HIV as social and ecological experience

Exploring the correlation between rising temperature and household electricity consumption: An empirical analysis in China

This study investigates the nexus between rising temperatures and household energy consumption using data from respondents' electricity bills in the "China Residential Energy Consumption Survey." Our analysis reveals a significant correlation, with an 8.9 % increase in yearly energy consumption observed when the average temperature exceeds 32 °C. Additionally, we explore potential shifts in power usage due to global warming by integrating baseline estimates with daily temperature forecasts from eight contemporary climate models. Our findings project alarming trends: without interventions to curb greenhouse gas emissions, home electricity consumption could surge by 9.59-30.09 % in the medium term and by 9.77-47.70 % in the long run. By shedding light on these critical connections, our research underscores the urgent need for policy actions to mitigate the adverse impacts of climate change on energy consumption patterns.

Landscapes of inequities, structural racism, and disease during the COVID-19 pandemic: Experiences of immigrant and racialized populations in Canada

The COVID-19 pandemic has disproportionately affected immigrant and racialized communities globally and revealed another public health crisis - structural racism. While structural racism is known to foster discrimination via mutually reinforcing systems, the unevenness of COVID-19 infections, hospitalizations, and deaths across societies has precipitated attention to the impacts of structural racism. Research highlights the inequitable burden of COVID-19 among immigrant and racialized groups; however, little is known about the synergistic impacts of structural racism and COVID-19 on the health and wellbeing of these groups. Fewer studies examine how structural racism and COVID-19 intersect within neighbourhoods to co-produce landscapes of disease exposure and management. This article examines the pathways through which structural racism shapes access, use, and control of environmental resources among immigrant and racialized individuals in the neighbourhoods of the Peel Region and how they converged to shape health and disease dynamics during the height of Canada's COVID-19 pandemic. Findings from in-depth interviews reveal that mutually reinforcing inequitable systems created environments for COVID-19 to reinscribe disparities in access, use, and control of key resources needed to manage health and disease, and created new forms of disparities and landscapes of inequality for immigrants and racialized individuals. We close with a discussion on the impacts for policy and practice.

Generic medicine brand knowledge structure, relationships and purchase

Purpose

Cheaper generic anti-retroviral medicines are encouraged and often prescribed in South Africa for HIV/AIDS treatment. However, the medicines’ acceptance rate is relatively low. This has been attributed to inadequate brand knowledge of the bioequivalence of generic medicines. Studies have examined how brand knowledge structure lead to purchase. The contributions of brand relationship builders (i.e. trust and satisfaction), which are indicators of sustainable purchase, are rarely considered. This study aims to adapt Esch, Langner, Schmitt and Geus’ (2006) brand knowledge structure and relationship model to examine the impact of South African young adults’ brand knowledge structure (brand awareness, brand image and brand beliefs) and trust on brand satisfaction and purchase.

Design/methodology/approach

Cross-sectional data was quantitatively collected from 207 young adults through self-administered, paper-based questionnaires. Data was analysed with structural equation modelling.

Findings

Brand awareness, image, trust and belief in efficacy positively influenced purchase. All these factors, except brand awareness, positively led to satisfaction. The tested adapted model explained 53.0 and 58.5% variances of purchase and brand satisfaction, respectively.

Practical implications

Considering how much brand knowledge structure and trust explained purchase and satisfaction from the tested model, South African government, pharmaceutical marketers and consumer interest groups should educate young adults about the bioequivalence, safety and efficacy of generic medicines. With greater knowledge of these qualities, satisfaction is gained from purchase decision.

Originality/value

Instead of the usual examination of demographic differences in generic medicine beliefs and perception, this study contributes by revealing brand-related drivers of purchase and satisfaction.

Risk factors for loss to follow-up in human immunodeficiency virus care in the Greater Accra Regional Hospital in Ghana: a retrospective cohort study

BACKGROUND

Loss of human immunodeficiency virus (HIV)-positive patients to follow-up increases HIV-related morbidity and mortality. This study identified the factors associated with loss to follow-up (LTFU) in an urban health facility in Ghana.

METHODS

A 12-y retrospective study was conducted using routinely collected data from the National Acquired Immune Deficiency Syndrome (AIDS) Control Programme (NACP) on persons living with HIV/AIDS (PLWHA) who initiated antiretroviral therapy (ART) from 2006 to 2017 at the Greater Accra Regional Hospital. Convenience sampling was used to select the study area. All gathered data were exported to Stata 14 statistical software for analysis.

RESULTS

A total of 4330 PLWHA initiated ART between January 2006 and December 2017. Of these, 1166 (26.9%) were lost to follow-up over the 12-y period. The factors associated with LTFU included being a Muslim (adjusted hazard ratio [aHR] 1.31 [95% confidence interval {CI} 1.05 to 1.65]), having CD4 <250 cells/ml (aHR 1.45 [95% CI 1.21 to 1.76]) and completing adherence counselling (aHR 1.58 [95% CI 1.31 to 1.92]). Having other sources of health care funding and disclosure of one's disease status were found to be protective (aHR 0.74 [95% CI 0.58 to 0.94] and 0.80 [95% CI 0.65 to 0.98], respectively).

CONCLUSIONS

Some of the determinants of LTFU in the hospital are comparable to those found in other parts of Africa and could be addressed using existing interventions.

Marital infidelity, food insecurity, and couple instability: A web of challenges for dyadic coordination around antiretroviral therapy

RATIONALE

Despite the importance of primary partners for health, little is known about factors that constrain the ability of couples to work collaboratively towards HIV care and treatment (dyadic coordination). This study examined the interplay of marital infidelity, food insecurity, and couple instability on dyadic coordination and adherence to antiretroviral therapy (ART) in Malawi.

METHODS

In 2016, we conducted 80 in-depth interviews with 25 couples with at least one partner on ART. Couples were recruited at two HIV clinics in the Zomba district when attending clinic appointments. Participants were asked about their relationship history, relationship dynamics (love, trust, conflict), experiences with HIV care and treatment, and how partners were involved. Using an innovative analysis approach, we analyzed the data at the couple-level by examining patterns within and between couples.

RESULTS

Three patterns emerged. For some couples, ART led to positive changes in their relationships after men terminated their extramarital partnerships in exchange for love and support. For other couples with power imbalances and ongoing conflict, men's infidelity continued after ART and negatively affected dyadic coordination. Finally, some couples agreed to remain "faithful", but could not overcome stressors related to food insecurity, which directly impacted their adherence.

CONCLUSIONS

Couples-based interventions targeting ART adherence should improve relationship quality, while also addressing interpersonal stressors such as marital infidelity and food insecurity. Multi-level interventions that address both dyadic and structural levels may be necessary for couples with severe food insecurity.