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Salehi H, Mohammadi N, Ardebili ME, Manshadi SAD, Kalantari S. "Struggle against Bitter Life": Lived Experience of Iranian Nurses with HIV/AIDS. MAEDICA 2023; 18:307-316. [PMID: 37588831 PMCID: PMC10427084 DOI: 10.26574/maedica.2023.18.2.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Objectives: The impact of HIV/AIDS on the healthcare system in many countries, particularly in developing countries is significant. Due to the high prevalence of HIV/AIDS in these countries, remarkable number of nurses have contracted HIV through their work. HIV/AIDS poses a major threat to people's physical and emotional health status as well as their social well-being and it has overwhelming effects on personal and social lives of HIV-positive people. HIV-positive nurses, like other patients, are subject to many stresses, but because of their special professional and social conditions they may bear more psychological and social burdens. Materials and methods: A hermeneutic phenomenological approach was used to examine the everyday experiences of nurses who suffer HIV/AIDS. To conduct the study, six methodical steps which developed by van Manen (1990) applied in the process of the inquiry. Eight HIV-positive nurses were recruited and selected through a purposive sampling method. Data was collected by conducting 12 face-to-face in-depth semi-structured interviews with participants, two women and six men who became HIV-infected through occupational exposure. A thematic analysis method was used to extract themes and sub-themes. Results:Through thematic analysis of transcriptions, two main themes 'past, not passed' and 'struggle against bitter life' emerged. We found that the daily life of HIV/AIDS nurses is like a limbo between the past and the present. They are constantly trying to push themselves from this limbo of death to life. Conclusion:According to the results, participants were immersed in bitter memories of their past, which has always cast a dark shadow over their lives. Their lived space surrounded by many bitterness and adversities, yet they have the enthusiasm to move on with their lives and struggle day-to-day to maintain their relative health and have their job as a nurse. As result, management of HIV/AIDS is not only about fighting the virus, but it imposes many issues and problems on nurses, which should be given more attention and support.
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Affiliation(s)
- Hamid Salehi
- School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Nooredin Mohammadi
- Multicultural Nursing, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Eftekhar Ardebili
- Education Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Science, Tehran, Iran
| | - Seyed Ali Dehghan Manshadi
- Department of Infectious Disease, School of Medicine Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Kalantari
- Infectious Disease School of Medicine, Iran University of Medical Sciences, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
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Mitchell KM, Maheu-Giroux M, Dimitrov D, Moore M, Hughes JP, Donnell D, Beyrer C, El-Sadr WM, Cohen MS, Boily MC. How Can Progress Toward Ending the Human Immunodeficiency Virus Epidemic in the United States Be Monitored? Clin Infect Dis 2022; 75:163-169. [PMID: 34849635 PMCID: PMC9403299 DOI: 10.1093/cid/ciab976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Indexed: 11/14/2022] Open
Abstract
The plan for Ending the HIV (human immunodeficiency virus) Epidemic (EHE) in the United States aims to reduce new infections by 75% by 2025 and by 90% by 2030. For EHE to be successful, it is important to accurately measure changes in numbers of new HIV infections after 5 and 10 years (to determine whether the EHE goals have been achieved) but also over shorter timescales (to monitor progress and intensify prevention efforts if required). In this viewpoint, we aim to demonstrate why the method used to monitor progress toward the EHE goals must be carefully considered. We briefly describe and discuss different methods to estimate numbers of new HIV infections based on longitudinal cohort studies, cross-sectional incidence surveys, and routine surveillance data. We particularly focus on identifying conditions under which unadjusted and adjusted estimates based on routine surveillance data can be used to estimate changes in new HIV infections.
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Affiliation(s)
- Kate M Mitchell
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
- HIV Prevention Trials Network Modelling Centre, Imperial College London, London, United Kingdom
| | - Mathieu Maheu-Giroux
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, Canada
| | - Dobromir Dimitrov
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Mia Moore
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - James P Hughes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Deborah Donnell
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Chris Beyrer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wafaa M El-Sadr
- International Center for AIDS Care and Treatment Programs at Columbia University, Mailman School of Public Health, New York, New York, USAand
| | - Myron S Cohen
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marie Claude Boily
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
- HIV Prevention Trials Network Modelling Centre, Imperial College London, London, United Kingdom
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Kireev DE, Chulanov VP, Shipulin GA, Semenov AV, Tivanova EV, Kolyasnikova NM, Zueva EB, Pokrovskiy VV, Galli C. Serological diagnosis and prevalence of HIV-1 infection in Russian metropolitan areas. BMC Infect Dis 2021; 21:24. [PMID: 33413197 PMCID: PMC7791727 DOI: 10.1186/s12879-020-05695-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND HIV infection is a major health problem in Russia. We aimed to assess HIV prevalence in different population groups and to compare the characteristics of 4th generation immunoassays from Abbott, Bio-Rad, Vector-Best, Diagnostic Systems, and Medical Biological Unit. METHODS The study included 4452 individuals from the general population (GP), 391 subjects at high risk of HIV infection (HR) and 699 with potentially interfering conditions. HIV positivity was confirmed by immunoblot and by HIV RNA, seroconversion and virus diversity panels were also used. HIV avidity was employed to assess recent infections. RESULTS The prevalence in GP was 0.40%, higher in males (0.62%) and in people aged < 40 years (0.58%). Patients attending dermo-venereal centers and drug users had a high prevalence (34.1 and 58.8%). Recent infections were diagnosed in 20% of GP and in 4.2% of HR. Assay sensitivity was 100% except for one false negative (99,54%, MBU). Specificity was 99.58-99.89% overall, but as low as 93.26% on HR (Vector-Best). Small differences on early seroconversion were recorded. Only the Abbott assay detected all samples on the viral diversity panel. CONCLUSION HIV infection rate in the high-risk groups suggests that awareness and screening campaigns should be enhanced. Fourth generation assays are adequate but performance differences must be considered.
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Affiliation(s)
- D E Kireev
- Federal Budget Institute of Science Central Research Institute of Epidemiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), Novogireyevskaya St., 3A, 111123, Moscow, Russia.
| | - V P Chulanov
- Federal Budget Institute of Science Central Research Institute of Epidemiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), Novogireyevskaya St., 3A, 111123, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - G A Shipulin
- Center of Strategical Planning and Management of Biomedical Health Risks of the Ministry of Health, Moscow, Russia
| | - A V Semenov
- St. Petersburg Pasteur Research Institute of Epidemiology and Microbiology, St. Petersburg, Russia
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - E V Tivanova
- Federal Budget Institute of Science Central Research Institute of Epidemiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), Novogireyevskaya St., 3A, 111123, Moscow, Russia
| | - N M Kolyasnikova
- Federal Budget Institute of Science Central Research Institute of Epidemiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), Novogireyevskaya St., 3A, 111123, Moscow, Russia
| | - E B Zueva
- St. Petersburg Pasteur Research Institute of Epidemiology and Microbiology, St. Petersburg, Russia
| | - V V Pokrovskiy
- Federal Budget Institute of Science Central Research Institute of Epidemiology Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), Novogireyevskaya St., 3A, 111123, Moscow, Russia
| | - C Galli
- Abbott Diagnostics, Rome, Italy
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Sun X, Nishiura H, Xiao Y. Modeling methods for estimating HIV incidence: a mathematical review. Theor Biol Med Model 2020; 17:1. [PMID: 31964392 PMCID: PMC6975086 DOI: 10.1186/s12976-019-0118-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/24/2019] [Indexed: 01/07/2023] Open
Abstract
Estimating HIV incidence is crucial for monitoring the epidemiology of this infection, planning screening and intervention campaigns, and evaluating the effectiveness of control measures. However, owing to the long and variable period from HIV infection to the development of AIDS and the introduction of highly active antiretroviral therapy, accurate incidence estimation remains a major challenge. Numerous estimation methods have been proposed in epidemiological modeling studies, and here we review commonly-used methods for estimation of HIV incidence. We review the essential data required for estimation along with the advantages and disadvantages, mathematical structures and likelihood derivations of these methods. The methods include the classical back-calculation method, the method based on CD4+ T-cell depletion, the use of HIV case reporting data, the use of cohort study data, the use of serial or cross-sectional prevalence data, and biomarker approach. By outlining the mechanistic features of each method, we provide guidance for planning incidence estimation efforts, which may depend on national or regional factors as well as the availability of epidemiological or laboratory datasets.
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Affiliation(s)
- Xiaodan Sun
- Department of Applied Mathematics, Xi'an Jiaotong University, No 28, Xianning West Road, Xi'an, Shaanxi, 710049, China
| | - Hiroshi Nishiura
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kitaku, Sapporo, 0608638, Japan.
| | - Yanni Xiao
- Department of Applied Mathematics, Xi'an Jiaotong University, No 28, Xianning West Road, Xi'an, Shaanxi, 710049, China
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O'Byrne P, MacPherson P, Orser L, Jacob JD, Holmes D. PrEP-RN: Clinical Considerations and Protocols for Nurse-Led PrEP. J Assoc Nurses AIDS Care 2019; 30:301-311. [PMID: 31008817 PMCID: PMC6551248 DOI: 10.1097/jnc.0000000000000075] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HIV pre-exposure prophylaxis (PrEP) is an increasingly important part of the HIV prevention armamentarium. Issues with PrEP, however, include access. We propose that one way to surmount this issue would be to have nurses provide PrEP. Although clinical guidelines exist for PrEP, they are overwhelmingly not targeted to nonprescriber clinicians. In this article, we overview current U.S. and Canadian PrEP guidelines and provide explicit guidance about how nurses can provide PrEP, including the clinical pathways and medical directives we use in our clinic. We call nurse-led provision of PrEP, PrEP-RN (Pre-Exposure Prophylaxis-Registered Nurse) and feel it may be an important step forward in HIV prevention.
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Affiliation(s)
- Patrick O'Byrne
- Patrick O'Byrne, RN-EC, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Paul MacPherson, MD, PhD, is a Staff Physician, Division of Infectious Diseases, The Ottawa Hospital, Ontario, Canada. Lauren Orser, RN, is a Master's Student, School of Nursing, University of Ottawa, Ontario, Canada. Jean Daniel Jacob, RN, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Dave Holmes, RN, PhD, is a Professor of Nursing, University of California, Irvine, California, USA
| | - Paul MacPherson
- Patrick O'Byrne, RN-EC, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Paul MacPherson, MD, PhD, is a Staff Physician, Division of Infectious Diseases, The Ottawa Hospital, Ontario, Canada. Lauren Orser, RN, is a Master's Student, School of Nursing, University of Ottawa, Ontario, Canada. Jean Daniel Jacob, RN, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Dave Holmes, RN, PhD, is a Professor of Nursing, University of California, Irvine, California, USA
| | - Lauren Orser
- Patrick O'Byrne, RN-EC, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Paul MacPherson, MD, PhD, is a Staff Physician, Division of Infectious Diseases, The Ottawa Hospital, Ontario, Canada. Lauren Orser, RN, is a Master's Student, School of Nursing, University of Ottawa, Ontario, Canada. Jean Daniel Jacob, RN, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Dave Holmes, RN, PhD, is a Professor of Nursing, University of California, Irvine, California, USA
| | - Jean Daniel Jacob
- Patrick O'Byrne, RN-EC, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Paul MacPherson, MD, PhD, is a Staff Physician, Division of Infectious Diseases, The Ottawa Hospital, Ontario, Canada. Lauren Orser, RN, is a Master's Student, School of Nursing, University of Ottawa, Ontario, Canada. Jean Daniel Jacob, RN, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Dave Holmes, RN, PhD, is a Professor of Nursing, University of California, Irvine, California, USA
| | - Dave Holmes
- Patrick O'Byrne, RN-EC, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Paul MacPherson, MD, PhD, is a Staff Physician, Division of Infectious Diseases, The Ottawa Hospital, Ontario, Canada. Lauren Orser, RN, is a Master's Student, School of Nursing, University of Ottawa, Ontario, Canada. Jean Daniel Jacob, RN, PhD, is an Associate Professor of Nursing, University of Ottawa, Ontario, Canada. Dave Holmes, RN, PhD, is a Professor of Nursing, University of California, Irvine, California, USA
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