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2.
Rev Med Suisse ; 16(686): 539-542, 2020 Mar 18.
Artigo em Francês | MEDLINE | ID: mdl-32186799

RESUMO

HIV affection affects sexual function, sexual health and relationships as well as mental health and quality of life. Due to the importance of sexual health for each individual and in order to ensure optimal and quality care, we have assessed the demand for sexual health and advise not only among HIV patients but also among professionals in this area and nursing staff. The results showed that sexuality was important both for patients and caregivers. Also, we did find out that carers want to create a better professional network with the aim of redirecting patients to specialists according to their specific needs. Carers have also expressed a desire to have relevant training in sexology and sexual health to achieve this.


Assuntos
Infecções por HIV/psicologia , Infecções por HIV/terapia , Comportamento Sexual/psicologia , Saúde Sexual , Sexualidade/psicologia , Cuidadores , Infecções por HIV/enfermagem , Humanos , Qualidade de Vida
3.
Pan Afr Med J ; 33: 209, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692730

RESUMO

Introduction: management of tuberculosis (TB) and Human Immunodeficiency Virus (HIV) within primary health care (PHC) facilities involve nursing students as part of them integrating theory to practice. Clinical learning for nursing students requires adequate support from the Nursing Education Institution (NEI) and nursing professionals. Given the dearth of literature regarding clinical support for nursing students in the management of TB/HIV in PHC setting, this study is aimed at exploring and describing nursing students' experiences regarding clinical support. Methods: a phenomenological design was used to explore and describe the experiences of nursing students using an individual, unstructured, in-depth interview. Audio-taped interviews were transcribed verbatim and analysed using Atlas TI software. Results: themes derived from the study were factors inhibiting clinical support which incorporated shortage of professional nurses (PNs), lack of accompaniment, fear of managing TB/HIV patients and negative attitudes of PNs; outcomes of poor clinical support included inability to integrate TB/HIV theory to practice and lack of confidence among nursing students; nursing students' desired outcomes through clinical support included becoming a competent TB/HIV nurse and the ability to integrate TB/HIV theory to practice; and strategies to strengthen and promote clinical support in TB/HIV management through strengthened occupational health and safety learning, provision of knowledge regarding post-exposure prophylaxis and infection control, and appointed clinical PN for students in each facility. Conclusion: the development of policies for clinical support, increasing supervision, appointment of clinical preceptors and accompanists in facilities where nursing students are placed would promote clinical learning within the NEI and the production of competent and confident nurses.


Assuntos
Infecções por HIV/enfermagem , Atenção Primária à Saúde/organização & administração , Estudantes de Enfermagem/estatística & dados numéricos , Tuberculose/enfermagem , Adulto , Competência Clínica , Feminino , Humanos , Entrevistas como Assunto , Masculino , Adulto Jovem
5.
Afr J Prim Health Care Fam Med ; 11(1): e1-e8, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31038343

RESUMO

BACKGROUND: Postnatal care (PNC) provides the opportunity for protecting the lives of women infected with human immune deficiency virus (HIV) and their babies. The prevention of mother-to-child transmission of HIV (PMTCT) guidelines provide a framework for implementation of PNC. There has been no empirical evidence on how the nurses at the clinic level implement these guidelines. In addition, there are reports that PNC has been neglected in South Africa. AIM: The study aimed to explore the implementation of PNC for HIV-positive women, by explicating nurses' views regarding their practices. SETTING: The study was conducted in 2015 at three clinics at Mangaung Metro Municipality in the Free State. METHODS: A qualitative, evaluative case study was conducted to provide a detailed account of the implementation of PNC, using 2015 PMTCT guidelines as a framework for evaluation. Eighteen key informants participated in three focus groups. Data were reviewed through direct thematic analysis. RESULTS: Four themes emerged from data analysis, namely, guidelines as an empowering tool, implementation of HIV guidelines, perceived successes and challenges of postnatal HIV care, and measures to strengthen postnatal HIV care services. The study found that nurses interpreted and used guidelines to direct their practice. However, there were challenges and some successes. CONCLUSION: It was concluded that nurses had a good understanding of the guidelines provided for their practices and implemented them with various levels of success. Effective management of HIV-infected women during the postnatal period requires well-designed multidisciplinary collaborations, adequate resources, continuous professional development programmes, a high level of competence and confidence.


Assuntos
Atitude do Pessoal de Saúde , Infecções por HIV/enfermagem , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Enfermeiras e Enfermeiros/psicologia , Cuidado Pós-Natal/psicologia , Complicações Infecciosas na Gravidez/enfermagem , Adulto , Feminino , Grupos Focais , Infecções por HIV/transmissão , Implementação de Plano de Saúde/normas , Humanos , Recém-Nascido , Cuidado Pós-Natal/normas , Guias de Prática Clínica como Assunto , Gravidez , Complicações Infecciosas na Gravidez/virologia , Pesquisa Qualitativa , África do Sul , Adulto Jovem
6.
Implement Sci ; 14(1): 41, 2019 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-31029171

RESUMO

BACKGROUND: The introduction of option B+-rapid initiation of lifelong antiretroviral therapy regardless of disease status for HIV-infected pregnant and breastfeeding women-can dramatically reduce HIV transmission during pregnancy, birth, and breastfeeding. Despite significant investments to scale-up Option B+, results have been mixed, with high rates of loss to follow-up, sub-optimal viral suppression, continued pediatric HIV transmission, and HIV-associated maternal morbidity. The Systems Analysis and Improvement Approach (SAIA) cluster randomized trial demonstrated that a package of systems engineering tools improved flow through the prevention of mother-to-child HIV transmission (PMTCT) cascade. This five-step, facility-level intervention is designed to improve understanding of gaps (cascade analysis), guide identification and prioritization of low-cost workflow modifications (process mapping), and iteratively test and redesign these modifications (continuous quality improvement). This protocol describes a novel model for SAIA delivery (SAIA-SCALE) led by district nurse supervisors (rather than research nurses), and evaluation procedures, to serve as a foundation for national scale-up. METHODS: The SAIA-SCALE stepped wedge trial includes three implementation waves, each 12 months in duration. Districts are the unit of assignment, with four districts randomly assigned per wave, covering all 12 districts in Manica province, Mozambique. In each district, the three highest volume health facilities will receive the SAIA-SCALE intervention (totaling 36 intervention facilities). The RE-AIM framework will guide SAIA-SCALE's evaluation. Reach describes the proportion of clinics and population in Manica province reached, and sub-groups not reached. Effectiveness assesses impact on PMTCT process measures and patient-level outcomes. Adoption describes the proportion of districts/clinics adopting SAIA-SCALE, and determinants of adoption using the Organizational Readiness for Implementing Change (ORIC) tool. Implementation will identify SAIA-SCALE core elements and determinants of successful implementation using the Consolidated Framework for Implementation Research (CFIR). Maintenance describes the proportion of districts sustaining the intervention. We will also estimate the budget and program impact from the payer perspective for national scale-up. DISCUSSION: SAIA packages user-friendly systems engineering tools to guide decision-making by frontline health workers, and to identify low-cost, contextually appropriate PMTCT improvement strategies. By integrating SAIA delivery into routine management structures, this pragmatic trial is designed to test a model for national intervention scale-up. TRIAL REGISTRATION: ClinicalTrials.gov NCT03425136 (registered 02/06/2018).


Assuntos
Infecções por HIV/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal/métodos , Melhoria de Qualidade , Análise de Sistemas , Adulto , Feminino , Infecções por HIV/enfermagem , Pesquisa sobre Serviços de Saúde , Humanos , Ciência da Implementação , Modelos Organizacionais , Moçambique , Gravidez , Complicações Infecciosas na Gravidez/enfermagem , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Fluxo de Trabalho
7.
Curationis ; 42(1): e1-e6, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30843402

RESUMO

BACKGROUND:  Integration of human immunodeficiency virus and acquired immune deficiency syndrome (HIV and AIDS) services into primary healthcare (PHC) is a key public health approach to achieving universal access to antiretroviral therapy (ART). Despite the government's efforts of integrating HIV services into PHC, an insufficient number of PHC staff and inadequate infrastructure are challenging when integrating HIV and AIDS services into PHC. This study explored the challenges of PHC nurses regarding the integration of HIV and AIDS services into PHC. OBJECTIVES:  The aim of the study was to explore the challenges of PHC nurses regarding the integration of HIV and AIDS services into PHC. METHOD:  An exploratory, descriptive and contextual qualitative research design utilising face-to-face semi-structured interviews was conducted with 12 PHC nurses from selected clinics and health centres in the Vhembe district of Limpopo province. RESULTS:  Two main themes emerged from data analysis which included challenges related to healthcare recipients and challenges related to healthcare providers. CONCLUSION:  Clear policies on the integration of HIV and AIDS services into PHC should be available and should include strategies to promote HIV testing and counselling, adherence to ART and scheduled appointments, disclosure of HIV status as well as revising the human resource policy to reduce workload.


Assuntos
Infecções por HIV/enfermagem , Enfermagem de Atenção Primária/métodos , Adulto , Instituições de Assistência Ambulatorial/organização & administração , Prestação Integrada de Cuidados de Saúde/tendências , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Acesso aos Serviços de Saúde/normas , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , África do Sul
9.
Rev Lat Am Enfermagem ; 27: e3112, 2019 Mar 18.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-30916226

RESUMO

OBJECTIVE: to analyze aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus treated in a specialized outpatient service. METHOD: analytical cross-sectional study with 135 patients aged 18 and over, of both sexes, who are followed up on the service. The independent variables and outcomes were collected from the nursing consultation instrument, whose theoretical reference is the Orem's Theory. The data were analyzed by parametric approach. Relationships or differences were considered significant if p <0.05. The analysis was done with SPSS v21.0 software. RESULTS: most participants were male (56.3%), with a mean age of 42.1 years. Patients who needed to conceal the diagnosis had less self-care (ß = -0.72 (-1.38, -0.06), p <0.031). The chance of performing self-care decreased with increasing age (OR = 0.93 (0.89, 0.97), p <0.003). On the other hand, patients with a permanent partner had a higher chance of performing self-care (OR = 3.46 (1.27, 9.46), p <0.015). CONCLUSION: aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus were evidenced. However, further studies are necessary to emphasize the analytical character of the self-care of these patients.


Assuntos
Infecções por HIV/enfermagem , Cuidados de Enfermagem/métodos , Autocuidado , Adolescente , Adulto , Fatores Etários , Idoso , Assistência Ambulatorial , Fármacos Anti-HIV/uso terapêutico , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Humanos , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Processo de Enfermagem , Planejamento de Assistência ao Paciente , Inquéritos e Questionários , Adulto Jovem
10.
AIDS Care ; 31(2): 243-249, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30146895

RESUMO

With the increase in the US of the number of older adults living with HIV, more research is needed to understand the caregiving and advance care planning needs of this population. This descriptive study examined the relationship between social support and caregiving preferences and advance care planning. Older adults living with HIV were recruited from clinics in Los Angeles, CA and New Orleans, LA to complete cross-sectional surveys (n = 154). Logistic regression analyses were modeled to determine the characteristics associated with 1) preference for formal short-term term care, 2) preference for formal long-term care, 3) having at least one contact for emergency care, 4) having an advance directive or living will, and 5) having a healthcare proxy or agent. The mean age was 56.8 years. The majority of participants indicated a preference for informal support for both short-term (73.4%) and long-term care (66.2%), 13.2% had no one they could call for emergency care, 26.0% had an advance directive/living will, and 30.5% had a healthcare proxy/agent. In adjusted models, greater social support was associated with preference for informal short-term care and with having at least one emergency contact. Findings suggest that older adults living with HIV prefer informal sources of support for their caregiving needs despite having small social networks and individuals with limited social networks are particularly vulnerable due to lack of access to caregivers in sudden or unexpected health situations.


Assuntos
Infecções por HIV/enfermagem , Testamentos Quanto à Vida/estatística & dados numéricos , Assistência ao Paciente/estatística & dados numéricos , Preferência do Paciente/estatística & dados numéricos , Procurador/estatística & dados numéricos , Idoso , Estudos Transversais , Emergências , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Assistência de Longa Duração , Los Angeles , Masculino , Pessoa de Meia-Idade , Apoio Social
11.
Int Nurs Rev ; 66(1): 139-146, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30184249

RESUMO

BACKGROUND: Most public hospitals in African countries are overpopulated with patients suffering from conditions related to HIV and AIDS. These patients increase the burden on healthcare providers, among which are enrolled nurses. AIM: To explore enrolled nurses' experiences of caring for patients living with HIV and AIDS at a public rural community hospital in the Vhembe district of Limpopo Province, South Africa. DESIGN: The study was underpinned by the interpretative phenomenological design. PARTICIPANTS: A total of 11 purposively selected enrolled nurses who met the inclusion criteria participated in the study. The sample size was based on data saturation. METHOD: Data were collected through semi-structured individual face-to-face interviews guided by an interview guide. Interviews were audio-recorded; and field notes were also taken. Data were analysed thematically following a framework for interpretative phenomenological analysis. RESULTS: The study revealed that enrolled nurses are working without adequate resources. They also experience minimal support despite the negative circumstances they are exposed to in the process of caring for patients admitted with HIV-related illnesses. CONCLUSIONS: A lack of resources, limited support and inadequate skills have a negative impact on the health care that enrolled nurses provide to patients admitted in hospital with HIV-related ailments. Researchers recommend the importance of supporting and equipping enrolled nurses to provide quality care to patients living with HIV. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The findings have highlighted the challenges faced by enrolled nurses while caring for patients with HIV. The identified gaps will assist the Department of Health in developing policies to enhance the support offered to enrolled nurses and improve the care provided to patients with HIV-related conditions that are admitted to rural hospitals.


Assuntos
Síndrome de Imunodeficiência Adquirida/enfermagem , Atitude do Pessoal de Saúde , Infecções por HIV/enfermagem , Satisfação no Emprego , Recursos Humanos de Enfermagem no Hospital/psicologia , Qualidade da Assistência à Saúde , Adulto , Feminino , Hospitais Rurais , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , África do Sul
12.
AIDS Care ; 31(3): 283-292, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30360643

RESUMO

Prior studies show an association between caregiver depression and child health outcomes. There has been little examination of depression among caregivers of HIV-infected children in sub-Saharan countries where pediatric HIV is concentrated. Using baseline data collected in the pediatric HIV disclosure intervention trial, Sankofa, we examined the prevalence and factors associated with depression among caregivers (N = 446) of children infected with HIV in Ghana. Data were analyzed with descriptive and regression analyses. The mean age of the caregivers was 42.2 ± 10.4 years. Eighty percent of the caregivers were female and 59% were HIV-infected. Twenty-eight percent (n = 126) of the caregivers were found to have mild to severe depression. In the adjusted model, factors significantly associated with caregiver depression included: HIV-positive caregiver status (P = 0.04), low income (P = 0.02), lower social support, (P = 0.01), lower HIV knowledge, (P = 0.01), worse HIV illness perceptions (P≤0.001), and greater perceived HIV stigma (P≤0.001). Although we found a high prevalence of depression among our study participants, several of the risks factors identified are modifiable and amenable to interventions that are locally available and affordable.


Assuntos
Cuidadores/psicologia , Depressão/epidemiologia , Infecções por HIV/psicologia , Adulto , Cuidadores/estatística & dados numéricos , Criança , Feminino , Gana/epidemiologia , Infecções por HIV/enfermagem , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Prevalência , Fatores de Risco , Estigma Social , Apoio Social
13.
Nurs Ethics ; 26(4): 1087-1100, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29153012

RESUMO

BACKGROUND: Studies have established that negative perceptions of people living with HIV/AIDS exist among nursing students throughout the world, perceptions which can be detrimental to the delivery of high-quality nursing care. OBJECTIVES: The purpose of this research was to explore socio-cultural influences on the perceptions of nursing students towards caring for people living with HIV/AIDS. RESEARCH DESIGN: The study was guided by stigma theory, a qualitative descriptive research approach was adopted. Data collected via semi-structured interviews were thematically analysed. PARTICIPANTS AND RESEARCH CONTEXT: Participants were 21 international and Australian undergraduate nursing students enrolled in a Bachelor of Nursing programme at an Australian university. ETHICAL CONSIDERATIONS: Ethical approval was granted by the Social and Behavioural Research Ethics Committee at the study university. Participation was entirely voluntary; informed consent was obtained before the study commenced; confidentiality and anonymity were assured. FINDINGS: Three major themes were found: blame, othering and values. Complex and interrelated factors constructed participant perceptions of people living with HIV/AIDS, perceptions underscored by the prevailing culturally construed blame and othering associated with HIV/AIDS. The study found discordance between the negative personal beliefs and perceptions some nursing students have towards people living with HIV/AIDS, and the professional values expected of them as Registered Nurses. DISCUSSION: There was considerable commonality between this and previous studies on how homosexuality and illicit drug use were perceived and stigmatised, correlating with the blame directed towards people living with HIV/AIDS. These perceptions indicated some nursing students potentially risked not fulfilling the ethical and professional obligations the Registered Nurse. CONCLUSION: Nursing curriculum should be strengthened in relation to comprehending the meaning of being stigmatised by society. Educational institutions need to work towards enhancing strategies that assist nursing students to reconcile any incongruity between their personal beliefs and requisite professional nursing values.


Assuntos
Cultura , Ética em Enfermagem , Estudantes de Enfermagem/psicologia , Adulto , Atitude do Pessoal de Saúde , Austrália , Bacharelado em Enfermagem/métodos , Feminino , Infecções por HIV/enfermagem , Infecções por HIV/psicologia , Humanos , Masculino , Percepção , Pesquisa Qualitativa , Valores Sociais
14.
BMC Health Serv Res ; 18(1): 874, 2018 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-30458844

RESUMO

BACKGROUND: An interprofessional medication adherence program (IMAP) for chronic patients was developed and successfully implemented in the community pharmacy of the Department of ambulatory care and community medicine (Lausanne, Switzerland). This study assesses the capacity of a physician and a nurse at the infectious diseases service of a public hospital and of community pharmacists in the Neuchâtel area (Switzerland) to implement the IMAP in their practice. METHODS: Mixed method, prospective, observational study. Quantitative and qualitative analyses of the implementation process were conducted following the RE-AIM model (reach, effectiveness, adoption, implementation and maintenance). RESULTS: Implementation started in November 2014. One physician, one nurse, and five pharmacists agreed to participate. Healthcare professionals perceived the benefits of the program and were motivated to implement it in their practice (adoption). Seventeen patients were included in the program; 13 refused to participate. The inclusion of naïve HIV patients was easier than the inclusion of experienced patients with difficult psychosocial issues (reach). Pharmacists were engaged in reinforcing patient medication adherence in 25% of interviews (effectiveness). Key facilitators expressed by healthcare professionals were patient inclusion by the physician and the nurse instead of the pharmacist and the organisation of regular meetings between all stakeholders. In contrast, the encountered barriers were the lack of time and resources, the lack of team uptake, and the lack of adoption by senior managers (implementation). Interviewed patients were all satisfied with this new program, encouraging healthcare professionals to scale it up. Structural changes allowed the hospital and one pharmacy to enter the maintenance stage (maintenance). CONCLUSION: The research team and collaboration between all professionals involved played an important role in this implementation. However, the dissemination of such a program to a larger scale and for the long term requires financial and structural resources as well as transitional external support.


Assuntos
Infecções por HIV/tratamento farmacológico , Adesão à Medicação , Assistência Ambulatorial/normas , Atitude do Pessoal de Saúde , Competência Clínica/normas , Serviços Comunitários de Farmácia/normas , Feminino , Infecções por HIV/enfermagem , Pessoal de Saúde/normas , Recursos em Saúde/normas , Hospitais Públicos , Humanos , Relações Interprofissionais , Masculino , Enfermeiros de Saúde Comunitária/normas , Percepção , Farmácias/normas , Farmacêuticos/normas , Médicos/normas , Estudos Prospectivos , Suíça
15.
Artigo em Inglês | MEDLINE | ID: mdl-30380715

RESUMO

HIV care outcomes must be improved to reduce new human immunodeficiency virus (HIV) infections and health disparities. HIV infection-related care outcome measures were examined for U.S.-born and non-U.S.-born black persons aged ≥13 years by using National HIV Surveillance System data from 40 U.S. areas. These measures include late-stage HIV diagnosis, timing of linkage to medical care after HIV diagnosis, retention in care, and viral suppression. Ninety-five percent of non-U.S.-born blacks had been born in Africa or the Caribbean. Compared with U.S.-born blacks, higher percentages of non-U.S.-born blacks with HIV infection diagnosed during 2016 received a late-stage diagnoses (28.3% versus 19.1%) and were linked to care in ≤1 month after HIV infection diagnosis (76.8% versus 71.3%). Among persons with HIV diagnosed in 2014 and who were alive at year-end 2015, a higher percentage of non-U.S.-born blacks were retained in care (67.8% versus 61.1%) and achieved viral suppression (68.7% versus 57.8%). Care outcomes varied between African- and Caribbean-born blacks. Non-U.S.-born blacks achieved higher care outcomes than U.S.-born blacks, despite delayed entry to care. Possible explanations include a late-stage presentation that requires immediate linkage and optimal treatment and care provided through government-funded programs.


Assuntos
Infecções por HIV/enfermagem , /estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
16.
Curationis ; 41(1): e1-e6, 2018 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-30198290

RESUMO

BACKGROUND:  Adolescent sexual and reproductive health is one of the essential health care programmes in the world. However, adolescents still face numerous challenges in the area of sexual and reproductive health, which hinder their utilisation of available Sexual and Reproductive HealthCare Services (SRHCS). Male adolescents face further obstacles in accessing and utilising sexual reproductive health services owing to the influence of social constructions of masculinity, which has a bearing on how they view sexual and reproductive health services and their use. OBJECTIVES:  The aim of this study was to investigate individual determinants associated with utilisation of SRHCS for HIV and AIDS prevention by male adolescents. METHOD:  An exploratory, descriptive and contextual qualitative design was used and semi-structured interviews with 20 purposively selected male adolescents aged 18-24 years living in the South African seat of government were conducted. Data were analysed using Tesch's approach of data analysis. RESULTS:  Knowledge of existing services was described as a significant individual determinant of utilisation of SRHCS. This was linked to the quality of SRHCS and violation of human rights of male adolescents. CONCLUSION:  The study recommends the development of a strategy that will enhance and promote the utilisation of SRHCS by male adolescents.


Assuntos
Comportamento do Adolescente , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Síndrome de Imunodeficiência Adquirida/enfermagem , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Adolescente , Serviços de Saúde do Adolescente , Infecções por HIV/enfermagem , Humanos , Masculino , Serviços de Saúde Reprodutiva , África do Sul , Adulto Jovem
17.
AIDS Care ; 30(12): 1614-1621, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30112926

RESUMO

Persistent Human Immunodeficiency Virus (HIV) prevalence rates remain a challenge, particularly because health care providers (HCP) are not fully prepared to engage in HIV care. This hesitancy to engage creates access to care barriers for people living with HIV (PLWH). We conducted a systematic review to identify educational interventions focused on developing HIV competencies in higher education across health science disciplines. We searched databases for primary studies focused on interventions. Using PRISMA guidelines, we identified 20 articles from 19 distinct studies. While there was an overwhelming body of literature that assessed knowledge, skills, and attitudes in health sciences students on HIV and AIDS, the low number of intervention studies was notable. With the exception of two studies, PLWH were not included in the interventions. This finding stands in sharp contrast to the well-established Greater Involvement of People Living with HIV and/or AIDS (GIPA) and Meaningful Engagement of People Living with HIV and/or AIDS (MEPA) principles. The primary means of the educational intervention was focused on delivering lectures to address HIV and AIDS knowledge for HCP. There was a significant lack of focus on historical, cultural, policy and legal contexts of HIV and AIDS care; theoretical justifications for the interventions were absent. No study focused on the impact of an intervention on the care provided to PLWH by HCP after graduation. There is an urgent need to develop long-term sustainable and scalable interventions that address the consistently identified lack of knowledge and skills, and stigmatizing attitudes of HCP and students.


Assuntos
Infecções por HIV/enfermagem , Estudantes de Ciências da Saúde , Pessoal de Saúde , Humanos , Estereotipagem
18.
Res Nurs Health ; 41(5): 417-427, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30152537

RESUMO

Co-infection with HIV and hepatitis C virus (HCV) results in a threefold increase in relative risk of progression to end stage liver disease and cirrhosis compared to HCV alone. Although curative treatments exist, less than one quarter of people with HCV are linked to care, and even fewer have received treatment. The Care2Cure study is a single-blinded, randomized controlled trial to improve the HCV care continuum among people co-infected with HIV. This ongoing study was designed to test whether a nurse case management intervention can (i) improve linkage to HCV care and (ii) decrease time to HCV treatment initiation among 70 adults co-infected with HIV who are not engaged in HCV care. The intervention is informed by the Andersen Behavioral Model of Health Services Use and consists of nurse-initiated referral, strengths-based education, patient navigation, appointment reminders, and care coordination for drug-drug interactions in the setting of HIV primary care. Validated instruments are used to measure participant characteristics including HCV knowledge, substance use, and depression. The primary outcome is linkage to HCV care (yes/no) within 60 days. In this protocol paper, we describe the first clinical trial to examine the effects of a nurse case management intervention to improve the HCV care continuum among people co-infected with HIV/HCV in the era of all-oral HCV treatment. We describe our work in progress, challenges encountered, and strategies to engage this hard-to-reach population.


Assuntos
Administração de Caso/organização & administração , Infecções por HIV/enfermagem , Hepatite C Crônica/enfermagem , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente , Adulto , Antivirais/uso terapêutico , Continuidade da Assistência ao Paciente/organização & administração , Feminino , Infecções por HIV/complicações , Hepatite C Crônica/complicações , Humanos , Masculino , Pesquisa em Avaliação de Enfermagem
19.
Am J Public Health ; 108(10): 1363-1365, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30138074

RESUMO

Casey House, a small Toronto, Ontario, hospital for people living with HIV, implemented a harm-reduction kit distribution program in October 2014 to decrease harms from reuse of injection and smoking equipment among its clients-inpatients and outpatients. Program statistics (November 2014-June 2017) show an increase in the number of kits-injection and smoking-distributed each year. The program is perceived by staff to communicate openness and increased willingness of clinicians and clients to discuss drug-related harms.


Assuntos
Equipamentos e Provisões/provisão & distribução , Infecções por HIV/enfermagem , Redução do Dano , Hospitais Especializados , Agulhas , Fumar , Esterilização/métodos , Cocaína Crack , Acesso aos Serviços de Saúde , Humanos , Ontário , Eliminação de Resíduos
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