The Experience of HIV-Positive Transgender Women Engaging in Physical Activity: An Interpretative Phenomenological Analysis.

Regular physical activity should benefit HIV-positive transgender women because they are a particularly vulnerable population. However, engaging in physical activity seems particularly difficult among this population. To inform the development of interventions to increase adherence to physical activity, we explored perceptions of physical activity in 10 semi-structured interviews with HIV-positive transgender women. Interviews were subjected to a qualitative approach named interpretative phenomenological analysis (IPA). Inspired by Cooley's theory, we chose to illustrate the results according to a three-level structure, i.e., confronting oneself to oneself with a specific identity, then confronting oneself with others on an interpersonal level, and eventually confronting oneself with society as a normative frame through the specific prism of physical activity, and thus relationship to one's body. The idea of practicing physical activity meant for them: having to face what they tried to be kept hidden, being ostracized by the cis population, and facing social heteronormativity. The fears about health were mostly about HIV and the transitioning process side effects. The psychological issues were mostly about the fear of developing male shaped bodies and worsened by traumatic life stories. External factors were often related to the passing concept and violence caused by stigma and discrimination. The group appeared as a strong motivation factor, facilitating self-acceptance and socialization.

[Cancer prevention and screening: What french GPs could do?] / Place des médecins généralistes dans le dispositif de prévention/dépistage des cancers en France.

An effective health system is based on effective primary care, at the center of which is family medicine. Cancer prevention and screening are integral aspects of general practitioners skills. Prevention is linked with the notion of risk. The relationship between the general practitioner and his or her patient reinforces the prevention of the development of preventable risk factors. It also strengthens information on intrinsic risk factors for patients. The protective factors highlighted by the general practitioner can thus reduce the risk a little more. Screening strategies differs across cancers and countries. In France, general practitioner's involvement is important for colorectal cancer screening. The active participation of their general practitioner, strengths patient's adherence and participation. Their role is to inform and collect data for breast cancer screening. Recently organized cervical cancer screening requires greater involvement of general practitioners who can act as both actors and informants. Family medicine is at the heart of cancer prevention and screening. It is a central hub for improving the health of patients in our healthcare system. The general practitioner knows the patient, which gives him an important advantage to accompany him in the prevention and screening of his risk factors.

The acceptability and effectiveness of a questionnaire for the identification of risk factors for HIV and hepatitis B and C: An observational study in general practice.

BACKGROUND: Many people in Europe remain undiagnosed for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV). OBJECTIVES: To evaluate acceptability and effectiveness of a questionnaire designed to facilitate identification of risk factors for these viruses. METHODS: We performed an observational study, in a prospectively enrolled cohort of patients in Paris (France) seen in 2014. Eighteen GPs administered a questionnaire to the first 50 patients, collecting information about risk factors. GPs were randomized into two groups: A (self-administered questionnaire) and B (GP-administered questionnaire). We used the overall response rate to assess the acceptability of the questionnaire. We used the rate of newly identified risk factors and compared the number of tests performed one year before and immediately after the intervention to assess the effectiveness of the questionnaire. RESULTS: 842 patients were randomized: 349 (41.5%) in group A and 493 (58.5%) in group B. Acceptability was 88.5% (95%CI: 86.3-90.6); 93.1% (95%CI: 90.5-95.8) in-group A and 85.2% (95%CI: 82.1-88.3) in group B (P = 0.0004). Prevalence of risk factors was 51.8% (95%CI: 48.2-54.4) and 58.3% were newly identified (95%CI: 52.9-63.7). The number of HIV tests performed during the four weeks after intervention increased by 27% compared to the same period one year before (P = 0.22). It increased by 113% (P = 0.005) and 135% (P = 0.005) for HBV and HCV, respectively. CONCLUSION: The questionnaire proved acceptable and effective in identifying risk factors for HIV, HBV and HCV in general practice.