Intimate Partner Violence, Partner Risk, and Depression as a Predictor for PrEP Uptake Among African-American Women in the United States.

African-Americans bear a disproportionate burden of HIV infections in the United States and African-American women make up 64% of new HIV infections. Therefore, this study aimed to explore the predictors of those who are more likely to use Pre-Exposure Prophylaxis (PrEP) among women reporting IPV, depression, and partner risk. This study used secondary data analysis to explore IPV, depression, and increased partner risk as predictors of PrEP use among 768 women (506 African-American women and 262 White women in the United States) who responded to survey questions regarding potential PrEP use and barriers to uptake. The parent data had been collected at Emory University Rollins School of Public Health. Results of the data analysis of the sample (N = 768) indicated that women who reported high levels of partner risk (p < 0.05), depression (p < 0.01), and/or experienced IPV (p < 0.01), were more likely to use PrEP. In addition, younger women aged 20-35 were more likely to use PrEP, compared to women older than 36 years. Furthermore, college educated African-American women were more likely to use PrEP than White women. Despite limitations, findings indicated that IPV, depression, and partner risk are predictors of PrEP use. There is need for a multi-modal approach in addressing these predictors of PrEP use among African-American women in the United States.

Barriers to and facilitators of HIV serostatus disclosure to sexual partners among postpartum women living with HIV in South Africa.

BACKGROUND: Disclosure of HIV serostatus to a sexual partner can facilitate partner's support and testing and better treatment outcomes. Studies examining changes in disclosure rates of serostatus from delivery and postpartum periods are scarce. Our study fills this gap by using a follow-up survey of postpartum women with HIV to examine if disclosure prevalence has improved compared to the proportion recorded at childbirth. We further assessed the reasons for non-disclosure and correlates of serostatus disclosure to sexual partners. METHODS: We conducted a cross-sectional analytical study (exit interview) with a final sample of 485 postpartum women with HIV drawn from the East London Prospective Cohort study database between January and May 2018. Disclosure of HIV status to partner was based on self-reporting. We fitted adjusted and unadjusted logistic regression models and also conducted descriptive statistical analyses. Sampling weights were used to correct for sampling errors. RESULTS: Overall, 81.8% of women in the study cohort had disclosed their status to their partners, representing a 7.4 percentage point increase since child delivery. After adjusting for important covariates, women were more likely to disclose their status if they were married [adjusted odds ratio (AOR): 3.10; 95% confidence interval (CI):1.39-6.91] but were less likely to disclose if they used alcohol [AOR: 0.61; 95% CI:0.37-0.99] or had reported adherence to ART [AOR: 0.59; 95% CI:0.36-0.96]. Fear of rejection, stigma or being judged, new or casual relationships, and having a violent partner were the main reasons for not disclosing HIV status to sexual partners. CONCLUSION: We found a relatively higher rate of HIV status disclosure in the cohort compared to the rate recorded at childbirth, suggesting an improvement over time. Also, complicated relationship dynamics and fear of social exclusion still constitute barriers to HIV status disclosure to sexual partners despite patients' counselling.

Examining the Health Belief Model Risk Factors on PrEP Use Among African-American Women Ages 20-44.

Truvada, also referred to as Pre-Exposure Prophylaxis (PrEP), is the first medication approved for the purpose of preventing HIV infection. This study examined the odds of PrEP use solely among African-American women by comparing, by demographic profile, the relationship between risk taking behaviors of the Health Belief Model and the likelihood of PrEP use. A secondary data analysis from the 2013 National Survey on the potential adoption of PrEP was analyzed in this study. The sample for this study was 791 African-American women aged 20-44. The Health Belief Model constructs served as predictor risk factors for PrEP use. Results indicated that younger women of lower socioeconomic status (SES), higher levels of barriers, and higher levels of perceived susceptibility were more willing to take PrEP. This has significant implications for public health practice, policy, and opportunities for further research to establish interventions that incorporate increasing self-efficacy in PrEP use.

Nursing Attitudes Toward Patients With Substance Use Disorders: A Quantitative Analysis of the Impact of an Educational Workshop.

BACKGROUND: Negative healthcare provider attitudes toward patients with substance use disorder (SUD) may adversely impact the quality of care and treatment outcomes. PURPOSE: In this article, we aim to characterize the effects of an 8-hour educational workshop on attitudes toward patients with SUD among nurses from an urban inpatient psychiatric hospital. METHODS: The Drug and Drug Problems Perceptions Questionnaire, a 22-item scale consisting of six subscales, was used to assess nurse attitudes to patients with SUD at pretest (n = 38), posttest (n = 36), and 30-day follow-up (n = 20). Generalized estimating equation models adjusted for gender and years of work experience were used to measure changes in Drug and Drug Problems Perceptions Questionnaire scores. RESULTS: Positive attitudes significantly increased at posttest (ß = -12.09, 95%CI [-16.83, -7.34]; p < .001) and were sustained at 30-day follow-up (ß = 1.71, 95% CI [-3.11, 6.53]; p = .49). Subscales of motivation (ß = -0.26, 95% CI [-0.87, 0.35]; p = .41) and task-specific self-esteem (ß = -0.56, 95% CI [-1.44, 0.32]; p = .21) did not significantly change at posttest. CONCLUSIONS: Our findings show workshop effectiveness in improving nurse attitudes toward patients with SUD. Future research may test similar interventions at a larger scale and with other health professionals.