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Lewis BE, Naik AR. A scoping review to identify and organize literature trends of bias research within medical student and resident education. BMC MEDICAL EDUCATION 2023; 23:919. [PMID: 38053172 PMCID: PMC10698960 DOI: 10.1186/s12909-023-04829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/01/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Physician bias refers to the unconscious negative perceptions that physicians have of patients or their conditions. Medical schools and residency programs often incorporate training to reduce biases among their trainees. In order to assess trends and organize available literature, we conducted a scoping review with a goal to categorize different biases that are studied within medical student (MS), resident (Res) and mixed populations (MS and Res). We also characterized these studies based on their research goal as either documenting evidence of bias (EOB), bias intervention (BI) or both. These findings will provide data which can be used to identify gaps and inform future work across these criteria. METHODS Online databases (PubMed, PsycINFO, WebofScience) were searched for articles published between 1980 and 2021. All references were imported into Covidence for independent screening against inclusion criteria. Conflicts were resolved by deliberation. Studies were sorted by goal: 'evidence of bias' and/or 'bias intervention', and by population (MS or Res or mixed) andinto descriptive categories of bias. RESULTS Of the initial 806 unique papers identified, a total of 139 articles fit the inclusion criteria for data extraction. The included studies were sorted into 11 categories of bias and showed that bias against race/ethnicity, specific diseases/conditions, and weight were the most researched topics. Of the studies included, there was a higher ratio of EOB:BI studies at the MS level. While at the Res level, a lower ratio of EOB:BI was found. CONCLUSIONS This study will be of interest to institutions, program directors and medical educators who wish to specifically address a category of bias and identify where there is a dearth of research. This study also underscores the need to introduce bias interventions at the MS level.
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Affiliation(s)
- Brianne E Lewis
- Department of Foundational Sciences, Central Michigan University College of Medicine, Mt. Pleasant, MI, 48859, USA
| | - Akshata R Naik
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI, 48309, USA.
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Dunbar W, Alcide C, Raccurt C, Pape JW, Coppieters Y. Attitudes of medical students towards men who have sex with men living with HIV: implications for social accountability. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:233-239. [PMID: 33099520 PMCID: PMC7882130 DOI: 10.5116/ijme.5f87.39c2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 10/14/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To explore the attitudes that medical students in Haiti harbour toward Men who have Sex with Men living with HIV in order to better understand how stigma and other factors may impair healthcare, and to explore suggestions of opportunities in line with the values of social accountability. METHODS This study employed a qualitative design by using a grounded theory approach regarding the context of Haiti. We used purposive sampling to select the 22 research participants. In-depth interviews were conducted, audio-recorded, transcribed and analyzed using an inductive content analysis approach. RESULTS Although stigmatizing attitudes emerged through the findings, medical students expressed willingness to provide Men who have Sex with Men with adequate health services in relation to HIV care. Their expressions were based on the Men who have Sex with Men's comprehensive right to receive equitable care, the moral responsibility of healthcare professionals, their perception of health disparities and the HIV global risk reduction. Participants pointed out that the medical education curriculum did not consider sexual health and specificities of sexual minorities and suggested a more inclusive and socially accountable training based on equity and quality. CONCLUSIONS The students expressed favourable attitudes regarding health services to Men who have Sex with Men even though some layered stigmatizing attitudes emerged through the discussions. They all lacked skills on how to handle health specificities of sexual minorities. These findings recommend a revision of the medical education curriculum in regard to social accountability principles.
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Affiliation(s)
- Willy Dunbar
- Health Systems and Policies, International Health, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Colette Alcide
- Faculty of Health Sciences, Quisqueya University, Port-au-Prince, Haiti
| | - Christian Raccurt
- Faculty of Health Sciences, Quisqueya University, Port-au-Prince, Haiti
| | - Jean W. Pape
- Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Yves Coppieters
- Health Systems and Policies, International Health, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
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Alawad M, Alturki A, Aldoghayyim A, Alrobaee A, Alsoghair M. Knowledge, Attitudes, and Beliefs about HIV/AIDS and People Living with HIV among Medical Students at Qassim University in Saudi Arabia. Int J Health Sci (Qassim) 2019; 13:22-30. [PMID: 31501649 PMCID: PMC6728128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) is a global health problem. Since Saudi Arabia is becoming more open to the world, it is important to assess future doctors' knowledge, attitudes, and practices (KAPs) regarding HIV/AIDS and people living with HIV (PLHIV). MATERIALS AND METHODS This cross-sectional study included 204 male medical students of Qassim University who answered a self-administered questionnaire about HIV KAPs. RESULTS The mean HIV knowledge (HK) and attitude scores were 11.62 (64.5%) and 37.82 (67.5%), respectively. Positive correlations were observed between HK and attitude (r = 0.266) and HK and academic year (r = 0.277). No significant correlation was found between attitude and academic year (r = 0.097). More than half of the students exhibited ignorance about some modes of transmission such as deep kissing and vertical transmission. Around 81% of the students stated that they would not visit the homes of friends with HIV-infected members. Furthermore, 73.1% of the participants indicated that they would not provide care to HIV-positive relatives in their own homes. CONCLUSIONS The findings show a modest level of HK and negative attitudes toward PLHIV. The study identified the main knowledge gaps in the transmission and prevention of HIV. Educational institutions should tailor their educational approach based on the identified gaps, which might help to ease the stigma and negative attitudes.
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Affiliation(s)
- Moayad Alawad
- Medical Internship, College of Medicine, Qassim University, Saudi Arabia
| | - Abdulkarim Alturki
- Medical Internship, College of Medicine, Qassim University, Saudi Arabia
| | | | | | - Mansour Alsoghair
- Department of Community Medicine, College of Medicine, Qassim University, Saudi Arabia,Address for correspondence: Mansour Alsoghair, Department of Community Medicine, College of Medicine, Qassim University, Saudi Arabia. E-mail:
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Hemanthkumar BG, Keertish N, Sathyanarayana MT. Is there any difference between attitude of interns toward psychiatric illness and other chronic medical conditions? A comparative study. Indian J Psychiatry 2018; 60:195-198. [PMID: 30166675 PMCID: PMC6102956 DOI: 10.4103/psychiatry.indianjpsychiatry_107_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Attitude of doctors towards specific medical conditions plays a crucial role in patient care. Internship, being the final stage in undergraduate medical students' training, can have a bearing on the attitude they develop towards various specialties. However, there is dearth of Indian studies comparing the attitude of interns towards psychiatric illness and other chronic medical conditions. In this background, the study was conceived with the objective of comparing the attitude of interns towards psychiatric illness and other chronic medical conditions. AIMS (1) To compare the attitude of interns towards Psychiatric illness and Diabetes Mellitus. (2) To compare the attitude of interns towards Psychiatric illness and HIV/AIDS. SETTING AND DESIGN Conducted at Sri Siddhartha medical college, Tumakuru as a cross sectional study. METHODOLOGY The sample for this cross sectional study comprised of 130 interns in a tertiary care teaching hospital who had completed their postings in Psychiatry. Medical Condition Regard Scale (MCRS) was used to assess the attitude of interns towards Psychiatry, Diabetes Mellitus and HIV/AIDS. STATISTICAL ANALYSIS SPSS 20 was used with Descriptive statistics and non-parametric tests to analyze the data obtained. RESULTS There was no significant difference between the overall MCRS scores for Diabetes Mellitus and psychiatric illnesses. However, many individual items and the overall scores of MCRS were significantly higher for psychiatric illnesses when compared to those for HIV/AIDS. CONCLUSIONS The attitude of interns towards Psychiatric illness was comparable to that towards Diabetes Mellitus. However, their attitude towards Psychiatric illness was more favorable than that towards HIV/AIDS. Further studies need to focus on the various aspects of stigma/ attitude and the effect of undergraduate medical training on those aspects.
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Affiliation(s)
| | - Narayana Keertish
- Department of Psychiatry, BGS Global Institute of Medical Sciences, Bengaluru, Karnataka, India
| | - M T Sathyanarayana
- Department of Psychiatry, Sri Siddhartha Medical College, Tumakuru, Karnataka, India
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Vetrova MV, Aleksandrova OV, Paschenko AE, Toropov SE, Rassokhin VV, Abyshev RA, Levina OS, Niccolai LM, Heimer R. Early stages of HIV treatment cascade in people living with HIV in Saint-Petersburg, Russia. AIDS Care 2018; 30:857-862. [PMID: 29325435 DOI: 10.1080/09540121.2017.1417536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The proportion of people living with HIV (PLWH) in need of antiretroviral therapy (ART) is growing rapidly in Russia. Successful treatment outcomes reduces disease progression and contributes to HIV epidemic control. We conducted a pilot study following 100 PLWH newly found eligible for ART in St. Petersburg, Russia. We determined the proportion of PLWH who initiated ART, remained in treatment, and achieved an undetectable VL during 6-month follow up. Semi-structured interviews were conducted prior the initiation of ART and progress along the cascade was assessed through medical chart review. Individual characteristics associated with successful ART outcomes were assessed as part of efforts to generate hypotheses. Almost all (96%) participants initiated ART, full retention was demonstrated by 80%, among whom 71% achieved undetectable VL. Optimal retention was associated with older age and higher education (p < 0.05). There was no significant difference in ART outcomes between those who used illicit drugs and those had not. Interventions to improve treatment effectiveness should emphasize that initiation, optimal retention and achieving an undetectable VL are independent of drug abuse status. However, our pilot study highlights the need for the further research in the examining links between individual and structural factors and ART effectiveness.
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Affiliation(s)
- M V Vetrova
- a Laboratory of Clinical Psychopharmacology of Addictions , Valdman Institute of Pharmacology, First Pavlov State Medical University of St. Petersburg , Saint-Petersburg , Russia.,b Department of Addictions , St. Petersburg Bekhterev Research Psychoneurological Institute , Saint-Petersburg , Russia
| | - O V Aleksandrova
- c Department of Psychology , St. Petersburg State University , Saint-Petersburg , Russia
| | - A E Paschenko
- d Laboratory of Theoretical and Interdisciplinary Informatics Problems , St. Petersburg Institute for Informatics and Automation of the Russian Academy of Sciences , Saint-Petersburg , Russia
| | - S E Toropov
- e St. Petersburg Centre for Control and Prevention of AIDS and Other Infection , Saint-Petersburg , Russia
| | - V V Rassokhin
- f Department of Infectious Diseases and Epidemiology , First Pavlov State Medical University of St. Petersburg , Saint-Petersburg , Russia.,g Laboratory of Immunology and Virology of HIV Infection , Saint-Petersburg Pasteur Institute , Saint-Petersburg , Russia
| | - R A Abyshev
- e St. Petersburg Centre for Control and Prevention of AIDS and Other Infection , Saint-Petersburg , Russia
| | - O S Levina
- h Regional NGO of Social Projects in the Sphere of Population's Wellbeing "STELLIT" , St. Petersburg , Russia
| | - L M Niccolai
- i School of Public Health , Yale University , New Haven , USA
| | - R Heimer
- i School of Public Health , Yale University , New Haven , USA
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Jaworsky D, Gardner S, Thorne JG, Sharma M, McNaughton N, Paddock S, Chew D, Lees R, Makuwaza T, Wagner A, Rachlis A. The role of people living with HIV as patient instructors - reducing stigma and improving interest around HIV care among medical students. AIDS Care 2016; 29:524-531. [PMID: 27577683 DOI: 10.1080/09540121.2016.1224314] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People living with HIV/AIDS (PHAs) are increasingly recognized as experts in HIV and their own health. We developed a simulated clinical encounter (SCE) in which medical students provided HIV pre- and post-test counselling and point-of-care HIV testing for PHAs as patient instructors (PHA-PIs) under clinical preceptor supervision. The study assessed the acceptability of this teaching tool with a focus on assessing impact on HIV-related stigma among medical students. University of Toronto pre-clerkship medical students participated in a series of SCEs facilitated by 16 PHA-PIs and 22 clinical preceptors. Pre- and post-SCE students completed the validated Health Care Provider HIV/AIDS Stigma Scale (HPASS). HPASS measures overall stigma, as well as three domains within HIV stigma: stereotyping, discrimination, and prejudice. Higher scores represented higher levels of stigma. An additional questionnaire measured comfort in providing HIV-related care. Mean scores and results of paired t-tests are presented. Post-SCE, students (n = 62) demonstrated decreased overall stigma (68.74 vs. 61.81, p < .001) as well as decreased stigma within each domain. Post-SCE, students (n = 67) reported increased comfort in providing HIV-related care (10.24 vs. 18.06, p < .001). Involving PHA-PIs reduced HIV-related stigma among medical students and increased comfort in providing HIV-related care.
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Affiliation(s)
- Denise Jaworsky
- a Faculty of Medicine , University of Toronto , Toronto , ON , Canada
| | - Sandra Gardner
- b Ontario HIV Treatment Network , Toronto , ON , Canada.,c Dalla Lana School of Public Health , University of Toronto , Toronto , ON , Canada
| | - Julie G Thorne
- a Faculty of Medicine , University of Toronto , Toronto , ON , Canada
| | - Malika Sharma
- d Department of Infectious Diseases , University of Toronto , Toronto , ON , Canada
| | - Nancy McNaughton
- e Standardized Patient Program , University of Toronto , Toronto , ON , Canada
| | - Suzanne Paddock
- f Toronto People With AIDS Foundation , Toronto , ON , Canada
| | - Derek Chew
- a Faculty of Medicine , University of Toronto , Toronto , ON , Canada
| | - Rick Lees
- g Nine Circles Community Health Centre , Winnipeg , MB , Canada
| | | | - Anne Wagner
- h Department of Psychology , Ryerson University , Toronto , ON , Canada
| | - Anita Rachlis
- i Sunnybrook Health Sciences Centre , Toronto , ON , Canada.,j Faculty of Medicine , University of Toronto , Toronto , ON , Canada
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- k Collaboration for HIV Medical Education , Toronto , ON , Canada
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HIV Testing, Care, and Treatment Among Women Who Use Drugs From a Global Perspective: Progress and Challenges. J Acquir Immune Defic Syndr 2015; 69 Suppl 2:S162-8. [PMID: 25978483 DOI: 10.1097/qai.0000000000000660] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The article reviews data on HIV testing, treatment, and care outcomes for women who use drugs in 5 countries across 5 continents. We chose countries in which the HIV epidemic has, either currently or historically, been fueled by injection and non-injection drug use and that have considerable variation in social structural and drug policies: Argentina, Vietnam, Australia, Ukraine, and the United States. There is a dearth of available HIV care continuum outcome data [ie, testing, linkage, retention, antiretroviral therapy (ART) provision, viral suppression] among women drug users, particularly among noninjectors. Although some progress has been made in increasing HIV testing in this population, HIV-positive women drug users in 4 of the 5 countries have not fully benefitted from ART nor are they regularly engaged in HIV care. Issues such as the criminalization of drug users, HIV-specific criminal laws, and the lack of integration between substance use treatment and HIV primary care play a major role. Strategies that effectively address the pervasive factors that prevent women drug users from engaging in HIV care and benefitting from ART and other prevention services are critical. Future success in enhancing the HIV continuum for women drug users should consider structural and contextual level barriers and promote social, economic, and legal policies that overhaul the many years of discrimination and stigmatization faced by women drug users worldwide. Such efforts must emphasis the translation of policies into practice and approaches to implementation that can help HIV-infected women who use drugs engage at all points of the HIV care continuum.
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Gagnon M. Re-thinking HIV-Related Stigma in Health Care Settings: A Qualitative Study. J Assoc Nurses AIDS Care 2015; 26:703-19. [PMID: 26300466 DOI: 10.1016/j.jana.2015.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 07/23/2015] [Indexed: 10/23/2022]
Abstract
People living with HIV (PLWH) continue to endure stigma and discrimination in the context of health care. This paper presents the findings of a qualitative study designed to (a) describe stigmatizing and discriminatory practices in health care settings, and (b) explore both symbolic and structural stigma from the perspectives of PLWH. For the purpose of this qualitative study, 21 semi-structured in-depth interviews were conducted in the province of Quebec, Canada. The data were analyzed following the principles of thematic analysis. During analysis, three themes were identified, and relations between these themes were delineated to reflect the experiences of participants. The findings suggest that HIV-related stigma in health care settings is episodic in nature. The findings also suggest that HIV-related stigma is experienced through interactions with health care providers (symbolic stigma) and, finally, that it is applied systematically to manage risk in the context of health care (structural stigma).
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Balon R, Tait GR, Coverdale JH, Beresin EV, Louie AK, Roberts LW. Stigma and empathy: sex workers as educators of medical students. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2015; 39:239-41. [PMID: 25854454 DOI: 10.1007/s40596-015-0338-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/17/2015] [Indexed: 05/14/2023]
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Girchenko P, Ompad DC, Bikmukhametov D, Gensburg L. Association between Pregnancy and Active Injection Drug Use and Sex Work among Women Injection Drug Users in Saint Petersburg, Russia. J Urban Health 2015; 92:548-58. [PMID: 25835324 PMCID: PMC4456481 DOI: 10.1007/s11524-015-9954-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Widespread use of unsafe sexual practices among women injecting drugs both practicing and not practicing sex work leads to high levels of unplanned pregnancies in this population. The goal of this study was to investigate the association between pregnancy and active drug use and sex work. Data were collected using a convenience sample of 500 women in Saint Petersburg, Russia, in 2013. All women had recent experience of drug use, of which 200 were pregnant at the time of the study. The study consisted of a structured interview followed by a rapid HIV test. Pregnancy was protective against both active drug use and sex work. For HIV-positive women, these associations were stronger than for HIV-negative women: drug use prevalence ratio (PR) was 0.59 vs 0.85; for sex work, the PRs were 0.36 vs 0.64. Higher levels of education were associated with a lower prevalence ratio for active drug use and sex work in all models. Having children was not associated with active drug use or sex work. Pregnancy might be an optimal time for conducting interventions aimed at cessation of drug use and sex work among women injecting drugs.
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Affiliation(s)
- P Girchenko
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA,
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DeHovitz J, Uuskula A, El-Bassel N. The HIV epidemic in Eastern Europe and Central Asia. Curr HIV/AIDS Rep 2015; 11:168-76. [PMID: 24652411 DOI: 10.1007/s11904-014-0202-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Eastern Europe and Central Asia represent one of the few regions globally where there is a continued increase in the incidence of HIV infection. For example, in Eastern Europe the rate of diagnosed cases of HIV infection per 100 000 population has increased from 11.7 in 2004 to 22.5 in 2011. Initially propelled by injection drug use, heterosexual transmission has now become a major driver of new infections in the region. Nonetheless substance use remains an important factor, with its control limited by challenges in scaling up harm reduction efforts. While most countries have implemented opioid substitution therapy programs, their scale remains very limited. Similarly, coverage of needles syringe programs across the region is variable. Complicating the control of HIV has been the emergence of non-injection drugs and inadequate access to antiretroviral therapy. In addition, structural barriers and stigma toward HIV infected people may contribute to the high proportion of late presentations for HIV care. Finally in the wake of the HIV epidemic, high rates of hepatitis C infection and tuberculosis have been noted.
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Affiliation(s)
- Jack DeHovitz
- SUNY Downstate Medical Center, 450 Clarkson Ave., MSC 1240, Brooklyn, NY, 11203, USA,
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Zheluk A, Quinn C, Hercz D, Gillespie JA. Internet search patterns of human immunodeficiency virus and the digital divide in the Russian Federation: infoveillance study. J Med Internet Res 2013; 15:e256. [PMID: 24220250 PMCID: PMC3841350 DOI: 10.2196/jmir.2936] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/18/2013] [Accepted: 10/22/2013] [Indexed: 12/31/2022] Open
Abstract
Background Human immunodeficiency virus (HIV) is a serious health problem in the Russian Federation. However, the true scale of HIV in Russia has long been the subject of considerable debate. Using digital surveillance to monitor diseases has become increasingly popular in high income countries. But Internet users may not be representative of overall populations, and the characteristics of the Internet-using population cannot be directly ascertained from search pattern data. This exploratory infoveillance study examined if Internet search patterns can be used for disease surveillance in a large middle-income country with a dispersed population. Objective This study had two main objectives: (1) to validate Internet search patterns against national HIV prevalence data, and (2) to investigate the relationship between search patterns and the determinants of Internet access. Methods We first assessed whether online surveillance is a valid and reliable method for monitoring HIV in the Russian Federation. Yandex and Google both provided tools to study search patterns in the Russian Federation. We evaluated the relationship between both Yandex and Google aggregated search patterns and HIV prevalence in 2011 at national and regional tiers. Second, we analyzed the determinants of Internet access to determine the extent to which they explained regional variations in searches for the Russian terms for “HIV” and “AIDS”. We sought to extend understanding of the characteristics of Internet searching populations by data matching the determinants of Internet access (age, education, income, broadband access price, and urbanization ratios) and searches for the term “HIV” using principal component analysis (PCA). Results We found generally strong correlations between HIV prevalence and searches for the terms “HIV” and “AIDS”. National correlations for Yandex searches for “HIV” were very strongly correlated with HIV prevalence (Spearman rank-order coefficient [rs]=.881, P≤.001) and strongly correlated for “AIDS” (rs=.714, P≤.001). The strength of correlations varied across Russian regions. National correlations in Google for the term “HIV” (rs=.672, P=.004) and “AIDS” (rs=.584, P≤.001) were weaker than for Yandex. Second, we examined the relationship between the determinants of Internet access and search patterns for the term “HIV” across Russia using PCA. At the national level, we found Principal Component 1 loadings, including age (-0.56), HIV search (-0.533), and education (-0.479) contributed 32% of the variance. Principal Component 2 contributed 22% of national variance (income, -0.652 and broadband price, -0.460). Conclusions This study contributes to the methodological literature on search patterns in public health. Based on our preliminary research, we suggest that PCA may be used to evaluate the relationship between the determinants of Internet access and searches for health problems beyond high-income countries. We believe it is in middle-income countries that search methods can make the greatest contribution to public health.
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Affiliation(s)
- Andrey Zheluk
- Menzies Centre for Health Policy, The University of Sydney, University of Sydney NSW, Australia.
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