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Farooq HZ, Apea V, Kasadha B, Ullah S, Hilton-Smith G, Haley A, Scherzer J, Hand J, Paparini S, Phillips R, Orkin CM. Study protocol: the ILANA study - exploring optimal implementation strategies for long-acting antiretroviral therapy to ensure equity in clinical care and policy for women, racially minoritised people and older people living with HIV in the UK - a qualitative multiphase longitudinal study design. BMJ Open 2023; 13:e070666. [PMID: 37423623 DOI: 10.1136/bmjopen-2022-070666] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
INTRODUCTION Cabotegravir and rilpivirine (CAB+RPV long-acting (LA)) is recommended as a treatment for HIV-1 allowing people living with HIV to receive 2 monthly injectable treatment, rather than daily pills. Providing injectable therapy in a system designed to provide and manage study participants on oral treatments poses logistical challenges namely how resources are used to accommodate patient preference within constrained health economies with capacity limitations. In this pragmatic multicentre study, we aim to understand the implementation of CAB-RPV-LA administration in two settings via mixed methods to explore perspectives of participants and the clinical team delivering CAB+RPV LA. METHODS AND ANALYSIS Women, racially minoritised people and older people are chronically under-represented in HIV clinical trials so the ILANA trial has set recruitment caps to ensure recruitment of 50% women, 50% ethnically diverse people and 30% over 50 years of age to include a more representative study population. Using a mixed-methods approach, the primary objective is to identify and evaluate the critical implementation strategies for CAB+RPV LA in both hospital and community settings. Secondary objectives include evaluating feasibility and acceptability of CAB+RPV LA administration at UK clinics and community settings from the perspective of HIV care providers, nurses and representatives at community sites, evaluating barriers to implementation, the utility of implementation strategies and adherence. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Health Research Authority Research Ethics Committee (REC reference: 22/PR/0318). The dissemination strategy has been formulated with the SHARE Collaborative Community Advisory Board to maximise the impact of this work on clinical care and policy. This strategy draws on and leverages existing resources within the participating organisations, such as their academic infrastructure, professional relationships and community networks. The strategy will leverage the Public Engagement Team and press office to support dissemination of findings. TRIAL REGISTRATION NUMBER NCT05294159.
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Affiliation(s)
- Hamzah Z Farooq
- Blizard Institute, Queen Mary University, London, UK
- SHARE Collaborative, Queen Mary University, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
- Barts and The London School of Medicine and Dentistry, London, UK
| | - Vanessa Apea
- Blizard Institute, Queen Mary University, London, UK
- SHARE Collaborative, Queen Mary University, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
- Barts and The London School of Medicine and Dentistry, London, UK
| | - Bakita Kasadha
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sadna Ullah
- Blizard Institute, Queen Mary University, London, UK
- SHARE Collaborative, Queen Mary University, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | | | | | | | - James Hand
- SHARE Collaborative, Queen Mary University, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | - Sara Paparini
- SHARE Collaborative, Queen Mary University, London, UK
- Centre for Public Health and Policy, Wolfson Institute of Population Health, Queen Mary University, London, UK
| | - Rachel Phillips
- Pragmatic Clinical Trials Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Chloe M Orkin
- Blizard Institute, Queen Mary University, London, UK
- SHARE Collaborative, Queen Mary University, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
- Barts and The London School of Medicine and Dentistry, London, UK
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Dhairyawan R, Okhai H, Hill T, Sabin CA. Differences in HIV clinical outcomes amongst heterosexuals in the United Kingdom by ethnicity. AIDS 2021; 35:1813-1821. [PMID: 33973878 PMCID: PMC7611528 DOI: 10.1097/qad.0000000000002942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE We investigated differences in clinical outcomes in heterosexual participants, by ethnicity in the UK Collaborative HIV Cohort Study from 2000 to 2017. DESIGN Cohort analysis. METHODS Logistic/proportional hazard regression assessed ethnic group differences in CD4+ cell count at presentation, engagement-in-care, combination antiretroviral therapy (cART) initiation, viral suppression and rebound. RESULTS Of 12 302 participants [median age: 37 (interquartile range: 31-44) years, 52.5% women, total follow-up: 85 846 person-years], 64.4% were black African, 19.1% white, 6.3% black Caribbean, 3.6% black other, 3.3% South Asian/other Asian and 3.4% other/mixed. CD4+ cell count at presentation amongst participants from non-white groups were lower than the white group. Participants were engaged-in-care for 79.6% of follow-up time; however, black and other/mixed groups were less likely to be engaged-in-care than the white group (adjusted odds ratios vs. white: black African: 0.70 (95% confidence interval (CI) 0.63-0.79], black Caribbean: 0.74 (0.63-0.88), other/mixed: 0.78 (0.62-0.98), black other: 0.81 (0.64-1.02)). Of 8867 who started cART, 79.1% achieved viral suppression, with no differences by ethnicity in cART initiation or viral suppression. Viral rebound (22.2%) was more common in the black other [1.95 (1.37-2.77)], black African [1.85 (1.52-2.24)], black Caribbean [1.73 (1.28-2.33)], South Asian/other Asian [1.35 (0.90-2.03)] and other/mixed [1.09 (0.69-1.71)] groups than in white participants. CONCLUSION Heterosexual people from black, Asian and minority ethnic (BAME) groups presented with lower CD4+ cell counts, spent less time engaged-in-care and were more likely to experience viral rebound than white people. Work to understand and address these differences is needed.
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Affiliation(s)
| | - Hajra Okhai
- Institute for Global Health, University College London, UK
| | - Teresa Hill
- Institute for Global Health, University College London, UK
| | - Caroline A Sabin
- Institute for Global Health, University College London, UK
- National Institute for Health Research Health Protection Research Unit in Blood-Borne and Sexually Transmitted Infections, University College London, London, UK
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Folayan MO, Ibigbami O, El Tantawi M, Brown B, Aly NM, Ezechi O, Abeldaño GF, Ara E, Ayanore MA, Ellakany P, Gaffar B, Al-Khanati NM, Idigbe I, Ishabiyi AO, Jafer M, Khan ATA, Khalid Z, Lawal FB, Lusher J, Nzimande NP, Osamika BE, Quadri MFA, Roque M, Al-Tammemi AB, Yousaf MA, Virtanen JI, Zuñiga RAA, Okeibunor JC, Nguyen AL. Factors Associated with Financial Security, Food Security and Quality of Daily Lives of Residents in Nigeria during the First Wave of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7925. [PMID: 34360217 PMCID: PMC8345729 DOI: 10.3390/ijerph18157925] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 12/19/2022]
Abstract
An online survey was conducted to identify factors associated with financial insecurity, food insecurity and poor quality of daily lives of adults in Nigeria during the first wave of the COVID-19 pandemic. The associations between the outcome (experience of financial loss, changes in food intake and impact of the pandemic on daily lives) and the explanatory (age, sex, education level, anxiety, depression, HIV status) variables were determined using logistic regression analysis. Of the 4439 respondents, 2487 (56.0%) were financially insecure, 907 (20.4%) decreased food intake and 4029 (90.8%) had their daily life negatively impacted. Males (AOR:0.84), people who felt depressed (AOR:0.62) and people living with HIV -PLHIV- (AOR:0.70) had significantly lower odds of financial insecurity. Older respondents (AOR:1.01) had significantly higher odds of financial insecurity. Those depressed (AOR:0.62) and PLHIV (AOR:0.55) had significantly lower odds of reporting decreased food intake. Respondents who felt anxious (AOR:0.07), depressed (AOR: 0.48) and who were PLHIV (AOR:0.68) had significantly lower odds of reporting a negative impact of the pandemic on their daily lives. We concluded the study findings may reflect a complex relationship between financial insecurity, food insecurity, poor quality of life, mental health, and socioeconomic status of adults living in Nigeria during the COVID-19 pandemic.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
| | - Olanrewaju Ibigbami
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
| | - Maha El Tantawi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Brandon Brown
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Social Medicine, Population and Public Health, School of Medicine, University of California, Riverside, CA 92501, USA
| | - Nourhan M. Aly
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Oliver Ezechi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos 101212, Nigeria
| | - Giuliana Florencia Abeldaño
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Institute for Research on Public Health, School of Medicine, University of Sierra Sur, Oaxaca 70805, Mexico
| | - Eshrat Ara
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Government College for Women, Moulana Azad Road, Srinagar Kashmir, J&K 190001, India
| | - Martin Amogre Ayanore
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, PMB 31 Ho, Ghana
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Preventive Dentistry, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Nuraldeen Maher Al-Khanati
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus 36822, Syria
| | - Ifeoma Idigbe
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos 101212, Nigeria
| | - Anthonia Omotola Ishabiyi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Preventive Dental Sciences, Faculty of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Abeedha Tu-Allah Khan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- School of Biological Sciences, University of the Punjab, Quaid-i-Azam Campus, Lahore 54590, Pakistan
| | - Zumama Khalid
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- School of Biological Sciences, University of the Punjab, Quaid-i-Azam Campus, Lahore 54590, Pakistan
| | - Folake Barakat Lawal
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Periodontology and Community Dentistry, University of Ibadan, Ibadan 200212, Nigeria
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- School of Health and Life Sciences, University of the West of Scotland, London E142BE, UK
| | - Ntombifuthi P. Nzimande
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Economic and Human Geography, Faculty of Geosciences, University of Szeged, H-6722 Szeged, Hungary
| | - Bamidele Emmanuel Osamika
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Psychology, Faculty of Environment, Management and Social Sciences, Lead City University, Ibadan 200255, Nigeria
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Division of Dental Public Health, Department of Preventive Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Mark Roque
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Maternity & Childhood Nursing, College of Nursing, Taibah University, Madinah 42223, Saudi Arabia
| | - Ala’a B. Al-Tammemi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Family and Occupational Medicine, Faculty of Medicine, Doctoral School of Health Sciences, University of Debrecen, H-4032 Debrecen, Hungary
| | - Muhammad Abrar Yousaf
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Institute of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore 54590, Pakistan
| | - Jorma I. Virtanen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Faculty of Medicine, University of Turku, FI-20014 Turku, Finland
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Post Graduate School, University of Sierra Sur, Oaxaca 70800, Mexico
| | - Joseph Chukwudi Okeibunor
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Research Development and Innovations, Assistant Regional Director Cluster, WHO Regional Office for Africa, Brazzaville BP 06, Congo
| | - Annie Lu Nguyen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 91803, USA
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Solomon D, Tariq S, Alldis J, Burns F, Gilson R, Sabin C, Sherr L, Pettit F, Dhairyawan R. Ethnic inequalities in mental health and socioeconomic status among older women living with HIV: results from the PRIME Study. Sex Transm Infect 2021; 98:128-131. [PMID: 33782143 PMCID: PMC8862077 DOI: 10.1136/sextrans-2020-054788] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/12/2021] [Accepted: 02/20/2021] [Indexed: 02/03/2023] Open
Abstract
Objectives Women living with HIV in the UK are an ethnically diverse group with significant psychosocial challenges. Increasing numbers are reaching older age. We describe psychological and socioeconomic factors among women with HIV in England aged 45–60 and explore associations with ethnicity. Methods Analysis of cross-sectional data on 724 women recruited to the PRIME Study. Psychological symptoms were measured using the Patient Health Questionnaire 4 and social isolation with a modified Duke-UNC Functional Social Support Scale. Results Black African (BA) women were more likely than Black Caribbean or White British (WB) women to have a university education (48.3%, 27.0%, 25.7%, respectively, p<0.001), but were not more likely to be employed (68.4%, 61.4%, 65.2%, p=0.56) and were less likely to have enough money to meet their basic needs (56.4%, 63.0%, 82.9%, p<0.001). BA women were less likely to report being diagnosed with depression than WB women (adjusted odds ratio (aOR) 0.40, p<0.001) but more likely to report current psychological distress (aOR 3.34, p<0.05). Conclusions We report high levels of poverty, psychological distress and social isolation in this ethnically diverse group of midlife women with HIV, especially among those who were BA. Despite being more likely to experience psychological distress, BA women were less likely to have been diagnosed with depression suggesting a possible inequity in access to mental health services. Holistic HIV care requires awareness of the psychosocial needs of older women living with HIV, which may be more pronounced in racially minoritised communities, and prompt referral for support including psychology, peer support and advice about benefits.
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Affiliation(s)
- Danielle Solomon
- Institute for Global Health, University College London, London, UK
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
| | - Jon Alldis
- London South Bank University, London, UK
| | - Fiona Burns
- Institute for Global Health, University College London, London, UK.,Royal Free London NHS Foundation Trust, London, UK
| | - Richard Gilson
- Institute for Global Health, University College London, London, UK
| | - Caroline Sabin
- Institute for Global Health, University College London, London, UK
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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Cultural Neuropsychology Considerations in the Diagnosis of HIV-Associated Neurocognitive Disorders. Curr Top Behav Neurosci 2020; 50:193-223. [PMID: 32157665 DOI: 10.1007/7854_2019_121] [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] [Indexed: 03/15/2023]
Abstract
Human Immunodeficiency Virus Type-I (HIV) is a health disparities issue that affects culturally and linguistically diverse (CALD) and underrepresented minority populations to a greater degree than non-Hispanic white populations. Neurologically speaking, CALD populations experience worse HIV-related health outcomes, which are exacerbated by inadequate neurocognitive measures, poor normative samples, and the complex interplay of sociocultural factors that may affect test interpretation. Although cross-cultural neuropsychologists are working diligently to correct this gap in the literature, currently, studies examining neurocognitive outcomes among CALD populations are sparse. The most well-studied CALD groups are of African American/Black and Latinx adults in the US, and the chapter therefore focuses on these studies. There is more limited work among other populations in the US, such as Asians, Native Hawaiians, Pacific Islanders, and American Indians/Alaskan Natives, and even fewer studies for many CALD populations outside of the US. For example, HIV neuropsychology data is rare or nonexistent in the First Peoples of Australia and Indigenous People of Canada. It is often not adequately reported in Europe for the migrant populations within those countries or other world regions that have historically large multicultural populations (e.g., South America, Caribbean countries, Asia, and Africa). Therefore, this chapter reviews HIV-related health disparities faced by CALD populations with focus on North American research where it has been specifically studied, with particular attention given to disparities in HIV-Associated Neurocognitive Disorders (HAND). International data was also included for research with focus on First Peoples of Australia and Indigenous People of Canada. The chapter also examines other sociocultural and health factors, including global and regional (e.g., rural versus urban) considerations, migration, and gender. Further, guidelines for incorporating sociocultural consideration into assessment and interpretation of neurocognitive data and HAND diagnosis when working with HIV-positive CALD populations that would be relevant internationally are provided.
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Thames AD, Kuhn TP, Mahmood Z, Bilder RM, Williamson TJ, Singer EJ, Arentoft A. Effects of social adversity and HIV on subcortical shape and neurocognitive function. Brain Imaging Behav 2018; 12:96-108. [PMID: 28130744 PMCID: PMC5529267 DOI: 10.1007/s11682-017-9676-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The purpose of the current study was to examine the independent and interactive effects of social adversity (SA) and HIV infection on subcortical shape alterations and cognitive functions. Participants included HIV+ (n = 70) and HIV- (n = 23) individuals who underwent MRI, neurocognitive and clinical assessment, in addition to completing questionnaires from which responses were used to create an SA score. Bilateral amygdalae and hippocampi were extracted from T1-weighted images. Parametric statistical analyses were used to compare the radial distance of the structure surface to a median curve to determine the presence of localized shape differences as a function of HIV, SA and their interaction. Next, multiple regression was used to examine the interactive association between HIV and SA with cognitive performance data. An HIV*SA interactive effect was found on the shape of the right amygdala and left hippocampus. Specifically, HIV-infected participants (but not HIV-uninfected controls) who evidenced higher levels of SA displayed an inward deformation of the surface consistent with reduced volume of these structures. We found interactive effects of HIV and SA on learning/memory performance. These results suggest that HIV+ individuals may be more vulnerable to neurological and cognitive changes in the hippocampus and amygdala as a function of SA than HIV- individuals, and that SA indicators of childhood SES and perceived racial discrimination are important components of adversity that are associated with cognitive performance.
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Affiliation(s)
- April D Thames
- David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, 28-263, Los Angeles, CA, 90095, USA.
| | - Taylor P Kuhn
- David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, 28-263, Los Angeles, CA, 90095, USA
- Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
| | - Zanjbeel Mahmood
- David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, 28-263, Los Angeles, CA, 90095, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Robert M Bilder
- David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, 28-263, Los Angeles, CA, 90095, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Timothy J Williamson
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Elyse J Singer
- David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, 28-263, Los Angeles, CA, 90095, USA
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Arrey AE, Bilsen J, Lacor P, Deschepper R. Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium. PLoS One 2016; 11:e0159488. [PMID: 27447487 PMCID: PMC4957758 DOI: 10.1371/journal.pone.0159488] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 07/04/2016] [Indexed: 01/09/2023] Open
Abstract
Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA) migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking "why me?" A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into consideration in providing a caring and healthy environment.
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Affiliation(s)
- Agnes Ebotabe Arrey
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- * E-mail:
| | - Johan Bilsen
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Patrick Lacor
- Department of Internal Medicine and Infectious Diseases-AIDS Reference Center, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Reginald Deschepper
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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Nöstlinger C, Loos J. Involving lay community researchers in epidemiological research: experiences from a seroprevalence study among sub-Saharan African migrants. AIDS Care 2016; 28 Suppl 1:119-23. [PMID: 26885938 PMCID: PMC4828617 DOI: 10.1080/09540121.2016.1146398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/20/2016] [Indexed: 11/09/2022]
Abstract
Community-based participatory research (CBPR) has received considerable attention during past decades as a method to increase community ownership in research and prevention. We discuss its application to epidemiological research using the case of second-generation surveillance conducted among sub-Saharan African (SSA) migrants in Antwerp city. To inform evidence-based prevention planning for this target group, this HIV-prevalence study used two-stage time-location sampling preceded by formative research. Extensive collaborative partnerships were built with community organizations, a Community Advisory Board provided input throughout the project, and community researchers were trained to participate in all phases of the seroprevalence study. Valid oral fluid samples for HIV testing were collected among 717 SSA migrants and linked to behavioural data assessed through an anonymous survey between December 2013 and August 2014. A qualitative content analysis of various data sources (extensive field notes, minutes of intervision, and training protocols) collected at 77 data collection visits in 51 settings was carried out to describe experiences with challenges and opportunities inherent to the CBPR approach at three crucial stages of the research process: building collaborative partnerships; implementing the study; dissemination of findings including prevention planning. The results show that CBPR is feasible in conducting scientifically sound epidemiological research, but certain requirements need to be in place. These include among others sufficient resources to train, coordinate, and supervise community researchers; continuity in the implementation; transparency about decision-taking and administrative procedures, and willingness to share power and control over the full research process. CBPR contributed to empowering community researchers on a personal level, and to create greater HIV prevention demand in the SSA communities.
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Affiliation(s)
| | - Jasna Loos
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Elzi L, Conen A, Patzen A, Fehr J, Cavassini M, Calmy A, Schmid P, Bernasconi E, Furrer H, Battegay M. Ability to Work and Employment Rates in Human Immunodeficiency Virus (HIV)-1-Infected Individuals Receiving Combination Antiretroviral Therapy: The Swiss HIV Cohort Study. Open Forum Infect Dis 2016; 3:ofw022. [PMID: 26955645 PMCID: PMC4777901 DOI: 10.1093/ofid/ofw022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/28/2016] [Indexed: 11/13/2022] Open
Abstract
Background. Limited data exist on human immunodeficiency virus (HIV)-infected individuals' ability to work after receiving combination antiretroviral therapy (cART). We aimed to investigate predictors of regaining full ability to work at 1 year after starting cART. Methods. Antiretroviral-naive HIV-infected individuals <60 years who started cART from January 1998 through December 2012 within the framework of the Swiss HIV Cohort Study were analyzed. Inability to work was defined as a medical judgment of the patient's ability to work as 0%. Results. Of 5800 subjects, 4382 (75.6%) were fully able to work, 471 (8.1%) able to work part time, and 947 (16.3%) were unable to work at baseline. Of the 947 patients unable to work, 439 (46.3%) were able to work either full time or part time at 1 year of treatment. Predictors of recovering full ability to work were non-white ethnicity (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.20-3.54), higher education (OR, 4.03; 95% CI, 2.47-7.48), and achieving HIV-ribonucleic acid <50 copies/mL (OR, 1.83; 95% CI, 1.20-2.80). Older age (OR, 0.55; 95% CI, .42-.72, per 10 years older) and psychiatric disorders (OR, 0.24; 95% CI, .13-.47) were associated with lower odds of ability to work. Recovering full ability to work at 1 year increased from 24.0% in 1998-2001 to 41.2% in 2009-2012, but the employment rates did not increase. Conclusions. Regaining full ability to work depends primarily on achieving viral suppression, absence of psychiatric comorbidity, and favorable psychosocial factors. The discrepancy between patients' ability to work and employment rates indicates barriers to reintegration of persons infected with HIV.
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Affiliation(s)
- Luigia Elzi
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research , University Hospital Basel
| | - Anna Conen
- Division of Infectious Diseases , Cantonal Hospital Aarau
| | - Annalea Patzen
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research , University Hospital Basel
| | - Jan Fehr
- Division of Infectious Diseases and Hospital Epidemiology , University Hospital Zurich
| | - Matthias Cavassini
- Infectious Diseases Service, University Hospital and University of Lausanne
| | - Alexandra Calmy
- Division of Infectious Diseases , University Hospital Geneva
| | - Patrick Schmid
- Division of Infectious Diseases , Cantonal Hospital , St. Gallen
| | - Enos Bernasconi
- Division of Infectious Diseases , Regional Hospital , Lugano
| | - Hansjakob Furrer
- Department of Infectious Diseases , University Hospital Bern and University of Bern , Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research , University Hospital Basel
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Shah I, Dhabe H, Dey A. Demographic pattern of parents of HIV infected and exposed children. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2015. [DOI: 10.1016/j.cegh.2015.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mazanderani F, Paparini S. The stories we tell: qualitative research interviews, talking technologies and the 'normalisation' of life with HIV. Soc Sci Med 2015; 131:66-73. [PMID: 25753287 DOI: 10.1016/j.socscimed.2015.02.041] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Since the earliest days of the HIV/AIDS epidemic, talking about the virus has been a key way affected communities have challenged the fear and discrimination directed against them and pressed for urgent medical and political attention. Today, HIV/AIDS is one of the most prolifically and intimately documented of all health conditions, with entrenched infrastructures, practices and technologies--what Vinh-Kim Nguyen has dubbed 'confessional technologies'--aimed at encouraging those affected to share their experiences. Among these technologies, we argue, is the semi-structured interview: the principal methodology used in qualitative social science research focused on patient experiences. Taking the performative nature of the research interview as a talking technology seriously has epistemological implications not merely for how we interpret interview data, but also for how we understand the role of research interviews in the enactment of 'life with HIV'. This paper focuses on one crucial aspect of this enactment: the contemporary 'normalisation' of HIV as 'just another' chronic condition--a process taking place at the level of individual subjectivities, social identities, clinical practices and global health policy, and of which social science research is a vital part. Through an analysis of 76 interviews conducted in London (2009-10), we examine tensions in the experiential narratives of individuals living with HIV in which life with the virus is framed as 'normal', yet where this 'normality' is beset with contradictions and ambiguities. Rather than viewing these as a reflection of resistances to or failures of the enactment of HIV as 'normal', we argue that, insofar as these contradictions are generated by the research interview as a distinct 'talking technology', they emerge as crucial to the normative (re)production of what counts as 'living with HIV' (in the UK) and are an inherent part of the broader performative 'normalisation' of the virus.
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Affiliation(s)
- Fadhila Mazanderani
- University of Edinburgh, Science, Technology & Innovation Studies, Old Surgeon's Hall, High School Yard, EH1 1LZ, United Kingdom.
| | - Sara Paparini
- London School of Hygiene & Tropical Medicine, United Kingdom
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Liu L, Pang R, Sun W, Wu M, Qu P, Lu C, Wang L. Functional social support, psychological capital, and depressive and anxiety symptoms among people living with HIV/AIDS employed full-time. BMC Psychiatry 2013; 13:324. [PMID: 24289721 PMCID: PMC4219509 DOI: 10.1186/1471-244x-13-324] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 11/26/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychological distress (e.g., depression and anxiety) has been regarded as the main cause of leaving work for people living with HIV/AIDS (PLWHA) in workplaces. This study aims to explore the associations of functional social support (FSS) and psychological capital (PC) with depressive and anxiety symptoms among PLWHA employed full-time. METHODS This cross-sectional study was performed in Liaoning, China, during the period of December 2010-April 2011. The Center for Epidemiologic Studies Depression Scale, the Zung Self-Rating Anxiety Scale, the Duke-UNC Functional Social Support Questionnaire, and the Psychological Capital Questionnaire were completed by PLWHA employed full-time. Structural equation modeling was used to test the proposed relationships between variables. Asymptotic and resampling strategies were performed to explore the mediating roles of PC and its components (self-efficacy, hope, optimism, resilience). RESULTS Of 320 participants surveyed, 66.3% had depressive symptoms, and 45.6% had anxiety symptoms. Significant negative associations of FSS and PC with depressive and anxiety symptoms were revealed. PC (a*b = -0.209, BCa 95% CI: -0.293, -0.137, p < 0.05), hope (a*b = -0.103, BCa 95% CI: -0.192, -0.034, p < 0.05), and optimism (a*b = -0.047, BCa 95% CI: -0.106, -0.008, p < 0.05) significantly mediated the association between FSS and depressive symptoms. PC (a*b = -0.151, BCa 95% CI: -0.224, -0.095, p < 0.05) and self-efficacy (a*b = -0.080, BCa 95% CI: -0.158, -0.012, p < 0.05) significantly mediated the FSS-anxiety symptoms association. CONCLUSIONS FSS and PC could help reduce depressive and anxiety symptoms among PLWHA employed full-time. PC fully mediates the associations of FSS with depressive and anxiety symptoms. In addition to enhancing FSS, PC development could be included in the prevention and treatment strategies for depressive and anxiety symptoms targeted at PLWHA employed full-time.
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Affiliation(s)
- Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, No, 92 North 2nd Road, Heping District, Shenyang, Liaoning 110001, People's Republic of China.
| | - Ran Pang
- Department of Social Medicine, School of Public Health, China Medical University, No. 92 North 2nd Road, Heping District, Shenyang, Liaoning 110001, People’s Republic of China
| | - Wei Sun
- Department of Environmental Health, School of Public Health, China Medical University, No. 92 North 2nd Road, Heping District, Shenyang, Liaoning 110001, People’s Republic of China
| | - Ming Wu
- Liaoning Provincial Center for Disease Control and Prevention, No. 242 Shayang Road, Shenyang, Liaoning, People’s Republic of China
| | - Peng Qu
- Liaoning Provincial Center for Disease Control and Prevention, No. 242 Shayang Road, Shenyang, Liaoning, People’s Republic of China
| | - Chunming Lu
- Liaoning Women and Children’s Health Care Institute, No. 240 Shayang Road, Shenyang, Liaoning, People’s Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 92 North 2nd Road, Heping District, Shenyang, Liaoning 110001, People’s Republic of China
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Abstract
This review examines the interactions of financial status and HIV and its implications for women. MEDLINE and Google scholar were searched using the keywords 'women', 'poverty' and 'HIV' in any field of the article. The search was limited to articles published in English over the last 10 years. The first section of the article tries to establish whether poverty or wealth is a risk factor for HIV. There is credible evidence for both arguments. While wealth shows an increased risk for both sexes, poverty places women at a special disadvantage. The second section explains how the financial status interacts with other 'non biological' factors to put women at increased risk. While discrimination based on these factors disadvantage women, there are some paradoxical observations that do not fit with the traditional line of explanation (e.g. paradoxical impact of wealth and education on HIV). The final section assesses the impact of HIV in driving poverty and the role of women in interventional programmes. The specific impact of poverty on females in families living with HIV is less explored. Though microfinance initiatives to empower women are a good idea in theory, the actual outcome of such a programme is less convincing.
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Affiliation(s)
- Chaturaka Rodrigo
- University Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
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15
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Dhairyawan R, Tariq S, Scourse R, Coyne KM. Intimate partner violence in women living with HIV attending an inner city clinic in the UK: prevalence and associated factors. HIV Med 2012; 14:303-10. [DOI: 10.1111/hiv.12009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2012] [Indexed: 11/26/2022]
Affiliation(s)
- R Dhairyawan
- Department of Sexual Health; Homerton University Hospital; London; UK
| | - S Tariq
- School of Health Sciences; City University; London; UK
| | - R Scourse
- Department of Sexual Health; Homerton University Hospital; London; UK
| | - KM Coyne
- Department of Sexual Health; Homerton University Hospital; London; UK
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16
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Abstract
According to 2009 statistics, the human immunodeficiency virus (HIV) infected an estimated 86,500 individuals within the UK, although around one-quarter were unaware of their infection. In the majority of cases, it is now considered a long-term controllable but incurable infection. Indeed, most HIV-positive individuals are able to work. Employment is across most, if not all, workforce sectors and protection against workplace discrimination is provided by the Equality Act 2010. Issues including confidentiality, workplace adjustments, vaccinations and travel restrictions may be relevant to the occupational health of HIV-positive workers. There are special considerations concerning HIV-infected health care workers, including avoidance of performing exposure-prone procedures. Prevention of HIV acquisition in the workplace is relevant to a diverse range of occupational environments, and HIV post-exposure prophylaxis should be considered after potential HIV exposure incidents. If a worker contracts HIV by occupational means, financial help may be available.
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Affiliation(s)
- C McGoldrick
- Department of Infectious Diseases, Monklands Hospital, Airdrie ML6 0JS, UK.
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17
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Tariq S, Pillen A, Tookey PA, Brown AE, Elford J. The impact of African ethnicity and migration on pregnancy in women living with HIV in the UK: design and methods. BMC Public Health 2012; 12:596. [PMID: 22853319 PMCID: PMC3490824 DOI: 10.1186/1471-2458-12-596] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 07/18/2012] [Indexed: 11/20/2022] Open
Abstract
Background The number of reported pregnancies in women with diagnosed HIV in the UK increased from 80 in 1990 to over 1400 in 2010; the majority were among women born in sub-Saharan Africa. There is a paucity of research on how social adversity impacts upon pregnancy in HIV positive women in the UK; furthermore, little is known about important outcomes such as treatment uptake and return for follow-up after pregnancy. The aim of this study was to examine pregnancy in African women living with HIV in the UK. Methods and design This was a two phase mixed methods study. The first phase involved analysis of data on approximately 12,000 pregnancies occurring between 2000 and 2010 reported to the UK’s National Study of HIV in Pregnancy and Childhood (NSHPC). The second phase was based in London and comprised: (i) semi-structured interviews with 23 pregnant African women living with HIV, 4 health care professionals and 2 voluntary sector workers; (ii) approximately 90 hours of ethnographic fieldwork in an HIV charity; and (iii) approximately 40 hours of ethnographic fieldwork in a Pentecostal church. Discussion We have developed an innovative methodology utilising epidemiological and anthropological methods to explore pregnancy in African women living with HIV in the UK. The data collected in this mixed methods study are currently being analysed and will facilitate the development of appropriate services for this group.
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Affiliation(s)
- Shema Tariq
- School of Health Sciences, City University London, 20 Bartholomew Close, London, EC1A 7QN, United Kingdom.
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18
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Millett GA, Jeffries WL, Peterson JL, Malebranche DJ, Lane T, Flores SA, Fenton KA, Wilson PA, Steiner R, Heilig CM. Common roots: a contextual review of HIV epidemics in black men who have sex with men across the African diaspora. Lancet 2012; 380:411-23. [PMID: 22819654 DOI: 10.1016/s0140-6736(12)60722-3] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pooled estimates from across the African diaspora show that black men who have sex with men (MSM) are 15 times more likely to be HIV positive compared with general populations and 8·5 times more likely compared with black populations. Disparities in the prevalence of HIV infection are greater in African and Caribbean countries that criminalise homosexual activity than in those that do not criminalise such behaviour. With the exception of US and African epidemiological studies, most studies of black MSM mainly focus on outcomes associated with HIV behavioural risk rather than on prevalence, incidence, or undiagnosed infection. Nevertheless, black MSM across the African diaspora share common experiences such as discrimination, cultural norms valuing masculinity, concerns about confidentiality during HIV testing or treatment, low access to HIV drugs, threats of violence or incarceration, and few targeted HIV prevention resources.
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Affiliation(s)
- Gregorio A Millett
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 20201, USA.
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19
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Aiken ARA, Lever AML. Ethnic diversity and patterns of infection of a UK HIV-positive patient population outwith major conurbations. Int J STD AIDS 2011; 21:823-5. [PMID: 21297091 DOI: 10.1258/ijsa.2010.010043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We surveyed the HIV-positive population attending a major teaching hospital sited outwith a major conurbation. Eighty-five percent of homosexually acquired infections were contracted within the UK and 91% of heterosexually acquired infections were contracted outside of the UK. A strikingly wide range of nationalities (45) and countries of origin of infection were represented within a relatively small patient population. Most patients were non-UK-born immigrants. A high proportion of illegal immigrants were identified within which there was a high proportion lost to follow-up. This degree of ethnic diversity and domiciliary instability is rarely a feature of non-HIV populations in this setting and imposes additional demands on delivery of care and health-care planning.
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Affiliation(s)
- A R A Aiken
- Department of Medicine, University of Cambridge, Addenbrookes Hospital, Cambridge, UK
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20
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Beliefs of doctors-to-be concerning the possibility of pursuing a professional career by people living with HIV. HIV & AIDS REVIEW 2010. [DOI: 10.1016/s1730-1270(10)60092-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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21
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HIV and primary health care: disclosure and discrimination. Prim Health Care Res Dev 2009. [DOI: 10.1017/s1463423609990259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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22
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Patterns and distribution of HIV among adult men and women in India. PLoS One 2009; 4:e5648. [PMID: 19462003 PMCID: PMC2680483 DOI: 10.1371/journal.pone.0005648] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Accepted: 04/29/2009] [Indexed: 11/19/2022] Open
Abstract
Background While the estimated prevalence of HIV in India experienced a downward revision in 2007, the patterning and distribution of HIV in the population remains unclear. We examined the individual and state-level socioeconomic patterning of individual HIV status among adult men and women in India as well as the patterning of other individual demographic and behavioral determinants of HIV status. Methodology/Principal Findings We conducted logistic regression models accounting for the survey design using nationally representative, cross-sectional data on 100,030 women and men from the 2005–2006 India National Family Health survey which, for the first time, provided objective assessments of HIV seroprevalence. Although there was a weak relationship between household wealth and risk of being HIV-positive, there was a clear negative relationship between individual education attainment and risk of being HIV-positive among both men and women. A 1000 Rupee change in the per capita net state domestic product was associated with a 4% and 5% increase in the risk for positive HIV status among men and women, respectively. State-level income inequality was associated with increased risk of HIV for men. Marital status and selected sexual behavior indicators were significant predictors of HIV status among women whereas the age effect was the most dominant predictor of HIV infection among men. Conclusions/Significance Although the prevalence of HIV in India is low, the lack of strong wealth patterning in the risk of HIV suggests a more generalized distribution of HIV risk than some of India's high-risk group HIV prevention policies have assumed. The positive association between state economic development and individual risk for HIV is intriguing and requires further scrutiny.
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‘You are not yourself’: Exploring masculinities among heterosexual African men living with HIV in London. Soc Sci Med 2009; 68:1901-7. [DOI: 10.1016/j.socscimed.2009.02.032] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Indexed: 11/20/2022]
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