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1.
J Homosex ; 67(1): 79-103, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30307800

RESUMO

Young Black Men Who Have Sex With Men (BMSM) have been the subject of much research focused on health disparities in HIV occurrence, stigma, and mental health. Although such research is important, fewer studies focus on other equally salient areas of their lives such as spirituality, religious practices, and social support. Informed by literature on social support, this research endeavors to better understand these dynamics for a group of young BMSM who reside in a metropolitan city in Tennessee. Focus group results and content analysis uncover themes related to religion and resilience; queering Christianity; and virtual spirituality. Participants expressed an overarching need for support, safe spaces, genuine relationships, and godly instruction, conveyed through traditional Black Church involvement and nontraditional Internet usage. Findings are important for strategic, proactive, cross-generational collaboration with young BMSM to holistically meet their varied needs.


Assuntos
Afro-Americanos/psicologia , Homossexualidade Masculina/psicologia , Minorias Sexuais e de Gênero/psicologia , Mídias Sociais , Espiritualidade , Adolescente , Adulto , Grupos Focais , Infecções por HIV/psicologia , Humanos , Masculino , Estigma Social , Tennessee , Adulto Jovem
2.
J Homosex ; 67(1): 104-126, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30307803

RESUMO

Malay-Muslim men who have sex with men (MSM) are marginalized and hidden in Malaysia, a predominantly Muslim country in southeast Asia. We explored the policy, network, community, and individual factors related to HIV infection among Malay-Muslim MSM through 26 in-depth interviews and one focus group discussion (n = 5) conducted in Kuala Lumpur and Kota Bharu between October 2013 and January 2014. As religion plays an important role in their lives, participants viewed homosexuality as a sin. Low risk perception and misconceptions about HIV/AIDS were common, and most participants expressed reluctance to consult a doctor unless they had symptoms. Additionally, buying condoms was embarrassing and anxiety-producing. Fear of discrimination by health care providers and community hindered participants from disclosing sexual behaviors and accessing health services. Homophobic comments and policies by the government and religious leaders were concerns of participants. A safe and enabling environment is needed to reduce HIV risks among Malay-Muslim MSM.


Assuntos
Revelação , Infecções por HIV/psicologia , Homofobia , Homossexualidade Masculina , Islamismo , Religião e Sexo , Minorias Sexuais e de Gênero/psicologia , Adulto , Redes Comunitárias , Preservativos , Grupos Focais , Pessoal de Saúde , Acesso aos Serviços de Saúde , Humanos , Malásia , Masculino , Fatores de Risco
3.
BMC Public Health ; 19(1): 1429, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31672141

RESUMO

BACKGROUND: The feminization and ethnic diversification of HIV infection, has resulted in a call for gender- and culture-specific prevention strategies for at-risk groups including Latinos in the United States. The steadily changing demographic profile of the AIDS epidemic challenges prevention strategies to remain relevant and up-to-date, particularly in populations of women midlife and older where an understanding of risk remains under explored. As the CDC requests country-specific HIV risk profiles for Latino communities in the US, understanding the socio-economic, behavioral and personal risk reasons of HIV risk for older Dominican women is critical for prevention. METHODS: We conducted focus group discussions informed by the Theory of Gender and Power (TGP). The three constructs of the TGP: 1) Affective influences/social norms; 2) Gender-specific norms and. 3) Power and Authority guided the thematic analysis and identified themes that described the socio-cultural and contextual reasons that that contribute to perceptions of HIV risk. RESULTS: Sixty Dominican American women ages 57-73 participated in our focus group discussions. Sexual Division of Labour: 1) Economic Dependence; 2) Financial Need and 3) Education and Empowerment. Sexual Division of Power: 4) HIV Risk and 5) Relationship Dynamics. Cathexis: Affective Influences/Social Norms: 6) HIV/AIDS Knowledge and 7) Prevention and Testing. Importantly, participants were concerned about partner fidelity when visiting the Dominican Republic, as the country accounts for the second highest HIV rates in the Caribbean. CONCLUSIONS: Our results confirm previous findings about perceptions of HIV risk and provide additional insight into aging-related aspects of HIV risk for Latino women midlife and older.


Assuntos
Atitude Frente a Saúde/etnologia , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Hispano-Americanos/psicologia , Idoso , República Dominicana/etnologia , Feminino , Grupos Focais , Hispano-Americanos/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Medição de Risco , Comportamento Sexual/etnologia , Parceiros Sexuais/psicologia , Estados Unidos
4.
Pan Afr Med J ; 33: 277, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692880

RESUMO

Introduction: Adherence is vital to effective antiretroviral therapy (ART) for reducing viral load and HIV/AIDS-related morbidity and mortality. This study was aimed at evaluating the adherence of HIV seropositive patients to ART in a tertiary institution in Nigeria. Methods: A cross sectional observational study was conducted among 400 HIV seropositive patients. The study was carried out between December 2016 and February 2017 at the HIV clinic of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Results: The mean age of the HIV patients was 42.2±9.5 years with a predominant female gender (Male:Female = 1:2.8). The median CD4 counts increased from 302.1±15.0cells/mm3 at diagnosis to 430.8±13.3cells/mm3 at the time of the study. Majority of participants were unaware of their spouses' HIV status (59.3%) while 32.5% of participants had a serodiscordant spouse. Poverty was a major challenge as 73.3% earned less than 140 dollars per month. Depressive symptoms, anxiety disorder and insomnia were also reported in 40.7%, 33.2% and 47.2% respectively. Poor adherence to ART was observed in almost 20% of the patients. Logistic regression indicated that predictors of poor adherence were depression, anxiety and low CD4 counts. Conclusion: Adherence to anti-retroviral therapy was good amongst the majority of HIV seropositive patients. Depression, anxiety disorder and low CD4 count were however associated with poor adherence. This emphasizes the role of the psychology units as integral part of the HIV clinic to assist patients' adherence to anti-retroviral regimens.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Contagem de Linfócito CD4 , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adulto , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários
5.
BMC Public Health ; 19(1): 1529, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31729969

RESUMO

BACKGROUND: Human papillomavirus (HPV) has been associated with certain types of oropharyngeal cancers and yet, the level of knowledge that dental professionals and the lay public have in terms of HPV transmission, oral sexual activities, and oral cancer development needs exploration. The aim of this study was to assess the knowledge held by practicing dental professionals as well as the lay public regarding Human Papillomavirus (HPV) transmission through oral sex and subsequent oropharyngeal cancer development. METHODS: Textual data were collected from a public forum with dental professionals in. Vancouver, who discussed the HPV-oral sex-oral cancer triad, and from survey data gathered from 212 lay public participants (also in Vancouver) who answered a 13-item questionnaire on the perceived risks of oral sex in terms of HPV infection and oropharyngeal cancer development. The data were analyzed statistically by age group, gender, and sexual orientation using descriptive statistics, while an ANOVA test was used to compare variation in the responses to the survey (p-value = 0.05). RESULTS: The forum engaged 46 health care professionals, many of whom were aware of the potential risks for head and neck cancer development due to HPV infection, while also questioning "how to effectively talk about HPV with patients." The survey revealed that 34.5% of the participants believed that oral sex is an activity with no or low risk for the transmission of HPV, while 84% of participants believed the same sexual practices were of low or no-risk for HIV (Human Immunodeficiency Virus) transmission. Most participants (82%) never discussed oral sexual activities with their physicians or dentists/dental hygienists. CONCLUSIONS: The general public remains mostly unaware of the potential links between HPV infection and oropharyngeal cancer. Physicians and dental providers should discuss oral sexual practice with their patients to raise awareness.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Bucais/psicologia , Neoplasias Orofaríngeas/psicologia , Infecções por Papillomavirus/psicologia , Comportamento Sexual/psicologia , Adulto , Recursos Humanos em Odontologia/psicologia , Feminino , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/virologia , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Infecções por Papillomavirus/transmissão , Infecções por Papillomavirus/virologia , Inquéritos e Questionários
6.
BMC Public Health ; 19(1): 1531, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31730450

RESUMO

BACKGROUND: In the U.S., transgender and gender diverse (TGD) populations face structural, interpersonal, and individual barriers to healthcare. Less is known, however, about the HIV prevention and treatment experiences of TGD youth in the U.S. The current study was developed to fill this research gap. METHODS: This article describes the research protocol for a multi-site, U.S.-based mixed-methods study that sought to identify the multi-level facilitators and barriers that influence participation of TGD youth in various stages of the HIV prevention (e.g., pre-exposure prophylaxis uptake) and care continua. A sample of diverse TGD youth ages 16-24 was recruited from 14 U.S. sites. TGD youth participants completed a one-time, in-person visit that included an informed consent process, computer-based quantitative survey, and in-depth qualitative interview assessing experiences accessing HIV prevention and/or care services. Providers serving TGD youth were recruited from the same 14 sites and completed a one-time visit via phone that included informed consent, demographic questionnaire, and in-depth qualitative interview assessing their experiences providing HIV prevention or treatment services to TGD youth. RESULTS: Overall, 186 TGD youth ages 16-24 and 59 providers serving TGD youth were recruited and enrolled from across the 14 U.S. sites. TGD youth participants had a mean age of 20.69; 77.3% youth of color; 59.7% trans-feminine; 15.5% trans-masculine; 24.9% non-binary; 53.6% family income under poverty level. Providers included medical and mental health providers as well as case manager/care coordinators, HIV test counselors, and health educators/outreach workers. Providers were 81.3% cisgender and 30.5% people of color. Successes with community-engagement strategies and gender-affirming research methods are reported. CONCLUSIONS: This study addresses critical gaps in current knowledge about the HIV prevention and care experiences of TGD youth. Findings have implications for the development of HIV interventions across levels to support the health and well-being of TGD youth. Future research is warranted to replicate and expand on lessons learned regarding recruitment and engagement of communities of TGD youth, including longitudinal designs to assess engagement across their developmental stages. Lessons learned working with TGD youth through developing and implementing the study protocol are shared. TRIAL REGISTRATION: Registered on ClinicalTrials.gov on 05/20/2015 (NCT02449629).


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Minorias Sexuais e de Gênero/psicologia , Pessoas Transgênero/psicologia , Adolescente , Feminino , Infecções por HIV/prevenção & controle , Acesso aos Serviços de Saúde , Humanos , Masculino , Pesquisa Qualitativa , Projetos de Pesquisa , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
7.
BMC Public Health ; 19(1): 1336, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640612

RESUMO

BACKGROUND: Perceived risk of HIV plays an important role in the adoption of protective behaviours and HIV testing. However, few studies have used multiple-item measures to assess this construct. The Perceived Risk of HIV Scale (PRHS) is an 8-item measure that assesses how people think and feel about their risk of HIV infection. This cross-sectional study aimed to assess the psychometric properties (reliability and validity) of the European Portuguese version of the PRHS, including the ability of this scale to discriminate between individuals from the general population and HIV-uninfected partners from sero-different couples on their perceived risk of HIV infection (known-groups validity). METHODS: This study included 917 individuals from the general population (sample 1) to assess the psychometric properties of the PRHS. To assess the known-groups validity, the sample comprised 445 participants from the general population who were in an intimate relationship (sub-set of sample 1) and 42 HIV-uninfected partners from sero-different couples (sample 2). All participants filled out a set of questionnaires, which included a self-reported questionnaire on sociodemographic information, sexual behaviours, HIV testing and the PRHS. Sample 1 also completed the HIV Knowledge Questionnaire - 18-item version. RESULTS: The original unidimensional structure was reproduced both in exploratory and confirmatory factor analyses, and the PRHS demonstrated good reliability (α = .78; composite reliability = .82). The differential item functioning analyses indicated that the items of the PRHS, in general, did not function differently for men and women or according to HIV testing. Significant associations with sexual risk behaviours and HIV testing provided evidence for criterion validity. The known-groups validity was supported. CONCLUSIONS: The PRHS is a suitable scale in the evaluation of the perceived risk of HIV, and its psychometric characteristics validate its use in the Portuguese population. Furthermore, the present study suggests that interventions improving individuals' HIV risk perceptions may be important since they were associated with different sexual behaviours and the likelihood of HIV testing.


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Soronegatividade para HIV , Soropositividade para HIV , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Psicometria , Reprodutibilidade dos Testes , Medição de Risco , Traduções , Adulto Jovem
8.
Afr Health Sci ; 19(2): 1978-1987, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656480

RESUMO

Introduction: Chronic pain classification in HIV positive patients is essential for diagnosis and treatment. However, this is rarely done despite association with poor outcomes. Methods: A cross-sectional survey of 345 consented patients at a specialized HIV care center in Uganda was conducted. Chronic pain was defined as pain of more than two weeks duration. Data was collected using a socio-demographic questionnaire, the IASP classification of chronic pain; the StEP; Mini Mental Status Examination, Patient Health Questionnaire, Mini International Neuropsychiatric Interview and the World Health Organization quality of life instrument brief version. Chi-square, Fisher's exact, t-test and logistic regression analyses were carried out to determine factors associated with chronic pain. Results: Description of pain aetiology was difficult. Chronic pain was reported in 21.5% of the participants. Non-neuropathic (92.0%) was more common than neuropathic pain (8.0%). Chronic pain was found to be associated with feeling ill [OR=6.57 (3.48 - 12.39)], and worse scores in the quality of life domain for physical health [OR=0.71 (0.60 - 0.83)]. Conclusion: People living with HIV/AIDS commonly have chronic pain that is associated with poor quality of life. More sensitive tools are needed to accurately describe chronic pain in resource limited settings.


Assuntos
Dor Crônica/classificação , Infecções por HIV/complicações , Manejo da Dor/métodos , Adulto , Fármacos Anti-HIV/uso terapêutico , Dor Crônica/epidemiologia , Dor Crônica/etiologia , Comorbidade , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Neuralgia , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Fatores Socioeconômicos , Inquéritos e Questionários , Uganda/epidemiologia
9.
BMC Public Health ; 19(1): 1382, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660947

RESUMO

BACKGROUND: Private health facilities are increasingly being recognized as the neglected partner in the provision of HIV services. The non-adherence rate in the study sites ranged from 19 to 22%. This study explored the factors associated with non-adherence from antiretroviral therapy (ART) among adult patients accessing ART services at two privately owned urban health facilities in Malawi. METHODS: We conducted a descriptive qualitative approach employing in-depth interviews among adults who either defaulted or were retained in HIV care in two privately owned facilities in Malawi from March to July 2017. We purposively selected participants and interviewed a total of 6 ART providers and 24 ART clients. Data were analyzed manually using a thematic approach. RESULTS: Overall, participants identified four facilitators for retention in care and four broad categories of barriers namely individual, psychological, drug related and human resource related factors. The factors that facilitated retention in care included follow up visits after missing a visit, adequate information education and counseling, and supportive relationships. CONCLUSION: The main reason for defaulting from antiretrovirals (ARVs) was fear of disclosing an HIV status to avert potential stigma and discrimination. In implementing ART clinics due consideration and strategies need to be adopted to ensure that privacy and confidentiality is preserved. Although adoption of all the key Malawi Implementing strategies like expert clients and a guardian may optimize retention in care, there is need for prior analysis of how those may lead to unintended disclosure which inadvertently affects adherence. Furthermore, private facilities should orient their clients to the public facilities within the catchment area so that clients have an option for alternative access to HIV care in the event of financial constraints.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Instalações Privadas/estatística & dados numéricos , Adulto , Revelação , Medo , Feminino , Infecções por HIV/psicologia , Humanos , Malaui , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estigma Social , Adulto Jovem
10.
West Afr J Med ; 36(3): 246-252, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622487

RESUMO

BACKGROUND AND OBJECTIVE: Disclosure of human immuno-deficiency virus (HIV) sero-status is a difficult process that involves communication of information about a potentially stigmatizing and transmissible illness. Despite this, it is important for preventing HIV infection and mitigating its impacts. This study aimed to assess the rate and determinants of self-disclosure of HIV sero-status among people living with HIV/AIDS (PLHIV) attending an Antiretroviral Therapy (ART) Clinic in North Central Nigeria with a view to promoting self- disclosure as an intervention for secondary prevention of HIV/AIDS. METHODS: It was a cross-sectional study involving 325 consenting adults aged 18 to 65 years PLHIV attending ART clinic who were recruited using systematic random sampling method. Data collected from the participants include socio-demographic data and medical history. The rate and factors affecting self-disclosure of HIV sero-status were obtained by using a structured interviewer-administered questionnaire. Data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0 Results: Most of the participants (66.2%) were females. 96% of the participants had disclosed their HIV sero-status. Self-disclosure of HIV sero-status had statistically significant association with age (c2 = 12.614; p = 0.027) and gender (c2 = 4.638; p = 0.031). CONCLUSION: Self-disclosure of HIV sero-status was high among the participants. Being female and within 15-44 year age group were statistically significant factors associated with disclosure of HIV sero-status. Multiple counselling sessions are needed to improve disclosure particularly in males and older PLHIV as self-disclosure of HIV sero-status is a process that requires ongoing support and encouragement.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Soropositividade para HIV/psicologia , Revelação da Verdade , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/psicologia , Idoso , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Soropositividade para HIV/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Ambulatório Hospitalar/estatística & dados numéricos , Parceiros Sexuais , Centros de Atenção Terciária , Adulto Jovem
11.
AIDS Behav ; 23(Suppl 3): 276-286, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31586283

RESUMO

We characterized the potential benefits and risks of participating in a microenterprise program targeting low-income women living with HIV (WLWH) in Alabama; and described potential mechanisms through which microenterprise programs could influence sexual risk behaviors and engagement in HIV care. Fourteen stakeholders and 46 WLWH (89% African American) participated in the qualitative study. Data were collected using in-depth interviews (stakeholders) and focus group discussions (WLWH). NVivo qualitative software was used for the management and analysis of the data. The data revealed four main mechanisms through which microenterprise programs could potentially improve health outcomes: (1) social support and encouragement from other women, (2) improvement in self-esteem, (3) creating structure in the women's lives, and (4) financial strengthening. Potential risks included unwanted disclosure of HV status, stigma and loss of insurance benefits. Microenterprise programs have the potential to be acceptable and may contribute to improved health and social outcomes among low-income WLWH in Alabama.


Assuntos
Infecções por HIV/psicologia , Motivação , Autoimagem , Empresa de Pequeno Porte/organização & administração , Adulto , Alabama/epidemiologia , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Humanos , Entrevistas como Assunto , Pobreza , Pesquisa Qualitativa , Assunção de Riscos , Comportamento Sexual , Estigma Social
12.
Afr J AIDS Res ; 18(3): 244-253, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31575340

RESUMO

Unprotected sexual activity increases the risk of pregnancy and HIV and AIDS. More than three decades into the AIDS pandemic, the condom remains the most effective strategy for protecting against the dual risks of pregnancy and HIV and AIDS, but data from national surveys suggest that condom use among young people aged 15-24 is on the decline in South Africa. This study uses qualitative data from 20 in-depth interviews and one focus group to examine the risk behaviours of university students aged 18-24 years old, with particular emphasis on understanding the decline in the use of condoms. It is well documented that South Africa has one of the highest prevalence rates of HIV and AIDS in the world, however the findings of this study suggest that even though students were well informed about the perceived risks associated with unsafe sexual behaviours, they continue to engage in risk behaviours including unprotected sexual intercourse, multiple sexual partners and the use of alcohol. Male students were more likely than female students to report risky sexual behaviours. Condom use is occurring but not consistently. The majority of students did not use condoms during their first sexual encounter because of a lack of preparedness. Negative attitudes towards condoms continue to discourage students from using them consistently, especially those provided by the government. In light of this, it is recommended that rigorous efforts are directed towards challenging inaccurate perceptions about, and attitudes towards, condom use to promote consistency.


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Assunção de Riscos , Comportamento Sexual/psicologia , Estudantes/estatística & dados numéricos , Sexo sem Proteção/psicologia , Adolescente , Preservativos/estatística & dados numéricos , Feminino , HIV , Humanos , Masculino , Gravidez , Parceiros Sexuais/psicologia , África do Sul , Inquéritos e Questionários , Universidades/estatística & dados numéricos , Adulto Jovem
13.
Medicine (Baltimore) ; 98(40): e17419, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577756

RESUMO

Prospective cohort studies have been conducted to estimate HIV incidence among men who have sex with men (MSM) in first-line megacities cities (>10 million residents) in China, but few in the second-line large- or middle-size cities. This study was to investigate HIV incidence and cohort retention among MSM in a second-line city Hangzhou in eastern China.A total of 523 HIV-seronegative MSM were recruited during September 2014 to September 2015, and were followed up prospectively at 3, 6, 9, and 12 months. Questionnaire interviews were conducted, and laboratory tests were performed to evaluate baseline syphilis infection and HIV seroconversions. Chi-square test and logistic regression model were used to identify factors associated with cohort retention rate and syphilis prevalence.Of 523 participants, 137 (26.2%) completed 6-month follow-up, and use of Internet for recruiting study participants (vs other recruitments: adjusted odds ratio [AOR] = 0.5; 95% confidence interval [CI]: 0.3-0.8) and being homosexual (vs heterosexual or bisexual: AOR = 0.6; 95% CI: 0.4-0.9) were associated with lower cohort retention. The overall HIV incidence during 12 months of follow-up was 6.6 per 100 person-years (95% CI: 3.4-9.8/100 PY). The prevalence of syphilis at baseline was 6.5% (95% CI: 4.4%-8.6%), and disclosing sexual orientation (AOR = 0.4, 95% CI: 0.2-0.9) was associated with lower risk of syphilis infection.HIV is spreading rapidly among MSM in the second-line Chinese city. Effective interventions are needed to target this population in both first-line megacities and second-line large and middle-size cities.


Assuntos
Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Cidades/epidemiologia , Estudos de Coortes , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Retenção nos Cuidados , Sífilis/epidemiologia , Adulto Jovem
14.
Nonlinear Dynamics Psychol Life Sci ; 23(4): 491-515, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31586499

RESUMO

The number of people living with HIV (PLWH) increases rapidly with advancement in antiretroviral therapy. Suicide prevention is challenging, particularly for PLWH because of the negative impact of HIV-related stigma and social capital reduction. However, only a small proportion of the variance in suicide risk can be explained by these variables if a linear paradigm is used as guidance. In this study, we tested a nonlinear cusp catastrophe modeling. Participants (N = 523) were PLWH selected through a risk venue-based method in Wuhan, a provincial capital city in China. Suicidal ideation post HIV+ diagnosis and in the past 30 days and suicide plan and attempt were assessed. Data were collected using self-report questionnaire and were analyzed using both the direct and multivariate stochastic cusp catastrophe modeling methods with social capital as asymmetry variable and HIV-related stigma as bifurcation variable. The analysis was executed using R, including nls() function for the direct method and 'cusp' package for the stochastic modeling. Results from stochastic cusp modeling analysis indicated that social capital was significantly associated with risk of suicide after controlling for key covariates; the association was significantly bifurcated by HIV-related stigma. The data fit the cusp model better than the alternative linear model (R2 =.483 vs. .127). Findings of this study indicate suicide behaviors among Chinese PLWH follow a nonlinear dynamic system. In addition to enhancing our understanding of suicide risk, findings of this study underscore the significance in social capital enhancement and stigma reduction for suicide prevention among PLWH in China.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Estigma Social , Suicídio/psicologia , Suicídio/estatística & dados numéricos , China/epidemiologia , Humanos , Ideação Suicida
15.
AIDS Behav ; 23(9): 2514-2521, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31520239

RESUMO

To inform the development of interventions to increase uptake and adherence to antiretroviral therapy (ART), we explored perceptions of ART in semi-structured interviews with 52 men and women from UK black African and black Caribbean communities. Verbatim transcripts were analyzed using framework analysis. Perceptions of ART could be grouped into two categories: doubts about the personal necessity for ART and concerns about potential adverse effects. Doubts about necessity stemmed from feeling well, doubts about the efficacy of ART, religious beliefs and the belief that treatment was futile because it could not cure HIV. Concerns about adverse effects included the fear that attending HIV services and taking treatment would lead to disclosure of HIV, feeling overwhelmed at the prospect of starting treatment soon after diagnosis, fears about side effects and potential long-term effects, and physical repulsion. The findings will facilitate the development of interventions to increase uptake and adherence to ART.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Medo , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/psicologia , Adulto , África ao Sul do Saara/etnologia , Grupo com Ancestrais do Continente Africano/etnologia , Região do Caribe/etnologia , Estudos Transversais , Revelação , Feminino , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Masculino , Adesão à Medicação/etnologia , Pessoa de Meia-Idade , Percepção , Pesquisa Qualitativa , Religião , Estigma Social , Reino Unido/epidemiologia
16.
Georgian Med News ; (292-293): 32-38, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31560659

RESUMO

The diseases of social significance are one of the biggest threats of people's health and well-being all over the world and a great burden for the healthcare system and community in general. It is widely known that the consequences of most of such diseases include temporary or permanent loss of working ability and continuous significant investments of money in the prediction, curing, and rehabilitation measures. The increase in the number of individuals with deviant behavior, especially among teenagers and young people, social disadaptation, migration of people, insufficient government funding for healthcare and social sphere concerning prevention of diseases of social significance and diseases linked with social status - all these factors create the background for the further complication of the STIs epidemic situation in Ukraine. It is scientifically proven that raising the quality of help given people with STIs and increasing its accessibility for different social strata, particularly for the representatives of the target groups, is an effective method for decreasing the rate of parenteral hepatitis and HIV infections in society. The aim of the current research is to assess the quality of the specialized help given patients with STIs (on the example of HIV-infected persons) in order to implement the integrated system of medical and social rehabilitation considering the features of the target group. The survey was conducted on the basis of designed questionnaires which included questions regarding the level of education, social status, necessity and frequency of appeals for medical help, particularly for dermatovenereological help, the affordability and comprehensiveness of the latter, the level of satisfaction with the received medical care, the respondent's assessment of quality and modernity of medical equipment. 389 questionaries' served as material for the research. Each questionnaire was composed of 15 questions. The respondents included 201 males and 188 females diagnosed with HIV-infection, who permanently live in Odessa region. Methods of research: analytical, descriptive, and statistical. The majority of HIV-infected respondents received incomplete secondary, complete secondary or vocational secondary education, 10,28% of them (40 respondents) received incomplete or complete higher education, which characterized the cohort of respondents as people with low level of education, social and sexual awareness. 24,16% of respondents (94 persons) were permanently employed; the others - were unemployed due to different reasons, and, consequently, had low social security level. More than half of respondents (220 individuals - 56,56%) were dissatisfied by the quality of dermatovenereological medical help due to the lack of medical equipment. Only 76 respondents (19,54%) were completely satisfied and positively characterized the latter. The necessity of the establishment of the specialized center of dermatovenereological help for HIV-infected patients was pointed out by 226 respondents (58,10%). The vast majority of HIV-infected respondents (80,98%) expresses quite strong opinion regarding the necessity of the establishment of multiprofile health care institution, which would provide the whole spectrum of medical services, taking into consideration the specific features of HIV-infected patients.


Assuntos
Prestação Integrada de Cuidados de Saúde , Infecções por HIV/psicologia , Doenças Sexualmente Transmissíveis/psicologia , Adolescente , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Comportamento Sexual , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/tratamento farmacológico , Inquéritos e Questionários , Ucrânia , Adulto Jovem
17.
Medicine (Baltimore) ; 98(37): e17174, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517872

RESUMO

HIV-positive individuals encounter a number of negative life events (NLEs). This cross-sectional study aimed to evaluate the association between NLEs and major depressive disorder (MDD) among HIV-positive individuals in Guangdong, China, about which little is known.HIV-positive individuals were recruited from the Centers for Disease Prevention and Control of Guangzhou, Zhongshan, and Yangjiang from September 2007 to September 2008. Data on NLEs were collected using a questionnaire. The Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition (SCID-I/P) based on the DSM-IV criteria was used to diagnose MDD. Multiple logistic regression analyses were conducted to evaluate the association between NLEs and MDD.Among the 339 participants, 306 (90.27%) reported that one or more NLEs had ever occurred. Participants who reported NLEs that included HIV infection, financial problems, AIDS diagnosis, HIV/AIDS discrimination, conflict with spouse or lover, conflict with other family members, problems in childbearing, and conflict with nonfamily were at a higher risk of MDD. Participants who reported more NLEs in the last year had a higher risk of MDD (OR = 2.86, 95%CI: 1.76-4.65) than individuals who reported fewer NLEs. Individuals with higher chronic stress scores had a higher risk of MDD (OR = 4.36, 95%CI: 2.44-7.78) than individuals with lower chronic stress scores. However, acute stress was not associated with MDD.NLEs were common among HIV-positive individuals. MDD was associated with a greater number of NLEs and the increased chronic stress caused by the NLEs. Interventions should be tailored to those who reported NLEs to help reduce the risk of MDD and increase the quality of life among HIV-positive individuals.


Assuntos
Transtorno Depressivo Maior/complicações , Infecções por HIV/complicações , Infecções por HIV/psicologia , Adolescente , Adulto , China , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estresse Psicológico/complicações , Estresse Psicológico/epidemiologia , Adulto Jovem
18.
BMC Public Health ; 19(1): 1254, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510974

RESUMO

BACKGROUND: The World Health Organisation (WHO) advocates early initiation of HIV treatment as a prevention strategy among people living with HIV. There is strong evidence for the effectiveness of antiretroviral therapy (ART) as a preventive tool for HIV transmission. We aimed to determine the sexual behaviour of HIV outpatients and assess if it reflects the current preventive strategy for HIV transmission. METHODS: We conducted a cross-sectional study among adult (aged at least 18 years) patients with confirmed HIV diagnosis, and aware of their diagnosis, attending HIV outpatient care in Kenya. Data were gathered through self-report (using validated questionnaires) and file extraction. Multivariate logistic regression assessed the association between sexual risk taking behaviour controlling for gender, HIV clinical stage, HIV treatment status, Tuberculosis (TB) treatment status, and CD4 count. RESULTS: We recruited n = 400 participants (n = 280[70%] female gender). The mean age was 39.4 (SD = 9.9) years. The mean CD4 count was 393.7 (SD = 238.2) and ranged from 2 to 1470 cells/mm3. N = 61 (15.64%) were on TB treatment. The majority (n = 366, 91.5%) were on ART. Just over half (n = 202, 50.5%) reported having a sexual partner. Of these n = 33 (16.1%) reported having unprotected sexual intercourse with a person of unknown HIV status in the previous 3 months. Multivariate analysis showed that participants not on ART (HIV treatment) were more likely to report unprotected sexual intercourse compared to those who were on ART (odds ratio .25, 95% CI .09 to .69; P = 0.007). Participants at early stage of HIV infection (stages 1/2) were more likely to report unprotected sexual intercourse compared to participants at advanced HIV infection (stages 3/4) (odds ratio .34, 95% CI .13 to .92; P = 0.035). Males participants were more likely to be involved in sexual risk taking behaviours compared to female participants (odds ratio .36, 95% CI .16 to .82; P = 0.015). TB treatment status, and CD4 count were not significantly associated with sexual risk taking. CONCLUSION: Participants not on ART have more unprotected sexual intercourse than those who are on ART. This calls for the need to scale up coverage and early ART initiation in order to reduce transmission of HIV.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Comportamento Sexual/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Quênia , Masculino , Razão de Chances , Autorrelato , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Sexo sem Proteção , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-31547374

RESUMO

Cigarette pack graphic warning labels (GWLs) are associated with increased knowledge of tobacco-related harms; scant research has evaluated their effects on behavior among vulnerable populations. We used a behavioral economic approach to measure the effects of GWLs and price on hypothetical cigarette purchasing behavior among HIV-positive smokers. Participants (n = 222) completed a cigarette valuation task by making hypothetical choices between GWL cigarette packs at a fixed price ($7.00) and text-only warning label cigarette packs at increasing prices ($3.50 to $14.00; $0.25 increments). More than one-quarter (28.8%) of participants paid more to avoid GWLs. The remaining participants' purchasing decisions appear to have been driven by price: 69.8% of participants chose the cheaper pack. Across all participants, overall monetary choice value observed for GWL cigarette packs (mean = $7.75) was greater than if choice was driven exclusively by price ($7.00). Most (87.4%) preferred the text-only warning label when GWL and text-only cigarette packs were equally priced. Correlation analysis indicated GWL pack preference was associated with agreement with statements that GWLs would stop individuals from having a cigarette or facilitate thoughts about quitting. These data suggest that GWLs may influence some HIV-positive smokers in such a way that they are willing to pay more to avoid seeing GWLs.


Assuntos
Infecções por HIV/psicologia , Rotulagem de Produtos/estatística & dados numéricos , Fumantes/psicologia , Produtos do Tabaco/economia , Populações Vulneráveis/estatística & dados numéricos , Adulto , Comportamento do Consumidor/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Mensagem de Texto/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Estados Unidos , Populações Vulneráveis/psicologia , Adulto Jovem
20.
Braz J Infect Dis ; 23(5): 313-321, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31491370

RESUMO

BACKGROUND: The 36-Item Short Form Health Survey questionnaire (SF-36) is a widely used instrument for evaluating health-related quality-of-life (HRQoL). The psychometric validation of the SF-36 version 2.0 (SF-36v2) in HIV-infected patients had not yet conducted in Brazil. AIM: To test data quality, reliability and validity of the SF-36v2 as a measure of HRQoL among Brazilian individuals living with HIV. METHODS: A cross-sectional study included 393 HIV-infected patients in whom HRQoL was assessed by using the SF-36v2 questionnaire. Demographic characteristics, socioeconomic status and clinical data were also collected. The SF-36 version 1 translated into Brazilian-Portuguese was adapted and introduced version 2 improvements according to the instrument developers. SPSS version 21 was used for data analyses. Confirmatory factor analysis (CFA) and structural equation modelling were performed using AMOS SPSS version 18. T-test for independent samples was used to compare differences between mean levels of HRQoL components in different groups. Linear multiple regression techniques were used to analyze the relationship between Physical Component Summary (PCS), Mental Component Summary (MCS) and independent variables. RESULTS: We performed the CFA and tested the hypothetical measurement model. We included five parameters to improve the adherence of data to the model. All indicators met the requirement suggested by specialized literature (χ2 (gl): 980.7 (527); CFI: 0.949; GFI: 0.873; TLI: 0.943; RMSEA: 0.047; 90% IC: 0.042-0.051). Multiple regression analyses revealed that depression (p=0.001), family income (p=0.007), sex (p=0.001) and age (p<0.021) were associated with MCS. Comorbidities (p=0.001), health self-perception (p=0.001), age (p=0.001), and sex (p=0.025) were associated with PCS. CONCLUSIONS: A consistent validation of the SF-36v2 in Brazilian HIV patients were shown. Further studies with SF-36v2 psychometric analyses would be required in other populations to establish Brazilian normative data.


Assuntos
Infecções por HIV/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários , Adulto , Brasil , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Fatores Socioeconômicos , Tradução
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