RESUMEN
Respiratory syncytial virus (RSV)-the most common viral cause of bronchiolitis-is a significant cause of serious illness among young children between the ages of 0-5 years and is especially concerning in the first year of life. Globally, RSV is a common cause of childhood acute lower respiratory illness (ALRI) and a major cause of hospital admissions in young children and infants and represents a substantial burden for health-care systems. This burden is strongly felt as there are currently no effective preventative options that are available for all infants. However, a renaissance in RSV prevention strategies is unfolding, with several new prophylactic options such as monoclonal antibodies and maternal vaccinations that are soon to be available. A key concern is that health decision makers and systems may not be ready to take full advantage of forthcoming technological innovations. A multi-stakeholder approach is necessary to bridge data gaps to fully utilise upcoming options. Knowledge must be made available at multiple levels to ensure that parents and doctors are aware of preventative options, but also to ensure that stakeholders and policymakers are given the necessary information to best advise implementation strategies.
RESUMEN
OBJECTIVES: Limited understanding of pre-exposure prophylaxis (PrEP), coupled with negative public discourse, are significant barriers to its introduction. What works to support PrEP awareness and broader HIV literacy among diverse communities in the context of biomedical HIV prevention remains unclear. This article considers how PrEP can be translated across diverse communities and what the HIV literacy challenges might be in the current context of PrEP provision. SETTING: We developed an HIV literacy informed community tool to support the roll-out of PrEP in Scotland. We undertook qualitative research with practitioners in urban and rural settings across nine Scottish health boards. PRIMARY OUTCOME MEASURE: To examine HIV literacy challenges in the context of PrEP provision. PARTICIPANTS: Interviews and focus groups with community (n=19) and clinical (n=13) practitioners working with gay and bisexual men and African communities were undertaken between March and October 2017 concerning PrEP support, stigma and HIV literacy. RESULTS: HIV literacy in the context of PrEP needs to consider more than the provision of individually targeted information. Practitioners identified and responded to stratified communities and social norms of knowledge, which influenced messaging, support and informed how practitioners enabled PrEP engagement and dialogue. Social barriers in HIV literacy, including structural stigmas relating to HIV and homophobia, shaped practitioner concerns and support for community members' willingness to engage with PrEP. CONCLUSION: Critical HIV literacy in the age of PrEP is a complex social practice. Attention needs to be paid to how information is provided and facilitates engagement, rather than simply what information is given.By exploring practitioner use of the Know about PrEP tool, we have shown how consideration of the patterns of access to services and information, the delivery of and support for engagement with PrEP information and the wider strategies employed to negotiate ongoing structural social barriers can support more equitable and diverse PrEP community conversations.
Asunto(s)
Infecciones por VIH/prevención & control , Alfabetización en Salud , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Población Negra , Femenino , Grupos Focales , Accesibilidad a los Servicios de Salud , Humanos , Difusión de la Información , Masculino , Desarrollo de Programa , Investigación Cualitativa , Servicios de Salud Rural , Escocia , Normas Sociales , Servicios Urbanos de SaludRESUMEN
A ‘new normal’ in public health and healthcare has arisen with socioeconomic shifts, technological developments, political strife, climate change, environmental degradation, and COVID-19. Challenges cannot be solved by one discipline or profession alone, but requires multiple sectors coming together, combining knowledge, expertise and methods. One Health is an integrated epidemiological and economic approach aiming to sustainably optimise the health of people, animals and ecosystem. This article reflects on the roles of Association of Schools of Public Health in the European Region (ASPHER) and European Health Management Association (EHMA) and the concrete steps needed to address skills for One Health.