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Aluah CP, Robillard A, Billings D, Smallwood S. Courtesy Stigma and HIV Professionals: A Brief Review of Implications for Psychosocial and Professional Well-Being. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:368-378. [PMID: 38459705 DOI: 10.1080/19371918.2024.2325566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
The impact of HIV-related stigma on social workers, clinicians, counselors, and advocates working in organizations serving people living with HIV (PLWH), is rarely considered. Professionals experience "courtesy stigma" when working with or on behalf of PLWH, regardless of their personal HIV status. PubMed, Medline, and PsycInfo databases, along with a review of relevant reference lists and referrals, identified 13 studies addressing this phenomenon. Although limited, this brief review suggests that members of the HIV workforce do indeed face challenges that compromise their personal and professional well-being as a result of courtesy stigma. Addressing stigma among professionals is necessary to support the health of those working in the field, and to avoid undermining the efforts of this important workforce. More research is needed to understand the perceptions and experiences of courtesy stigma and how this stigma may adversely impact the psychological well-being, social functioning, and professional practice of HIV professionals.
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Affiliation(s)
- Christopher Peter Aluah
- Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA
| | - Alyssa Robillard
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Deborah Billings
- Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA
- Group Care Global, Philadelphia, PA, USA
| | - Stacy Smallwood
- Department of Health Policy & Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University Statesboro, Statesboro, Georgia, USA
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Huang S, Gardner S, Piper KN, Coleman AS, Becan JE, Robertson AA, Elkington KS. Bridging Systems to Implement HIV/STI Programming Within the Juvenile Justice System: Strengths and Challenges of a Local Change Team Approach. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:432-453. [PMID: 33112673 DOI: 10.1521/aeap.2020.32.5.432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Justice-involved youth are at risk for HIV/STIs but do not access services. The complex challenges of improving the delivery of health-related services within juvenile justice (JJ) settings warrant exploration of strategies to close this service gap. This study describes the successes and challenges of utilizing a local change team (LCT) strategy comprising JJ and health agency staff to implement HIV/STI programming in JJ settings, across six counties in six states in the U.S. Five focus groups comprising n = 28 JJ and health agency staff who served as LCT members were conducted. Results demonstrated the structured nature of the collaborative process and strength of commitment among LCT members were necessary for successful implementation of HIV/STI programming. The use of LCTs comprising membership of JJ and (behavioral) health systems has broader applicability to other health and behavioral health issues faced by youth on probation that JJ staff may feel ill equipped to address.
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Affiliation(s)
- Sofia Huang
- Columbia University and New York State Psychiatric Institute, New York, New York
| | - Sheena Gardner
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | - Kaitlin N Piper
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ashley S Coleman
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | | | - Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
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Elkington KS, Spaulding A, Gardner S, Knight D, Belenko S, Becan JE, Robertson AA, Oser C, DiClemente R. A System-Level Intervention to Encourage Collaboration Between Juvenile Justice and Public Health Agencies to Promote HIV/STI Testing. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:337-355. [PMID: 32897134 PMCID: PMC9426765 DOI: 10.1521/aeap.2020.32.4.337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Justice-involved youth are at high risk for HIV and STIs, and justice agencies are uniquely poised to offer HIV/STI testing. However, testing in these settings is not routine and represents a missed opportunity. This study describes a system-level implementation intervention designed to increase access to HIV/STI testing through juvenile justice (JJ) and public health agency collaboration across six counties in six states in the United States. Local change teams, active facilitation, and training were utilized to facilitate agency partnerships and development of HIV/STI practice change protocols. Five counties established health and JJ partnerships and four counties successfully implemented their protocols. Sites with HIV/STI education and testing protocols behaviorally screened 98.5% of youth and tested 41.2% of those youth; 0% were HIV+ and 43.2% had an STI. The intervention provides a feasible, scalable solution, through promoting partnerships between JJ and health agencies, to link youth to testing and treatment services.
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Affiliation(s)
- Katherine S. Elkington
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY
| | - Anne Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Sheena Gardner
- Social Science Research Center, Mississippi State University, Starkville, MS
| | - Danica Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX
| | - Steven Belenko
- Department of Criminal Justice, Temple University, Philadelphia, PA
| | - Jennifer E. Becan
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX
| | - Angela A. Robertson
- Social Science Research Center, Mississippi State University, Starkville, MS
| | - Carrie Oser
- Department of Sociology, University of Kentucky, Lexington, KY
| | - Ralph DiClemente
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Department of Social and Behavioral Sciences, New York University (NYU) College of Global Public Health, New York, NY
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Elkington KS, Robertson AA, Knight DK, Gardner SK, Funk RR, Dennis ML, Oser C, DiClemente R. HIV/STI Service Delivery Within Juvenile Community Supervision Agencies: A National Survey of Practices and Approaches to Moving High-Risk Youth Through the HIV Care Cascade. AIDS Patient Care STDS 2020; 34:72-80. [PMID: 32049557 PMCID: PMC7044763 DOI: 10.1089/apc.2019.0157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Justice-involved youth (JIY) are at considerable risk for human immunodeficiency virus (HIV), but are disconnected from treatment and prevention. Juvenile justice agencies providing community supervision (CS) are well positioned to provide HIV prevention, testing, and prompt referral to treatment for JIY. However, we lack an understanding of juvenile CS agency responses to HIV/sexually transmitted infection (STI) needs among JIY. We conducted a nationwide systematic assessment of how juvenile CS agencies identify, refer, and move youth through the HIV care cascade using a nationally representative sample of 195 juvenile CS agencies across 20 states. Two-thirds of CS agencies did not offer any HIV-/STI-related services, and 82% reported no collaboration with health agencies. Screening or referral for HIV risk behaviors was reported by 32% of the CS agencies and 12% for any intervention or prevention for HIV/STI risk behaviors. Between 21% and 30% of agencies were unaware of the location of local HIV/STI services. HIV/STI prevention training was not a priority for directors and was ranked second to last out of 16 training topics. Agencies where staff expressed need for HIV risk training and where specific court programming was available were more likely to provide or refer for HIV/STI screening and/or testing. Agencies were more likely to provide or refer for services if they provided pre-trial/pre-adjudication supervision, parole, or court programming. Considering the low provision of HIV/STI-related services and limited collaboration between health and justice agencies, interventions that promote cross-system collaboration designed to minimize barriers and facilitate identification, referral, and linkage to HIV services for JIY are necessary.
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Affiliation(s)
- Katherine S. Elkington
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York
| | - Angela A. Robertson
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | - Danica K. Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, Texas
| | - Sheena K. Gardner
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | | | | | - Carrie Oser
- Department of Sociology and Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, Kentucky
- Department of Behavioral Science, Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Ralph DiClemente
- Department of Social and Behavioral Sciences, New York University, New York, New York
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Gardner SK, Elkington KS, Knight DK, Huang S, DiClemente RJ, Spaulding AC, Oser CB, Robertson AA, Baird-Thomas C. Juvenile justice staff endorsement of HIV/STI prevention, testing, and treatment linkage. HEALTH & JUSTICE 2019; 7:15. [PMID: 31485779 PMCID: PMC6724232 DOI: 10.1186/s40352-019-0096-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/22/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND While involvement in the legal system offers an opportunity to educate, screen, and treat high-risk youth, research shows that staff attitudes toward these practices can serve as barriers to implementation. The current study investigates the degree to which JJ staff endorse HIV prevention, testing, and treatment linkage practices with youth under community supervision and examines differences between individuals who supervise youth (e.g., juvenile probation officer) and those working in non-supervisory roles (e.g., case manager, assessment specialist). METHODS Juvenile justice staff consenting to participation in JJ-TRIALS completed an initial staff survey (N = 501). Survey items measured perceived importance of HIV/STI prevention (4 items); perceived importance of HIV/STI testing (7 items); and perceived importance of HIV/STI treatment linkage (8 items). RESULTS Confirmatory Factor Analysis (CFA) was computed (SAS CALIS procedure) for each of the three domains. Findings suggest that while staff recognize that youth are at risk for HIV/STIs and require provision of HIV/STI prevention and treatment linkage, attitudes concerning the importance of procuring or providing testing services for youth is substantially lower. Furthermore, analytic models comparing staff with and without supervision responsibilities (computed using SAS PROC MIXED) indicated that attitudes differed by site and staff responsible for supervision rated HIV treatment linkage practices as less important compared to non-supervising staff. CONCLUSIONS Establishing partnerships with health agencies equipped with resources and skillsets to provide HIV/STI testing and related services may be an effective model to promote greater awareness and use of best practices among JJ staff and more effectively address the unmet needs of this high-risk population of youth.
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Affiliation(s)
- Sheena K. Gardner
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Katherine S. Elkington
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY 10032 USA
| | - Danica K. Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX 76109 USA
| | - Sofia Huang
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY 10032 USA
| | - Ralph J. DiClemente
- College of Global Public Health, New York University, 715 #719, Broadway, New York, NY 10003 USA
| | - Anne C. Spaulding
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - Carrie B. Oser
- Department of Sociology, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506 USA
| | - Angela A. Robertson
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Connie Baird-Thomas
- Social Science Research Center, Mississippi State University, 153 Mississippi Parkway, Canton, MS 39046 USA
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Elkington KS, Jaiswal J, Spector AY, Reukauf H, Tesoriero JM, Nash D, Remien RH. Can TasP Approaches Be Implemented in Correctional Settings?: A review of HIV testing and linkage to community HIV treatment programs. J Health Care Poor Underserved 2018; 27:71-100. [PMID: 27133513 DOI: 10.1353/hpu.2016.0047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
High rates of HIV in correctional populations makes evaluation of programs that increase HIV testing in correctional settings and linkage to HIV treatment upon release, and understanding key implementation issues of these programs, essential to reducing new HIV infection. We conducted a systematic search for studies of outcomes or implementation issues of programs that promote HIV testing or that promote linkage to community HIV treatment post-release. Thirty-five articles met inclusion criteria: nine HIV testing initiatives and four linkage programs. HIV testing uptake rates were between 22% and 98% and rates of linkage to community treatment were between 79% and 84%. Findings suggest that some programs may be effective at reducing HIV transmission within the communities to which inmates return. However, attention to implementation factors, such as organizational culture and staff collaborations, appears critical to the success of these programs. Future research using rigorous design and adequate comparison groups is needed.
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Gordon MS, Carswell SB, Wilson M, Kinlock TW, Restivo L, McKenzie M, Rich JD. Factors Associated With Receiving Rapid HIV Testing Among Individuals on Probation or Parole. JOURNAL OF CORRECTIONAL HEALTH CARE 2018; 22:290-299. [PMID: 27742854 DOI: 10.1177/1078345816669347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite the strong correlation between HIV and corrections, testing and prevention efforts have largely been ignored among community corrections populations. The current study is a secondary analysis to compare characteristics of individuals under community corrections supervision who completed rapid HIV testing with those who refused such testing (N = 2,382) in Baltimore, Maryland, and Providence, Rhode Island. Results indicate that the following variables were significantly associated with the receipt of rapid HIV testing: being female (p = .024), Black race (p = .004), homeless (p = .016), early age of crime onset (p = .001), more drug use during the past 90 days (p = .033), and previously tested for hepatitis C virus/hepatitis B virus (p = .024). Such findings make it especially important that individuals under community supervision be linked with services in the community to ensure that HIV testing and health care planning occur simultaneously.
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Affiliation(s)
- Michael S Gordon
- Friends Research Institute, Inc., Baltimore, MD, USA Department of Criminal Justice, Stevenson University, Stevenson, MD, USA
| | | | - Monique Wilson
- Friends Research Institute, Inc., Baltimore, MD, USA University of Maryland, Baltimore, MD, USA
| | - Timothy W Kinlock
- Friends Research Institute, Inc., Baltimore, MD, USA Department of Criminal Justice, University of Baltimore, Baltimore, MD, USA
| | | | - Michelle McKenzie
- The Miriam Hospital, Center for Prisoner Health and Human Rights, Brown University, Providence, RI, USA
| | - Josiah D Rich
- The Miriam Hospital, Center for Prisoner Health and Human Rights, Brown University, Providence, RI, USA
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Chandler R, Gordon MS, Kruszka B, Strand LN, Altice FL, Beckwith CG, Biggs ML, Cunningham W, Chris Delaney J, Flynn PM, Golin CE, Knight K, Kral AH, Kuo I, Lorvick J, Nance RM, Ouellet LJ, Rich JD, Sacks S, Seal D, Spaulding A, Springer SA, Taxman F, Wohl D, Young JD, Young R, Crane HM. Cohort profile: seek, test, treat and retain United States criminal justice cohort. Subst Abuse Treat Prev Policy 2017; 12:24. [PMID: 28511680 PMCID: PMC5433052 DOI: 10.1186/s13011-017-0107-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 04/28/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The STTR treatment cascade provides a framework for research aimed at improving the delivery of services, care and outcomes of PLWH. The development of effective approaches to increase HIV diagnoses and engage PLWH in subsequent steps of the treatment cascade could lead to earlier and sustained ART treatment resulting in viral suppression. There is an unmet need for research applying the treatment cascade to improve outcomes for those with criminal justice involvement. METHODS The Seek, Test, Treat, and Retain (STTR) criminal justice (CJ) cohort combines data from 11 studies across the HIV treatment cascade that focused on persons involved in the criminal justice system, often but not exclusively for reasons related to substance use. The studies were conducted in a variety of CJ settings and collected information across 11 pre-selected domains: demographic characteristics, CJ involvement, HIV risk behaviors, HIV and/or Hepatitis C infections, laboratory measures of CD4 T-cell count (CD4) and HIV RNA viral load (VL), mental illness, health related quality of life (QoL), socioeconomic status, health care access, substance use, and social support. RESULTS The STTR CJ cohort includes data on 11,070 individuals with and without HIV infection who range in age from 18 to 77 years, with a median age at baseline of 37 years. The cohort reflects racial, ethnic and gender distributions in the U.S. CJ system, and 64% of participants are African-American, 12% are Hispanic and 83% are men. Cohort members reported a wide range of HIV risk behaviors including history of injection drug use and, among those who reported on pre-incarceration sexual behaviors, the prevalence of unprotected sexual intercourse ranged across studies from 4% to 79%. Across all studies, 53% percent of the STTR CJ cohort reported recent polysubstance use. CONCLUSIONS The STTR CJ cohort is comprised of participants from a wide range of CJ settings including jail, prison, and community supervision who report considerable diversity in their characteristics and behavioral practices. We have developed harmonized measures, where feasible, to improve the integration of these studies together to answer questions that cannot otherwise be addressed.
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Affiliation(s)
- Redonna Chandler
- Division of Clinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Washington, DC USA
| | | | - Bridget Kruszka
- Department of Biostatistics, University of Washington, Seattle, WA USA
| | - Lauren N. Strand
- Department of Biostatistics, University of Washington, Seattle, WA USA
| | | | - Curt G. Beckwith
- Division of Infectious Diseases, Alpert Medical School of Brown University, Providence, RI USA
| | - Mary L. Biggs
- Department of Biostatistics, University of Washington, Seattle, WA USA
| | - William Cunningham
- Department of Health Policy and Management, Medicine, General Internal Medicine, University of California at Los Angeles, Los Angeles, CA USA
| | | | | | - Carol E. Golin
- Departments of Health Behavior and Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Kevin Knight
- Institute of Behavior Research, Texas Christian University, Fort Worth, TX USA
| | - Alex H. Kral
- Urban Health Program, RTI International, Research Triangle Park, NC USA
| | - Irene Kuo
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC USA
| | - Jennifer Lorvick
- Urban Health Program, RTI International, Research Triangle Park, NC USA
| | - Robin M. Nance
- Department of Medicine, University of Washington, Seattle, WA USA
| | - Lawrence J. Ouellet
- Department of Epidemiology, University of Illinois at Chicago, Chicago, IL USA
| | - Josiah D. Rich
- Medicine and Epidemiology, Brown University, Center for Prisoner Health and Human Rights, The Miriam Hospital, Providence, RI USA
| | - Stanley Sacks
- Center for the Integration of Research & Practice (CIRP), National Development & Research Institutes, Inc. (NDRI), New York, NY USA
| | - David Seal
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Anne Spaulding
- Department of Epidemiology, Emory University, Atlanta, GA USA
| | - Sandra A. Springer
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT USA
| | - Faye Taxman
- Department of Criminology, Law and Society, George Mason University, Fairfax, VA USA
| | - David Wohl
- School of Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Jeremy D. Young
- Infectious Disease Fellowship Program, University of Illinois at Chicago, Chicago, USA
| | - Rebekah Young
- Department of Biostatistics, University of Washington, Seattle, WA USA
| | - Heidi M Crane
- School of Medicine, University of Washington, Seattle, WA USA
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Richardson JB, Brown J, Van Brakle M. Pathways to early violent death: the voices of serious violent youth offenders. Am J Public Health 2013; 103:e5-16. [PMID: 23678923 DOI: 10.2105/ajph.2012.301160] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Quantitative studies have uncovered factors associated with early violent death among youth offenders detained in the juvenile justice system, but little is known about the contextual factors associated with pathways to early violent death among youths detained in adult jails. We interviewed young Black male serious violent youth offenders detained in an adult jail to understand their experience of violence. Their narratives reveal how the code of the street, informal rules that govern interpersonal violence among poor inner-city Black male youths, increases the likelihood of violent victimization. Youth offenders detained in adult jails have the lowest rate of service provision among all jail populations. We have addressed how services for youth offenders can be improved to reduce the pathways to early violent death.
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Affiliation(s)
- Joseph B Richardson
- Department of African American Studies, University of Maryland, College Park, MD 20742, USA.
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Kerr ZY, Miller KR, Galos D, Love R, Poole C. Challenges, coping strategies, and recommendations related to the HIV services field in the HAART era: a systematic literature review of qualitative studies from the United States and Canada. AIDS Patient Care STDS 2013; 27:85-95. [PMID: 23336722 DOI: 10.1089/apc.2012.0356] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Qualitative research methods have been utilized to study the nature of work in the HIV services field. Yet current literature lacks a Highly Active Anti-Retroviral Treatment (HAART) era compendium of qualitative research studying challenges and coping strategies in the field. This study systematically reviewed challenges and coping strategies that qualitative researchers observed in the HIV services field during the HAART era, and their recommendations to organizations. Four online databases were searched for peer-reviewed research that utilized qualitative methods, were published from January 1998 to February 2012, utilized samples of individuals in the HIV services field; occurred in the U.S. or Canada, and contained information related to challenges and/or coping strategies. Abstracts were identified (n=846) and independently read and coded for inclusion by at least two of the four first authors. Identified articles (n=26) were independently read by at least two of the four first authors who recorded the study methodology, participant demographics, challenges and coping strategies, and recommendations. A number of challenges affecting those in the HIV services field were noted, particularly interpersonal and organizational issues. Coping strategies were problem- and emotion-focused. Summarized research recommendations called for increased support, capacity-building, and structural changes. Future research on challenges and coping strategies must provide up-to-date information to the HIV services field while creating, implementing, and evaluating interventions to manage current challenges and reduce the risk of burnout.
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Affiliation(s)
- Zachary Y. Kerr
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Katye R. Miller
- Student Wellness Center, Office of Student Life, The Ohio State University, Columbus, Ohio
| | - Dylan Galos
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Randi Love
- Division of Health Behavior/Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
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