Characterizing the "HIV Care Adherence Journey" for Persons With HIV in the Philippines: Conceptual Foundation for Person-Centered Intervention.

ABSTRACT: Promoting adherence to HIV care among persons with HIV (PWH) is a key component to address the rising HIV epidemic in the Philippines. HIV care adherence is a complex process that may change throughout an individual's life course or "journey" living with HIV. This qualitative study aimed to explore the HIV care adherence journey of PWH. Maximum variation sampling was used in selecting 12 PWH and 3 health care providers for in-depth online interviews analyzed using thematic analysis. The four themes that emerged to describe the HIV care adherence journey are integration, relation, navigation, and manifestation. Each theme corresponds to a unique set of activities and goals related to PWH's lived experiences as they initiate, practice, and maintain care adherence. This study provides a preliminary framework to characterize the HIV care adherence journey as a dynamic, complex, and multifaceted phenomenon, which can help to inform holistic interventions to support PWH.

Exploring the status and critical issues in mixed methods research in doctoral nursing education in the Philippines.

BACKGROUND: Mixed methods research (MMR) can be a pathway for doctoral nursing students to create innovative and noble contributions for the advancement of nursing theory, practice, and education. Several issues and challenges must be identified to successfully train, mentor, and support doctoral nursing students in conducting MMR. AIM: The study aimed to explore the status and critical issues in conducting, mentoring, and training MMR in doctoral nursing programs in the Philippines. METHODS: A descriptive qualitative study was conducted by performing semi-structured online interviews with 10 purposively selected participants who were faculty and educators with doctoral degrees, involved in teaching and mentoring MMR among doctoral nursing students in the last 10 years. Data were analyzed using Braun and Clarke's thematic analysis. FINDINGS: Four key themes emerged, namely, (1) perceptions on the use of MMR, (2) facilitators to use MMR, (3) barriers to the use of MMR, and (4) recommendations to promote the use of MMR focused on the student, faculty, and educational institution levels. CONCLUSION: Providing educational, institutional, and research support for doctoral nursing students and faculty could flourish the use of MMR in doctoral nursing programs with deeper meaning and reasoning.

Psychometric Testing of the Filipino Version of the Clients' Perceptions of Providers' Cultural Competency (CPOPCC) Instrument Among LGBTQ+ Population in the Philippines.

Background and Purpose: Cultural competence is significant in addressing the health needs of vulnerable populations. This study conducted psychometric testing of a cultural competency instrument in the Philippines. Methods: Brislin's translation and a cross-sectional online design were used. Exploratory factor analysis (EFA) with varimax rotation examined construct validity of the 23-item scale among 157 adult LGBTQ+ residents. The scale revealed overall reliability (α = .85) including two subscales (α = .87, α = .81, and α = .61). The EFA yielded three theoretical factorial solutions. Conclusion: The Filipino version of the instrument demonstrated reliability and validity. Measuring clients' perceptions of provider and organizational cultural competency can improve the utilization of healthcare in Filipino LGBTQ+ communities. Future research will examine the dimensional structures of the instrument among expanded LGBTQ+ communities.

Significance of Home Visiting in Providing Care to Filipino Mothers and Their Infants During the Postpartum Period.

INTRODUCTION: Home visiting is recommended for mothers and young infants during the first week of life to provide needed support. This study describes the significance of home visiting in providing care to Filipino mothers and their infants during the postpartum period. METHODOLOGY: Using a descriptive qualitative design, individual interviews were conducted with 10 mothers, four registered nurses, and five barangay health workers involved in home visits. Data analysis was guided by the four phases of Leininger's ethnonursing method. RESULTS: Three themes emerged: (1) home visiting provides accessible, affordable, and meaningful interventions; (2) home visiting allows for contextual understanding of mothers' behaviors and realistic planning of care; and (3) barangay health workers promote mothers' engagement in care. CONCLUSION: Home visits enable negotiation of differences between generic and professional care practices, thus enhancing professional collaboration with families and community workers, potentiating culturally congruent participation and empowerment of clients in their care.

Facilitators and barriers to condom use among Filipinos: A systematic review of literature.

Background: Between 2010 and 2018, the Philippines had a 203% increase in new human immunodeficiency virus (HIV) infections. The use of condoms is an effective and practical means to prevent HIV transmission. The purpose of this study was to identify facilitators and barriers to condom use among Filipinos guided by the Ecological Model of Health Promotion. Methods: A systematic review of literature using electronic databases was performed using the following keywords: "condom," "Filipinos," and "Philippines." To be included in this review, papers should be (1) research studies, (2) studies that examined condom use, and (3) studies that sampled Filipinos residing in the Philippines. The final sample comprised of 27 articles. Results: Multiple and interrelated factors at the individual and social environment levels influence condom use among different groups of Filipinos. Majority of these factors originated at the intrapersonal level. Some of the facilitators to condom use were knowledge on HIV, higher perceived HIV risk, peer support, positive manager attitude, health provider engagement, and city ordinances. In contrast, some of the barriers to condom use were discomfort and displeasure on condom use, low parental communication, lack of sex education, social stigma, and the high price of condoms. Conclusion: A collaborative, culturally-sensitive, and population-specific approach is essential to develop and implement acceptable, sustainable, and successful condom use interventions.

Wolbachia in mosquitoes from the Central Valley of California, USA.

BACKGROUND: Wolbachia bacteria are widely distributed throughout terrestrial arthropod species. These bacteria can manipulate reproduction and influence the vector competence of their hosts. Recently, Wolbachia have been integrated into vector control programmes for mosquito management. A number of supergroups and strains exist for Wolbachia, and they have yet to be characterized for many mosquito species. In this study, we examined Wolbachia prevalence and their phylogenetic relationship to other Wolbachia, using mosquitoes collected in Merced County in the Central Valley of California. METHODS: Adult mosquitoes were collected from 85 sites in Merced County, California in 2017 and 2018. Traditional and quantitative PCR were used to investigate the presence or absence and the density of Wolbachia, using Wolbachia-specific 16S rRNA and Wolbachia-surface protein (wsp) genes. The supergroup of Wolbachia was determined, and Multilocus Sequence Typing (MLST) by sequencing five housekeeping genes (coxA, gatB, ftsZ, hcpA and fbpA) was also used to determine Wolbachia supergroup as well as strain. RESULTS: Over 7100 mosquitoes of 12 species were collected: Aedes melanimon, Ae. nigromaculis, Ae. vexans, Ae. aegypti, Culex pipiens, Cx. stigmatosoma, Cx. tarsalis, Anopheles franciscanus, An. freeborni, An. punctipennis, Culiseta incidens and Cs. inornata. Eight showed evidence of Wolbachia. To our knowledge, this study is the first to report detection of Wolbachia in five of these species (Ae. melanimon, Cx. stigmatosoma, Cx. tarsalis, Cs. incidens and Cs. inornata). Culex pipiens and Cx. stigmatosoma had a high frequency and density of Wolbachia infection, which grouped into supergroup B; Cs. inornata clustered with supergroup A. MLST comparisons identified Cx. pipiens and Cx. stigmatosoma as wPip strain type 9 supergroup B. Six species had moderate to low (< 14%) frequencies of Wolbachia. Four species were negative, Ae. nigromaculis, An. franciscanus, An. freeborni and Ae. aegypti. CONCLUSIONS: New records of Wolbachia detection were found in mosquitoes from Merced County, California. Culex stigmatosoma and Cs. inornata were new records for Wolbachia supergroup B and A, respectively. Other species with Wolbachia occurred with low frequency and low density. Detection of Wolbachia in mosquitoes can be used to inform potential vector control applications. Future study of Wolbachia within Cx. stigmatosoma and Cs. inornata in California and through the range of these species could further explore Wolbachia infection in these two species.

Environmental and Sociological Factors Associated with the Incidence of West Nile Virus Cases in the Northern San Joaquin Valley of California, 2011-2015.

Environmental and socioeconomic risk factors associated with the incidence of human West Nile virus (WNV) cases were investigated in the Northern San Joaquin Valley region of California, a largely rural area. The study included human WNV cases from the years 2011 to 2015 in the three-county area of San Joaquin, Stanislaus, and Merced Counties, and used census tracts as the unit of analysis. Environmental factors included temperature, precipitation, and WNV-positive mosquito pools. Socioeconomic variables included age, housing age, housing foreclosures, median income, and ethnicity. Chi-square independence tests were used to examine whether each variable was associated with the incidence of WNV cases using data from the three counties combined. In addition, negative binomial regression revealed that the environmental factors of temperature and precipitation were the strongest predictors of the incidence of human WNV cases, while the socioeconomic factor of ethnicity was a significant predictor as well, and is a factor to consider in prevention efforts. Source reduction of mosquito breeding sites and targeted prevention and education remain key in reducing the risk associated with WNV.

Genetic variability of the Aedes aegypti (Diptera: Culicidae) mosquito in El Salvador, vector of dengue, yellow fever, chikungunya and Zika.

BACKGROUND: Aedes aegypti is associated with dengue, yellow fever, chikungunya and Zika viruses. This vector is widespread in tropical and subtropical areas, and can also occur in temperate areas at higher latitudes. The geographical distribution of Ae. aegypti continues to spread due to human activities. This is the first study to examine the population genetic structure of this insect in El Salvador, Central America. METHODS: Aedes aegypti larvae were collected from six geographical regions of El Salvador: Sonsonate, San Salvador, Chalatenango, Usulután, San Miguel and Morazán. Larvae were raised into adults, identified and preserved. Two molecular markers, amplified fragment length polymorphism (AFLP) genotyping and mitochondrial DNA (mtDNA) cytochrome c oxidase subunit 1 (cox1) sequencing, were used to investigate population genetic structure. RESULTS: Structure analysis found two genetically distinct populations; one occurs predominantly in the north and west, and a mix of two populations occurs in the southeast of the country. Genetic distances ranged from 0.028 (2.8%) to 0.091 (9%), and an AMOVA analysis found 11% variation between populations. Mitochondrial DNA cox1 sequences produced a haplotype network which consisted of 3 haplogroups and 10 haplotypes. Haplogroup 1 had low haplotype and nucleotide diversity and was found in all six regions. Haplogroups 2 and 3 had higher haplotype and nucleotide diversity, and were less abundant; haplogroup 3 was found in only 3 of the six regions studied. Bottleneck tests were significant, suggesting that populations had undergone a recent bottleneck. A maximum likelihood tree, which combined samples from this study with available sequences in GenBank, suggested that two genetically divergent lineages had been introduced. CONCLUSIONS: Relatively high genetic diversity was found in Ae. aegypti in El Salvador. The mtDNA sequences clustered into two lineages, as found in previous studies. Samples in El Salvador may be introduced from regions in North and South America where past eradication was not complete. Future study of genotypes in surrounding countries would provide a more complete picture of the movement and potential source of introductions of this vector. The distribution of the lineages and haplogroups may further our understanding of the epidemiology of Ae. aegypti associated vector borne diseases.

Histomorphologic effects of Bacillus clausii spores in enteropathogenic E. coli O127:H21-infected mice: A pilot study

OBJECTIVE: The study aimed to determine the basic histomorphologic effects of Bacillus clausii (B. clausii) spores in enteropathogenic Escherichia coli (E. coli) O127:H21-infected mice by evaluating the spleen, mesenteric lymph nodes, and intestinal mucosa. METHODS: The study involved 46 apparently healthy Balb/c mice (Mus musculus) which were acclimatized for 19 days prior to any intervention. Sixteen mice were used to determine the sublethal dose of E. coli, which was performed by administering serially-diluted solutions and subsequent generation of a standard curve. From the remaining 30 mice, ten served as normal controls while the remaining 20 were randomized to receive either B. clausii or placebo of sterile water for a week. All mice were then challenged with E. coli for another week and euthanized, and the spleen, mesenteric lymph nodes, and small intestine harvested and examined microscopically. All study personnel were blinded of the treatment assignments. RESULTS: Histologic evaluation of the small intestine in E. coli only-fed mice exhibited prominent attachment effacement lesions, with severely denuded mucosa, lymphocytic infiltration, and debris in the intestinal lumen. However, mice given B. clausii prior to E. coli infection displayed only minimal mucosal damage with less sloughing of villus tips, plus increased mucus-secreting goblet cells. In the spleen, E. coli only-fed mice showed moderate to severe lymphoid hyperplasia with blurred boundaries between red and white pulp. In contrast, mice which received B. clausii prior to E. coli infection had only mild degrees of lymphoid hyperplasia. Similar findings were seen in the mesenteric lymph nodes where E. coli only-fed mice showed moderate to severe lymphoid hyperplasia while those given B. clausii prior to E. coli infection merely had mild lymphoid hyperplasia. CONCLUSION: B. clausii exerts a potential protective and immunomodulatory action in E. coli O127:H21-infected mice based on histomorphologic effects. However, additional studies are needed to fully characterize these mechanisms.mice based on histomorphologic effects.