Barriers to Oral PrEP: A Qualitative Study of Female Sex Workers, PrEP Prescribers, Policymakers, and Community Advocates in Morocco.

In 2017, Morocco became the first Arab country to incorporate pre-exposure prophylaxis (PrEP) in its HIV-prevention program. Yet no research has been published on PrEP from Morocco. Although female sex workers are one of the target populations of PrEP in Morocco, their enrollment in PrEP is lower than men who have sex with men. In this study, we conducted 38 semi-structured interviews with female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. We also investigated preferences for daily oral, vaginal ring, and long-acting injectable PrEP. A reflexive thematic analysis revealed seven themes: PrEP stigma; stigmatization and criminalization of sex work; one size doesn't fit all; knowledge and misconceptions about PrEP; economic burden; inconvenience of PrEP pills; and preferred PrEP modalities. This paper discusses the implications of the findings for increasing access and use of PrEP in Morocco.

Factors that Influence Uptake of Oral PrEP among Female Sex Workers One of the most recent scientific advancements in the history of the HIV pandemic was the introduction of pre-exposure prophylaxis (PrEP). However, the uptake of PrEP in the Arab world is low. In this paper we interviewed female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. Several barriers were identified including stigma attached to PrEP, misconceptions about PrEP, and financial burden. Although most female sex workers in our study were interested in using PrEP, the delivery methods of PrEP should be tailored to fit the lifestyle and personal circumstances of potential users.

The Influence of Disagreements over COVID-19 Preventive Measures on Stress and Sleep Quality.

In this paper we reported the rate of disagreements and their effect on stress levels and sleep quality. Data was collected from 573 South Dakota residents. We estimated two ordinary least squares regressions using stress and sleep quality due to COVID-19 as outcome variables. A high percentage (62.1%) of the participants reported disagreements over COVID-19 with friends and family members. Disagreements over COVID-19 were associated with a higher level of stress (ß = 1.001, p = .000) and a lower level of sleep quality (ß = -.431, p = .039). The results of this study should serve as a reminder to researchers to consider the impact of interpersonal conflict over public health measures with family and friends on mental health.

Attitudes of Physicians and Nurses in Oman Toward Mandatory COVID-19 Vaccination.

Objectives: To investigate the relationship between attitudes toward COVID-19 vaccines and disapproval of the policy of mandatory COVID-19 vaccination among unvaccinated physicians and nurses in Oman. Methods: The subjects were (N = 346) unvaccinated physicians and nurses in Oman. Their demographic data and attitudes regarding COVID-19 vaccines and mandatory vaccination policy were collected through an anonymous web-based survey and statistically analyzed. Results: The participants' negative attitudes toward COVID-19 vaccines were positively related (r = 0.68, p < 0.001) to the extent of their non-support for COVID-19 mandatory vaccination policy. Analysis of variance test showed that after controlling for age, male healthcare providers were more likely to endorse mandating COVID-19 vaccinations. There was no difference between physicians and nurses in support of mandatory vaccination, after controlling for age. Conclusions: Regardless of job type, male, and older physicians, and nurses in Oman were more supportive of mandatory COVID-19 vaccination than their younger and female counterparts. This research provides insights from an Arabian Gulf country about the attitudes of its unvaccinated healthcare providers toward compulsory COVID-19 vaccination.

Cross-Cultural Adaptation and Psychometric Assessment of an Arabic Version of the Health Care Provider HIV/AIDS Stigma Scale.

HIV stigma among health care providers in the Arab world is understudied due to a lack of valid and reliable measures. Data from 352 Egyptian physicians was used to validate an Arabic version of the Health Care Provider HIV/AIDS Stigma Scale (HPASS). Exploratory factor analysis (n = 1 9 4) suggested a 3 -factor structure. Confirmatory factor analysis (n = 1 5 8) validated the three-factor solution with 18 items, which explained 5 3 .3 6% of the variance. All items loaded on their designated constructs, which ranged from 0 .58 to 0 .82 (prejudice) to 0 .58 to 0 .66 (stereotypes) and 0 .52 to 0 .91 (discrimination). The prejudice, stereotypes, and discrimination subscales consisted of seven, five, and six items, respectively. The internal consistency (α = 0 .9 0) and the test-retest reliability demonstrated (r = 0 .9 5) were excellent. The cultural adaptation of the Arabic version of HPASS suggests that it is a suitable scale for assessing HIV stigma among Arab health care providers.

Attitudes Toward Restricting the Sexual and Reproductive Rights of Women Living With HIV Infection in Yemen.

A considerable amount of research has demonstrated the pervasive and destructive power of discrimination against people living with HIV, which limits their full and equal participation in society. This study surveyed 613 young adults from Yemen about their attitudes toward the sexual and reproductive rights of women living with HIV (WLWH). Among survey respondents, 80% believed that WLWH should be sterilized and not allowed to get married. Furthermore, 62% thought that WLWH should be forced to have abortions if they became pregnant. Men were more likely than women to impose restrictions on the sexual and reproductive rights of WLWH. HIV stigma predicted respondent attitudes toward WLWH, but religiosity and knowledge about HIV did not. The results of the study have implications for developing programs to protect and promote the rights of WLWH in Yemen.

"I want to stand on my own legs": A qualitative study of antiretroviral therapy adherence among HIV-positive women in Egypt.

A review of the antiretroviral therapy (ART) literature revealed that not a single published study has examined the factors that influence patients' adherence to HIV medications in the Arab world. To mend this gap, this qualitative study collected data via face-to-face interviews with 27 HIV-positive Egyptian women who had been on ART for at least three months. Using a thematic analysis technique, five themes were identified: fear of stigma, financial constraints, characteristics of ART, social support, and reliance on faith. Notwithstanding the overwhelming number of inhibiting factors, most patients in this study were highly motivated to achieve perfect adherence.

Stigmatization of persons with HIV/AIDS in Saudi Arabia.

Data about the stigmatization of persons living with HIV/AIDS in Saudi Arabia are scarce. Recent statistics from Saudi Ministry of Health showed that 77% of HIV-positive Saudis were males. The present study analyzed data from 162 Saudi male college students. The findings suggest that students who knew less about HIV/AIDS were more likely to stigmatize persons living with HIV/AIDS than those who knew more. Neither degree of religiosity nor worry about HIV infection was related to AIDS stigma. However, AIDS-related shame was the best predictor of AIDS stigma. The findings of this study point to important suggestions for AIDS prevention programs in Saudi Arabia.

Attribution and helping behavior: testing the attribution-affect-help judgment model in a Saudi sample.

A review of the literature on Weiner's attributional theory indicates that the theory has not been tested in Arabic cultures. The present study examined the reactions of Saudi men toward a friend with AIDS, using Weiner's attributional theory of social motivation. A sample of 298 Saudi men read two different vignettes about a friend with AIDS, in which the cause of AIDS was manipulated. Then the assignment of responsibility, reactions of anger and pity, and participants' willingness to provide help were measured.