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Peng W, Zhou Q, Goldsamt LA, Shen Y, Wang R, Li X. Culture-based stigmatizing attitudes toward condom use among Chinese older adults: An interpretative phenomenological analysis. Public Health Nurs 2024. [PMID: 38940530 DOI: 10.1111/phn.13358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/12/2024] [Accepted: 06/07/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To explore their perceptions and attitudes toward condom use and the underlying reasons for the low usage frequency among Chinese older adults. METHODS A qualitative study design utilizing interpretive phenomenological analysis was employed. Data were collected through field observation and face-to-face in-depth interviews among older adults aged 50 years or above and having engaged in sexual activities within the previous year. RESULTS Three main themes emerged: perceiving unnecessary due to misconceptions and low awareness, interactive stereotypes rooted in sociocultural beliefs, and stigmatized social norms including gender inequity and economic unbalance. CONCLUSIONS Tailored interventions focusing on addressing misconceptions, increasing awareness, and reducing culturally ingrained stereotypes and stigma surrounding condom use are essential to promote condom use among older adults in order to prevent HIV transmission in China.
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Affiliation(s)
- Wenwen Peng
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Qidi Zhou
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Lloyd A Goldsamt
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Yan Shen
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Run Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
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2
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Galletly CL, McAuliffe TL, Dickson-Gomez JB, Glasman LR, Ruelas DM. The Relative Influence of Perceived Immigration Laws and Consequences on HIV Testing Among US Latino Immigrants. AIDS Behav 2024; 28:1301-1313. [PMID: 37632603 DOI: 10.1007/s10461-023-04159-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 08/28/2023]
Abstract
The CDC recommends that persons aged 13-64 receive an HIV test at least once in their lifetime and that some groups test annually or more frequently. Nearly one-half of US Latino immigrants have never been tested for HIV. To the extent that immigration-related laws deter documented and undocumented immigrants from engaging in communicable disease control measures, these laws undermine public health efforts. 1750 noncitizen adult, sexually active, Spanish-speaking Latino immigrants across four cities in the US completed a cross-sectional survey assessing perceptions of immigration-related laws and immigration consequences related to HIV testing and diagnosis. Participants were recruited in-person by staff in community settings, through flyers posted in places frequented by Latino immigrants, and by word-of-mouth through snowball sampling. Outcomes were whether participants had ever received an HIV test and whether they tested in the previous 12 months. Multivariable analyses examined the relative contribution of perceived immigration laws and consequences on HIV testing behaviors when considering established predictors of HIV testing. Perceptions of HIV-related immigration laws and immigration consequences was a significant predictor of never having had an HIV test even when considered relative to common predictors of HIV testing. The influence of perceived immigration laws and consequences on testing in the previous 12 months was not significant in multivariable analysis. Perceived HIV-related immigration laws and consequences appear to be a substantial contributor to reluctance to be tested for HIV among Latino immigrants who have never been tested. Effective interventions should be developed to address these.
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Affiliation(s)
- Carol L Galletly
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 1710 East Lafayette Place, Milwaukee, WI, 53202, USA.
| | - Timothy L McAuliffe
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 1710 East Lafayette Place, Milwaukee, WI, 53202, USA
| | - Julia B Dickson-Gomez
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 1710 East Lafayette Place, Milwaukee, WI, 53202, USA
- Institute for Health Equity, Medical College of Wisconsin, Milwaukee, USA
| | - Laura R Glasman
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 1710 East Lafayette Place, Milwaukee, WI, 53202, USA
| | - Dulce M Ruelas
- College of Nursing & Healthcare Professions, Grand Canyon University, Phoenix, USA
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Factors Affecting the Intent to Use HIV Testing Services of Filipino Men Who Have Sex With Men: A Structural Equation Model. J Assoc Nurses AIDS Care 2020; 31:621-631. [PMID: 32482948 DOI: 10.1097/jnc.0000000000000179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In recent years, the Philippines has seen significant increases in the uptake of HIV testing services (HTSs) but considerably lags in achieving the 2030 goal of achieving 90% of the people knowing their HIV status. The purpose of this study was to determine the utility of the Health Belief Model, using partial least squares structural equation modeling (PLS-SEM), in identifying factors that affect the intentions of Filipino men who have sex with men to seek and get tested for HIV. A sample of 471 Filipino men who have sex with men completed the web-based survey. The mean age of the participants was 25.93 years (SD = 6.02), with a majority reporting having been tested at least once (n = 349; 74.10%) and planning to follow-up with HTS providers in 3 months (73.4%; n = 386). The final model was identified that predicted HTS utilization (R = 0.08); self-efficacy, perceived susceptibility, and benefits were most predictive of HTS utilization. The model produced may be useful in identifying gaps in HTS program planning and implementation.
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van den Bogaart L, Ranzani A, Oreni L, Giacomelli A, Corbellino M, Rusconi S, Galli M, Antinori S, Ridolfo AL. Overlooked cases of HIV infection: An Italian tale of missed diagnostic opportunities. Eur J Intern Med 2020; 73:30-35. [PMID: 31635999 DOI: 10.1016/j.ejim.2019.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/06/2019] [Accepted: 09/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Late diagnoses are still a cause of increased HIV-related morbidity and mortality despite the availability of highly effective treatments. The aim of this study was to identify indicator conditions (ICs) in late presenters with HIV infection (LPs) that may represent missed opportunities of undertaking earlier HIV testing. METHODS The medical records of LPs referred to a specialist clinic in Milan, Italy, between 2011 and 2017 were reviewed to assess the frequency of ICs during the five years preceding diagnosis. Logistic regression analysis was used to investigate the factors associated with missed opportunities of making an earlier diagnosis. RESULTS The analysis considered 203 LPs (60.6% of the patients newly diagnosed as having HIV infection during the study period). Most had had ≥1 medical encounter in the five years before diagnosis, and 54 (26.6%) had been diagnosed as having ≥1 IC without undergoing HIV testing. The most frequent ICs were herpes zoster (19.8%), constitutional symptoms (17.4%) and lympho/thrombocytopenia (12.8%), and the missed opportunities for testing occurred in the settings of primary care (44.9%), specialist medical (38.2%) or surgical services (11.3%), and emergency departments (5.6%). Twenty-five (53.2%) of the 47 subjects with a non AIDS-defining IC had AIDS at the time of the diagnosis of HIV infection. Subjects aged >60 years were at increased risk of missed diagnostic opportunities (aOR 4.80, p = 0.008). CONCLUSION Implementing IC-guided HIV testing in non-specialist settings is an essential means of reducing late diagnoses of HIV infection even in the case of older subjects.
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Affiliation(s)
- Lorena van den Bogaart
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Alice Ranzani
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Letizia Oreni
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Andrea Giacomelli
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Stefano Rusconi
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
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Rodrigues DL, Prada M, Lopes D. Perceived sexual self-control and condom use with primary and casual sex partners: age and relationship agreement differences in a Portuguese sample. Psychol Health 2019; 34:1231-1249. [PMID: 31111739 DOI: 10.1080/08870446.2019.1603384] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Consistent condom use is still not ideal. Research showed that perceived sexual self-control is associated with greater likelihood of using condoms. However, this association seems to vary according to age and relationship agreement (i.e. non-consensual non-monogamy, NCNM vs. consensual non-monogamy, CNM). DESIGN Cross-sectional study with 307 heterosexual users of a dating web site for romantically involved individuals (81.8% men; Mage = 42.24, SD = 9.65, range: 23-76 years). All individuals were in a romantic relationship (Mlength = 13.47 years, SD = 9.39). MEASURES Demographic information, perceived sexual self-control, condom use frequency (casual sex partners; primary partner in the last 3 months) and relationship agreement. RESULTS Independently of relationship agreement, perceived sexual self-control was positively associated with condom use frequency with casual sex partners among younger and middle age participants, but not older ones (>49 years). Regarding the primary partner, a similar pattern emerged for CNM participants. In contrast, no significant association between perceived sexual self-control and condom use frequency with the primary partner emerged for NCNM individuals, regardless of age. CONCLUSION Our findings can inform evidence-based strategies to promote consistent condom use as an effective behaviour to prevent sexually transmitted infections, especially among older and NCNM individuals.
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Affiliation(s)
- David L Rodrigues
- Department of Social and Organizational Psychology, CIS-IUL, Instituto Universitário de Lisboa (ISCTE-IUL) , Lisboa , Portugal
| | - Marília Prada
- Department of Social and Organizational Psychology, CIS-IUL, Instituto Universitário de Lisboa (ISCTE-IUL) , Lisboa , Portugal
| | - Diniz Lopes
- Department of Social and Organizational Psychology, CIS-IUL, Instituto Universitário de Lisboa (ISCTE-IUL) , Lisboa , Portugal
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Psychological threat avoidance as a barrier to HIV testing in gay/bisexual men. J Behav Med 2019; 42:534-544. [PMID: 30600404 DOI: 10.1007/s10865-018-0003-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 12/07/2018] [Indexed: 02/02/2023]
Abstract
The present study examined how three psychosocial barriers-anticipated HIV stigma, HIV infectiousness-reduction beliefs, and optimism about available HIV treatments-related to HIV testing history and acceptance of an at-home HIV test among men who have sex with men. We also examined the mediating role of a variable that affects medical screening for other health conditions but has not yet been investigated in HIV contexts: the tendency to avoid psychologically threatening information. Volunteers completed a paper and pencil survey and were offered a free at-home HIV test during the 2015 Atlanta Pride Festival in Atlanta, GA. Anticipated HIV stigma, infectiousness beliefs, and treatment optimism were inconsistently related to HIV testing history and acceptance of an at-home HIV test, but all had direct effects on the desire to avoid HIV information. In a mediation model, each of these psychosocial barriers had indirect effects on both HIV testing outcomes via information avoidance. These findings suggest that information avoidance is an important proximal HIV testing barrier, thus providing a novel target for interventions and information campaigns.
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Ritter LJ, Ueno K. Same-Sex Contact and Lifetime Sexually Transmitted Disease Diagnoses Among Older Adults. J Aging Health 2018; 31:1043-1064. [PMID: 29405812 DOI: 10.1177/0898264317754028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: This study examines difference in sexually transmitted disease (STD) prevalence between sexual minority and heterosexual older adults using lifetime experience of same-sex contact (SSC) as a measure of sexual orientation. Method: Data from the National Social Life, Health, and Aging Project (N = 2,519) are analyzed using negative binomial regression and propensity matching models to test for differences in average STD counts by sexual orientation. Results: Older adults who report any SSC have higher lifetime counts of STDs. This difference persists even when controlling for sex, race, education, age, military status, and incarceration. Propensity matching models show that this difference persists when respondents are matched on several factors that may influence SSC prior to STD contraction. Discussion: The present results call for greater attention from policy makers and researchers because the sexual orientation differences in STDs may exacerbate disparities in overall health status and quality of life.
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Affiliation(s)
| | - Koji Ueno
- 2 Florida State University, Tallahassee, FL, USA
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Tavoschi L, Gomes Dias J, Pharris A. New HIV diagnoses among adults aged 50 years or older in 31 European countries, 2004-15: an analysis of surveillance data. Lancet HIV 2017; 4:e514-e521. [PMID: 28967582 DOI: 10.1016/s2352-3018(17)30155-8] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 07/07/2017] [Accepted: 07/13/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The HIV burden is increasing in older adults in the European Union (EU) and European Economic Area (EEA). We investigated factors associated with HIV diagnosis in older adults in the 31 EU/EEA countries during a 12 year period. METHODS In this analysis of surveillance data, we compared data from older people (aged ≥50 years) with those from younger people (aged 15-49 years). We extracted new HIV diagnoses reported to the European Surveillance System between Jan 1, 2004, and Dec 31, 2015, and stratified them by age, sex, migration status, transmission route, and CD4 cell count. We defined late diagnosis as CD4 count of less than 350 cells per μL at diagnosis and diagnosis with advanced HIV disease as less than 200 cells per μL. We compared the two age groups with the χ2 test for difference, and used linear regression analysis to assess temporal trends. FINDINGS During the study period 54 102 new HIV diagnoses were reported in older adults. The average notification rate of new diagnoses was 2·6 per 100 000 population across the whole 12 year period, which significantly increased over time (annual average change [AAC] 2·1%, 95% CI 1·1-3·1; p=0·0009). Notification rates for new HIV diagnoses in older adults increased significantly in 16 countries in 2004-15, clustering in central and eastern EU/EEA countries. In 2015, compared with younger adults, older individuals were more likely to originate from the reporting country, to have acquired HIV via heterosexual contact, and to present late (p<0·0001 for all comparisons). HIV diagnoses increased significantly over time among older men (AAC 2·2%, 95% CI 1·2-3·3; p=0·0006), women (1·3%, 0·2-2·4; p=0·025), men who have sex with men (5·8%, 4·3-7·5; p<0·0001), and injecting drug users (7·4%, 4·8-10·2; p<0·0001). INTERPRETATION Our findings suggest that there is a compelling need to deliver more targeted testing interventions for older adults and the general adult population, such as by increasing awareness among health-care workers and expanding opportunities for provider-initiated and indicator-condition-guided testing programmes. FUNDING European Centre for Disease Prevention and Control.
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Affiliation(s)
- Lara Tavoschi
- European Centre for Disease Prevention and Control, Solna, Sweden.
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control, Solna, Sweden
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The intimate lives of older adults living with HIV: a qualitative study of the challenges associated with the intersection of HIV and ageing. AGEING & SOCIETY 2017. [DOI: 10.1017/s0144686x1700068x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTOlder adults living with human immunodeficiency virus (HIV) are at risk of experiencing difficulties in their intimate lives due to the combined effects of HIV and ageing. To date, little research has focused on the lived experience of sexuality. This article seeks to fill in the gap by documenting the challenges faced by this population with respect to their intimate relationships and sexual lives. Based upon the results of a qualitative study conducted in Montreal (2010–2012) using semi-structured interviews with a diverse sample of 38 people aged 50–73 and living with HIV, this study revealed several difficulties, including those related to their social location, whereby HIV and ageing intersect with other social determinants (including gender, sexual orientation and drug use). Difficulties that were identified include lower sexual desire linked to ageing, erectile changes, difficulty in using condoms, stigma related to HIV and/or ageism, changes in appearance caused by HIV and/or ageing, along with the impact of their lifecourse experiences. Our results shed light on the specific nature of the difficulties experienced by older adults living with HIV with regard to their intimate lives, as well as on the importance of using an analysis that combines the theoretical approaches of intersectionality and lifecourse to enhance our capacity for understanding complex and unique experiences.
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Syme ML, Cohn TJ, Barnack-Tavlaris J. A Comparison of Actual and Perceived Sexual Risk Among Older Adults. JOURNAL OF SEX RESEARCH 2017; 54:149-160. [PMID: 26813853 PMCID: PMC5573595 DOI: 10.1080/00224499.2015.1124379] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Sexual risk among older adults (OAs) is prevalent, though little is known about the accuracy of sexual risk perceptions. Thus, the aim was to determine the accuracy of sexual risk perceptions among OAs by examining concordance between self-reported sexual risk behaviors and perceived risk. Data on OAs aged 50 to 92 were collected via Amazon.com's Mechanical Turk. Frequency of sexual risk behaviors (past six months) were reported along with perceived risk, namely, sexually transmitted infection (STI) susceptibility. Accuracy categories (accurate, underestimated, overestimated) were established based on dis/concordance between risk levels (low, moderate, high) and perceived risk (not susceptible, somewhat susceptible, very susceptible). Approximately half of the sample reported engaging in vaginal (49%) and/or oral sex (43%) without a condom in the past six months. However, approximately two-thirds of the sample indicated they were "not susceptible" to STIs. No relationship was found between risk behaviors and risk perceptions, and approximately half (48.1%) of OAs in the sample underestimated their risk. Accuracy was found to decrease as sexual risk level increased, with 93.1% of high-risk OAs underestimating their risk. Several sexual risk behaviors are prevalent among OAs, particularly men. However, perception of risk is often inaccurate and warrants attention.
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Abstract
It is recognised that those diagnosed with HIV infection over the age of 50 have higher rates of morbidity and mortality. Little is known about how clinical presentation at diagnosis of HIV varies within this group. We sought to compare clinical presentation and markers of outcome among those diagnosed with HIV aged 60 and over vs. those diagnosed aged 50-59, over a ten-year period. The results showed that 84/111 were diagnosed with HIV aged 50-59 and 27/111 aged ≥60. Ethnicity and HIV risk factors were similar between groups, and most infections were sexually acquired with 7.4% of those aged ≥60 suspected to have a recent infection. Median CD4 cell count at presentation was significantly lower in the ≥60 age group (111 vs. 249; p < 0.001), and the proportion with a CD4 cell count <50 was also significantly lower in this population (33% vs. 15%; p = 0.04). In keeping with this, the frequency of AIDS-defining illness at diagnosis was higher in the ≥60 group (38% vs. 4%; p < 0.001). Co-morbidities were found in both groups, and 38% of those aged ≥60 at diagnosis were known to have since died compared to 4% of those aged 50-59 at diagnosis ( p ≤ 0.01). Those aged ≥60 had lower CD4 cell counts at diagnosis and more AIDS-defining illnesses, highlighting the increased risk of poor outcomes in this group. The majority of infections were sexually acquired. More work is needed to understand survival in adults diagnosed with HIV at an older age and to consider those over 60 as a specific population worthy of further research.
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Affiliation(s)
- Rebecca Metcalfe
- 1 Sandyford Sexual Health Service, NHS Greater Glasgow & Clyde, Glasgow, UK.,2 Gartnavel General Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Joe Schofield
- 3 Public Health Protection Unit, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Catriona Milosevic
- 3 Public Health Protection Unit, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Seija Peters
- 2 Gartnavel General Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK
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12
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Hughes AK, Alford KR. HIV Transmission: Myths about Casual Contact and Fear about Medical Procedures Persist Among Older Adults. SOCIAL WORK IN PUBLIC HEALTH 2017; 32:49-52. [PMID: 27429205 DOI: 10.1080/19371918.2016.1188743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
HIV infection among older adults is increasing. Previous research suggests that many older adults do not see themselves as at risk for HIV and that many subscribe to myths related to HIV transmission. In this focus group study (N = 48) we solicited the beliefs that older adults held about HIV. The older adults in this study were knowledgeable about how HIV is typically transmitted. However, we also identified that they subscribed to misconceptions regarding casual contact transmission and were fearful of transmission from the medical system. Educational efforts aimed at older adults must be tailored to address these persistent misconceptions.
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Affiliation(s)
- Anne K Hughes
- a School of Social Work, Michigan State University , East Lansing , Michigan , USA
| | - Kristen R Alford
- b Department of Sociology and Social Work , Calvin College , Grand Rapids , Michigan , USA
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13
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Prati G, Zani B, Pietrantoni L, Scudiero D, Perone P, Cosmaro L, Cerioli A, Oldrini M. PEP and TasP Awareness among Italian MSM, PLWHA, and High-Risk Heterosexuals and Demographic, Behavioral, and Social Correlates. PLoS One 2016; 11:e0157339. [PMID: 27294777 PMCID: PMC4905673 DOI: 10.1371/journal.pone.0157339] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 05/28/2016] [Indexed: 11/19/2022] Open
Abstract
Post-exposure prophylaxis (PEP) has been proposed as a strategy to prevent the acquisition of HIV infection after certain high-risk exposures, and treatment as prevention (TasP) is also being advocated as a means to reduce sexual transmission of HIV. The aim of this study was to investigate the prevalence of PEP and TasP awareness and their demographic, behavioral, and social correlates in Italy. We conducted a cross-sectional survey of 1,028 high-risk heterosexual men and women, 1,874 non-HIV positive MSM (men who have sex with men), and 694 people living with HIV/AIDS (PLWHA). The majority of the participants was aware of PEP and unaware of TasP. MSM were less knowledgeable about PEP and TasP than were PLWHA and more knowledgeable about PEP and TasP than were high-risk heterosexual participants. The variables most consistently associated with PEP and TasP awareness were contact with HIV/AIDS organizations, HIV testing, and HIV stigma. A positive relationship between unprotected sexual intercourse and PEP and TasP awareness was found among high risk heterosexual participants, while this association was not significant among MSM and PLWHA. Because PEP and TasP are currently recommended, effective educational and dissemination strategies are needed to increase the level of knowledge about PEP and TasP.
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Affiliation(s)
- Gabriele Prati
- Department of Psychology, University of Bologna, Bologna, Italy
- * E-mail:
| | - Bruna Zani
- Department of Psychology, University of Bologna, Bologna, Italy
| | | | | | | | - Lella Cosmaro
- Italian League for the Fight against AIDS, Como, Italy
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Brown MJ, Serovich JM, Kimberly JA, Umasabor-Bubu O. Disclosure and Self-Efficacy Among HIV-Positive Men Who Have Sex with Men: A Comparison Between Older and Younger Adults. AIDS Patient Care STDS 2015; 29:625-33. [PMID: 26348705 PMCID: PMC4808275 DOI: 10.1089/apc.2015.0133] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Men who have sex with men (MSM) continue to be disproportionately affected by HIV in the US. HIV among older adults also continues to be an important public health problem. Age is associated with disclosure of HIV serostatus and self-efficacy for condom use. However, studies examining self-efficacy and disclosure among older MSM (age 50 and older) living with HIV are lacking. The aim of this study was to assess the associations between being 50 and older, and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices among HIV-positive MSM. Data were gathered from 340 participants at the baseline assessment of a longitudinal disclosure intervention study. Linear regression was used to determine the association between being older (age 50 and older) and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices. After adjusting for time since diagnosis and number of sexual partners, MSM aged 50 and older scored lower in disclosure behavior (β = -7.49; 95% CI: -14.8, -0.18) and in self-efficacy for negotiation of safer sex practices (β = -0.80; 95% CI: -1.57, -0.04) compared to MSM 18-34 years. Intervention and prevention programs should endeavor to improve disclosure and self-efficacy for negotiating safer sex practices among older HIV-positive MSM. More health care providers should initiate sexual health discussions, especially among older HIV-positive MSM populations, which may help to improve their disclosure behavior and self-efficacy for negotiating safer sex practices.
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Affiliation(s)
- Monique J. Brown
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida
| | - Julianne M. Serovich
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida
| | - Judy A. Kimberly
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida
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Chappell CA, Isaacs CE, Xu W, Meyn LA, Uranker K, Dezzutti CS, Moncla BJ, Hillier SL. The effect of menopause on the innate antiviral activity of cervicovaginal lavage. Am J Obstet Gynecol 2015; 213:204.e1-6. [PMID: 25818668 DOI: 10.1016/j.ajog.2015.03.045] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/25/2015] [Accepted: 03/20/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Reproductive hormones are known to impact innate mucosal immune function of the lower genital tract. Our objectives were to determine the effect of hormonal status on intrinsic antiviral (herpes simplex virus [HSV]-1, HSV-2, and human immunodeficiency virus [HIV]-1) activity of cervicovaginal lavage (CVL). STUDY DESIGN CVL was collected from 165 asymptomatic women including postmenopausal women (n = 29); women not on contraception in days 1-14 (n = 26) or days 15-28 (n = 27) of the menstrual cycle; and women using the levonorgestrel intrauterine device (n = 28), depot medroxyprogesterone acetate (n = 28), or combined oral contraceptives (n = 27). The anti-HSV-1/-2 and the anti-HIV-1 activity of the CVL were measured using plaque assays and the Jurkat-Tat-CCR5 assay, respectively. RESULTS CVL from all of the groups had modest antiviral activity. Anti-HIV-1 activity was decreased in CVL from postmenopausal women when compared to premenopausal women (11% vs 34%, P = .002). However, there was no difference in anti-HIV-1 activity among premenopausal women regardless of phase of menstrual cycle or contraceptive use. Anti-HIV-1 activity was associated with the protein content of the CVL (r = 0.44, P < .001). There was no difference in anti-HSV-1 or -2 activity by hormonal group. CONCLUSION Menopause is associated with decreased innate HIV-1 activity in the lower genital tract, suggesting that factors in the vaginal fluid could play a role in increased susceptibility of HIV-1 infection in postmenopausal women. Hormonal contraceptive use, menopause, and phase of menstrual cycle did not have a measurable impact on the intrinsic anti-HSV-1 or -2 activity.
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Affiliation(s)
- Catherine A Chappell
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA.
| | - Charles E Isaacs
- Department of Developmental Biochemistry, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY
| | - Weimin Xu
- Department of Developmental Biochemistry, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY
| | | | | | - Charlene S Dezzutti
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA
| | - Bernard J Moncla
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA
| | - Sharon L Hillier
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA
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