Forging Resilience to HIV/AIDS: Personal Strengths of Middle-aged and Older Gay, Bisexual, and Other Men Who Have Sex With Men Living With HIV/AIDS

HIV-positive gay, bisexual, two-spirit, and other men who have sex with men (MSM) have exhibited significant resilience to HIV/AIDS in Canada since the start of the epidemic. Since 2012, most of the research that has been conducted on resilience to HIV/AIDS has utilized quantitative methods and deficits-based approaches, with a preferential focus on the plight of young MSM. In order to address apparent gaps in research on HIV/AIDS resilience, we conducted a community-based participatory research qualitative study that utilized a strengths-based approach to examine the perspectives and lived experiences of HIV-positive, middle-aged and older MSM on their individual attributes that helped forge their HIV/AIDS resilience. We conducted 41 semistructured interviews with diverse, HIV-positive, middle-aged and older MSM from Central and Southwestern Ontario, Canada. From our thematic analysis of our interviews, we identified four themes, which represented personal strengths that fostered resilience to HIV/AIDS: (a) proactiveness, (b) perseverance, (c) having the right mindset, and (d) self-awareness with self-control. This article discusses the importance of these personal strengths to fostering HIV/AIDS resilience, and how community-based resources could potentially lessen the need to muster such personal strengths, or alternatively, cultivate them.

Heparin free hemodialysis does not cause fibrin consumptive coagulopathy and maintains alternate pathway complement activation

Heparin-free hemodialysis allows demonstration of the intradialytic coagulation status not previously possible during standard heparin anticoagulant hemodialysis protocols in patients with end-stage renal disease. No evidence for consumptive coagulopathy was noted in the absence of heparin during hemodialysis with cuprophane hollow fiber dialyzers. Fibrinogen levels, euglobulin lysis time, and platelet counts remained stable throughout 3 hours of heparin-free hemodialysis. Serial thrombin times and platelet aggregation improved during heparin-free hemodialysis. Hemodialyzer volumes and the ultrafiltration coefficient decreased only minimally. The alternate pathway of complement activation associated with hemodialysis blood-membrane interaction is not prevented by heparin-free hemodialysis.