ABSTRACT
Although a significant amount of biomedical research has been conducted to study HIV-associated neurocognitive disorder (HAND), there has been scant research done to assess the awareness and knowledge of this public health concern among middle-aged and older people living with HIV/AIDS (PLWH). Our qualitative community-based participatory research study sought to address this research gap by examining the awareness and knowledge of HAND among relevant stakeholders in southern Nevada, USA. We conducted 15 semistructured interviews with middle-aged and older PLWH to examine their awareness and knowledge of HAND and access to pertinent resources. After our thematic analysis of our interviews, we identified two overarching themes: (1) limited awareness and knowledge of HAND among PLWH, and (2) southern Nevada social determinants of health. Our findings underscore the importance of raising awareness and knowledge of HAND among PLWH through community-based education programs, and improving access to resources related to social determinants of health.
Subject(s)
Community-Based Participatory Research , HIV Infections , Health Knowledge, Attitudes, Practice , Interviews as Topic , Qualitative Research , Social Determinants of Health , Humans , Female , Nevada , Middle Aged , Male , HIV Infections/psychology , HIV Infections/complications , Aged , Health Education/methods , Neurocognitive Disorders/psychology , AIDS Dementia Complex/psychologyABSTRACT
Most prior research on resilience to HIV/AIDS among middle-aged and older men who have sex with men (MSM) has utilized quantitative methods that employ surveys and scales to measure constructs researchers have used to approximate the concept of resilience to HIV/AIDS. Only a few studies have purposively made efforts to incorporate the input of relevant stakeholders to guide their research on HIV/AIDS resilience and examine the perspectives and lived experiences of middle-aged and older MSM. To address this research gap, we conducted a community-based participatory research qualitative study to examine the perspectives and lived experiences of HIV-positive, middle-aged and older MSM from Southern Nevada in order to identify factors that promote such resilience. We conducted 16 semi-structured interviews with middle-aged and older MSM living with HIV/AIDS from January to April 2022. From our thematic analysis of our interviews, we identified factors that served as facilitators or challenges to the promotion of our participants' HIV/AIDS resilience. We discuss in this article both the facilitators and challenges to our participants' resilience-building as the key themes from our interviews. We recognized that the impacts of these factors were mediated by their strong influence on the social determinants of health that were explicitly relevant to our participants. We offer important insights based on our findings, which could be especially useful to future research on resilience to HIV/AIDS.
ABSTRACT
Although abundant research has been carried out to investigate the underlying mechanisms that may cause neurocognitive challenges among middle-aged and older people living with HIV/AIDS (PLWH), to monitor the prevalence rates of HIV-related neurocognitive deficits, and to identify factors related to the improvement of diagnostic screening tools, classification and nosology, and clinical and rehabilitative treatment of HIV-Associated Neurocognitive Disorder (HAND); to date, there have been only a few studies that have explored and examined the awareness and work experiences HIV sector healthcare and service providers have related to HAND. To address this research gap, we conducted a qualitative, community-based participatory research study and interviewed 12 HIV sector providers in Southern Nevada, USA, from January to April 2022. After performing a thematic analysis of our interviews, we were able to identify two major themes and several sub-themes. Under our first major theme, provider awareness and knowledge, we identified four sub-themes: (1) prior knowledge and current awareness; (2) lived experiences of patients and clients with neurocognitive challenges; (3) lack of knowledge as a barrier to providing needed care; and (4) continuing education and professional development. Under our second major theme, prospective provider roles, we identified three sub-themes: (1) early detection; (2) direct and practical support; and (3) appropriate and timely referrals. In this article, we discuss our findings and lessons learned from our study, as well as their implications for the future work of researchers and providers in the HIV sector related to improving care and support for people aging with HIV/AIDS and experiencing neurocognitive challenges.
Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Middle Aged , Humans , Aged , Nevada/epidemiology , HIV Infections/drug therapy , Aging , Qualitative ResearchABSTRACT
When the COVID-19 pandemic emerged in early 2020, not only did it abruptly impede the progress that was being made toward achieving global targets to end the HIV pandemic, but it also created significant impacts on the physical and mental health of middle-aged and older men who have sex with men living with HIV. Utilizing a qualitative, community-based participatory research approach, we conducted semi-structured, one-on-one interviews with 16 ethnoracially diverse, middle-aged and older men who have sex with men living with HIV residing in Southern Nevada, to examine the different ways the COVID-19 pandemic directly impacted their physical and mental health, and explore how they eventually coped and thrived during the peak of the crisis. Using thematic analysis to analyze our interview data, we identified three prominent themes: (1) challenges to obtaining credible health information, (2) the physical and mental health impacts of the COVID-19-pandemic-imposed social isolation, and (3) digital technologies and online connections for medical and social purposes. In this article, we extensively discuss these themes, the current discourse on these themes in academic literature, and how the perspectives, input, and lived experiences of our participants during the peak of the COVID-19 pandemic could be critical to addressing issues they had already been experiencing prior to the emergence of the pandemic in 2020, and just as importantly, helping us best prepare in stark anticipation of the next potentially devastating pandemic.
Subject(s)
COVID-19 , HIV Infections , Sexual and Gender Minorities , Male , Middle Aged , Humans , Aged , Pandemics , Homosexuality, Male , COVID-19/epidemiology , Adaptation, Psychological , HIV Infections/epidemiologyABSTRACT
Evidence-based research has highlighted the need for exploring factors that support the mental health of men who have sex with men living with HIV/AIDS (MSMLWH), and environmental influences that promote their resilience to HIV/AIDS. This exploratory study utilized a community-based participatory research approach to investigate barriers and facilitators to promoting resilience to HIV/AIDS, specifically among racial and ethnic minority, middle-aged and older MSMLWH, a population that continues to be significantly impacted by HIV/AIDS today. This collaborative, qualitative study recruited participants who identified as racial or ethnic minority MSMLWH, were aged 40 or older, and resided in Ontario, Canada. Participants (n = 24) discussed in their interviews barriers and facilitators to promoting resilience to HIV/AIDS, which they recognized from their lived experiences. Utilizing thematic analysis, themes related to barriers and facilitators to promoting resilience to HIV/AIDS were identified. Themes related to identified barriers included: (1) language proficiency, (2) racism, (3) pernicious norms in North American gay culture, and (4) HIV stigma. Themes related to identified facilitators included: (1) compartmentalization, (2) perseverance, and (3) community-based health and social services. This article discusses the implications of the study's findings, particularly on how they may influence the development of future services for racial and ethnic minority, middle-aged and older MSMLWH.
Subject(s)
HIV Infections , Sexual and Gender Minorities , Aged , Ethnicity , Homosexuality, Male , Humans , Male , Middle Aged , Minority Groups , Ontario , Qualitative Research , Social StigmaABSTRACT
The large majority of social neuroscience research uses WEIRD populations-participants from Western, educated, industrialized, rich, and democratic locations. This makes it difficult to claim whether neuropsychological functions are universal or culture specific. In this study, we demonstrate one approach to addressing the imbalance by using portable neuroscience equipment in a study of persuasion conducted in Jordan with an Arabic-speaking sample. Participants were shown persuasive videos on various health and safety topics while their brain activity was measured using functional near infrared spectroscopy (fNIRS). Self-reported persuasiveness ratings for each video were then recorded. Consistent with previous research conducted with American subjects, this work found that activity in the dorsomedial and ventromedial prefrontal cortex predicted how persuasive participants found the videos and how much they intended to engage in the messages' endorsed behaviors. Further, activity in the left ventrolateral prefrontal cortex was associated with persuasiveness ratings, but only in participants for whom the message was personally relevant. Implications for these results on the understanding of the brain basis of persuasion and on future directions for neuroimaging in diverse populations are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Subject(s)
Brain Mapping/methods , Cognitive Neuroscience/methods , Persuasive Communication , Prefrontal Cortex/physiology , Spectroscopy, Near-Infrared/methods , Adult , Cognitive Neuroscience/standards , Humans , Jordan , Prefrontal Cortex/diagnostic imaging , Young AdultABSTRACT
Activity in medial prefrontal cortex (mPFC) during persuasive messages predicts future message-consistent behavior change, but there are significant limitations to the types of persuasion processes that can be invoked inside an MRI scanner. For instance, real world persuasion often involves multiple people in conversation. Functional near infrared spectroscopy (fNIRS) allows us to move out of the scanner and into more ecologically valid contexts. As a first step, the current study used fNIRS to replicate an existing fMRI persuasion paradigm (i.e. the sunscreen paradigm) to determine if mPFC shows similar predictive value with this technology. Consistent with prior fMRI work, activity in mPFC was significantly associated with message-consistent behavior change, above and beyond self-reported intentions. There was also a difference in this association between previous users and non-users of sunscreen. Activity differences based on messages characteristics were not observed. Finally, activity in a region of right dorsolateral PFC (dlPFC), which has been observed with counterarguing against persuasive messages, correlated negatively with future behavior. The current results suggest it is reasonable to use fNIRS to examine persuasion paradigms that go beyond what is possible in the MRI scanner environment.
Subject(s)
Persuasive Communication , Sunscreening Agents , Adult , Brain Mapping , Female , Health Behavior , Humans , Male , Prefrontal Cortex/diagnostic imaging , Prefrontal Cortex/physiology , Spectroscopy, Near-Infrared , Young AdultABSTRACT
In grapheme-color synesthesia, graphemes (e.g., numbers or letters) evoke color experiences. It is generally reported that the opposite is not true: colors will not generate experiences of graphemes or their associated information. However, recent research has provided evidence that colors can implicitly elicit symbolic representations of associated graphemes. Here, we examine if these representations can be cognitively accessed. Using a mathematical verification task replacing graphemes with color patches, we find that synesthetes can verify such problems with colors as accurately as with graphemes. Doing so, however, takes time: ~250 ms per color. Moreover, we find minimal reaction time switch-costs for switching between computing with graphemes and colors. This demonstrates that given specific task demands, synesthetes can cognitively access numerical information elicited by physical colors, and they do so as accurately as with graphemes. We discuss these results in the context of possible cognitive strategies used to access the information.