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1.
Artículo en Inglés | MEDLINE | ID: mdl-33557412

RESUMEN

This study aimed to examine the effectiveness of Human Immunodeficiency Virus (HIV)-assisted smartphone applications in the treatment of HIV/AIDS patients in Vietnam. A cross-sectional study was performed in two urban outpatient clinics in Hanoi from May to December 2019. A simple random sampling method and a structured questionnaire were used to recruit 495 eligible participants and to collect data. Multivariable modified Poisson regression and multivariable linear regression models were employed to investigate the factors associated with the willingness to pay (WTP) and amount of money patients were willing to pay. Approximately 82.8% of respondents were willing to pay for the hypothetical applications, with the mean amount the participants were willing to pay of Vietnam Dong (VND) 72,100/month. Marital status (separate/divorced/widow: Odds ratio (OR) = 1.28, 95% confidence interval (CI) = (1.09; 1.50) and having spouse/partner: OR = 1.18, 95% CI = (1.03; 1.36)) and using health services (OR = 1.03, 95% CI = (1.01; 1.04)) were positively associated with nominating they would be WTP for the app, whereas the duration of antiretroviral treatment (ART) (OR = 0.98, 95% CI = (0.96; 0.99)) had a negative association. The frequency of using health services (ß = 0.04, 95% CI = (-0.07; -0.01)) was negatively associated with the amount of WTP. High levels of WTP revealed the feasibility of implementing smartphone-based apps for HIV treatment. This study implied the necessity to consider a co-payment system to reach populations who were in need but where such applications may be unaffordable in lieu of other treatment-associated expenses. Developers also need to pay attention to privacy features to attract single people living with HIV/AIDS and additional measures to initiate people with a long duration on ART into using the applications.

2.
Subst Abus ; : 1-11, 2021 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-33617733

RESUMEN

BACKGROUND: Naloxone distribution and training programs have been implemented to combat the opioid overdose crisis. While many individuals are trained, ongoing naloxone access is not ensured by these programs. We explored whether people who use drugs (PWUD) in Baltimore City, Maryland could identify a location where they would go to obtain naloxone and how training changed where they would be willing to access naloxone. Methods: We surveyed 574 PWUD as to whether they had heard of, been trained to use, and knew where to get naloxone. Among participants who had heard of naloxone, we tested for differences in knowing where to get naloxone by training. Results: The majority (95.3%) had heard of naloxone. Of these, 84.0% could name a location where they would access naloxone, but only 11.7% named multiple. Pharmacies (32.3%) and medical providers (excluding drug treatment providers) (22.9%) were the most commonly identified sources. Participants who had been trained to use naloxone were more likely to report that they would obtain naloxone from the needle exchange and were less likely to report they did not know where they would go to get it or that they would go to a medical provider (excluding drug treatment providers) for naloxone. Conclusions: Naloxone training was associated with participants' ability to name a location where they would obtain naloxone. Medicalized sources of naloxone remained the most commonly reported. These sources, however, may be associated with significant barriers to access, such as cost. Trainings should provide comprehensive education about low-cost/free sources to ensure ongoing naloxone access among people who use drugs.

3.
PLoS One ; 16(2): e0246970, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33592035

RESUMEN

Vaccine hesitancy could become a significant impediment to addressing the COVID-19 pandemic. The current study examined the prevalence of COVID-19 vaccine hesitancy and factors associated with vaccine intentions. A national panel survey by the National Opinion Research Center (NORC) was designed to be representative of the US household population. Sampled respondents were invited to complete the survey between May 14 and 18, 2020 in English or Spanish. 1,056 respondents completed the survey-942 via the web and 114 via telephone. The dependent variable was assessed by the item "If a vaccine against the coronavirus becomes available, do you plan to get vaccinated, or not?" Approximately half (53.6%) reported intending to be vaccinated, 16.7% did not intend, and 29.7% were unsure. In the adjusted stepwise multinominal logistic regression, Black and Hispanic respondents were significantly less likely to report intending to be vaccinated as were respondents who were females, younger, and those who were more politically conservative. Compared to those who reported positive vaccine intentions, respondents with negative vaccine intentions were significantly less likely to report that they engaged in the COVID-19 prevention behaviors of wearing masks (aOR = 0.53, CI = 0.37-0.76) and social distancing (aOR = 0.22, CI = 0.12-0.42). In a sub-analysis of reasons not to be vaccinated, significant race/ethnic differences were observed. This national survey indicated a modest level of COVID-19 vaccine intention. These data suggest that public health campaigns for vaccine uptake should assess in greater detail the vaccine concerns of Blacks, Hispanics, and women to tailor programs.

4.
AIDS Care ; : 1-10, 2021 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-33625941

RESUMEN

With the growing number of older people living with HIV, "What is the most effective geriatric care and the research trend of existing literature?" is a compelling question after 30 years since the first paper related to aging and HIV/AIDS published. Our study aims to apply quantitative and qualitative analysis to explore the knowledge gaps and describes the research interest of gerontology research in the field of HIV. A bibliometric analysis was conducted based on the databased of the Web of Science from 1991 to 2019. The major domains of research areas were visualized by using VOSviewer software. Latent Dirichlet Allocation (LDA) was applied to classify the dataset into topics. There was a rising number of publications about this topic over time. Our findings indicated that antiretroviral treatment and evaluating quality of life and harm reduction were the major domains regarding care for OPLWH. In addition, the finding highlights the role of social competence in treatment outcomes. Further research needs to tailor multi-disciplinary programs and flexible interventions to reduce the burden and the mortality rate of HIV/AIDS.

5.
J Med Internet Res ; 23(2): e18750, 2021 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-33565987

RESUMEN

BACKGROUND: Patient portal modules, including electronic personal health records, health education, and prescription refill ordering, may be leveraged to address the sexually transmitted infection (STI) burden, including HIV, among gay, bisexual, and other sexual minority men (SMM). Theoretical frameworks in the implementation sciences highlight examining constructs of innovation attributes and performance expectations as key determinants of behavioral intentions and the use of new web-based health technologies. However, behavioral intentions to use patient portals for HIV and other STI prevention and care among SMM is understudied. OBJECTIVE: The aim of this study is to develop a brief instrument for measuring attitudes focused on using patient portals for STI prevention and care among a nationwide sample of SMM. METHODS: A total of 12 items of the American Men's Internet Survey-Patient Portal Sexual Health Instrument (AMIS-PPSHI) were adapted from a previous study. Psychometric analyses of the AMIS-PPSHI items were conducted among a randomized subset of 2018 AMIS participants reporting web-based access to their health records (N=1375). Parallel analysis and inspection of eigenvalues in a principal component analysis (PCA) informed factor retention in exploratory factor analysis (EFA). After EFA, Cronbach α was used to examine the internal consistency of the scale and its subscales. Confirmatory factor analysis (CFA) was used to assess the goodness of fit of the final factor structure. We calculated the total AMIS-PPSHI scale scores for comparisons within group categories, including age, STI diagnosis history, recency of testing, serious mental illness, and anticipated health care stigma. RESULTS: The AMIS-PPSHI scale resulting from EFA consisted of 12 items and had good internal consistency (α=.84). The EFA suggested 3 subscales: sexual health engagement and awareness (α=.87), enhancing dyadic communication (α=.87), and managing sexual health care (α=.79). CFA demonstrated good fit in the 3-factor PPSHI structure: root mean square error of approximation=0.061, comparative fit index=0.964, Tucker-Lewis index=0.953, and standardized root mean square residual=0.041. The most notable differences were lower scores on the enhanced dyadic communication subscale among people living with HIV. CONCLUSIONS: PPSHI is a brief instrument with strong psychometric properties that may be adapted for use in large surveys and patient questionnaires in other settings. Scores demonstrate that patient portals are favorable web-based solutions to deliver health services focused on STI prevention and care among SMM in the United States. More attention is needed to address the privacy implications of interpersonal use of patient portals outside of traditional health settings among persons with HIV.

7.
Curr Psychol ; : 1-9, 2021 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-33424206

RESUMEN

COVID-19 skepticism can be conceptualized as the denial of the seriousness of the illness and the perception that the pandemic is overblown or a hoax. In the current study, we examined the association between COVID-19 skepticism and frequency of engaging in COVID-19 prevention behaviors, political ideology, social norms about distancing, COVID-19 information-seeking behaviors, and COVID-19 conspiracy theories. A survey was administered from May 5th-14th. At that time, there were over 1 million COVID-19 cases in the US. Participants were recruited online through MTurk. The three outcome variables were handwashing, mask wearing, and social distancing. Injunctive and descriptive norms were assessed as well as measures of perceived risk to self and others. There were 683 participants in the analyses. In the multiple logistic regression model, those who were of younger age (aOR = 0.97, p < 0.05), better health (aOR = 0.56, p < 0.01), and more politically conservative (aOR = 1.32, p < 0.01) were more likely to endorse COVID-19 skepticism statements. People who reported higher Skepticism were also less likely to that believe people close to them would die from COVID-19 (aOR = 4.2, p < 0.01), engage in COVID-19 prevention behaviors, including spending time inside to prevent coronavirus (aOR = 0.33, p < 0.01) and frequently wear a mask outside (aOR = 0.44, p < 0.01). Those who were more skeptical about COVID-19 were also more likely to believe the conspiracy theory that China purposefully spread the virus (aOR = 6.38 p < 0.01). COVID-19 Skepticism was strongly associated with reduced engagement in COVID-19 prevention behaviors. These findings bolster the arguments for making these public health recommendations mandatory.

8.
AIDS Behav ; 2021 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-33392969

RESUMEN

Brief interventions to reduce frequent alcohol use among persons with HIV (PWH) are evidence-based, but resource-constrained settings must contend with competition for health resources. We evaluated the cost-effectiveness of two intervention arms compared to the standard of care (SOC) in a three-arm randomized control trial targeting frequent alcohol use in PWH through increasing the percent days abstinent from alcohol and viral suppression. We estimated incremental cost per quality-adjusted life year (QALY) gained from a modified societal perspective and a 1-year time horizon using a Markov model of health outcomes. The two-session brief intervention (BI), relative to the six-session combined intervention (CoI), was more effective and less costly; the estimated incremental cost-effectiveness of the BI relative to the SOC, was $525 per QALY gained. The BI may be cost-effective for the HIV treatment setting; the health utility gained from viral suppression requires further exploration.

9.
J Affect Disord ; 281: 208-215, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33333474

RESUMEN

BACKGROUND: The burden of depression is high among people who inject drugs (PWID) and may contribute to the spread of HIV through poor treatment engagement and persistent viremia. We estimated the effects of depression on antiretroviral therapy (ART) initiation and viral suppression among PWID living with HIV. METHODS: Longitudinal data were collected from 455 PWID living with HIV in Vietnam during 2009-2013. We estimated the 6- and 12-month cumulative incidence of ART initiation and viral suppression, accounting for time-varying confounding, competing events, and missing data. The cumulative incidence difference (CID) contrasted the incidence of each outcome had participants always vs. never experienced severe depressive symptoms across study visits to date. RESULTS: Severe depressive symptoms decreased the cumulative incidence of ART initiation, with CID values comparing always vs. never having severe depressive symptoms of -7.5 percentage points (95% CI: -17.2, 2.2) at 6 months and -7.1 (95% CI: -17.9, 3.7) at 12 months. There was no appreciable difference in the cumulative incidence of viral suppression at 6 months (CID = 0.3, 95% CI: -11.3, 11.9) or 12 months (CID = 2.0, 95% CI: -21.8, 25.8). LIMITATIONS: Discrepancies between the ART initiation and viral suppression outcomes could be due to under-reporting of ART use and missing data on viral load. CONCLUSIONS: Future work probing the seemingly antagonistic effect of depression on treatment uptake - but not viral suppression - will inform the design of interventions promoting HIV clinical outcomes and reducing onward transmission among PWID.

10.
Drug Alcohol Depend ; 218: 108419, 2020 Nov 24.
Artículo en Inglés | MEDLINE | ID: mdl-33296857

RESUMEN

BACKGROUND: As opioid overdoses and deaths increase globally, little is known about these dimensions in Sub-Saharan Africa. In this paper, we explore factors associated with opioid overdose experiences among a sample of women who use opioids in Dar es Salaam, Tanzania. METHODS: We conducted a cross-sectional survey with 200 women who use opioids in Dar es Salaam, Tanzania, recruited via respondent-driven sampling. We fitted unadjusted and adjusted log-binomial regression models with robust standard errors to examine associations between participant characteristics and reporting ever had an opioid overdose in terms of prevalence ratios. RESULTS: Thirty-four percent (n = 68) of participants reported having ever had an opioid overdose. In the final adjusted model, having ever attempted to stop using heroin (adj. PR = 1.46, 95% CI: 1.01-2.12), sleeping outside in the past 6 months (adj. PR = 1.93, 95% CI: 1.29-2.91), injecting drugs (adj. PR = 1.78, 95% CI: 1.19-2.66), alcohol use (adj. PR = 1.56, 95% CI: 1.09-2.23), and having moderately severe to severe depression (adj. PR = 3.10, 95% CI: 1.07-8.97) were all found to be significantly associated with having ever had an opioid overdose. CONCLUSIONS: We demonstrate factors associated with opioid overdose among women who use drugs in Tanzania that may not be addressed with injection-focused harm reduction efforts. Our findings suggest the need for overdose surveillance efforts and further work to characterize overdose risks in this context in order to design relevant, targeted interventions to prevent opioid overdose in sub-Saharan Africa.

11.
J Addict Dis ; : 1-12, 2020 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-33287681

RESUMEN

BACKGROUND: People engaged in injection opioid use often have drug-free family or friends that could be mobilized to support risk reduction and treatment seeking. OBJECTIVE: This pilot study evaluated the feasibility and preliminary efficacy of a 6-week community-supported risk reduction group intervention for syringe exchange program (SEP) registrants and drug-free network members. METHOD: The group provided risk reduction and treatment readiness education, with weekly assignments for participants to engage together in community activities designed to meet other drug-free people. RESULTS: Thirty-nine SEP registrants (and 39 community supports) enrolled in the study, and 21 pairs attended at least one group. For this smaller sample, participants attended 67% of scheduled sessions and engaged in scheduled activities during 42% of the study weeks, with 48% of SEP participants (n = 10) choosing to enter substance use disorder treatment. SEP participants who entered treatment reported reduced rates of injection drug use, opioid use, and cocaine use. CONCLUSIONS: While this intervention shows promise for linking syringe exchange and substance use disorder treatment participation in select SEP registrants, outcomes demonstrating low demand and modest acceptability suggest that additional research is necessary to understand barriers to participation and motivate higher levels of engagement.

12.
BMC Public Health ; 20(1): 1846, 2020 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-33267860

RESUMEN

BACKGROUND: Acceptability is a critical requisite in establishing feasibility when planning a larger effectiveness trial. This study assessed the acceptability of conducting a feasibility randomized clinical trial of a 20-week microenterprise intervention for economically-vulnerable African-American young adults, aged 18 to 24, in Baltimore, Maryland. Engaging MicroenterprisE for Resource Generation and Health Empowerment (EMERGE) aimed to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. METHODS: Thirty-eight participants were randomized to experimental (n = 19) or comparison group (n = 19). The experimental group received text messages on job openings plus educational sessions, mentoring, a start-up grant, and business and HIV prevention text messages. The comparison group received text messages on job openings only. Qualitative and quantitative post-intervention, in-person interviews were used in addition to process documentation of study methods. RESULTS: Our results found that the study design and interventions showed promise for being acceptable to economically-vulnerable African-American young adults. The largely positive endorsement suggested that factors contributing to acceptability included perceived economic potential, sexual health education, convenience, incentives, and encouraging, personalized feedback to participants. Barriers to acceptability for some participants included low cell phone connectivity, perceived payment delays, small cohort size, and disappointment with one's randomization assignment to comparison group. Use of peer referral, network, or wait-list designs, in addition to online options may enhance acceptability in a future definitive trial. Expanding administrative and mentoring support may improve overall experience. CONCLUSION: Microenterprise interventions are acceptable ways of providing young adults with important financial and sexual health content to address HIV risks associated with economic vulnerability. TRIAL REGISTRATION: ClinicalTrials.gov. NCT03766165 . Registered 04 December 2018.

13.
Front Public Health ; 8: 589437, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33313040

RESUMEN

To effectively control the COVID-19 (coronavirus disease 2019) outbreak in later stages in Vietnam requires addressing the existing gaps in the national health emergency framework, consolidate, and inform its structure, we conducted this study to evaluate the importance and collaborative mechanism between health and community service workers with intersectional organizations at grassroots levels in Vietnam. A cross-sectional, web-based survey was conducted from 12/2019 to 02/2020 on 581 participants (37 health workers, 473 medical students, and 71 community service workers). The snowball sampling technique was used to recruit participants. We used exploratory factor analysis to test the construct validity of the questionnaire measuring the perceived efficiency of involving community service workers in health care-related activities and Tobit models to examine its associated factors. The results showed the importance of local organizations in epidemic preparedness and response at grassroots levels, with scores ranging from 6.4 to 7.1, in which the Vietnam Youth Federation played the most important role (mean = 7.1, SD = 2.2). Of note, community service workers were viewed as performing well in health communication and education at agencies, schools, and other localities. Medical students perceived higher efficiency of involving community service workers in health care-related activities at grassroots levels as compared to health workers. We encourage the government to promote intersectoral collaboration in epidemic preparedness and response, giving attention to scale up throughout training as well as interdistrict and interprovincial governance mechanisms.


Asunto(s)
/epidemiología , Defensa Civil , Relaciones Comunidad-Institución , Personal de Salud/estadística & datos numéricos , Colaboración Intersectorial , Estudiantes de Medicina/estadística & datos numéricos , Adulto , /transmisión , Estudios Transversales , Estudios de Factibilidad , Femenino , Humanos , Internet , Masculino , Encuestas y Cuestionarios , Vietnam/epidemiología , Adulto Joven
14.
Front Public Health ; 8: 589331, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33224921

RESUMEN

Upon the outbreak of the COVID-19 pandemic, countries worldwide face a critical shortage of human resources in the health sector. Medical students are a potential task force with the capability to support the stretched health sector. This study aims to evaluate their training need for epidemic control in order to employ them effectively. A cross-sectional study was conducted using a web-based survey from December 2019 to February 2020. There were 5,786 observations collected using the snowball sampling technique. Logistic regression was applied to identify factors associated with training participation in epidemic prevention and disaster prevention. Multiple Poisson regression model was constructed to examine factors associated with the number of times they participated in sanitation training and disaster prevention activities in the previous 12 months. Sanitation and health education communication activities had the highest proportion of participants, with 76.5 and 38.4%, followed by examining and treating diseases in the community (13.4%). Those who participated in community activities had a higher number of times to participate in epidemic sanitation training and be involved in disaster prevention. This study informed the need for training programs to prepare medical students for COVID-19 epidemic responses. The training curriculum should include both theoretical approaches and contextual approaches to achieve efficient epidemic control.

15.
AIDS Behav ; 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33185776

RESUMEN

Disclosure of HIV and other sexually transmitted infection (HIV/STI) testing history to sexual partners is low among gay, bisexual, and other U.S. sexual minority men (SMM). Patient portals (PP) could increase HIV/STI testing history disclosure. This study estimated the predictive validity of the Enhancing Dyadic Communication (EDC) latent construct for perceived behavioral intentions to use PP for HIV/STI test disclosures. A randomized subset of SMM completed the Patient Portal Sexual Health Instrument as part of the 2018 American Men's Internet Survey. Multivariable logistic regression models estimated associations between EDC and intentions to use PP for test disclosures. Among a sample of 1,509 SMM aged 15 to 77 years, EDC was associated with intentions to use PP to disclose test history with main partners (aOR 2.17; 95% CI 1.90 to 2.47) and non-main partners (aOR 2.39; 95%CI 2.07 to 2.76). Assessing EDC could be useful in clinical settings for interventions encouraging patients to communicate with partners about testing.

16.
Int J Drug Policy ; 88: 103019, 2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-33160152

RESUMEN

BACKGROUND: Social network interventions that take advantage of existing individual and group relationships may help overcome the significant patient, provider, and system level barriers that contribute to low hepatitis C Virus (HCV) treatment uptake among people who inject drugs (PWID). METHODS: We conducted semi-structured interviews with 20 HCV antibody positive PWID (15 male, 5 female) in Baltimore, Maryland, USA. We utilized thematic analysis and employed both inductive and deductive coding techniques to assess perceptions of barriers and facilitators of social network interventions for HCV testing, linkage to care, and treatment among PWID. RESULTS: PWID perceived a high prevalence of HCV within their social networks, especially within injection drug use networks. Overwhelmingly, participants reported a willingness to discuss HCV and provide informational, instrumental, and emotional support to their network members. Support included sharing knowledge, such as where and how to access HCV care, as well as sharing lived experiences about HCV treatment that could help peers build trust within networks. Participants who were already linked into HCV care had an increased understanding of using social network interventions to provide peer navigation, by accompanying network members to HCV related appointments. Across interviews, drug use related stigma and feeling undeserving of HCV treatment due to previous negative experiences accessing the health care system emerged as a major barrier to linkage to HCV treatment and cure. Undeservingness was often internalized and projected onto network members. To overcome this, participants supported access to low-barrier HCV treatment in alternative locations such as community-based or mobile clinics and drug treatment centers. CONCLUSION: Social network based interventions have potential to increase HCV treatment uptake among PWID. To be successful, these interventions will need to train peers to share accurate information and personal experiences with HCV testing and treatment and enhance their ability to provide support to network members who face significant stigma related to both HCV and drug use.

17.
Front Public Health ; 8: 589053, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33163473

RESUMEN

Introduction: Public perceptions and attitudes toward preventive and control measures are vital to ensure the success of national response strategies in combating COVID-19. This study assessed perceptions and attitudes via the importance of national response measures to COVID-19 among people under the nationwide partial lockdown of Vietnam. Methods: An online cross-sectional survey was conducted on 1382 people in Vietnam mainly public administration and health workers with relatives. Perceptions and attitudes toward seven national response measures to COVID-19 epidemics were assessed. Multivariable Tobit regression models were employed to identify factors associated with the perceptions. Results: The proportion of participants strongly agreeing with the measure "Isolate people from abroad and people in contact with people infected with COVID 19" was the highest (96.9%), following by the measure "Obligatory to wear face masks in public places" (96.8%), and "Blockade of places having new cases" (92.9%). Living in the Southern region, having a family with more than 5 people, and having post-graduate education were negatively correlated to the levels of perceived importance of "Social distancing and community screening" measures. Meanwhile, having post-graduate education (Coef. = -0.04; 95%CI: -0.07; -0.01), working as white-collar workers (Coef. = -0.04; 95%CI: -0.08; -0.01), and having fixed-term, full-time employment (Coef. = -0.07; 95%CI: -0.10; -0.03) were inversely associated with the levels of perceived importance of the "Mandatory quarantine and personal protective equipment" measures. Conclusion: This study informed highly positive perceptions and attitudes toward the national response measure to combat the COVID-19 in Vietnam. Contextualized strategies to maintain and improve these perceptions are warranted to ensure the success of preventive measures in the future.

18.
Trop Med Int Health ; 2020 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-33164300

RESUMEN

OBJECTIVES: Pregnant women and new mothers are among the most vulnerable to seasonal influenza; however, little is known about their preferences for flu vaccination. We examined the rural-urban differences in uptake, demand and willingness to pay (WTP) for influenza vaccination among women of childbearing age, to assess the feasibility of implementing locally produced vaccines in Vietnam. METHODS: A cross-sectional study was performed in both urban and rural areas of Hanoi in 2018. Socio-demographic characteristics, history of vaccination, demand and WTP for influenza vaccines were obtained. A multivariate logistic regression model was employed to identify the associated factors. RESULTS: Of 750 participants, 29.9% had had flu shots in the current or previous flu season and 64.3% indicated demand for this vaccine. The median of the maximum amount of WTP for influenza vaccination services was US$ 8.5 (IQR: 8.5-17.0). Women living in rural areas had a significantly lower uptake and higher demand, and were willing to pay less than women in urban locations (21.1% vs. 36.6%; 69% vs. 60.2%; and US $8.5 vs. US $11.7, respectively). For urban participants, factors associated with higher demand and WTP for flu shots included having ANC in health facilities and having been vaccinated against influenza in the past; for rural women, these factors were having suffered from influenza and hearing about it. CONCLUSIONS: This study informs the feasibility of implementing locally produced influenza vaccines in Vietnam. Educational programs, along with counselling services and government subsidies, should be implemented to improve the coverage, demand and WTP for the vaccine.

19.
BMC Infect Dis ; 20(1): 815, 2020 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-33167892

RESUMEN

BACKGROUND: The availability of effective, oral direct acting antivirals (DAAs) for hepatitis C virus (HCV) treatment has put elimination of HCV as a public health challenge within reach. However, little is known about the characteristics of transmission networks of people who inject drugs (PWID). METHODS: Sequencing of a segment of the HCV genome was performed on samples collected from a community-based cohort of PWID between August 2005 and December 2016. Phylogenetic trees were inferred, and clusters were identified (70% bootstrap threshold; 0.04 maximum genetic distance threshold). We describe sex, race, age difference, and HIV infection status of potential transmission partners. Logistic regression was used to assess factors associated with being in an HCV cluster. RESULTS: Of 508 HCV genotype 1 viremic PWID, 8% (n = 41) were grouped into 20 clusters, consisting of 19 pairs and 1 triad. In adjusted analyses, female sex (odds ratio [OR] 2.3 [95% confidence interval (CI) 1.2-4.5]) and HIV infection (OR 5.7 [CI 2.7-11.9]) remained independently associated with being in an HCV infection cluster. CONCLUSIONS: Molecular epidemiological analysis reveals that, in this cohort of PWID in Baltimore, HIV infection and female sex were associated with HCV clustering. Combination HCV prevention interventions targeting HIV infected PWID and addressing HCV infection prevention needs of women have potential to advance HCV elimination efforts.


Asunto(s)
Infecciones por VIH/epidemiología , VIH/genética , Hepacivirus/genética , Hepatitis C/epidemiología , Filogenia , Abuso de Sustancias por Vía Intravenosa/epidemiología , Anciano , Anciano de 80 o más Años , Antivirales/uso terapéutico , Baltimore/epidemiología , Análisis por Conglomerados , Femenino , Estudios de Seguimiento , Genotipo , Infecciones por VIH/transmisión , Infecciones por VIH/virología , Hepatitis C/transmisión , Hepatitis C/virología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Factores Sexuales , Parejas Sexuales , Viremia/epidemiología
20.
Front Public Health ; 8: 589359, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33194995

RESUMEN

This study aimed to evaluate the psychological effects of the partial lockdown on the people in Vietnam during the COVID-19 pandemic. An online questionnaire regarding attitudes toward COVID-19 along with psychological parameters, including the Impact of Event Scale-Revised (IES-R) Depression, Anxiety, Stress Scale-21 (DASS-21) was conducted. From a total of 1,382 questionnaires, the respondents reported low prevalence of depression (4.9%), anxiety (7.0%), and stress (3.4%). The mean DASS-21 scores recorded were also markedly lower compared to similar studies conducted in China, Italy, and Iran. Respondents who reported severe PTSD had significantly higher depression, anxiety, and stress levels. Factors that were associated with an increased level of depression, stress, and anxiety were being single, separated, or widowed, a higher education level, a larger family size, loss of jobs and being in contact with potential COVID-19 patients. Contrary to expectations, the level of depression, stress, and anxiety observed has been low. Our findings can aid in future research on the impact of a partial lockdown and guide mental health professionals in Vietnam and other countries in the preparation of better care for populations under such circumstances.

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