Uptake of HIV testing among aging adults in Agincourt, South Africa: perception of community, social network, and individual characteristics.

This cross-sectional study examined the impact of perception of community, social network and individual variables on the likelihood of voluntary HIV testing of people 40 years and older living in Agincourt, South Africa. The data came from Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in SA (HAALSI) Cohort from Agincourt. We applied three logistic regression models. Results showed that voluntary uptake of HIV testing was significantly associated with two network factors, namely friendships within the network and frequency of fighting in the network. At the community level, attachment to place was significantly associated with voluntary testing, while at the individual level, education, sexual behaviour, employment and age were significantly associated with the voluntary uptake of HIV testing. The implications of these findings are that age-appropriate interventions must be devised to sensitise older people in Agincourt about HIV risks. Also, leadership at the community level and in social networks must encourage members to consider voluntary testing for their own and community interests.

Caring for a loved one with cancer: it is my job.

This study investigated the experiences of caregivers of loved ones with cancer in Lomé, Togo. The authors developed a framework that captures the experiences of 17 caregivers. The framework explains the exploratory factors that influenced the lives of caregivers from the caregivers' own perspectives. Findings showed that even though the caregivers experienced significant challenges that affected their lives and the lives of their families, because of cultural norms and expectations, they tried their best to overcome the challenges. Although some reported positive impacts on their family functioning, others reported negative impacts such as fragmentation of the family unit. Implications for practice and policy are discussed.

Examining Participation Disparities in Cancer Clinical Trials.

OBJECTIVES: To examine factors that account for disparities in cancer clinical trial participation. SAMPLE & SETTING: Pooled data from Behavioral Risk Factor Surveillance System surveys between 2010 and 2017. METHODS & VARIABLES: Univariate and binary logistic regression analyses were used to examine the associations between participation in clinical trials and demographic and health characteristics, using SAS® procedures to account for complex sample features. RESULTS: Univariate analyses showed that age, race, income, and self-rated health status were significantly associated with the likelihood of participating in cancer clinical trials. Binary logistic analyses showed that Black respondents who were ever diagnosed with cancer were more likely to participate in cancer clinical trials relative to White counterparts. Respondents aged 50-64 years were more likely to have participated in cancer clinical trials compared to those aged 65 years or older. However, respondents who self-rated their health as excellent or very good were less likely to participate in cancer clinical trials. IMPLICATIONS FOR NURSING: Involving properly trained nurses and nurse practitioners from diverse backgrounds in cancer clinical trials to inform people with cancer about trials and ways to reduce personal barriers will increase participation from all people, regardless of socioeconomic and demographic characteristics.

Correlates of Single Versus Multiple Functional Disabilities Among Aging Americans: Race/Ethnicity and Region of Birth.

BACKGROUND: Significant racial/ethnic disparities exist in the prevalence of functional disability among older Americans. OBJECTIVE: The study analyzed the odds of older people in the United States experiencing single and multiple disabilities, by race and region of birth. METHOD: Data came from the American Community Survey (2011-2015). Multinomial logistic regression analysis was used. RESULTS: Region of birth, race/ethnicity, age, citizenship status, duration of stay, sex, marital status, veteran status, educational attainment, poverty status, and class of workers were all significantly associated with reports of either single or multiple disabilities. However, the introduction of the interaction terms for citizenship status by race modified some of the significant results. For instance, being born in Latin America no longer reduced the odds in reports of both single and multiple disabilities. However, compared with Whites and native-born of all races, both Hispanics who were either naturalized or were noncitizens had lower odds of reporting multiple disabilities (27% and 28% lower, respectively), whereas naturalized Hispanics also had significantly reduced odds (22%) for a single disability. CONCLUSION: These findings add to the disability, race/ethnicity, and place of birth literature.

Trusting Sources of Information on Quality of Physician Care.

Reporting healthcare quality has become an important factor in healthcare delivery. Prior research has shown that patient-consumers do not frequently use information on websites reporting physician quality to guide their choice of physicians. Our aim is to understand the contextual and personal characteristics that influence patient-consumers' decisions to trust or ignore information sources about healthcare quality. We use data from Finding Quality Doctors: How Americans Evaluate Provider Quality in the US, 2014, to examine factors that explain trust in sources reporting healthcare quality provided by physicians. Using factor analysis, 3 overarching information sources were identified: (1) employers and healthcare providers; (2) user advocacy sources; and (3) insurance companies and government. We use multiple regression analysis to understand the factors that impact trust in these 3 information sources. Our study found that contrary to previous findings, health status was not a significant factor that affects trust in sources reporting care quality data. Also, age was the only factor that significantly correlated with trusting information from all 3 sources. Specifically, younger adults trusted information from all sources compared to older adults. Furthermore, political affiliation, employment status, income, and area of residence correlated with trusting care quality information from either companies and government agencies or family and social network sources. Results suggest that individual and contextual characteristics are significant factors in trusting information sources regardless of health status and these should be taken into consideration by those promoting public reporting of healthcare quality information.

Determinants of support for government involvement in obesity control among American adults.

Obesity takes a substantial toll on society as a whole. Obesity and its health-related complications contribute significantly to healthcare costs and negatively affects almost every aspect of human life. It is therefore reasonable for the government to be involved in finding solutions to control the epidemic. This article examined factors that influence support for government intervention in the obesity epidemic in the United States. We used data from Obesity in the United States: Public Perceptions, a survey of a nationally representative sample of American adults. We conducted OLS regression analysis, to understand how three main covariates that described beliefs about causes of obesity and a series of controls impact support for government intervention in obesity control. There was a significant negative relationship between support for government intervention and beliefs about causes of obesity. Also, political ideology and party affiliation significantly influenced support for government intervention. For instance, while Democrats were more supportive of government interventions to control obesity, Republicans were not supportive of such intervention. Additionally, race and environmental characteristics of place of residence significantly influenced support for government intervention. Further, there were significant joint effects of political affiliation, race, and weight status on support for government intervention. Unlike previous studies, we find that one of the important factors that drive people to either support or abhor government intervention is the perception of what causes obesity. It is important that public health officials and other stakeholders understand the intricacies of public support for obesity control.

Sexual responses to living with HIV/AIDS in Lomé, Togo.

A qualitative study of sexual behaviour among 88 people living with HIV was conducted in Lomé, Togo. Data were collected by means of open-ended interviews. Three separate sexual-behaviour patterns were identified: people who reported not having sex at all; people who reported using condoms consistently; and people who reported not using condoms at all or using them inconsistently. Reasons given to explain these behaviours were analysed. Findings reveal the need for different programmes and policy approaches to dealing with problems of HIV and AIDS in Lomé, Togo.

Polygyny and child survival in West Africa.

This study examines the relationship between polygyny and child survival in light of conflicting findings reported in a number of studies. Using data from the Demographic and Health Surveys from six West African countries, the risks of neonatal, postneonatal, and overall infant mortality are estimated. Controlling for a set of social and bio-demographic factors, it is found that substantial risks of mortality are associated with polygyny. A separate analysis explores the possibility that polygyny's impact could differ from country to country. No significant interaction effects are detected, leading to the conclusion that regardless of the country in which it is practiced, polygyny still poses a challenge to the survival chances of West African children.