to research participation in 5 domains: attitudes toward participation, perceptions of research benefits, emotional reactions, perceived drawbacks of the research, and global evaluations of the research. We also examine whether internalized HIV-related stigma is associated with difficulty in answering questions related to sensitive topics. We found that women with higher levels of internalized HIV-related stigma reported more emotional reactions to research, perceived more drawbacks of the research, and expressed more difficulty in answering sensitive questions. Understanding how HIV-related stigma influences perceived risks and benefits of research participation may play an important role in guiding best practices for ethical engagement with HIV-positive African American women who participate in health research.
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Hampton CJ, Gillum TL. 'Today I feel strong': African American women overcoming HIV-related stigma. Psychol Health 2020; 35:1440-1458. [PMID: 32372665 DOI: 10.1080/08870446.2020.1761978] [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: 10/24/2022]
Abstract
Objective: African American account for more than 60% of women living with HIV/AIDS in the United States. This population is disproportionately affected in areas of diagnosis, treatment, and morbidity. HIV-related stigma has been found to play a pivotal role in the experiences of African American women living with HIV/AIDS (WLWHA) impacting self-perception, treatment adherence, depression, interpersonal relationships, and overall quality of life. Limited studies have explored the ways in which HIV-related stigma impacts the self-perceptions of African American WLWHA. To explore these experiences, this study examined the ways in which HIV-related stigma impacts the intrapersonal experiences of African American WLWHA.Design: A phenomenological investigation was conducted to explore the experiences of African American WLWHA.Main Outcome Measure: In-depth, semi-structured qualitative interviews.Results: Interpretive phenomenological analysis revealed four emergent themes: (1) increased vulnerability; (2) processing the diagnosis of HIV/AIDS; (3) surviving HIV/AIDS; and (4) quality of life.Conclusion: Findings of this study contribute to existing literature by highlighting the intricacies of the lived experiences of African American WLWHA from initial diagnosis to present day. Exploring the trajectory of the illness among this population allows for a deeper understanding of the ways in which HIV/AIDS impacts the intrapersonal experiences and self-perceptions of WLWHA.
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Affiliation(s)
| | - Tameka L Gillum
- Department of Psychology, Russell Sage College, Troy, NY, USA
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12
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Tanhan A, Strack RW. Online photovoice to explore and advocate for Muslim biopsychosocial spiritual wellbeing and issues: Ecological systems theory and ally development. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00692-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
HIV stigma is a harmful social phenomenon present in United States (US)-based health care settings. This study assessed the efficacy of a participatory PhotoVoice-informed stigma reduction training program focusing on people living with HIV (PLWH) and targeting health care workers. Seventy-three (N = 73) participants were assessed at baseline (T1), within approximately a week of the training (T2), and at a 3-month follow-up (T3) regarding their HIV/AIDS knowledge, attitudes towards PLWH, and observations of enacted HIV stigma. Findings indicated that the training increased knowledge and improved attitudes (β = 0.56, p < 0.01; β = 0.58, p < 0.01, respectively) at T2, but these effects diminished at T3 (β = - 0.03, p > 0.05; β = - 0.29, p > 0.05, respectively). The training did not, however, have an impact on observations of enacted stigma at T2 (β = 0.10, p > 0.05) or at T3 (β = 0.02, p > 0.05). Additional participatory stigma reduction programs that involve diverse groups of health care workers, offer salient study incentives, include time-saving training methods, and comprise a variety of stigma measures, may be particularly beneficial.
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Drainoni ML, Childs E, Biello KB, Biancarelli DL, Edeza A, Salhaney P, Mimiaga MJ, Bazzi AR. "We don't get much of a voice about anything": perspectives on photovoice among people who inject drugs. Harm Reduct J 2019; 16:61. [PMID: 31775757 PMCID: PMC6882205 DOI: 10.1186/s12954-019-0334-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the context of the current US opioid crisis, people who inject drugs (PWID) are increasingly researched, but their ability to tell their own stories may be limited. Photovoice is a participatory action research method that allows participants to use photography to directly depict their experiences. METHODS We conducted interviews with PWID (n = 33) as part of a qualitative study on the health needs of PWID in the USA to explore interest and acceptability of photovoice as a potential research method and way to share their voices. RESULTS Participants identified facilitators and barriers to participating in a future photovoice project. Facilitators included a chance to depict one's unique experience, help others in need by sharing one's own story, and photography being a more "comfortable" way to tell their stories than traditional research methods. Barriers included safety concerns, embarrassment, and ability to retain cameras. Participants also identified areas of sensitivity related to documenting drug use. CONCLUSIONS While we found broad acceptability of photovoice, barriers would need to be addressed and additional training and support for research staff and potential participants related to the ethics of public photography and engaging PWID in photovoice research would be required.
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Affiliation(s)
- Mari-Lynn Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA. .,Evans Center for Implementation and Improvement Sciences, Boston University School of Medicine, Boston, MA, USA. .,Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA. .,Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA.
| | - Ellen Childs
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | - Katie B Biello
- Center for Health Equity Research, Brown University, Providence, RI, USA.,Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.,The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Dea L Biancarelli
- Evans Center for Implementation and Improvement Sciences, Boston University School of Medicine, Boston, MA, USA.,Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | - Alberto Edeza
- Center for Health Equity Research, Brown University, Providence, RI, USA.,Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Peter Salhaney
- Center for Health Equity Research, Brown University, Providence, RI, USA.,Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Matthew J Mimiaga
- Center for Health Equity Research, Brown University, Providence, RI, USA.,Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.,The Fenway Institute, Fenway Health, Boston, MA, USA.,Department of Psychiatry & Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - Angela R Bazzi
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
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15
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Abstract
Palm Springs, CA, is a retirement community with the highest prevalence of gay men living with HIV older than 50 years in the United States. Through a community-academic partnership, we explored the major health issues, resiliencies, and priority research topics related to HIV and aging. We conducted five community facilitated focus groups with different stakeholders, including two focus groups with older adults living with HIV, one with their caregivers, one with HIV-focused community-based organizations, and a joint focus group with researchers and HIV care providers. Using the rigorous and accelerated data reduction technique, five major themes emerged, which included long-term side effects of medication, social determinants of health, mental health, resiliencies, and involving community in research. These data are important for developing effective interventions, conducting useful and impactful research, and providing health care providers with the tools and knowledge to provide optimal care.
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16
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Sousa LRM, Moura LKB, Valle ARMDC, Magalhães RDLB, Moura MEB. Social representations of HIV/AIDS by older people and the interface with prevention. Rev Bras Enferm 2019; 72:1129-1136. [PMID: 31531632 DOI: 10.1590/0034-7167-2017-0748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/07/2018] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To apprehend the social representations elaborated by older people about HIV/AIDS and to understand how they relate to the prevention of HIV infection. METHOD Descriptive and qualitative research based on the Theory of Social Representations with 42 older people assisted at primary care. Data were produced through in-depth interviews with a semi-structured instrument, processed in the IRaMuTeQ software, and analyzed by means of the descending hierarchical classification. RESULTS Five classes emerged: "HIV/AIDS: a problem of young people"; "Quality of life improvement for people living with HIV/AIDS"; "Vulnerability to HIV/AIDS among heterosexual women in a stable union"; "HIV/AIDS Information Network: process of creation and transformation of social representations" and "Prevention versus stigma". FINAL CONSIDERATIONS The social representations that older people have about HIV/AIDS influence the adoption of preventive measures negatively because stigma is present and HIV/AIDS is attributed to young men, and to men who have sex with other men.
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Varas-Díaz N, Rivera-Segarra E, Neilands TB, Pedrogo Y, Carminelli-Corretjer P, Tollinchi N, Torres E, Soto Del Valle Y, Rivera Díaz M, Ortiz N. HIV/AIDS and intersectional stigmas: Examining stigma related behaviours among medical students during service delivery. Glob Public Health 2019; 14:1598-1611. [PMID: 31296120 DOI: 10.1080/17441692.2019.1633378] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
HIV/AIDS stigma remains a major global health issue with detrimental consequences for people with HIV/AIDS (PWHA), especially when manifested by health professionals. Research on HIV/AIDS stigma has documented negative attitudes towards PWHA among health professionals. However, fewer studies have examined how HIV/AIDS stigma is manifested behaviourally during clinical interactions and how it interacts with other stigmas (i.e. drug use, sexism, homophobia). This study aimed to: (1) examine behavioural manifestations of HIV/AIDS stigma among medical students during clinical interactions, and (2) explore HIV/AIDS stigma intersectionality with other stigmas. We implemented an experimental design using Standardised Patient (SP) simulations, observational techniques, and quantitative questionnaires. A total of 237 medical students engaged in SP encounters with three experimental scenarios: (1) PWHA infected via illegal drug use, (2) PWHA infected via unprotected heterosexual relations, (3) PWHA infected via unprotected homosexual relations. They also interacted with a person with common cold (control condition). Results evidenced statistically significant differences between the experimental and control simulation, with higher number of stigma behaviours manifested towards experimental conditions. Results also evidence higher HIV/AIDS stigma towards MSM when compared to the drug user and heterosexual woman SP's. We discuss the implications of these findings for training of medical students.
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Affiliation(s)
- Nelson Varas-Díaz
- Department of Global and Sociocultural Studies, Florida International University , Miami , USA
| | - Eliut Rivera-Segarra
- School of Behavioral and Brain Sciences, Ponce Health Sciences University , Ponce , Puerto Rico
| | - Torsten B Neilands
- Center for AIDS Prevention Studies, University of California , San Francisco , USA
| | - Yasmín Pedrogo
- Department of Medicine, University of Puerto Rico , San Juan , Puerto Rico
| | | | - Nelmit Tollinchi
- School of Behavioral and Brain Sciences, Ponce Health Sciences University , Ponce , Puerto Rico
| | - Estefanía Torres
- School of Behavioral and Brain Sciences, Ponce Health Sciences University , Ponce , Puerto Rico
| | - Yanira Soto Del Valle
- School of Behavioral and Brain Sciences, Ponce Health Sciences University , Ponce , Puerto Rico
| | | | - Nerian Ortiz
- Department of Medicine, University of Puerto Rico , San Juan , Puerto Rico
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18
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Experienced HIV-Related Stigma in Health Care and Community Settings: Mediated Associations With Psychosocial and Health Outcomes. J Acquir Immune Defic Syndr 2019; 77:257-263. [PMID: 29140873 DOI: 10.1097/qai.0000000000001590] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
INTRODUCTION There are multiple dimensions of HIV-related stigma that can compromise the mental and physical health of people living with HIV. We focused on the dimension of experienced stigma, defined as exposure to acts of discrimination, devaluation, and prejudice, and investigated its relationship with HIV health and psychosocial outcomes. METHODS We examined associations between experienced stigma in the community and health care settings and psychosocial and health outcomes for people living with HIV (N = 203) receiving care at an urban HIV clinic in the Southeastern United States. We also investigated whether those effects are unique to experienced stigma or are mediated by other dimensions of HIV-related stigma. RESULTS Experienced stigma was associated with suboptimal clinical outcomes such as viral nonsuppression, as well as poor affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, and blame coping) and interpersonal outcomes such as social support and physician trust. Furthermore, serial mediation models suggested significant indirect effects of experienced stigma through internalized stigma and anticipated stigma from various theoretically expected sources of stigma (eg, community members, friends and family, and health care workers), with varying effects depending on the source. CONCLUSIONS These findings suggest nuanced mechanisms for the effects of experienced HIV-related stigma, especially in health care settings, and may be used to inform stigma-reduction interventions. Interventions designed to address experienced stigma in health care settings might be more tailored to specific outcomes, such as depression and physician trust, than interventions designed to address experienced stigma in the community.
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Daniels J. Building Global Health Capacity at a Minority-Serving Institution in the Bronx: The Potential Role of PhotoVoice and the Geo-Social Pathway Framework in This Endeavor. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 39:19-30. [PMID: 30479193 DOI: 10.1177/0272684x18809508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Global health training programs for undergraduate students are expanding in the United States, which includes Minority-Serving Institutions (MSIs), but capacity building is needed at MSIs to develop career pathways into the field, especially for those institutions that serve low-income students who live in communities with high health disparities. Often, global health pathways begin by building a global lens through the examination of local health issues coupled with international educational experiences. This approach is limited for students who come from low-income settings with limited funding for international experiences, and as a result, may not see the feasibility of a global health career. However, there may be opportunity in harnessing student motivations and participatory research methods to build interest in a global health career. This article outlines the course, Fundamentals of Global Health, offered at a public MSI in the Bronx. The course was grounded in the Geo-Social Pathway Framework and utilized PhotoVoice to engage students in individual research projects. A constant comparison method was used to analyze papers, photos, reflections, and presentations in order to identify themes. Analysis of course materials submitted by students suggests that they were motivated to examine health disparities using PhotoVoice and that they focused their research projects on their family and community health disparities, or aligned with educational or professional goals to address their community health needs. This course model may inform future training in global health for students at MSIs, but community-based participatory research priority funding is needed to sustain global health at these key institutions.
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Affiliation(s)
- Joseph Daniels
- 1 Lehman College, City University of New York, Bronx, NY, USA
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20
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Mkanta WN, Eustace RW, Reece MC, Alamri AD, Davis T, Ezekekwu EU, Potluri A. From images to voices: A photo analysis of medical and social support needs of people living with HIV/AIDS in Tanzania. JOURNAL OF GLOBAL HEALTH REPORTS 2018. [DOI: 10.29392/joghr.2.e2018031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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21
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Nelson E, Werremeyer A, Kelly GA, Skoy E. Self-stigma of antidepressant users through secondary analysis of PhotoVoice data. Ment Health Clin 2018; 8:214-221. [PMID: 30206504 PMCID: PMC6125114 DOI: 10.9740/mhc.2018.09.214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Aspects of self-stigma and medication-related stigma among individuals with depressive disorders remain largely unexplored. The primary objective of this study is to highlight and characterize self-stigma and medication-related stigma experiences of antidepressant users. Methods: This is a secondary analysis of data obtained from PhotoVoice studies examining psychotropic medication experiences. Transcripts of reflections from 12 individuals self-reporting a depressive disorder diagnosis and receipt of a prescription for an antidepressant were included. A directed content analysis approach based on expansion of the Self-Stigma of Depression Scale and an iterative process of identification of medication-stigma and stigma-resistance were used. Total mentions of self-stigma, stigma resistance, medication stigma, and underlying themes were tallied and evaluated. Results: Self-stigma was mentioned a total of 100 times with at least 2 mentions per participant. Self-blame was the most prominent construct of self-stigma and was mentioned nearly twice as often as any other self-stigma construct. Most participants also made mentions of self-stigma resistance. Half of the individual participants mentioned stigma resistance more times than they mentioned self-stigma, which suggests some surmounting of self-stigma. Medication-related stigma was also prominent, denoting negativity about the presence of medications in one's life. Discussion: Self-stigma related to self-blame may be problematic for antidepressant users. Identification and measurement of stigma resistance, especially in peer interactions, may represent a promising concept in overcoming self-stigma. Future work should explore emphasizing self-blame aspects when designing interventions to reduce self-stigma among individuals with depressive disorders and explore development of tools to measure stigma resistance.
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Affiliation(s)
- Erik Nelson
- (Corresponding author) PharmD Candidate 2018, North Dakota State University, School of Pharmacy, Fargo, North Dakota,
| | - Amy Werremeyer
- Faculty Mentor, Associate Professor of Practice, North Dakota State University, School of Pharmacy, Fargo, North Dakota
| | - Gina Aalgaard Kelly
- Associate Professor of Sociology, North Dakota State University, School of Sociology and Anthropology, Fargo, North Dakota
| | - Elizabeth Skoy
- Associate Professor of Practice, North Dakota State University, School of Pharmacy, Fargo, North Dakota
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22
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Daniels J, Struthers H, Lane T, Maleke K, McIntyre J, Coates T. "Booze is the main factor that got me where I am today": alcohol use and HIV risk for MSM in rural South Africa. AIDS Care 2018; 30:1452-1458. [PMID: 29807437 DOI: 10.1080/09540121.2018.1475626] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Excessive alcohol consumption has been shown to increase HIV risk for men who have sex with men (MSM) and compromise HIV prevention behaviors. However, there is limited contextual understanding of alcohol use for MSM in rural sub-Saharan African settings, which can inform and direct HIV interventions. Applying an adaptation of PhotoVoice, we worked with 35 HIV-positive MSM who created photo-essays about alcohol and HIV in Mpumalanga. A semi-structured protocol was used in focus group discussions that were audio-recorded, translated and transcribed. Transcript data and visual data of 24 photo-essays were analyzed using a constant comparison approach. We found that participants used alcohol to build and sustain social networks, meet sexual partners, and enhance sexual experience. Excessive alcohol use was common, which was associated with increased HIV risk behaviors within a community of MSM who maintained multiple partnerships. Our study suggests that HIV interventions need to address excessive alcohol use to mitigate the associated HIV risk at both the individual and community levels.
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Affiliation(s)
- Joseph Daniels
- a Lehman College, The City University of New York , New York , USA
| | | | - Tim Lane
- c Center for AIDS Prevention Science , University of California San Francisco , San Francisco , USA
| | - Kabelo Maleke
- b Anova Health Institute , Johannesburg , South Africa
| | | | - Tom Coates
- d Center for World Health , David Geffen School of Medicine, University of California Los Angeles , Los Angeles , USA
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23
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Andu E, Wagenaar BH, Kemp CG, Nevin PE, Simoni JM, Andrasik M, Cohn SE, French AL, Rao D. Risk and protective factors of posttraumatic stress disorder among African American women living with HIV. AIDS Care 2018; 30:1393-1399. [PMID: 29695184 DOI: 10.1080/09540121.2018.1466981] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We sought to examine risk and protective factors for Posttraumatic Stress Disorder (PTSD) among African American women living with HIV. This is a cross-sectional analysis of baseline data from a randomized trial of an HIV stigma reduction intervention. We examined data from two-hundred and thirty-nine African American women living with HIV. We examined whether age, marital status, level of education, internalized HIV-related stigma, and social support as potential protective and risk factors for PTSD symptoms using logistic regression. We analyzed bi-variate associations between each variable and PTSD symptoms, and constructed a multivariate logistic regression model adjusting for all variables. We found 67% reported clinically significant PTSD symptoms at baseline. Our results suggest that age, education, and internalized stigma were found to be associated with PTSD symptoms (p < 0.001), with older age and more education as protective factors and stigma as a risk factor for PTSD. Therefore, understanding this relationship may help improve assessment and treatment through evidence- based and trauma-informed strategies.
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Affiliation(s)
- Eaden Andu
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Brad H Wagenaar
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Chris G Kemp
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Paul E Nevin
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Jane M Simoni
- b Department of Psychology , University of Washington , Seattle , WA , USA
| | | | - Susan E Cohn
- d Department of Infectious Diseases , Northwestern University , Chicago , IL , USA
| | | | - Deepa Rao
- f Department of Global Health/Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA
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Fernandes CS, Ferreira F, Marques G. Conceito de família em estudantes de graduação em enfermagem através do Photovoice. AVANCES EN ENFERMERÍA 2018. [DOI: 10.15446/av.enferm.v36n1.63988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: el presente estudio describe la utilización de Fotovoz para profundizar el concepto de familia en estudiantes de enfermería.Metodología: es un estudio de investigación acción participativa, en el que participaron 33 estudiantes de enfermería. La recolección de datos utilizó Fotovoz para definir el concepto de familia, las sesiones fueron grabadas y transcritas. Para el análisis se recurrió a la triangulación de datos con las fotografías con el software Atlas-ti versión 8.0. Resultados: cuatro temas principales surgieron de las fotografías y de las grabaciones: Concepto de familia en la perspectiva del estudiante, Mi familia, Funciones de la Familia, Lo que veo en esta fotografía.Conclusión: el estudio contribuyó a la divulgación del Fotovoz, una herramienta aún poco utilizada en estudios de enfermería. Adicionalmente, promovió la importancia de la familia en el cuidado en enfermería, por medio de la conceptualización de lo que es familia.
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Daniels J, Marlin R, Medline A, Wilson G, Young S, Rosengren L, Huang E, Klausner JD. Getting HIV Self-Test Kits into the Home for Young African American MSM in Los Angeles: A Qualitative Report. J Assoc Nurses AIDS Care 2017; 29:115-119. [PMID: 29239823 DOI: 10.1016/j.jana.2017.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/28/2017] [Indexed: 11/24/2022]
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26
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Papaloukas P, Quincey K, Williamson IR. Venturing into the visual voice: combining photos and interviews in phenomenological inquiry around marginalisation and chronic illness. QUALITATIVE RESEARCH IN PSYCHOLOGY 2017. [DOI: 10.1080/14780887.2017.1329364] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Kerry Quincey
- Psychology, De Montfort University, Leicester, United Kingdom
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27
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Learning to Live With HIV in the Rural Townships: A Photovoice Study of Men Who Have Sex With Men Living With HIV in Mpumalanga, South Africa. J Assoc Nurses AIDS Care 2017; 28:408-421. [PMID: 28279587 DOI: 10.1016/j.jana.2017.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 02/06/2017] [Indexed: 11/21/2022]
Abstract
There is limited understanding about the health and well-being of men who have sex with men (MSM) with HIV infection living in rural African areas. We present the results of an adapted photovoice project with 35 MSM with HIV infection who live in townships in Mpumalanga, South Africa. The project was designed to explore the social factors that influenced HIV care. Twenty-four photo essays were developed by participants in focus group discussions that were audio-recorded and transcribed for analysis. Transcripts and photo essays were coded using a constant comparison approach combining researcher observation notes and reflection on participant-identified themes. Participants identified (a) a shared experience of illness and coming to terms with having HIV infection and (b) family and taverns as necessary support systems. The findings suggested that family- and tavern-based interventions might improve health outcomes for MSM newly diagnosed with HIV infection living in rural and semi-rural African communities.
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28
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HIV Testing Preferences Among MSM Members of an LGBT Community Organization in Los Angeles. J Assoc Nurses AIDS Care 2017; 28:363-371. [PMID: 28185723 DOI: 10.1016/j.jana.2017.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/04/2017] [Indexed: 11/23/2022]
Abstract
Lack of regular HIV testing puts African American, Asian, and Latino men who have sex with men (MSM) at high risk for HIV infection. Rapid self-testing may be an effective option for these men. We explored acceptability, preferences, and usability of HIV self-test kits with MSM of color using semi-structured focus groups to discuss HIV testing history, reasons for testing, and self-testing preferences. Participants (n = 21) lived in Los Angeles, identified as MSM of color, and were 18-35 years of age. Discussions were audio-recorded, transcribed, and analyzed using grounded theory. Participants expressed needs for (a) accessibility, (b) privacy, (c) local support, and (d) access to testing professionals. Self-testing for HIV infection may be an effective method for high-risk MSM. Effective self-testing programs need to consider accessibility, confidentiality, and support to increase routine testing. Community-based organizations have an opportunity to increase HIV testing for MSM of color.
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