Perceived Discrimination and Physical Health among HIV-Positive Black and Latino Men who have Sex with Men

Science.gov (United States)

Bogart, Laura M.; Landrine, Hope; Galvan, Frank H.; Wagner, Glenn J.; Klein, David J.

2012-01-01

We conducted the first study to examine health correlates of discrimination due to race/ethnicity, HIV-status, and sexual orientation among 348 HIV-positive Black (n=181) and Latino (n=167) men who have sex with men. Participants completed audio computer-assisted self-interviews. In multivariate analyses, Black participants who experienced greater racial discrimination were less likely to have a high CD4 cell count [OR=0.7, 95%CI=(0.5, 0.9), p=.02], and an undetectable viral load [OR=0.8, 95%CI=(0.6, 1.0), p=.03], and were more likely to visit the emergency department [OR=1.3, 95%CI=(1.0, 1.7), p=.04]; the combined three types of discrimination predicted greater AIDS symptoms [F (3,176)=3.8, pdiscrimination predicted greater medication side effect severity [F (3,163)=4.6, pdiscrimination plays a role in health outcomes. PMID:23297084

The intersection between masculinity and health among rural immigrant Latino men.

Science.gov (United States)

Daniel-Ulloa, Jason; Sun, Christina; Rhodes, Scott D

2017-01-01

Latino men experience health disparities in STI/HIV, diabetes, hypertension, and cancer. Gender roles likely play a role in risk behaviors and outcomes; however, there has been little focus on masculinity in Latino men. We conducted 20 semi-structured interviews with Latino men living in North Carolina. The interviews, conducted by a trained bilingual/bicultural Latino male, prompted discussion around work, family, and stress. Four themes were identified: masculine roles of being a family provider and protector, sources of stress, family responsibility and interconnectedness to health, and coping mechanism. For Latino men, masculinity may have both positive and negative influences on health. For example, the role of family provider may contribute to coping and be a stressor simultaneously. Future research should examine masculinity as a positive and a negative health influence and the additional impacts of gender roles on mens' health.

Correlates of HIV stigma in HIV-positive women.

Science.gov (United States)

Wagner, Anne C; Hart, Trevor A; Mohammed, Saira; Ivanova, Elena; Wong, Joanna; Loutfy, Mona R

2010-06-01

We examined the variables associated with HIV stigma in HIV-positive women currently living in Ontario, Canada. Based on previous literature, we predicted that variables of social marginalization (e.g., ethnicity, income, education), medical variables (e.g., higher CD4 count, lower viral load), and increased psychological distress would be associated with higher perceived HIV stigma among HIV-positive women. One hundred fifty-nine HIV-positive women between the ages of 18 and 52 in Ontario completed self-report measures of the aforementioned variables. Women were recruited through 28 AIDS service organizations, eight HIV clinics, and two community health centers. In multiple regression analyses, for women born in Canada, lower educational level and higher anxiety were associated with higher HIV stigma. For women born outside of Canada, having been judged by a physician in Canada for trying to become pregnant was associated with higher HIV stigma. For HIV-positive women born outside of Canada, negative judgment by a physician regarding intentions to become pregnant should be addressed to reduce perceived HIV stigma and vice versa. Health care providers should be trained in the provision of sensitive and effective health care for women living with HIV, especially when providing reproductive health care.

Psychosocial, behavioral, and cultural predictors of sexual risk for HIV infection among Latino men who have sex with men.

Science.gov (United States)

Jarama, S Lisbeth; Kennamer, J David; Poppen, Paul J; Hendricks, Michael; Bradford, Judith

2005-12-01

This study sought to replicate and extend an investigation by Diaz et al. (1999) on determinants of HIV risk among Latino gay and bisexual men living in San Francisco who were predominantly English-speaking. Compared to the Diaz et al. study, the current study sample consisted of predominantly Spanish-speaking MSM, who resided outside of HIV/AIDS epicenters and whose countries of origin were primarily Central & South American. The relationships of unprotected anal sex and multiple sexual partners with demographic, developmental, behavioral, cultural and psychosocial variables were examined. Data were collected in a convenience sample of 250 participants (primarily immigrants from El Salvador) residing in Virginia. Most men in the sample had more than one sexual partner in the last 3 months (62%) and more than a third had unprotected anal sex with a casual partner in the same time period. Communication about HIV, sexual attraction, machismo, and experiences of discrimination based on homosexual behavior were predictive of HIV risk behaviors. The findings support an integrative approach to investigating HIV risk among Latino MSM. Implications for prevention programs are discussed.

Factors related to sexual practices and successful sexually transmitted infection/HIV intervention programs for Latino adolescents.

Science.gov (United States)

Lee, Young-Me; Dancy, Barbara; Florez, Elizabeth; Holm, Karyn

2013-01-01

The purpose of this integrative literature review was to explore factors that are related to sexual practices among Latino adolescents and identify which of those factors are common across successful sexually transmitted infection (STI)/HIV intervention programs for Latino adolescents. An integrative literature review was conducted. Search terms included Latino, Hispanic, education, intervention/prevention programs, sex, sexuality, reproductive health, health risk behaviors, multiple sex partners, contraception, STI/HIV/AIDS, sexually transmitted diseases, delay in initiation of sexual intercourse, consistent use of birth control, avoidance of STI/HIV infections, unintended pregnancy, cultural factors, and gender roles. Findings revealed from the review of 17 articles addressing factors related to sexual practices among Latino adolescents included familialism, religion, gender roles, level of knowledge/information, and privacy/confidentiality. Five successful STI/HIV intervention programs, that incorporated those factors to effectively reduce risky sexual behaviors were identified. STI/HIV knowledge and gender roles were recognized as common factors integrated into and across successful intervention programs for this population. Only STI/HIV knowledge and gender roles were found as common factors across the five successful STI/HIV intervention programs and should be incorporated into future intervention programs that are culturally and gender specific. Therefore, health care providers need to understand culturally related gender roles and their impact on sexual practices to provide culturally sensitive and appropriate sex education about STIs and HIV for Latino adolescents to increase the program potential for reducing STI/HIV. © 2013 Wiley Periodicals, Inc.

SOMOS: Evaluation of an HIV Prevention Intervention for Latino Gay Men

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Vega, Miriam Y.; Spieldenner, Andrew R.; DeLeon, Dennis; Nieto, Bolivar X.; Stroman, Carolyn A.

2011-01-01

Latino gay men face multiple barriers to human immunodeficiency virus (HIV) prevention, in particular a lack of intervention programs that integrate prevention messages with cultural norms and address issues of social marginalization from multiple communities (gay community and Latino community), homophobia and racism. In order to address these…

Developing a Culturally Appropriate HIV and Hepatitis C Prevention Intervention for Latino Criminal Justice Clients.

Science.gov (United States)

Ibañez, Gladys E; Whitt, Elaine; Rosa, Mario de la; Martin, Steve; O'Connell, Daniel; Castro, Jose

2016-07-01

The population within the criminal justice system suffers from various health disparities including HIV and hepatitis C virus (HCV). African American and Latino offenders represent the majority of the offender population. Evidence-based interventions to prevent HIV and HCV among criminal justice clients are scant and usually do not take cultural differences into account. Toward this end, this study describes the process of culturally adapting an HIV/HCV prevention intervention for Latino criminal justice clients in Miami, Florida, by using the ecological validity model. Recommendations for culturally adapting an intervention for Latinos include an emphasis on language and integrating cultural themes such as familism and machismo. © The Author(s) 2016.

Tu Amigo Pepe: Evaluation of a Multi-media Marketing Campaign that Targets Young Latino Immigrant MSM with HIV Testing Messages.

Science.gov (United States)

Solorio, Rosa; Norton-Shelpuk, Pamela; Forehand, Mark; Montaño, Daniel; Stern, Joshua; Aguirre, Joel; Martinez, Marcos

2016-09-01

Latino immigrant men who have sex with men (MSM) are at risk for HIV and delayed diagnosis in the United States. This paper describes the evaluation of a pilot of the Tu Amigo Pepe, a multimedia HIV testing campaign aimed at Latino MSM in Seattle, WA particularly targeting immigrants who may not identify as gay, ages 18-30 years old. The 16-week campaign included Spanish-language radio public service announcements (PSAs), a Web site, social media outreach, a reminder system using mobile technology, print materials and a toll-free hotline. In developing the PSAs, the Integrated Behavioral Model was used as a framework to reframe negative attitudes, beliefs and norms towards HIV testing with positive ones as well as to promote self-efficacy towards HIV testing. The campaign had a significant and immediate impact on attitudes, beliefs, norms and self-efficacy towards HIV testing as well as on actual behavior, with HIV testing rates increasing over time.

HIV infection and testing among Latino men who have sex with men in the United States: the role of location of birth and other social determinants.

Directory of Open Access Journals (Sweden)

Alexandra M Oster

Full Text Available BACKGROUND: In the United States, Latino men who have sex with men (MSM are disproportionately affected by HIV. Latino MSM are a diverse group who differ culturally based on their countries or regions of birth and their time in the United States. We assessed differences in HIV prevalence and testing among Latino MSM by location of birth, time since arrival, and other social determinants of health. METHODS: For the 2008 National HIV Behavioral Surveillance System, a cross-sectional survey conducted in large US cities, MSM were interviewed and tested for HIV infection. We used generalized estimating equations to test associations between various factors and 1 prevalent HIV infection and 2 being tested for HIV infection in the past 12 months. RESULTS: Among 1734 Latino MSM, HIV prevalence was 19%. In multivariable analysis, increasing age, low income, and gay identity were associated with HIV infection. Moreover, men who were U.S.-born or who arrived ≥5 years ago had significantly higher HIV prevalence than recent immigrants. Among men not reporting a previous positive HIV test, 63% had been tested for HIV infection in the past 12 months; recent testing was most strongly associated with having seen a health care provider and disclosing male-male attraction/sexual behavior to a health care provider. CONCLUSIONS: We identified several social determinants of health associated with HIV infection and testing among Latino MSM. Lower HIV prevalence among recent immigrants contrasts with higher prevalence among established immigrants and suggests a critical window of opportunity for HIV prevention, which should prioritize those with low income, who are at particular risk for HIV infection. Expanding health care utilization and encouraging communication with health care providers about sexual orientation may increase testing.

A Systematic Review of Behavioral Interventions to Reduce Condomless Sex and Increase HIV Testing for Latino MSM.

Science.gov (United States)

Pérez, Ashley; Santamaria, E Karina; Operario, Don

2017-12-15

Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV, and there have been calls to improve availability of culturally sensitive HIV prevention programs for this population. This article provides a systematic review of intervention programs to reduce condomless sex and/or increase HIV testing among Latino MSM. We searched four electronic databases using a systematic review protocol, screened 1777 unique records, and identified ten interventions analyzing data from 2871 Latino MSM. Four studies reported reductions in condomless anal intercourse, and one reported reductions in number of sexual partners. All studies incorporated surface structure cultural features such as bilingual study recruitment, but the incorporation of deep structure cultural features, such as machismo and sexual silence, was lacking. There is a need for rigorously designed interventions that incorporate deep structure cultural features in order to reduce HIV among Latino MSM.

Nursing Care of HIV-Positive Women

DEFF Research Database (Denmark)

Nielsen, Ben; Martinsen, Bente

2015-01-01

to improve quality of life after being diagnosed with HIV, a sharp distinction between HIV and AIDS and a religious and spiritually coping. Identifying the emotional challenges women living with HIV face in their daily lives may help nurses obtain a clearer understanding and greater knowledge of how...... to provide HIV-positive women with effective care that empower and support these women in managing their chronic disease. However to ensure that nurses have the proper tools for effective care for women living with HIV European studies are essentials in relation to what emotional challenges these women...

Stigma, activism, and well-being among people living with HIV.

Science.gov (United States)

Earnshaw, Valerie A; Rosenthal, Lisa; Lang, Shawn M

2016-01-01

Evidence demonstrates that HIV stigma undermines the psychological and physical health of people living with HIV (PLWH). Yet, PLWH describe engaging in HIV activism to challenge stigma, and research suggests that individuals may benefit from activism. We examine associations between experiences of HIV stigma and HIV activism, and test whether HIV activists benefit from greater well-being than non-activists. Participants include 93 PLWH recruited from drop-in centers, housing programs, and other organizations providing services to PLWH in the Northeastern USA between 2012 and 2013 (mean age = 50 years; 56% Black, 20% White, 18% Other; 61% non-Latino(a), 39% Latino(a); 59% male, 38% female, 3% transgender; 82% heterosexual, 15% sexual minority). Participants completed a cross-sectional written survey. Results of regression analyses suggest that PLWH who experienced greater enacted stigma engaged in greater HIV activism. Anticipated, internalized, and perceived public stigma, however, were unrelated to HIV activism. Moreover, results of a multivariate analysis of variance suggest that HIV activists reported greater social network integration, greater social well-being, greater engagement in active coping with discrimination, and greater meaning in life than non-activists. Yet, HIV activists also reported somewhat greater depressive symptoms than non-activists, suggesting that the association between HIV activism and well-being is complex. By differentiating between HIV stigma mechanisms, the current study provides a more nuanced understanding of which experiences of HIV stigma may be associated with HIV activism. It further suggests that engagement in activism may offer benefits to PLWH, while raising the possibility that activists could experience greater depressive symptoms than non-activists. Given the preliminary nature of this study, future research should continue to examine these complex associations between HIV stigma, activism, and well-being among PLWH

Men's serostatus disclosure to parents: associations among social support, ethnicity, and disease status in men living with HIV.

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Fekete, Erin M; Antoni, Michael H; Lopez, Corina R; Durán, Ron E; Penedo, Frank J; Bandiera, Frank C; Fletcher, Mary Ann; Klimas, Nancy; Kumar, Mahendra; Schneiderman, Neil

2009-07-01

Directly disclosing a positive HIV serostatus to family members can affect psychological and disease status. Perceptions that one is in a supportive family environment may moderate these effects; however, ethnic differences may exist in the support processes of families coping with HIV. We examined the role of serostatus disclosure to parents, HIV-specific family support, and ethnicity (Latino versus non-Hispanic White) in explaining disease status (HIV Viral Load, CD4+ cell count) in a sample of men living with HIV (MLWH). Men (n=120) reported whether they had disclosed their serostatus to their mothers and fathers, rated their perceptions of HIV-specific social support received from family members, and provided morning peripheral venous blood samples to assess immune function. We also collected psychosocial and urinary neuroendocrine indicators of stress/distress as possible mediator variables. A three-way interaction emerged between serostatus disclosure to mothers, HIV-specific family support, and ethnicity in explaining both viral load and CD4+ cell count. Non-Hispanic White men who had disclosed to mothers and were receiving high family support had a lower viral load and higher CD4+ cell count, but Latino men who had disclosed to mothers and were receiving low family support had a higher viral load. These associations were not accounted for by men's medication adherence, psychological distress, or neuroendocrine hormones. Disclosure to fathers was not related to disease status. The effects of serostatus disclosure on disease status may depend, in part, on ethnic differences in the interpersonal processes of men's close family relationships.

AIDS-related stigma and social interaction: Puerto Ricans living with HIV/AIDS.

Science.gov (United States)

Varas-Díaz, Nelson; Serrano-García, Irma; Toro-Alfonso, José

2005-02-01

People living with HIV/AIDS are stigmatized. Although personal and social consequences of this stigmatization have been documented, research regarding its impact on social interactions is scarce. Latinos, and Puerto Ricans in particular, have voiced concern regarding AIDS stigma. The authors investigated the key role of social interaction in the process of stigmatization through in-depth, semistructured interviews in a sample of 30 Puerto Ricans living with HIV/AIDS. Participants reported instances in which AIDS stigma negatively influenced social interactions with family, friends, sexual partners, coworkers, and health professionals. Some of the consequences they described were loss of social support, persecution, isolation, job loss, and problems accessing health services. Findings support the need for interventions to address AIDS stigma and its consequences.

"Where It Falls Apart": Barriers to Retention in HIV Care in Latino Immigrants and Migrants.

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Levison, Julie H; Bogart, Laura M; Khan, Iman F; Mejia, Dianna; Amaro, Hortensia; Alegría, Margarita; Safren, Steven

2017-09-01

Latino immigrants in the United States are disproportionately affected by HIV. Barriers to consistent attendance (retention) in HIV primary care constrain opportunities for HIV treatment success, but have not been specifically assessed in this population. We conducted semistructured interviews with 37 HIV-infected Latinos (aged ≥18 years and born in Puerto Rico or a Latin American Spanish-speaking country) and 14 HIV providers in metropolitan Boston (total n = 51). The Andersen Model of Healthcare Utilization informed a semistructured interview guide, which bilingual research staff used to explore barriers to HIV care. We used thematic analysis to explore the processes of retention in care. Six ubiquitous themes were perceived to influence HIV clinic attendance: (1) stigma as a barrier to HIV serostatus disclosure; (2) social support as a safety net during negative life circumstances; (3) unaddressed trauma and substance use leading to interruption in care; (4) a trusting relationship between patient and provider motivating HIV clinic attendance; (5) basic unmet needs competing with the perceived value of HIV care; and (6) religion providing a source of hope and optimism. Cultural subthemes were the centrality of family (familismo), masculinity (machismo), and trusting relationships (confianza). The timing of barriers was acute (e.g., eviction) and chronic (e.g., family conflict). These co-occurring and dynamic constellation of factors affected HIV primary care attendance over time. HIV-infected Latino immigrants and migrants experienced significant challenges that led to interruptions in HIV care. Anticipatory guidance to prepare for these setbacks may improve retention in HIV care in this population.

Foreign-Born Latinos Living in Rural Areas are more likely to Experience Health Care Discrimination: Results from Proyecto de Salud para Latinos.

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López-Cevallos, Daniel F; Harvey, S Marie

2016-08-01

Health care discrimination is increasingly considered a significant barrier to accessing health services among minority populations, including Latinos. However, little is known about the role of immigration status. The purpose of this study was to examine the association between immigration status and perceived health care discrimination among Latinos living in rural areas. Interviews were conducted among 349 young-adult Latinos (ages 18 to 25) living in rural Oregon, as part of Proyecto de Salud para Latinos. Over a third of participants experienced health care discrimination (39.5 %). Discrimination was higher among foreign-born (44.9 %) rather than US-born Latinos (31.9 %). Multivariate results showed that foreign-born Latinos were significantly more likely to experience health care discrimination, even after controlling for other relevant factors (OR = 2.10, 95 % CI 1.16-3.82). This study provides evidence that health care discrimination is prevalent among young-adult Latinos living in rural areas, particularly the foreign-born. Effective approaches towards reducing discrimination in health care settings should take into consideration the need to reform our broken immigration system.

Reducing cultural and psychological barriers to Latino enrollment in HIV-prevention counseling: initial data on an enrollment meta-intervention.

Science.gov (United States)

Wilson, Kristina; Durantini, Marta R; Albarracín, Julia; Crause, Candi; Albarracín, Dolores

2013-01-01

Aspects of Latino culture (e.g., machismo, marianism) can act as barriers to enrollment in HIV-prevention programs. To lift these barriers, a culturally appropriate meta-intervention was designed to increase intentions to enroll in HIV-prevention counseling by Latinos. Latino participants (N=41) were recruited from the community and randomly assigned to either an experimental or control meta-intervention condition that varied the introduction to a HIV-prevention counseling program. Following the meta-intervention, participants were issued an invitation to take part in HIV-prevention counseling. The outcome measure was the intention to enroll in a HIV-prevention counseling session. Findings indicated that enrollment intentions were higher in the experimental meta-intervention condition (96%) than in the control meta-intervention condition (53%). In addition, the effects of the meta-intervention were comparable across genders and participant ages. Findings suggest that the use of a culturally appropriate meta-intervention may be an effective strategy for increasing Latino enrollment in HIV-prevention programs. These promising findings warrant further investigation into the efficacy and effectiveness of this meta-intervention.

HIV disclosure and stigma among women living with HIV in Denmark

DEFF Research Database (Denmark)

Wessman, Maria; Thorsteinsson, Kristina; Storgaard, Merete

2017-01-01

OBJECTIVE: To identify disclosure, stigma and predictors of non-disclosure among women living with HIV in Denmark. METHODS: A questionnaire study of women living with HIV in Denmark was performed. The enrolment period was from February 2013 to March 2014. Logistic regression was used to estimate......%), friends (63%) and children (41%). The primary reason for non-disclosure was a feeling that it did not concern others (55%), although reactions upon disclosure were mainly positive in 53%. Predictors of non-disclosure were being of black or Asian ethnicity. Following their HIV diagnosis, 40% no longer...... diagnosis to fewer than three people and black or Asian ethnicity predicted non-disclosure. HIV-related stigma regarding sex and contact with others is still highly prevalent; however, reactions to disclosure were mainly positive and associated with secondary positive gains. We strongly urge healthcare...

Self-Identified Sexual Orientation and Sexual Risk Behavior Among HIV-Infected Latino Males.

Science.gov (United States)

Champion, Jane Dimmitt; Szlachta, Alaina

2016-01-01

The HIV testing, disclosure, and sexual practices of ethnic minority men suggest that addressing sexual risk behavior and the underlying reasons for not receiving HIV testing or disclosing HIV-infection status-unique to differing populations-would improve public health interventions. Descriptive behaviors and underlying perspectives reported in our study suggest that public health interventions for HIV-infected Latino men who self-identify as heterosexual should explicitly identify substance use, needle sharing, and unprotected sex to current partners as behaviors placing both oneself and one's partners at high risk for contracting HIV. However, diversity of sexual behavior among gay, straight, and bisexual HIV-infected Latino men in our study ultimately suggested that clinicians should not rely on simplistic conceptions of sexuality in assessment of self-care needs. Care in presentation and discussion of self-identified sexual preference and sexual behavior is indicated, as these do not determine actual sexual orientation or behavior and vice versa. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

"You've Got to Love Yourself": Photovoice Stories From African Americans and Hispanic/Latinos Living With Diabetes.

Science.gov (United States)

Peña-Purcell, Ninfa C; Cutchen, Lauren; McCoy, Traechel

2018-05-01

Health disparities persist among African Americans (AAs) and Latino adults with type 2 diabetes. The purpose of this research was to use PhotoVoice to examine AAs and Latinos' daily experiences of managing diabetes. An exploratory, descriptive study using PhotoVoice and focus groups was conducted over a 3-week period: Week 1 orientation session, Week 2 photo taking and returning cameras, and Week 3 focus group to share and discuss photos. Ten AAs and nine Latino adults were enrolled, forming four focus groups. Four categories emerged: (1) daily life living with type 2 diabetes mellitus, (2) negative and positive emotions, (3) supports and barriers, and (4) needs. The social determinants of health influencing diabetes self-care were observed in discussions and photos-this included the built environment to promote a healthy lifestyle, social support, and education. PhotoVoice promotes culturally congruent care to better understand AA and Latinos' experience living with type 2 diabetes mellitus.

Using syndemic theory to understand vulnerability to HIV infection among Black and Latino men in New York City.

Science.gov (United States)

Wilson, Patrick A; Nanin, Jose; Amesty, Silvia; Wallace, Scyatta; Cherenack, Emily M; Fullilove, Robert

2014-10-01

HIV is a public health crisis that disproportionately affects Black and Latino men. To understand this crisis, syndemic theory, which takes into account multiple interrelated epidemics, should be used. A syndemic is "two or more afflictions, interacting synergistically, contributing to excess burden of disease in a population." Vulnerability to HIV among Black and Latino men is increased as structural, social, and biological factors interact in the context of social marginalization. In New York City, Black and Latino men experience a syndemic of HIV/AIDS, substance abuse, trauma, incarceration, and poverty; however, current research has yet to fully identify the mechanisms of resilience that may reduce the negative impact of a syndemic or explore the potential adaptive functions of individual-level risk behaviors. To understand HIV risk as part of a syndemic and address HIV prevention in Black and Latino men, we propose the following: (1) the use of complex systems analysis, ethnography, and other mixed-methods approaches to observe changes in relations among social conditions and disease; (2) multidisciplinary and inter-institution collaboration; and (3) involvement of public health practitioners and researchers from diverse and underrepresented backgrounds.

Social networks, migration, and HIV testing among Latinos in a new immigrant destination: Insights from a qualitative study.

Science.gov (United States)

Barrington, Clare; Gandhi, Anisha; Gill, Adrienne; Villa Torres, Laura; Brietzke, Maria Priscila; Hightow-Weidman, Lisa

2017-12-03

Latinos in the U.S. are disproportionately affected by HIV and are more likely than non-Latinos to present with a late diagnosis, which delays engagement in HIV care and treatment. Social networks may provide normative influence and social support for HIV testing, but a contextualised understanding of networks is needed in order to maximise these social resources. We conducted qualitative interviews with foreign-born Latino men and transgender women (n = 17) in a new immigrant destination to explore their social networks. Most participants described having smaller social networks after migrating. Networks included both local and transnational ties, but most participants had few close ties. Contextual factors including stigma and geographic dispersion limited the re-construction of networks with close ties after migration. HIV testing was not a common topic of discussion with social network ties. Efforts to improve early uptake of HIV testing among Latino immigrants may benefit from engaging with social networks, but such efforts need to address how the context in which networks operate enables access to testing.

Can additive measures add to an intersectional understanding? Experiences of gay and ethnic discrimination among HIV-positive Latino gay men.

Science.gov (United States)

Reisen, Carol A; Brooks, Kelly D; Zea, Maria Cecilia; Poppen, Paul J; Bianchi, Fernanda T

2013-04-01

The current study investigated a methodological question of whether traditional, additive, quantitative data can be used to address intersectional issues, and illustrated such an approach with a sample of 301 HIV-positive, Latino gay men in the United States. Participants were surveyed using A-CASI. Hierarchical logistic set regression investigated the role of sets of variables reflecting demographic characteristics, gender nonconformity, and gay and ethnic discrimination in relation to depression and gay collective identity. Results showed the discrimination set was related to depression and to gay collective identity, as was gender nonconformity. Follow-up logistic regression showed that both types of discrimination were associated with greater depression, but gender nonconformity was not. Gay discrimination and gender nonconformity were positively associated with gay collective identity, whereas ethnic discrimination was negatively associated. Results are discussed in terms of the use of traditional quantitative data as a potential means of understanding intersectional issues, as well as of contributing to knowledge about individuals facing multiple structural inequalities.

National Latino AIDS Awareness Day

Centers for Disease Control (CDC) Podcasts

2014-10-08

This podcast highlights National Latino AIDS Awareness Day, to increase awareness of the disproportionate impact of HIV on the Hispanic or Latino population in the United States and dependent territories. The podcast reminds Hispanics or Latinos that they have the power to take control of their health and protect themselves against HIV.  Created: 10/8/2014 by Office of Health Equity, Office of the Director, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention.   Date Released: 10/14/2014.

Incidental lung cancers and positive computed tomography images in people living with HIV

DEFF Research Database (Denmark)

Ronit, Andreas; Kristensen, Thomas; Klitbo, Ditte M.

2017-01-01

in 901 patients, including 113 at high risk for lung cancer. A positive image was found in 28 (3.1% of the entire cohort and 9.7% of the high-risk group). Nine patients (all in the high-risk group) had invasive procedures undertaken with no serious adverse events. Lung cancer (stages IA, IIA, and IIIA......Objective: Lung cancer screening with low-dose computed tomography (LDCT) of high-risk groups in the general population is recommended by several authorities. This may not be feasible in people living with HIV (PLWHIV) due to higher prevalence of nodules. We therefore assessed the prevalence...... of positive computed tomography (CT) images and lung cancers in PLWHIV. Design: The Copenhagen comorbidity in HIV infection (COCOMO) study is an observational, longitudinal cohort study. Single-round LDCT was performed with subsequent clinical follow-up (NCT02382822). Method: Outcomes included histology...

Sexual behavior and risk practices of HIV positive and HIV negative Rwandan women

Science.gov (United States)

ADEDIMEJI, Adebola A.; HOOVER, Donald R.; SHI, Qiuhu; GARD, Tracy; MUTIMURA, Eugene; SINAYOBYE, Jean d’Amour; COHEN, Mardge H.; ANASTOS, Kathryn

2014-01-01

It is not well understood how infection with HIV and prior experience of sexual violence affects sexual behavior in African women. We describe factors influencing current sexual practices of Rwandan women living with or without HIV/AIDS. By design, 75% of participants were HIV positive and ~50% reported having experienced genocidal rape. Univariate and multivariate logistic regression models were fit to describe demographic and clinical characteristics that influenced sexual behavior in the previous 6 months, condom use, history of transactional sex, and prior infection with a non-HIV sexually transmitted disease. Respondents’ age, where they lived, whether or not they lived with a husband or partner, experience of sexual trauma, CD4 count, CES-D and PTSD scores were strongly associated with risky sexual behavior and infection with non-HIV STI. HIV positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to some high-risk sexual behaviors. PMID:25488169

The Latino Migrant Worker HIV Prevention Program: building a community partnership through a community health worker training program.

Science.gov (United States)

Sánchez, Jesús; Silva-Suarez, Georgina; Serna, Claudia A; De La Rosa, Mario

2012-01-01

There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article describes the Latino Migrant Worker HIV Prevention Program and its efforts to train and engage community health workers in the prevention of HIV among LMWs in South Florida.

Contraceptive options for women living with HIV.

Science.gov (United States)

Phillips, Sharon; Steyn, Petrus; Temmerman, Marleen

2014-08-01

Women living with HIV are often of reproductive age, and many desire effective contraceptive options to delay or prevent pregnancy. We review the safety of various hormonal and non-hormonal contraceptive methods for women living with human immunodeficiency virus (HIV). Additionally, we discuss drug interactions between contraceptive methods and antiretrovirals and the safety of methods with respect to onward transmission to HIV-negative partners for women in sero-discordant partnerships. In general, most methods are safe for most women living with HIV. An understanding of the reproductive goals of each individual patient, as well as her medical condition and medication, should be taken into account when counselling women on their contraceptive options. Further research is needed to understand drug interactions between contraceptives and antiretrovirals better and how to fulfil the contraceptive needs of HIV-positive women. Copyright © 2014. Published by Elsevier Ltd.

National Latino AIDS Awareness Day

Centers for Disease Control (CDC) Podcasts

This podcast highlights National Latino AIDS Awareness Day, to increase awareness of the disproportionate impact of HIV on the Hispanic or Latino population in the United States and dependent territories. The podcast reminds Hispanics or Latinos that they have the power to take control of their health and protect themselves against HIV.

HIV/AIDS stigma among a sample of primarily African-American and Latino men who have sex with men social media users.

Science.gov (United States)

Garett, Renee; Smith, Justin; Chiu, Jason; Young, Sean D

2016-01-01

The recent increase in social media use allows these technologies to rapidly reach communities with higher HIV prevalence, such as African-American and Latino men who have sex with men (MSM). However, no studies have looked at HIV/AIDS stigma among social media users from African-American and Latino MSM communities, or the association between stigma and social media use among these groups. This study sought to assess the level of HIV/AIDS stigma among a sample of social media-using African-American and Latino MSM from Los Angeles. A total of 112 (primarily African-American and Latino, n = 98, 88%) MSM Facebook users completed a survey on demographics, online social network use, and HIV/AIDS stigma. A composite stigma score was created by taking the cumulative score from a 15-item stigma questionnaire. Cumulative logistic models were used to assess the association between HIV/AIDS stigma and online social network use. In general, participants reported a low level of HIV/AIDS stigma (mean = 22.2/75, SD = 5.74). HIV/AIDS stigma composite score was significantly associated with increased time spent on online social networks each day (Adjusted odds ratios (AOR): 1.07, 95% CI: 1.00, 1.15). Among this diverse sample of MSM online social network users, findings suggest that HIV/AIDS stigma is associated with usage of social media. We discuss the implications of this work for future HIV prevention.

Living with HIV

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Hombres Sanos: exposure and response to a social marketing HIV prevention campaign targeting heterosexually identified Latino men who have sex with men and women.

Science.gov (United States)

Martínez-Donate, Ana P; Zellner, Jennifer A; Fernández-Cerdeño, Araceli; Sañudo, Fernando; Hovell, Melbourne F; Sipan, Carol L; Engelberg, Moshe; Ji, Ming

2009-10-01

This study examined the reach and impact of a social marketing intervention to reduce HIV risk among heterosexually identified (HI) Latino men who have sex with men and women (MSMW). Repeated cross-sectional intercept surveys were conducted in selected community venues during and after the campaign with 1,137 HI Latino men. Of them, 6% were classified as HI Latino MSMW. On average, 85.9% of the heterosexual respondents and 86.8% of the HI MSMW subsample reported exposure to the campaign. Responses to the campaign included having made an appointment for a male health exam that included HIV testing and using condoms. Campaign exposure was significantly associated with HIV testing behavior and intentions and with knowledge of where to get tested. The campaign reached its underserved target audience and stimulated preventive behaviors. Social marketing represents a promising approach for HIV prevention among HI Latinos, in general, and HI Latino MSMW, in particular.

Cell phone utilization among foreign-born Latinos: a promising tool for dissemination of health and HIV information.

Science.gov (United States)

Leite, Lorena; Buresh, Megan; Rios, Naomi; Conley, Anna; Flys, Tamara; Page, Kathleen R

2014-08-01

Latinos in the US are disproportionately affected by HIV and are at risk for late presentation to care. Between June 2011 and January 2012, we conducted a cross-sectional survey of 209 Baltimore Latinos at community-based venues to evaluate the feasibility of using information communication technology-based interventions to improve access to HIV testing and education within the Spanish-speaking community in Baltimore. Participants had a median age of 33 years interquartile range (IQR) (IQR 28-42), 51.7 % were male, and 95.7 % were foreign-born. Approximately two-thirds (63.2 %) had been in the US less than 10 years and 70.1 % had been previously tested for HIV. Cell phone (92.3 %) and text messaging (74.2 %) was used more than Internet (52.2 %) or e-mail (42.8 %) (p < 0.01). In multivariate analysis, older age and lower education were associated with less utilization of Internet, e-mail and text messaging, but not cell phones. Interest was high for receiving health education (73.1 %), HIV education (70.2 %), and test results (68.8 %) via text messaging. Innovative cell phone-based communication interventions have the potential to link Latino migrants to HIV prevention, testing and treatment services.

Personality dimensions, positive emotions and coping strategies in the caregivers of people living with HIV in Lahore, Pakistan.

Science.gov (United States)

Ashraf, Mujeeba; Sitwat, Aisha

2016-08-01

The aim of this research was to study the relationship between personality dimensions, positive emotions and coping mechanisms of caregivers of patients living with HIV. This study used a cross-sectional research design. A sample comprising 56 caregivers was recruited from HIV/AIDS clinics in three teaching hospitals in Lahore, Pakistan. Data were collected between February and July 2010. Most caregivers were men, and of low socio-economic status. Individuals with both high and low extraversion used problem-focused coping, self-control and accepting responsibility, but those with low extraversion used more escape-avoidance coping, and they had also high levels of negative emotions. Those high in neuroticism used more tension-reduction coping than problem-focused coping, and experienced fewer positive emotions. Regression analysis findings revealed neuroticism as a significant predictor of negative emotions as well as emotion-focused coping, and only extraversion significantly predicted negative emotions. This research could help in devising psychological management plans for caregivers of patients living with HIV in order to assist them in coping with the burden of care. © 2016 John Wiley & Sons Australia, Ltd.

HIV-related symptoms and patient clusters among Chileans living with HIV.

Science.gov (United States)

Araya, A X; Norr, K F; Pérez, C M; Levy, J A; Park, C G; Kim, M J

2013-01-01

Identifying both Human immunodeficiency virus (HIV)-related and co-morbid symptoms experienced by people living with HIV (PLWH) who are receiving antiretroviral therapy (ART) treatment is a major challenge for healthcare providers globally. Yet, little research to date has examined the symptoms of illness experienced by PLWH including patients living in Central and South American. To address this gap, this study was designed to identify symptoms of HIV by socio-demographic and/or clinical characteristics among Chilean patients living with the virus. A convenience sample of 209 Chilean PLWH was recruited from an outpatient clinic in Santiago, Chile. A structured interview was used to elicit socio-demographic information and HIV symptoms status. Additional clinical information was obtained through a review of the participants' medical records. Results show that patients' most commonly reported HIV-related symptoms were fear/worries (66%), anxiety (52%), gas/bloating (50%), and thirst (50%). Multivariate analysis revealed a positive association between the number of reported HIV-related symptoms and number of years living with HIV. Having completed college was negatively associated with number of symptoms. Latent class analysis indicated that PLWH in the sample who had completed college were two times more likely to experience a mild intensity of HIV-related symptoms than their lesser educated counterparts. Similarly, logistic regression revealed that college-educated PLWH were twice as likely to be classified in the subgroup reporting mild intensity of symptoms than those who lacked a college degree. Overall, the study's results reveal that many Chilean PLWH, even those with high CD4 counts and low or undetectable viral loads, are not symptom free. The findings point to the need for clinicians to tailor a plan of care for individuals living with HIV that is based on their symptomatology.

Social Support Networks: An Underutilized Resource for the Prevention of HIV and other Sexually Transmitted Diseases among Hispanic/Latino Migrants and Immigrants.

Science.gov (United States)

Painter, Thomas M

2018-01-01

Hispanic/Latino migrants and immigrants are vulnerable to infection by HIV and other sexually transmitted diseases (STDs). Participation in social support networks helps them cope with circumstances in the U.S. Studies of Hispanic/Latino migrants suggest that participation may also be protective against HIV/STD infection. However the studies do not satisfactorily explain how participation leads to protective actions, and recommend externally-induced interventions for HIV/STD prevention rather than incorporating the spontaneously occurring forms of social support they describe. Given the potential protective effects of support networks, a database search was conducted to ascertain the extent to which published HIV/STD prevention interventions for these populations incorporate their support networks. Very few interventions were identified and fewer still incorporate support networks. This commentary calls for research to understand more fully how support networks affect HIV/STD risks among Hispanic/Latino migrants and immigrants and identifies potential benefits of incorporating these networks in HIV/STD prevention for these vulnerable populations.

Qualitative analysis of an educational intervention with HIV-discordant heterosexual Latino couples.

Science.gov (United States)

Pérez-Jiménez, David; Orengo-Aguayo, Rosaura E

2011-12-01

This qualitative analysis elucidates the potential elements of the intervention that may be effective in terms of a) increasing knowledge about HIV/ AIDS in the members of this population; b) increasing the use of male condoms and the practice of mutual masturbation; and c) changing opinions toward male condom use and mutual masturbation. Five heterosexual HIV-discordant couples participated in the adapted intervention, which consisted of four three-hour-long sessions. One month after the intervention, we conducted a qualitative semi-structured interview with every participant to evaluate issues related to the process and content of the activities comprising the intervention, the impact of the intervention, logistics, and recruitment and retention as well as to make a more general evaluation. The information was submitted to qualitative content analysis. After the intervention, participants reported having better attitudes regarding safer sex, particularly in terms of condom use. A reason given by the participants to feel more positive toward condom use and mutual masturbation was that these practices could prevent the infection of the HIV-negative partner. This study provides important evidence of an intervention that promises to be efficacious in preventing some high-risk sexual behaviors among Latino HIV-discordant heterosexual couples. The evidence presented seems to suggest that an intervention that includes basic relevant information about HIV/AIDS, that explains the benefits of condom use and other safer sex options, and that provides effective negotiation and communication strategies could significantly reduce HIV transmission among these couples.

HIV serostatus disclosure: Experiences and perceptions of people living with HIV/AIDS and their service providers in Gujarat, India

Directory of Open Access Journals (Sweden)

Sangita V Patel

2012-01-01

Full Text Available Background: Human immunodeficiency virus (HIV disclosure offers important benefits to people living with HIV/AIDS. However, fear of discrimination, blame, and disruption of family relationships can make disclosure a difficult decision. Barriers to HIV disclosure are influenced by the particular culture within which the individuals live. Although many studies have assessed such barriers in the U.S., very few studies have explored the factors that facilitate or prevent HIV disclosure in India. Understanding these factors is critical to the refinement, development, and implementation of a counseling intervention to facilitate disclosure. Materials and Methods: To explore these factors, we conducted 30 in-depth interviews in the local language with HIV- positive individuals from the Integrated Counselling and Testing Centre in Gujarat, India, assessing the experiences, perceived barriers, and facilitators to disclosure. To triangulate the findings, we conducted two focus group discussions with HIV medical and non-medical service providers, respectively. Results: Perceived HIV-associated stigma, fear of discrimination, and fear of family breakdown acted as barriers to HIV disclosure. Most people living with HIV/AIDS came to know of their HIV status due to poor physical health, spousal HIV-positive status, or a positive HIV test during pregnancy. Some wives only learned of their husbands′ HIV positive status after their husbands died. The focus group participants confirmed similar findings. Disclosure had serious implications for individuals living with HIV, such as divorce, maltreatment, ostracism, and decisions regarding child bearing. Interpretation and Conclusion: The identified barriers and facilitators in the present study can be used to augment training of HIV service providers working in voluntary counseling and testing centers in India.

HIV-infected individuals who delay, decline, or discontinue antiretroviral therapy: Comparing clinic- and peer-recruited cohorts

Directory of Open Access Journals (Sweden)

Marya eGwadz

2014-07-01

Full Text Available A substantial proportion of persons living with HIV/AIDS (PLHA delay, decline, or discontinue antiretroviral therapy (ART when it is medically indicated (40-45%, largely African Americans and Latinos/Hispanics. This study explores the feasibility of locating PLHA who are not on ART (PLHA-NOA through clinics and peer referral; compares the two cohorts on multi-level barriers to ART; and examines readiness to initiate/reinitiate ART, a predictor of treatment outcomes. We recruited adult HIV-infected African American and Latino/Hispanic PLHA-NOA through HIV hospital clinics and peer referral in 2012-13. Participants engaged in structured one-hour assessments with reliable/valid measures on barriers to ART. We found recruitment through peers (63.2%, 60/95 was more feasible than in clinics (36.8%, 35/90. Participants were 48.0 years old and had lived with HIV for 14.7 years on average, and 56.8% had taken ART previously. Most (61.1% were male and African American (76.8%, and 23.2% were Latino/Hispanic. Peer-recruited participants were older, had lived with HIV longer, were less engaged in HIV care, and were more likely to have taken ART previously. The cohorts differed in reasons for discontinuing ART. Levels of ART knowledge were comparable between cohorts (68.5% correct, and there were no differences in attitudes toward ART (e.g., mistrust, which were in the neutral range. In bivariate linear regression, readiness for ART was negatively associated with physician mistrust (B=-10.4, and positively associated with self-efficacy (B=5.5, positive outcome expectancies (B=6.3, beliefs about personal necessity of ART (B=17.5, and positive internal norms (B=7.9. The present study demonstrates the feasibility of engaging this vulnerable population through peer referral. Peer-recruited PLHA evidence particularly high rates of risk factors compared those in clinics. Interventions to support ART initiation and continuation are sorely needed for both subgroups.

Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study.

Science.gov (United States)

Martinez, Omar; Wu, Elwin; Shultz, Andrew Z; Capote, Jonathan; López Rios, Javier; Sandfort, Theo; Manusov, Justin; Ovejero, Hugo; Carballo-Dieguez, Alex; Chavez Baray, Silvia; Moya, Eva; López Matos, Jonathan; DelaCruz, Juan J; Remien, Robert H; Rhodes, Scott D

2014-04-24

Online social networking use has increased rapidly among African American and Latino men who have sex with men (MSM), making it important to understand how these technologies can be used to reach, retain, and maintain individuals in care and promote health wellness. In particular, the Internet is increasingly recognized as a platform for health communication and education. However, little is known about how primarily Spanish-speaking populations use and engage with each other through social media platforms. We aimed to recruit eligible couples for a study to adapt "Connect 'n Unite" (an HIV prevention intervention initially created for black gay couples) for Spanish-speaking Latino gay couples living in New York City. In order to successfully design and implement an effective social media recruitment campaign to reach Spanish-speaking Latino gay couples for our ongoing "Latinos en Pareja" study, our community stakeholders and research team used McGuire's communication/persuasion matrix. The matrix guided our research, specifically each marketing "channel", targeted "message", and target population or "receiver". We developed a social media recruitment protocol and trained our research staff and stakeholders to conduct social media recruitment. As a result, in just 1 month, we recruited all of our subjects (N=14 couples, that is, N=28 participants) and reached more than 35,658 participants through different channels. One of the major successes of our social media recruitment campaign was to build a strong stakeholder base that became involved early on in all aspects of the research process-from pilot study writing and development to recruitment and retention. In addition, the variety of "messages" used across different social media platforms (including Facebook, the "Latinos en Pareja" study website, Craigslist, and various smartphone applications such as Grindr, SCRUFF, and Jack'd) helped recruit Latino gay couples. We also relied on a wide range of community

Qualitative Analysis of an Educational Intervention with HIV-Discordant Heterosexual Latino Couples

Science.gov (United States)

Pérez-Jiménez, David; Orengo-Aguayo, Rosaura E.

2012-01-01

Objective This qualitative analysis elucidates the potential elements of the intervention that may be effective in terms of a) increasing knowledge about HIV/AIDS in the members of this population; b) increasing the use of male condoms and the practice of mutual masturbation; and c) changing opinions toward male condom use and mutual masturbation. Methods Five heterosexual HIV-discordant couples participated in the adapted intervention, which consisted of four three-hour-long sessions. One month after the intervention, we conducted a qualitative semi-structured interview with every participant to evaluate issues related to the process and content of the activities comprising the intervention, the impact of the intervention, logistics, and recruitment and retention as well as to make a more general evaluation. The information was submitted to qualitative content analysis. Results After the intervention, participants reported having better attitudes regarding safer sex, particularly in terms of condom use. A reason given by the participants to feel more positive toward condom use and mutual masturbation was that these practices could prevent the infection of the HIV-negative partner. Conclusion This study provides important evidence of an intervention that promises to be efficacious in preventing some high-risk sexual behaviors among Latino HIV-discordant heterosexual couples. The evidence presented seems to suggest that an intervention that includes basic relevant information about HIV/AIDS, that explains the benefits of condom use and other safer sex options, and that provides effective negotiation and communication strategies could significantly reduce HIV transmission among these couples. PMID:22263299

HIV/AIDS stigma among a sample of primarily African American and Latino men who have sex with men (MSM) social media users

OpenAIRE

Garett, Renee; Smith, Justin; Chiu, Jason; Young, Sean D.

2016-01-01

The recent increase in social media use allows these technologies to rapidly reach communities with higher HIV prevalence, such as African American and Latino men who have sex with men (MSM). However, no studies have looked at HIV/AIDS stigma among social media users from African American and Latino MSM communities, or the association between stigma and social media use among these groups. This study sought to assess the level of HIV/AIDS stigma among a sample of social media-using African Am...

Experiences of HIV stigma: the role of visible symptoms, HIV centrality and community attachment for people living with HIV.

Science.gov (United States)

Brener, Loren; Callander, Denton; Slavin, Sean; de Wit, John

2013-01-01

For many people living with HIV (PLHIV), disclosure or concealment of their HIV status may be under their personal control; however, for PLHIV with visible symptoms of their illness, disclosure may no longer be a choice. Previous research suggests that those with visible HIV symptoms have poorer mental and physical health than those without visible HIV symptoms. This study aimed to extend these findings and assess the role of perceived centrality of HIV in the lives of PLHIV as well as the role of attachment to an HIV-positive community in understanding the negative effects on health and well-being for PLHIV with visible HIV symptoms. Participants were 697 PLHIV who completed an online survey that assessed symptom visibility, HIV-status disclosure, perceived stigma, health and well-being, how central HIV was to identity and HIV community attachment. Results indicate that those with visible symptoms experienced more HIV-related stigma and had poorer outcomes on a range of psychological and mental health measures than those who were able to conceal their stigma. These effects remained after controlling for length of time since diagnosis, time on HIV treatment, perceived health satisfaction and age. PLHIV with visible symptoms also reported that HIV was more central to their identity and reported greater attachment to an HIV-positive community. Furthermore, findings suggest that while HIV centrality appears to increase the negative effects of having visible symptoms associated with HIV, greater community attachment seems to ameliorate these effects. This suggests the need for a nuanced understanding of the implications of visible HIV symptoms for PLHIV. The study also highlights the potential benefits of HIV-positive community attachment in buffering PLHIV from the negative effect of visible HIV symptoms on their health and well-being.

Sexual Behavior of Older Adults Living with HIV in Uganda.

Science.gov (United States)

Negin, Joel; Geddes, Louise; Brennan-Ing, Mark; Kuteesa, Monica; Karpiak, Stephen; Seeley, Janet

2016-02-01

Sexual behavior among older adults with HIV in Sub-Saharan Africa has been understudied despite the burgeoning of this population. We examined sexual behavior among older adults living with HIV in Uganda. Participants were eligible for the study if they were 50 years of age or older and living with HIV. Quantitative data were collected through face-to-face interviews, including demographic characteristics, health, sexual behavior and function, and mental health. Of respondents, 42 were men and 59 women. More than one-quarter of these HIV-positive older adults were sexually active. A greater proportion of older HIV-positive men reported being sexually active compared to women (54 vs. 15%). Among those who are sexually active, a majority never use condoms. Sixty-one percent of men regarded sex as at least somewhat important (42%), while few women shared this opinion (20%). Multivariate logistic regression analyses revealed that odds of sexual activity in the past year were significantly increased by the availability of a partner (married/cohabitating), better physical functioning, and male gender. As more adults live longer with HIV, it is critical to understand their sexual behavior and related psychosocial variables in order to improve prevention efforts.

Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men's and women's culturally-ascribed attitudes and behaviours.

Science.gov (United States)

Sastre, Francisco; De La Rosa, Mario; Ibanez, Gladys E; Whitt, Elaine; Martin, Steven S; O'Connell, Daniel J

2015-01-01

Among Latinos, cultural values such as machismo and marianismo may promote inconsistent condom use representing a significant risk factor for HIV infection. Yet there continues to be a need for additional research to explore the influence these cultural values have on Latino men and women's condom use attitudes and behaviours given increasing HIV rates of HIV infection among Latinos. The purpose of this study was to explore further Latino traditional culturally-ascribed attitudes and behaviour for emerging themes toward condom use among a diverse group of adult Latino men and women living in Miami-Dade County, Florida, USA. The study used a qualitative study-design and collected data from 16 focus groups with a total of 67 Latino men and women. Findings from the focus groups described attitudes and behaviours that counter traditional gender roles towards sex and expected sexual behaviours informed by machismo and marianismo. Common attitudes noted in the study include men's classification of women as dirty-clean to determine condom use and women's assertiveness during sexual encounters negotiating condom use--in favour and against it. As the findings of this study suggest, the process differ greatly between Latino men and women, having an impact on the risk behaviours in which each engage.

Respiratory health status is impaired in UK HIV-positive adults with virologically suppressed HIV infection.

Science.gov (United States)

Brown, J; McGowan, J A; Chouial, H; Capocci, S; Smith, C; Ivens, D; Johnson, M; Sathia, L; Shah, R; Lampe, F C; Rodger, A; Lipman, M

2017-09-01

We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals. We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation. PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P respiratory health appears more common in HIV-positive adults, and has a significant impact on health-related quality of life. © 2017 The Authors HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

Disclosure Decisions: HIV-Positive Persons Coping With Disease-Related Stressors

DEFF Research Database (Denmark)

Rodkjaer, Lotte; Sodemann, Morten; Østergaard, Lars Jørgen

2011-01-01

The purpose of this grounded theory study was to investigate how Danish HIV-positive persons live with their disease, focusing on HIV-related stressors. Using the Glaserian method, we analyzed textual data from in-depth interviews with 16 HIV-positive persons. Decisions about disclosure appeared ...... and plans, and offers a theoretical basis for interventions designed to assist persons living with HIV to make the best possible individual decisions regarding disclosure, and thereby reduce HIV-related stress....... to be a major concern and a determining factor for HIV-related stress. Consequently, we developed a substantive theory about disclosure decisions in which three different strategies could be identified: (a) disclosing to everyone (being open); (b) restricting disclosure (being partly open); and (c) disclosing...... to no one (being closed). Disclosure was a continuum; none of the three strategies automatically relieved HIV-related stress. The theory describes the main determinants and consequences of each strategy. Our study demonstrates the importance of recurrent individual considerations about disclosure choices...

The HoMBReS and HoMBReS Por un Cambio Interventions to Reduce HIV Disparities Among Immigrant Hispanic/Latino Men.

Science.gov (United States)

Rhodes, Scott D; Leichliter, Jami S; Sun, Christina J; Bloom, Fred R

2016-02-12

Hispanics/Latinos in the United States are affected disproportionately by human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), and other sexually transmitted diseases (STDs); however, few effective evidence-based prevention interventions for this population exist. This report describes the Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships) (HoMBReS) intervention, which was developed by a community-based, participatory research partnership in North Carolina and initially implemented during 2005-2009. HoMBReS is an example of an effective intervention that uses lay health advisors (known as Navegantes [navigators]) in the context of existing social networks (i.e., recreational soccer teams) to promote consistent condom use and HIV and STD testing among Hispanic/Latino men. In 2012, HoMBReS was classified as a best-evidence community-level HIV prevention intervention (CDC. Compendium of evidence-based behavioral interventions and best practices for HIV prevention. Atlanta, GA: US Department of Health and Human Services, CDC; 2015). The intervention has been implemented elsewhere, enhanced, and further evaluated in longitudinal intervention and implementation studies. HoMBReS has been adapted for other populations, including men who have sex with men and transgender persons. Additional evaluation has found that Navegantes continue in their roles as health advisors, opinion leaders, and community advocates after study support ends. Hispanic/Latino men's social networks can be leveraged to promote sexual health within the community by decreasing HIV risk behaviors among Hispanics/Latinos in the United States.

Still a Hard-to-Reach Population? Using Social Media to Recruit Latino Gay Couples for an HIV Intervention Adaptation Study

Science.gov (United States)

Wu, Elwin; Shultz, Andrew Z; Capote, Jonathan; López Rios, Javier; Sandfort, Theo; Manusov, Justin; Ovejero, Hugo; Carballo-Dieguez, Alex; Chavez Baray, Silvia; Moya, Eva; López Matos, Jonathan; DelaCruz, Juan J; Remien, Robert H; Rhodes, Scott D

2014-01-01

Background Online social networking use has increased rapidly among African American and Latino men who have sex with men (MSM), making it important to understand how these technologies can be used to reach, retain, and maintain individuals in care and promote health wellness. In particular, the Internet is increasingly recognized as a platform for health communication and education. However, little is known about how primarily Spanish-speaking populations use and engage with each other through social media platforms. Objective We aimed to recruit eligible couples for a study to adapt “Connect ‘n Unite” (an HIV prevention intervention initially created for black gay couples) for Spanish-speaking Latino gay couples living in New York City. Methods In order to successfully design and implement an effective social media recruitment campaign to reach Spanish-speaking Latino gay couples for our ongoing “Latinos en Pareja” study, our community stakeholders and research team used McGuire’s communication/persuasion matrix. The matrix guided our research, specifically each marketing “channel”, targeted “message”, and target population or “receiver”. We developed a social media recruitment protocol and trained our research staff and stakeholders to conduct social media recruitment. Results As a result, in just 1 month, we recruited all of our subjects (N=14 couples, that is, N=28 participants) and reached more than 35,658 participants through different channels. One of the major successes of our social media recruitment campaign was to build a strong stakeholder base that became involved early on in all aspects of the research process—from pilot study writing and development to recruitment and retention. In addition, the variety of “messages” used across different social media platforms (including Facebook, the “Latinos en Pareja” study website, Craigslist, and various smartphone applications such as Grindr, SCRUFF, and Jack’d) helped

Improving Health Services for Adolescents Living with HIV in Sub ...

African Journals Online (AJOL)

In sub-Saharan Africa (SSA), the aging of HIV-positive pediatric cohorts and growing numbers of adolescents on treatment, coupled with high HIV incidence in this age group, means the number of adolescents living with HIV (ALHIV) will continue to grow. The clinical, psychological, social, and reproductive health needs of ...

Aetiology and management of malnutrition in HIV-positive children.

Science.gov (United States)

Rose, Anna M; Hall, Charles S; Martinez-Alier, Nuria

2014-06-01

Worldwide, more than 3 million children are infected with HIV and, without treatment, mortality among these children is extremely high. Both acute and chronic malnutrition are major problems for HIV-positive children living in resource-limited settings. Malnutrition on a background of HIV represents a separate clinical entity, with unique medical and social aetiological factors. Children with HIV have a higher daily calorie requirement than HIV-negative peers and also a higher requirement for micronutrients; furthermore, coinfection and chronic diarrhoea due to HIV enteropathy play a major role in HIV-associated malnutrition. Contributory factors include late presentation to medical services, unavailability of antiretroviral therapy, other issues surrounding healthcare provision and food insecurity in HIV-positive households. Treatment protocols for malnutrition have been greatly improved, yet there remains a discrepancy in mortality between HIV-positive and HIV-negative children. In this review, the aetiology, prevention and treatment of malnutrition in HIV-positive children are examined, with particular focus on resource-limited settings where this problem is most prevalent. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Developing a Video-Based eHealth Intervention for HIV-Positive Gay, Bisexual, and Other Men Who Have Sex with Men: Study Protocol for a Randomized Controlled Trial.

Science.gov (United States)

Hirshfield, Sabina; Downing, Martin J; Parsons, Jeffrey T; Grov, Christian; Gordon, Rachel J; Houang, Steven T; Scheinmann, Roberta; Sullivan, Patrick S; Yoon, Irene S; Anderson, Ian; Chiasson, Mary Ann

2016-06-17

Gay, bisexual, and other men who have sex with men (GBMSM) accounted for 67% of new US human immunodeficiency virus (HIV) infections in 2012; however, less than 40% of HIV-positive GBMSM are virally suppressed. Preventing transmission from virally unsuppressed men who have condomless anal sex (CAS) with serodiscordant partners is a public health imperative. New HIV infections in GBMSM are attributed in part to online access to sex partners; therefore, low-cost eHealth interventions are a unique opportunity to reach men where they meet partners. To describe the protocol of a randomized controlled trial evaluating whether video-based messaging delivered online may lead to reductions in serodiscordant CAS and increased HIV disclosure. Sex Positive!([+]) is a two-arm, phase III, video-based randomized controlled trial delivered online to GBMSM living with HIV. Participants in the intervention arm receive 10 video vignettes grounded in social learning and social cognitive theories that are designed to elicit critical thinking around issues of HIV transmission and disclosure. Participants in the attention control arm receive 10 video vignettes that focus on healthy living. All videos are optimized for mobile viewing. The study protocol includes five online assessments conducted over a 1-year period among 1500 US white, black, or Hispanic/Latino GBMSM living with HIV who report suboptimal antiretroviral therapy (ART) adherence or a detectable viral load in the past 12 months and recent CAS (past 6 months) with HIV-negative or unknown status male partners. Compared to the control arm, we hypothesize that men who watch the intervention videos will report at 12-month follow-up significantly fewer serodiscordant CAS partners, increased HIV disclosure, and improved social cognition (eg, condom use self-efficacy, perceived responsibility). Participant recruitment began in June 2015 and ended in December 2015. This protocol describes the underlying theoretical framework and

Parental Protectiveness and Unprotected Sexual Activity Among Latino Adolescent Mothers and Fathers

OpenAIRE

Lesser, Janna; Koniak-Griffin, Deborah; Huang, Rong; Takayanagi, Sumiko; Cumberland, William G.

2009-01-01

Latino pregnant and parenting adolescents living in inner cities are one of the populations at risk for acquiring HIV. Although teen parenthood has been predominantly looked at with a focus on potential adverse physical, emotional, and socioeconomic outcomes for the mother and child; a growing body of literature has documented the strengths and resiliency of young parents. Respeto/Proteger: Respecting and Protecting Our Relationships is a culturally rooted couple-focused and asset-based HIV p...

Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men’s and women’s culturally-ascribed attitudes and behaviours

Science.gov (United States)

Sastre, Francisco; De La Rosa, Mario; Ibanez, Gladys E.; Whitt, Elaine; Martin, Steven S.; O’Connell, Daniel J.

2014-01-01

Among Latinos, cultural values such as machismo and marianismo may promote inconsistent condom use representing a significant risk factor for HIV infection. Yet, there continues to be a need for additional research to explore the influence these cultural values have on Latino men and women’s condom use attitudes and behaviours given increasing HIV rates of HIV infection among Latinos. The purpose of this study was to explore further Latino traditional culturally-ascribed attitudes and behaviour for emerging themes toward condom use among a diverse group of adult Latino men and women living in Miami-Dade County, Florida (USA). The study used a qualitative study-design and collected data from sixteen focus groups with a total of 67 Latino men and women. Finding from the focus groups described attitudes and behaviours that counter traditional gender roles towards sex and expected sexual behaviours informed by machismo and marianismo. Common attitudes noted in the study include men’s classification of women as clean/dirty to determine condom use and women’s assertiveness during sexual encounters negotiating condom use-in favour and against it. As the findings of this study suggest, the process differ greatly between Latino men and women, having an impact on the risk behaviours in which each engage. PMID:25530309

Sexual solicitation of Latino male day laborers by other men Solicitación sexual de hombres jornaleros latinos por otros hombres

Directory of Open Access Journals (Sweden)

Frank H Galvan

2008-12-01

Full Text Available OBJECTIVE: To examine the likelihood of Latino day laborers being solicited for sex by other men. MATERIAL AND METHODS: 450 Latino day laborers were recruited in Los Angeles, California, from July to September 2005. Logistic regression analysis was used to determine which day laborers were more likely to be solicited and subsequently to have sex. RESULTS: Thirty-eight percent reported being solicited for sex by another man while seeking work. Those solicited were more likely to live longer in the US, be more educated and screen positive for drug dependence. Of those solicited, 9.4% had sex with their solicitors. Those screening positive for drug dependence were more likely to have sex. Most of the day laborers who had anal sex with their solicitors did not always use condoms. CONCLUSIONS: HIV prevention efforts should target drug dependent day laborers, who may place themselves at risk for HIV through sex with male solicitors.OBJETIVO: Examinar hasta qué punto los jornaleros latinos son solicitados por otros hombres para tener relaciones sexuales. MATERIAL Y MÉTODOS: Cuatrocientos cincuenta jornaleros latinos fueron reclutados en Los Ángeles, California, de julio a septiembre de 2005. Un análisis de regresión logística fue utilizado para determinar cuáles jornaleros tenían más probabilidades de que fueran solicitados y, subsecuentemente, de que tuvieran sexo. RESULTADOS: Treinta y ocho por ciento reportaron que fueron solicitados para sexo por otros hombres mientras buscaban trabajo. Estos hombres que fueron solicitados tenían más probabilidades de haber vivido más tiempo en los Estados Unidos, tener más educación formal y dar resultados positivos en dependencia de drogas. De los solicitados, 9.4% tuvieron sexo con los solicitadores. Aquellos que dieron resultados positivos para dependencia de drogas tenían más probabilidades de tener sexo. La mayoría de los jornaleros que tuvieron sexo anal con los solicitadores no siempre

Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing

DEFF Research Database (Denmark)

Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

2016-01-01

Objectives: In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. Methods: In-depth int......Objectives: In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. Methods: In....... Results: Four themes emerged describing barriers to communication, from the HIV-positive women’s point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider’s emphasis on ‘scientific’ facts, (iv...

Why do marital partners of people living with HIV not test for HIV? A qualitative study in Lusaka, Zambia

Directory of Open Access Journals (Sweden)

Maurice Musheke

2016-08-01

Full Text Available Abstract Background Knowledge of HIV status is crucial for HIV prevention and management in marital relationships. Yet some marital partners of people living with HIV decline HIV testing despite knowing the HIV-positive status of their partners. To date, little research has explored the reasons for this. Methods An exploratory qualitative study was undertaken in Lusaka, Zambia, between March 2010 and September 2011, nested within a larger ethnographic study. In-depth interviews were held with individuals who knew the HIV-positive status of their marital partners but never sought HIV testing (n = 30 and HIV service providers of a public sector clinic (n = 10. A focus group discussion was also conducted with eight (8 lay HIV counsellors. Data was transcribed, coded and managed using ATLAS.ti and analysed using latent content analysis. Results The overarching barrier to uptake of HIV testing was study participants’ perception of their physical health, reinforced by uptake of herbal remedies and conventional non-HIV medication to mitigate perceived HIV-related symptoms. They indicated willingness to test for HIV if they noticed a decline in physical health and other alternative forms of care became ineffective. Also, some study participants viewed themselves as already infected with HIV on account of the HIV-positive status of their marital partners, with some opting for faith healing to get ‘cured’. Other barriers were the perceived psychological burden of living with HIV, modulated by lay belief that knowledge of HIV-positive status led to rapid physical deterioration of health. Perceived inability to sustain uptake of life-long treatment – influenced by a negative attitude towards treatment – further undermined uptake of HIV testing. Self-stigma, which manifested itself through fear of blame and a need to maintain moral credibility in marital relationships, also undermined uptake of HIV testing. Conclusions Improving uptake of HIV

Why do marital partners of people living with HIV not test for HIV? A qualitative study in Lusaka, Zambia.

Science.gov (United States)

Musheke, Maurice; Merten, Sonja; Bond, Virginia

2016-08-25

Knowledge of HIV status is crucial for HIV prevention and management in marital relationships. Yet some marital partners of people living with HIV decline HIV testing despite knowing the HIV-positive status of their partners. To date, little research has explored the reasons for this. An exploratory qualitative study was undertaken in Lusaka, Zambia, between March 2010 and September 2011, nested within a larger ethnographic study. In-depth interviews were held with individuals who knew the HIV-positive status of their marital partners but never sought HIV testing (n = 30) and HIV service providers of a public sector clinic (n = 10). A focus group discussion was also conducted with eight (8) lay HIV counsellors. Data was transcribed, coded and managed using ATLAS.ti and analysed using latent content analysis. The overarching barrier to uptake of HIV testing was study participants' perception of their physical health, reinforced by uptake of herbal remedies and conventional non-HIV medication to mitigate perceived HIV-related symptoms. They indicated willingness to test for HIV if they noticed a decline in physical health and other alternative forms of care became ineffective. Also, some study participants viewed themselves as already infected with HIV on account of the HIV-positive status of their marital partners, with some opting for faith healing to get 'cured'. Other barriers were the perceived psychological burden of living with HIV, modulated by lay belief that knowledge of HIV-positive status led to rapid physical deterioration of health. Perceived inability to sustain uptake of life-long treatment - influenced by a negative attitude towards treatment - further undermined uptake of HIV testing. Self-stigma, which manifested itself through fear of blame and a need to maintain moral credibility in marital relationships, also undermined uptake of HIV testing. Improving uptake of HIV testing requires a multi-pronged approach that addresses self-stigma, lay risk

Stigma towards PLWHA: The Role of Internalized Homosexual Stigma in Latino Gay/Bisexual Male and Transgender Communities

Science.gov (United States)

Ramirez-Valles, Jesus; Molina, Yamile; Dirkes, Jessica

2013-01-01

Stigma negatively affects the health of people living with HIV/AIDS (PLWHA). Negative attitudes and discriminatory actions towards PLWHA are thought to be based, among other factors, on stigma towards sexual minorities and beliefs about personal responsibility. Yet, there is little evidence to support these linkages and explain how they take place, especially among Latinos. This study analyzes attitudes towards PLWHA among 643 Latino gay/bisexual men and transgender (GBT) people. It examines whether discriminatory actions are predicted by beliefs about personal responsibility and internalized homosexual stigma. Results indicate that Discriminatory Actions towards PLWHA is associated with HIV/AIDS Personal Responsibility Beliefs and Internalized Homosexual Stigma. Further, HIV/AIDS Personal Responsibility Beliefs partially mediates the relationship between Internalized Homosexual Stigma and Discriminatory Actions towards PLWHA. Latino GBT persons who have internalized negative views about homosexuality may project those onto PLWHA. They may think PLWHA are responsible for their serostatus and, hence, deserving of rejection. PMID:23631713

Stigma towards PLWHA: the role of internalized homosexual stigma in Latino gay/bisexual male and transgender communities.

Science.gov (United States)

Ramirez-Valles, Jesus; Molina, Yamile; Dirkes, Jessica

2013-06-01

Stigma negatively affects the health of people living with HIV/AIDS (PLWHA). Negative attitudes and discriminatory actions towards PLWHA are thought to be based, among other factors, on stigma towards sexual minorities and beliefs about personal responsibility. Yet, there is little evidence to support these linkages and explain how they take place, especially among Latinos. This study analyzes attitudes towards PLWHA among 643 Latino gay/bisexual men and transgender (GBT) people. It examines whether discriminatory actions are predicted by beliefs about personal responsibility and internalized homosexual stigma. Results indicate that Discriminatory Actions towards PLWHA is associated with HIV/AIDS Personal Responsibility Beliefs and Internalized Homosexual Stigma. Further, HIV/AIDS Personal Responsibility Beliefs partially mediates the relationship between Internalized Homosexual Stigma and Discriminatory Actions towards PLWHA. Latino GBT persons who have internalized negative views about homosexuality may project those onto PLWHA. They may think PLWHA are responsible for their serostatus and, hence, deserving of rejection.

[HIV Stigma and Spiritual Care in People Living With HIV].

Science.gov (United States)

Yu, Chia-Hui; Chiu, Yi-Chi; Cheng, Su-Fen; Ko, Nai-Ying

2018-06-01

HIV infection has been a manageable and chronic illness in Taiwan since the highly active antiretroviral therapy was introduced in 1997. HIV infection is a stigmatized disease due to its perceived association with risky behaviors. HIV often carries a negative image, and people living with HIV(PLWH) face discrimination on multiple fronts. Internalized HIV stigma impacts the spiritual health of people living with HIV in terms of increased levels of shame, self-blame, fear of disclosing HIV status, and isolation and decreased value and connections with God, others, the environment, and the self. Nursing professionals provide holistic care for all people living with HIV and value their lives in order to achieve the harmony of body, mind, and spirit. This article describes the stigma that is currently associated with HIV and how stigma-related discrimination affects the spiritual health of PLWH and then proposes how to reduce discrimination and stigma in order to improve the spiritual health of PLWH through appropriate spiritual care. Reducing HIV stigma and promoting spiritual well-being will enable Taiwan to achieve the 'Three Zeros' of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Programme on HIV/AIDS for ending the AIDS epidemic in 2030.

Outcomes from a community-based, participatory lay health adviser HIV/STD prevention intervention for recently arrived immigrant Latino men in rural North Carolina.

Science.gov (United States)

Rhodes, Scott D; Hergenrather, Kenneth C; Bloom, Fred R; Leichliter, Jami S; Montaño, Jaime

2009-10-01

Latinos in the United States are at increased risk for HIV and sexually transmitted disease (STD) infection. We evaluated the efficacy of a pilot lay health adviser (LHA) intervention designed to increase condom use and HIV testing among Latino men. Fifteen LHAs (mean age = 35.6; range 23-60 years) from 15 Latino soccer teams were trained and worked with their teammates for 18 months. Another 15 teams served as the control group. Data were collected at baseline and at 18 months post-LHA training from a random sample of teammates from intervention and control teams. Data were collected from 222 men (mean age = 29 years) who participated in one of the 30 teams. Relative to the control condition, participants in the intervention reported more consistent condom use in the 30 days preceding follow-up (unadjusted analysis, intervention, 65.6% vs. control, 41.3%; p < .001). Participants in the intervention were more likely to report condom use (adjusted odds ratio [AOR] = 2.3; confidence interval [CI = 1.2-4.3) and HIV testing (AOR = 2.5; CI = 1.5-4.3). LHA interventions for Latino men that are developed in partnership with community members, rely on male-centered intrapersonal networks, and are culturally congruent can enhance preventive behaviors and may reduce HIV infection.

Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.

Science.gov (United States)

Turan, Bulent; Stringer, Kristi L; Onono, Maricianah; Bukusi, Elizabeth A; Weiser, Sheri D; Cohen, Craig R; Turan, Janet M

2014-12-03

While studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effects of antiretroviral therapy. We examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women. In this prospective observational study, data were obtained from 135 HIV-positive women from eight antenatal clinics in the rural Nyanza Province of Kenya at their first antenatal visit (prior to testing HIV-positive for the first time) and subsequently at 6 weeks after giving birth. At 6 weeks postpartum, women who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms. These results provide further support for current efforts to ensure that women who are newly diagnosed with HIV during pregnancy become linked to HIV care as early as possible, with important benefits for both physical and mental health.

Social networks of older adults living with HIV in Finland.

Science.gov (United States)

Nobre, Nuno Ribeiro; Kylmä, Jari; Kirsi, Tapio; Pereira, Marco

2016-01-01

The aim of this study was to explore the social networks of older adults living with HIV. Interviews were conducted with nine individuals aged 50 or older living with HIV in Helsinki, Finland. Analysis of transcripts was analysed by inductive qualitative content analysis. Results indicated that these participants' networks tended to be large, including those both aware and unaware of the participants' health status. Analysis identified three main themes: large multifaceted social networks, importance of a support group, and downsizing of social networks. Support received appeared to be of great importance in coping with their health condition, especially since the time of diagnosis. Friends and family were the primary source of informal support. The majority of participants relied mostly on friends, some of whom were HIV-positive. Formal support came primarily from the HIV organisation's support group. In this study group, non-disclosure did not impact participants' well-being. In years to come, social networks of older adults living with HIV may shrink due to personal reasons other than HIV-disclosure. What is of primary importance is that healthcare professionals become knowledgeable about psychosocial issues of older adults living with HIV, identifying latent problems and developing adequate interventions in the early stages of the disease; this would help prevent social isolation and foster successful ageing with HIV.

Experience of sexual self-esteem among men living with HIV.

Science.gov (United States)

Rohleder, Poul; McDermott, Daragh T; Cook, Rachel

2017-02-01

Much of the focus on sexual health for people living with HIV has been on promoting safe sex behaviours. However, also important for sexual health is a positive sexual self-esteem. This article reports on an interpretative phenomenological analysis of interviews with seven men about the impact that having HIV has had on their sense of sexual self. Five overarching themes were identified: the 'destruction' of a sexual self; feeling sexually hazardous; sexual inhibition; reclaiming a sexual self and finding a place through sero-sorting. With HIV now being a chronic illness, interventions are required to support people to lead sexually satisfying lives.

Optimism, well-being, and perceived stigma in individuals living with HIV.

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Ammirati, Rachel J; Lamis, Dorian A; Campos, Peter E; Farber, Eugene W

2015-01-01

Given the significant psychological challenges posed by HIV-related stigma for individuals living with HIV, investigating psychological resource factors for coping with HIV-related stigma is important. Optimism, which refers to generalized expectations regarding favorable outcomes, has been associated with enhanced psychological adaptation to health conditions, including HIV. Therefore, this cross-sectional study investigated associations among optimism, psychological well-being, and HIV stigma in a sample of 116 adults living with HIV and seeking mental health services. Consistent with study hypotheses, optimism was positively associated with psychological well-being, and psychological well-being was negatively associated with HIV-related stigma. Moreover, results of a full structural equation model suggested a mediation pattern such that as optimism increases, psychological well-being increases, and perceived HIV-related stigma decreases. The implications of these findings for clinical interventions and future research are discussed.

Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition.

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Uthman, Olalekan A; Ekström, Anna Mia; Moradi, Tahereh T

2016-09-20

Smoking is still gaining ground in Sub-Saharan Africa, especially among socially disadvantaged groups. People living with HIV represent a subgroup with a significantly elevated prevalence of cigarette smoking. The objective of the study was to examine the influence of individual-, neighbourhood- and country-level socioeconomic position on current cigarette smoking among people living with HIV in Sub-Saharan Africa. We applied multivariable multilevel logistic regression analysis on Demographic and Health Survey data collected between 2003 and 2012 in sub-Saharan Africa. We identified 31,270 individual living with HIV (Level 1) nested within 7,054 neighbourhoods (Level 2) from 19 countries (Level 3). After adjustment for individual-, neighbourhood- and country-level factors, respondents, the following significant independent risk factors for increasing odds of being a current cigarette smokers among people living with HIV: male gender (odds ratio [OR] = 62.49; 95 % credible interval [CrI] 45.93 to 78.28), from the poorer households (OR = 1.62, 95 % CrI 1.38 to 1.90); living in urban areas (OR = 1.24, 95 % CrI 1.09 to 1.41), from neighbourhoods with low poverty rate (OR = 1.25, 95 % CrI 1.09 to 1.43), illiteracy rate (OR = 1.28, 95 % CrI 1.14 to 1.42), low unemployment rate (OR = 1.11, 95 % crI 1.01 to 1.43); and from countries with low socio-economic deprivation (OR = 1.53, 95 CrI 1.08 to 1.96). About 3.4 % and 39.4 % variation in cigarette smoking behaviour among people living with HIV is conditioned by differences between neighbourhoods and countries. Gender, education and socioeconomic context are independently associated with current cigarette smoking among people living with HIV in sub-Saharan Africa.

Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: A qualitative study.

Science.gov (United States)

Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

2016-05-01

In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. In-depth interviews (IDIs) were conducted with 48 HIV infected women receiving ART at 7 different HIV clinics providing comprehensive HIV care services in four districts in Uganda, between July and August 2012. All women were aware of their HIV diagnosis prior to pregnancy or had given birth while living with HIV. Four themes emerged describing barriers to communication, from the HIV-positive women's point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider's emphasis on 'scientific' facts, (iv) 'accidental pregnancy'. Existing evidence regarding effective provider-patient communication should be considered for its application for reproductive counseling among HIV infected women. These data demonstrate the need for current counseling guidelines to explore approaches that encourage open, non-judgmental, non-directive discussions with HIV positive individuals around their reproductive desires and intentions in a health care setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sexual risk behavior among HIV-positive persons in Jamaica ...

African Journals Online (AJOL)

positive status potentially place their partners at risk for HIV transmission and other sexually transmitted infections. The study findings highlight the need to promote safe sexual behaviors and a positive social environment for people living with ...

Knowledge of HIV/AIDS and attitudes towards people living with HIV ...

African Journals Online (AJOL)

Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development.

HIV+ and HIV- youth living in group homes in South Africa need more psychosocial support.

Science.gov (United States)

Nestadt, D F; Alicea, S; Petersen, I; John, S; Myeza, N P; Nicholas, S W; Cohen, L G; Holst, H; Bhana, A; McKay, M M; Abrams, E J; Mellins, C A

2013-07-01

Orphans and vulnerable youth who live in group homes are at risk of poor mental health and sexual and drug-using behaviors that increase the risk of HIV transmission. This study explores factors related to this risk among youth living in group homes ("children's homes") for orphans and vulnerable children in South Africa, a country afflicted by high levels of parental loss due to HIV. The study explores 1) knowledge and attitudes about HIV, 2) social support, 3) communication with group home caregivers, and 4) the relevance of an existing evidence-based HIV prevention and mental health promotion program to situations where sexual and drug risk behaviors can occur. In-depth qualitative individual interviews were conducted with 20 youth (age 10 to 16 years) residing in two children's homes in Durban, South Africa. Content analysis focused on critical themes related to coping and prevention of risk activities. Respondents exhibited inconsistent and incomplete knowledge of HIV transmission and prevention. They displayed positive attitudes toward people living with HIV, but reported experiencing or witnessing HIV-related stigma. Participants witnessed substance use and romantic/sexual relationships among their peers; few admitted to their own involvement. While relationships with childcare workers were central to their lives, youth reported communication barriers related to substance use, sex, HIV, and personal history (including parental loss, abuse, and other trauma). In conclusion, these qualitative data suggest that evidence-based HIV prevention programs that bring caregivers and youth together to improve communication, HIV knowledge, social support, youth self-esteem, and health care, reduce sexual and drug risk behaviors, and strengthen skills related to negotiating situations of sexual and substance use possibility could benefit youth and childcare workers in children's homes.

Impact of HIV on and the constructions of masculinities among HIV-positive men in South Africa: implications for secondary prevention programs.

Science.gov (United States)

Sikweyiya, Yandisa M; Jewkes, Rachel; Dunkle, Kristin

2014-01-01

To date, whilst there have been many published studies exploring the links between masculinity and HIV, not much work has been done to explore how an HIV-positive diagnosis impacts men's sense of masculinity and contextualizing the masculinities as fluid and changing. To explore how human immunodeficiency virus (HIV) impacts the lives of men and their constructions of masculinity through interviews with 18 men living with HIV. Qualitative study involving conveniently and purposively selected black South African adult men who lived with HIV. In-depth interviews were conducted with 18 men who resided in Johannesburg and Mthatha, South Africa. Our analysis suggests that the performance of risky masculinity may influence the acquisition of HIV. Yet, it also reveals that HIV can have a significant effect on men and their masculinities. Men's constructions of harmful notions of hegemonic masculinity pre-HIV diagnosis negatively affected their help-seeking behavior and coping and adjustment to living with HIV, post-diagnosis. The dominant discourse that men are strong and healthy visibly presented challenges for men when faced with an HIV-positive status. They interpreted HIV diagnosis as a loss, a sign of failure as a man, and evidence of an inability to retain control. Being sick undermined their ability to perform roles expected of them, and this led to feelings of powerlessness, worthlessness, and distress. Interventions with men living with HIV need to provide safe spaces for men to critically explore gender and constructions of social identities and the pressures these place on men and implications for their health. With this approach, harmful constructions of masculinities may be challenged and mitigated, and this process may render men amenable to change.

HIV Stigma and Substance Use Among HIV-Positive Russians with Risky Drinking.

Science.gov (United States)

Edelman, E Jennifer; Lunze, Karsten; Cheng, Debbie M; Lioznov, Dmitry A; Quinn, Emily; Gnatienko, Natalia; Bridden, Carly; Chaisson, Christine E; Walley, Alexander Y; Krupitsky, Evgeny M; Raj, Anita; Samet, Jeffrey H

2017-09-01

The link between HIV stigma with substance use is understudied. We characterized individuals with high HIV stigma and examined whether HIV stigma contributes to substance use among HIV-positive Russians reporting risky alcohol use. We analyzed data from HERMITAGE, a randomized controlled trial of 700 people living with HIV/AIDS (PLWHA) with past 6-month risky sex and risky alcohol use in St. Petersburg, Russia (2007-2011). Participants who were female and reported depressive symptoms and lower social support were more likely to endorse high HIV stigma (all p's stigma was not significantly associated with the primary outcome unhealthy substance use and was not consistently associated with secondary substance use outcomes. Interventions to enhance social and mental health support for PLWHA, particularly women, may reduce stigma, though such reductions may not correspond to substantial decreases in substance use among this population.

Childbearing and family planning choices of women living with HIV ...

African Journals Online (AJOL)

Objective: The main objective of this study was to assess the reproductive choices for Women Living with HIV on ART in the urban health centres within Lusaka. Methods: Nine hundred and fifty six HIV-positive women receiving care in the zoned health centres were randomly sampled and 12 health care workers who were ...

Lifetime induced abortion: a comparison between women living and not living with HIV.

Science.gov (United States)

Pilecco, Flávia Bulegon; Teixeira, Luciana Barcellos; Vigo, Alvaro; Dewey, Michael E; Knauth, Daniela Riva

2014-01-01

Studies aimed at understanding the association between induced abortion and HIV are scarce and differ on the direction of the association. This paper aims to show the prevalence of induced abortion in a sample of pregnancies of women living and not living with HIV/Aids, determining variables associated with pregnancy termination and linked to the life course of women and to the specific context of the pregnancy. Data came from a cross-sectional study, using interviewer-administered questionnaire, developed with women that attended public health services in Porto Alegre, Brazil. A generalized estimating equation model with logit link measured the association between determinants and abortion. The final sample was composed of 684 women living with HIV/Aids (2,039 pregnancies) and 639 women not living with HIV/Aids (1,539 pregnancies). The prevalence of induced abortion among pregnancies in women living with HIV/Aids was 6.5%, while in women not living with HIV/Aids was 2.9%. Among women living with HIV/Aids, the following were associated with induced abortion in the multivariable analysis: being older, having a higher education level, having had more sexual partners (i.e., variables linked to the life course of women), having had children prior to the index pregnancy and living with a sexual partner during pregnancy (i.e., variables linked to the context of each pregnancy). On the other hand, among women not living with HIV/Aids, only having a higher education level and having had more sexual partners (i.e., determinants linked to the life course of women) were associated with voluntary pregnancy termination in multivariable analysis. Although determinants are similar between women living and not living with HIV/Aids, prevalence of induced abortion is higher among pregnancies in women living with HIV/Aids, pointing to their greater social vulnerability and to the need for public policy to address prevention and treatment of HIV associated with reproductive issues.

Outcomes from a community-based, participatory lay health advisor HIV/STD prevention intervention for recently arrived immigrant Latino men in rural North Carolina, USA

Science.gov (United States)

Rhodes, Scott D.; Hergenrather, Kenneth C.; Bloom, Fred R.; Leichliter, Jami S.; Montaño, Jaime

2012-01-01

Background Latinos in the United States are at increased risk for HIV and sexually transmitted disease (STD) infection. We evaluated the efficacy of a pilot, lay health advisor (LHA) intervention designed to increase condom use and HIV testing among Latino men. Methods Fifteen LHAs (mean age=35.6; range 23–60 years) from 15 Latino soccer teams were trained and worked with their teammates for 18 months. Another 15 teams served as the control group. Data were collected at baseline and 18-months post-LHA training from a random sample of teammates from intervention and control teams. Results Data were collected from 222 men (mean age=29 years) who participated in one of the 30 teams. Relative to the control condition, participants in the intervention reported more consistent condom use in the 30 days preceding follow-up (unadjusted analysis, intervention, 65.6% vs. control, 41.3%; P<.001). Participants in the intervention were more likely to report condom use (adjusted odds ratio=2.3; CI=1.2–4.3) and HIV testing (adjusted odds ratio=2.5; CI=1.5–4.3). Conclusions LHA interventions for Latino men that are developed in partnership with community members, rely on male-centered intrapersonal networks, and are culturally congruent can enhance preventive behaviors and may reduce HIV infection. PMID:19824838

Surviving Surveillance: How Pregnant Women and Mothers Living With HIV Respond to Medical and Social Surveillance.

Science.gov (United States)

Greene, Saara; Ion, Allyson; Kwaramba, Gladys; Lazarus, Lisa; Loutfy, Mona

2017-12-01

Pregnant women and mothers living with HIV are under surveillance of service providers, family members, and the community at large. Surveillance occurs throughout the medical management of their HIV during pregnancy, preventing HIV transmission to their baby, infant feeding practices, and as part of assessments related to their ability to mother. Enacted and anticipatory HIV-related stigma can exacerbate the negative impact that being under surveillance has on mothers living with HIV as they move through their pregnancy, birthing, and mothering experiences. In response, women living with HIV find ways to manage their experiences of surveillance through engaging in acts of distancing, planning, and resisting at different points in time, and sometimes enacting all three practices at once. Positioning the narratives of pregnant women and mothers living with HIV in relation to their experiences of surveillance illuminates the relationship between the surveillance of mothers living with HIV and HIV-related stigma.

Marketing HIV prevention for heterosexually identified Latino men who have sex with men and women: the Hombres Sanos campaign.

Science.gov (United States)

Fernández Cerdeño, Araceli; Martínez-Donate, Ana P; Zellner, Jennifer A; Sañudo, Fernando; Carrillo, Héctor; Engelberg, Moshe; Sipan, Carol; Hovell, Melbourne

2012-01-01

This article describes the development process of Hombres Sanos, a social marketing campaign to promote HIV testing and condom use for heterosexually identified Latino men who have sex with men and women. The steps included qualitative formative research and a social marketing analytic framework to understand our target audience better, identify incentives and barriers to risk reduction, guide product development, define an optimal promotional campaign, and inform the selection of campaign platforms. A better grasp of the authors' target beneficiaries' needs and values led to an innovative dual strategy for audience segmentation and targeting. The campaign had consumer-centered, culturally sensitive, and theory-driven communication materials. The authors found communication materials and events to be appealing and effective. The campaign was well received among the wider community, and evaluation showed promising results among Latino men in general and among heterosexually identified Latino men who have sex with men and women in particular. The authors provide a step-by-step overview of the project's formative research, including research methods and findings, and how these were translated into a social marketing campaign. In addition, the authors discuss the challenges encountered in this process and the potential of social marketing to reduce HIV risk among Latinos.

Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition

Directory of Open Access Journals (Sweden)

Olalekan A. Uthman

2016-09-01

Full Text Available Abstract Background Smoking is still gaining ground in Sub-Saharan Africa, especially among socially disadvantaged groups. People living with HIV represent a subgroup with a significantly elevated prevalence of cigarette smoking. The objective of the study was to examine the influence of individual-, neighbourhood- and country-level socioeconomic position on current cigarette smoking among people living with HIV in Sub-Saharan Africa. Methods We applied multivariable multilevel logistic regression analysis on Demographic and Health Survey data collected between 2003 and 2012 in sub-Saharan Africa. We identified 31,270 individual living with HIV (Level 1 nested within 7,054 neighbourhoods (Level 2 from 19 countries (Level 3. Results After adjustment for individual-, neighbourhood- and country-level factors, respondents, the following significant independent risk factors for increasing odds of being a current cigarette smokers among people living with HIV: male gender (odds ratio [OR] = 62.49; 95 % credible interval [CrI] 45.93 to 78.28, from the poorer households (OR = 1.62, 95 % CrI 1.38 to 1.90; living in urban areas (OR = 1.24, 95 % CrI 1.09 to 1.41, from neighbourhoods with low poverty rate (OR = 1.25, 95 % CrI 1.09 to 1.43, illiteracy rate (OR = 1.28, 95 % CrI 1.14 to 1.42, low unemployment rate (OR = 1.11, 95 % crI 1.01 to 1.43; and from countries with low socio-economic deprivation (OR = 1.53, 95 CrI 1.08 to 1.96. About 3.4 % and 39.4 % variation in cigarette smoking behaviour among people living with HIV is conditioned by differences between neighbourhoods and countries. Conclusions Gender, education and socioeconomic context are independently associated with current cigarette smoking among people living with HIV in sub-Saharan Africa.

HIV disclosure and stigma among women living with HIV in Denmark

DEFF Research Database (Denmark)

Wessman, Maria; Thorsteinsson, Kristina; Storgaard, Merete

2017-01-01

OBJECTIVE: To identify disclosure, stigma and predictors of non-disclosure among women living with HIV in Denmark. METHODS: A questionnaire study of women living with HIV in Denmark was performed. The enrolment period was from February 2013 to March 2014. Logistic regression was used to estimate...... professionals to initiate a dialogue regarding stigma and disclosure with women living with HIV with a view to increasing disclosure and minimising stigmatisation in this vulnerable population....

Impact of HIV on and the constructions of masculinities among HIV-positive men in South Africa: implications for secondary prevention programs

Directory of Open Access Journals (Sweden)

Yandisa M. Sikweyiya

2014-10-01

Full Text Available Background: To date, whilst there have been many published studies exploring the links between masculinity and HIV, not much work has been done to explore how an HIV-positive diagnosis impacts men's sense of masculinity and contextualizing the masculinities as fluid and changing. Objective: To explore how human immunodeficiency virus (HIV impacts the lives of men and their constructions of masculinity through interviews with 18 men living with HIV. Design: Qualitative study involving conveniently and purposively selected black South African adult men who lived with HIV. In-depth interviews were conducted with 18 men who resided in Johannesburg and Mthatha, South Africa. Results: Our analysis suggests that the performance of risky masculinity may influence the acquisition of HIV. Yet, it also reveals that HIV can have a significant effect on men and their masculinities. Men's constructions of harmful notions of hegemonic masculinity pre-HIV diagnosis negatively affected their help-seeking behavior and coping and adjustment to living with HIV, post-diagnosis. The dominant discourse that men are strong and healthy visibly presented challenges for men when faced with an HIV-positive status. They interpreted HIV diagnosis as a loss, a sign of failure as a man, and evidence of an inability to retain control. Being sick undermined their ability to perform roles expected of them, and this led to feelings of powerlessness, worthlessness, and distress. Conclusions: Interventions with men living with HIV need to provide safe spaces for men to critically explore gender and constructions of social identities and the pressures these place on men and implications for their health. With this approach, harmful constructions of masculinities may be challenged and mitigated, and this process may render men amenable to change.

A preliminary RCT of CBT-AD for adherence and depression among HIV-positive Latinos on the U.S.-Mexico border: the Nuevo Día study.

Science.gov (United States)

Simoni, Jane M; Wiebe, John S; Sauceda, John A; Huh, David; Sanchez, Giselle; Longoria, Virginia; Andres Bedoya, C; Safren, Steven A

2013-10-01

We conducted a preliminary RCT among 40 HIV-positive Latinos of Mexican descent on the U.S.-Mexico border who indicated imperfect adherence and depressive symptomatology. Participants were randomly assigned to culturally adapted cognitive-behavioral therapy for adherence and depression with an alarmed pillbox or usual care. Outcomes were depressive symptoms (self-report and blind clinician ratings), adherence (self-report and electronic pillbox), and biological markers. The intervention, delivered in English and Spanish, proved feasible and acceptable. Generalized estimating equations in intent-to-treat analyses showed some effects of "moderate" to "large" size, with maintenance over time. For example, intervention (vs. control) participants demonstrated at post-intervention a greater drop in BDI scores (OR = -3.64, p = 0.05) and greater adherence according to the electronic pillbox (OR = 3.78, p = 0.03). Biological markers indicated some relative improvement for CD4 count but not VL. The promising results suggest a larger trial to determine efficacy is warranted.

Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada.

Science.gov (United States)

O'Brien, Nadia; Greene, Saara; Carter, Allison; Lewis, Johanna; Nicholson, Valerie; Kwaramba, Gladys; Ménard, Brigitte; Kaufman, Elaina; Ennabil, Nourane; Andersson, Neil; Loutfy, Mona; de Pokomandy, Alexandra; Kaida, Angela

Women comprise nearly one-quarter of people living with human immunodeficiency virus (HIV) in Canada. Compared with men, women living with HIV experience inequities in HIV care and health outcomes, prompting a need for gendered and tailored approaches to HIV care. Peer and academic researchers from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study conducted focus groups to understand women's experience of seeking care, with the purpose of identifying key characteristics that define a women-centered approach to HIV care. Eleven focus groups were conducted with 77 women living with HIV across Quebec, Ontario, and British Columbia, Canada. Women envisioned three central characteristics of women-centered HIV care, including i) coordinated and integrated services that address both HIV and women's health care priorities, and protect against exclusion from care due to HIV-related stigma, ii) care that recognizes and responds to structural barriers that limit women's access to care, such as violence, poverty, motherhood, HIV-related stigma, and challenges to safe disclosure, and iii) care that fosters peer support and peer leadership in its design and delivery to honor the diversity of women's experiences, overcome women's isolation, and prioritize women's ownership over the decisions that affect their lives. Despite advances in HIV treatment and care, the current care landscape is inadequate to meet women's comprehensive care needs. A women-centered approach to HIV care, as envisioned by women living with HIV, is central to guiding policy and practice to improve care and outcomes for women living with HIV in Canada. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Quality of life of people living with HIV and AIDS and antiretroviral therapy.

Science.gov (United States)

Oguntibeju, Oluwafemi O

2012-01-01

The development of antiretroviral drugs has significantly changed the perception of HIV/AIDS from a very fatal to a chronic and potentially manageable disease, and the availability and administration of antiretroviral therapy (ART) has significantly reduced mortality and morbidity associated with HIV and AIDS. There is a relationship between ART and quality of life of people living with HIV and AIDS, and several studies have reported a strong positive association between ART and improved quality of life in different domains among people living with HIV and AIDS in both developed and developing countries. However, a few studies have reported on the negative effects of ART, which directly or indirectly relate to the quality of life and longevity of HIV-infected persons. In this review, the effects and benefits of ART on people living with HIV and AIDS based on studies done in developed and developing countries is examined.

Quality of life of people living with HIV and AIDS and antiretroviral therapy

Science.gov (United States)

Oguntibeju, Oluwafemi O

2012-01-01

The development of antiretroviral drugs has significantly changed the perception of HIV/AIDS from a very fatal to a chronic and potentially manageable disease, and the availability and administration of antiretroviral therapy (ART) has significantly reduced mortality and morbidity associated with HIV and AIDS. There is a relationship between ART and quality of life of people living with HIV and AIDS, and several studies have reported a strong positive association between ART and improved quality of life in different domains among people living with HIV and AIDS in both developed and developing countries. However, a few studies have reported on the negative effects of ART, which directly or indirectly relate to the quality of life and longevity of HIV-infected persons. In this review, the effects and benefits of ART on people living with HIV and AIDS based on studies done in developed and developing countries is examined. PMID:22893751

HIV-positive patients’ and their families’ comprehension of HIV- and AIDS-related information

Directory of Open Access Journals (Sweden)

Gedina E. de Wet

2013-04-01

Full Text Available Despite acknowledgement of the importance of sharing HIV- and AIDS-related information with people living with HIV, it is still unclear as to what their actual comprehension is of this information. This research was part of a larger project, Tswaragano, conducted in the North-West Province, South Africa, which explored and described the competence, ability and strengths of the family of the HIV-positive patient during home support. This research focused on Potchefstroom in the North-West Province. This article focuses on research with the objective being to explore and describe the comprehension of HIV-positive patients and their families with regard to HIV- and AIDS-related information, and to formulate recommendations to improve their comprehension of this information. A quantitative, explorative and descriptive survey design was followed. Data were collected by means of questionnaires completed by HIV-positive patients (n = 79 and their family members (n = 34. Descriptive statistical analysis by means of frequency analysis was conducted. Ethical considerations and mechanisms to enhance validity and reliability are discussed. The results indicated that both HIV-positive respondents and their families face social and financial challenges due to unemployment and low income. A strength found in this research is that the majority of respondents are linked to a church, which can be a valuable platform to share information on HIV and AIDS. With regards to sharing, sources and comprehension of HIV- and AIDS-related information, it is apparent that respondents perceived that pre- and post-counselling provided an opportunity for information sharing, but that they need health care workers to spend more time with them, to be non-judgemental and to make more use of visual aids. It furthermore seems that the majority of HIV-positive respondents in this study did comprehend the need for and negotiate for safer sexual practices. It was concluded that

HIV-positive patients’ and their families’ comprehension of HIV- and AIDS-related information

Directory of Open Access Journals (Sweden)

Gedina E. de Wet

2013-04-01

Full Text Available Despite acknowledgement of the importance of sharing HIV- and AIDS-related information with people living with HIV, it is still unclear as to what their actual comprehension is of this information. This research was part of a larger project, Tswaragano, conducted in the North-West Province, South Africa, which explored and described the competence, ability and strengths of the family of the HIV-positive patient during home support. This research focused on Potchefstroom in the North-West Province. This article focuses on research with the objective being to explore and describe the comprehension of HIV-positive patients and their families with regard to HIV- and AIDS-related information, and to formulate recommendations to improve their comprehension of this information. A quantitative, explorative and descriptive survey design was followed. Data were collected by means of questionnaires completed by HIV-positive patients (n= 79 and their family members (n= 34. Descriptive statistical analysis by means of frequency analysis was conducted. Ethical considerations and mechanisms to enhance validity and reliability are discussed. The results indicated that both HIV-positive respondents and their families face social and financial challenges due to unemployment and low income. A strength found in this research is that the majority of respondents are linked to a church, which can be a valuable platform to share information on HIV and AIDS. With regards to sharing, sources and comprehension of HIV- and AIDS-related information, it is apparent that respondents perceived that pre- and post-counselling provided an opportunity for information sharing, but that they need health care workers to spend more time with them, to be non-judgemental and to make more use of visual aids. It furthermore seems that the majority of HIV-positive respondents in this study did comprehend the need for and negotiate for safer sexual practices. It was concluded that although

Perceived stigma of purchasing sex among Latino and non-Latino male clients of female sex workers in Tijuana, Mexico.

Science.gov (United States)

Pitpitan, Eileen V; Strathdee, Steffanie A; Semple, Shirley J; Wagner, Karla D; Chavarin, Claudia V; Earnshaw, Valerie A; Patterson, Thomas L

2015-02-01

HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino versus non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed.

Testing HIV positive in pregnancy: A phenomenological study of women's experiences.

Science.gov (United States)

Lingen-Stallard, Andrew; Furber, Christine; Lavender, Tina

2016-04-01

globally women receive HIV testing in pregnancy; however, limited information is available on their experiences of this potentially life-changing event. This study aims to explore women's experiences of receiving a positive HIV test result following antenatal screening. a qualitative, phenomenological approach. two public National Health Service (NHS) hospitals and HIV support organisations. a purposive sampling strategy was used. Thirteen black African women with a positive HIV result, in England, participated. data were collected using in-depth semi-structured interviews. An interpretive phenomenological approach to data analysis was used. the emergent phenomenon was transition and transformation of 'being,' as women accepted HIV as part of their lives. Paired themes support the phenomenon: shock and disbelief; anger and turmoil; stigma and confidentiality issues; acceptance and resilience. Women had extreme reactions to their positive HIV diagnosis, compounded by the cultural belief that they would die. Initial disbelief of the unexpected result developed into sadness at the loss of their old self. Turmoil was evident, as women considered termination of pregnancy, self-harm and suicide. Women felt isolated from others and relationship breakdowns often occurred. Most reported the pervasiveness of stigma, and how this was managed alongside living with HIV. Coping strategies included keeping HIV 'secret' and making their child(ren) the prime focus of life. Growing resilience was apparent with time. this study gives midwives unique understanding of the complexities and major implications for women who tested positive for HIV. Women's experiences resonated with processes of bereavement, providing useful insight into a transitional and transformational period, during which appropriate support can be targeted. midwives are crucial in improving the experience of women when they test HIV positive and to do this they need to be appropriately trained. Midwives need to

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment.

Science.gov (United States)

Nduwimana, Estella; Mukunzi, Sylvere; Ng, Lauren C; Kirk, Catherine M; Bizimana, Justin I; Betancourt, Theresa S

2017-06-01

Fostering children is common in sub-Saharan Africa, but few studies examine these children's mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10-17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes.

Living with HIV: Patients Perspective

Centers for Disease Control (CDC) Podcasts

2009-06-04

This podcast showcases three people who are living with HIV. The patients share their experiences of being diagnosed with HIV, of the treatments they are undergoing, and on taking responsibility for their health.  Created: 6/4/2009 by Division of HIV and AIDS Prevention (DHAP), National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention ( NCHHSTP).   Date Released: 6/4/2009.

Social position, gender role, and treatment adherence among Colombian women living with HIV/AIDS: social determinants of health approach.

Science.gov (United States)

Arrivillaga, Marcela; Ross, Michael; Useche, Bernardo; Alzate, Martha Lucia; Correa, Diego

2009-12-01

To assess and analyze the associations between adherence to treatment and social position in women living with HIV/AIDS. A cross-sectional, descriptive, correlational study among 269 Colombian women was conducted. Participants completed three questionnaires: a socio-demographic and clinical characteristics survey, a treatment adherence scale, and a social position survey. Women of low social position had a significantly higher probability of low treatment adherence (OR = 5.651, P effect on adherence. A general model considering the variables 'type of national health care plan' ('contributive,' 'subsidized,' or, in the case of vinculadas or the uninsured, 'none'); 'having HIV-positive children'; and 'level of viral load' was statistically reliable in predicting study participants' treatment adherence. Membership in the subsidized plan or being uninsured had a greater effect on the probability of low adherence than membership in the contributive plan (OR = 3.478, P 400 copies/ml were more likely to have low adherence than women without those characteristics (OR = 2.395, P = 0.0274 and OR = 2.178, P = 0.0050, respectively). Improving women's adherence to HIV/AIDS treatment in Colombia would require eliminating barriers to national health care system and comprehensive health care services and implementing programs that take into account women's role as maternal caregivers The findings underscore the need to integrate variables related to gender inequality and social position in treatment adherence analysis, as advocated in the social determinants of health approach.

Cannabis Use, Medication Management and Adherence Among Persons Living with HIV.

Science.gov (United States)

Vidot, Denise C; Lerner, Brenda; Gonzalez, Raul

2017-07-01

Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.

The effects of antiretroviral therapy on HIV-positive individuals in Wakiso District, Uganda

OpenAIRE

Yang, Tina Yang

2015-01-01

AIM The aim was to explore the experiences of HIV-positive individuals before and after gaining access to antiretroviral therapy in Wakiso District, Uganda and how antiretroviral therapy impacts certain aspects of those living with HIV, such as sexual behavior, support systems, faith and personal identity. METHODS Based on secondary data analysis of “Life On Antiretroviral Therapy: People’s Adaptive Coping And Adjustment To Living With HIV As A Chronic Condition In Wakiso District, Uganda” by...

Nutrition and HIV-Positive Pregnancy

OpenAIRE

Montgomery, Kristen S.

2003-01-01

When an HIV-positive woman becomes pregnant, additional nutritional considerations are warranted. Compared to routine prenatal nutritional assessment and intervention, pregnant HIV-positive women have increased needs to promote a healthy outcome. This column contains information on HIV and pregnancy, nutrition and infection, and nutrition for HIV-positive pregnancy. This content can be integrated into childbirth education settings to improve care to women who are HIV-positive.

EXPERIENCES OF HIV/AIDS STIGMA OF PERSONS LIVING WITH HIV/AIDS AND NURSES INVOLVED IN THEIR CARE FROM FIVE AFRICAN COUNTRIES

OpenAIRE

Greeff, Minrie; Uys, Leana R; Holzemer, William L; Makoae, Lucia N; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Phetlhu, Rene D.

2008-01-01

The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year proje...

HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada.

Science.gov (United States)

Logie, Carmen H; James, Llana; Tharao, Wangari; Loutfy, Mona R

2011-11-01

HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada. We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender) described stigma/discrimination and coping across micro (intra/interpersonal), meso (social/community), and macro (organizational/political) realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro), social networks and support groups (meso), and challenging stigma (macro). HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being--as well as opportunities for coping--in HIV-positive women's lives. Understanding the deleterious effects of stigma and discrimination

HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada.

Directory of Open Access Journals (Sweden)

Carmen H Logie

2011-11-01

Full Text Available HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada.We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender described stigma/discrimination and coping across micro (intra/interpersonal, meso (social/community, and macro (organizational/political realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro, social networks and support groups (meso, and challenging stigma (macro.HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being--as well as opportunities for coping--in HIV-positive women's lives. Understanding the deleterious effects of stigma and

Living with HIV: Patients Perspective

Centers for Disease Control (CDC) Podcasts

This podcast showcases three people who are living with HIV. The patients share their experiences of being diagnosed with HIV, of the treatments they are undergoing, and on taking responsibility for their health.

Nutrition and HIV-Positive Pregnancy

Science.gov (United States)

Montgomery, Kristen S.

2003-01-01

When an HIV-positive woman becomes pregnant, additional nutritional considerations are warranted. Compared to routine prenatal nutritional assessment and intervention, pregnant HIV-positive women have increased needs to promote a healthy outcome. This column contains information on HIV and pregnancy, nutrition and infection, and nutrition for HIV-positive pregnancy. This content can be integrated into childbirth education settings to improve care to women who are HIV-positive. PMID:17273329

Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria

Directory of Open Access Journals (Sweden)

Titilayo Ainegbesua Okoror

2016-06-01

Full Text Available Abstract Background Though research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria. Methods Using purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by four questions that explored participants’ experiences of living with HIV/AIDS. Interviews and discussions were conducted in three languages: English, Yoruba and Pidgin English. Thematic data analysis approach was in coding transcribed data, while social constructivist thinking guided data analysis. Results Participants ranged in age from 30 to 57 years old, and all were receiving antiretroviral therapy. Findings indicated that participants’ experiences of stigma might be moderated by the social context surrounding their HIV diagnosis, and whether they have met the socio-cultural construction of masculinity. Participants whose diagnosis were preceded by immediate family members’ diagnosis were less likely to report experiencing HIV stigma and more likely to report “not feeling less than a man” and educating others about HIV/AIDS. Contrarily, participants whose diagnosis was preceded by their own sickness were more likely to report isolation, sigma and feeling of being less than a man. All participants reported limiting their sexual intimacy, and those with children reported adjusting how they performed their role as fathers. Conclusions Social context surrounding HIV diagnosis impact how heterosexual HIV positive men experience HIV

Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria.

Science.gov (United States)

Okoror, Titilayo Ainegbesua; Falade, Catherine Olufunke; Walker, Ebunlomo Mary; Olorunlana, Adetayo; Anaele, Agaptus

2016-06-13

Though research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria. Using purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by four questions that explored participants' experiences of living with HIV/AIDS. Interviews and discussions were conducted in three languages: English, Yoruba and Pidgin English. Thematic data analysis approach was in coding transcribed data, while social constructivist thinking guided data analysis. Participants ranged in age from 30 to 57 years old, and all were receiving antiretroviral therapy. Findings indicated that participants' experiences of stigma might be moderated by the social context surrounding their HIV diagnosis, and whether they have met the socio-cultural construction of masculinity. Participants whose diagnosis were preceded by immediate family members' diagnosis were less likely to report experiencing HIV stigma and more likely to report "not feeling less than a man" and educating others about HIV/AIDS. Contrarily, participants whose diagnosis was preceded by their own sickness were more likely to report isolation, sigma and feeling of being less than a man. All participants reported limiting their sexual intimacy, and those with children reported adjusting how they performed their role as fathers. Social context surrounding HIV diagnosis impact how heterosexual HIV positive men experience HIV related stigma and how they perceive themselves as men, which may influence their

Sexual behaviour and inheritance rights among HIV-positive women in Abia State, Nigeria.

Science.gov (United States)

Enwereji, E E

2008-04-01

In developing countries, culture favours males for economic ventures more than females. There is evidence that allowing HIV positive women inheritance rights will mitigate negative economic consequences of HIV/AIDS and other related risks. This study aimed to examine the extent to which HIV positive women have access to family resources in Abia State, Nigeria. Data collection instruments were questionnaire, focus group discussion and interview guides using 98 HIV positive women in network of people living with HIV/AIDS. Five key informants were also interviewed to authenticate women's responses. Results showed that 85 (86.7%) of the women were denied rights to family resources. Thirty-eight (64.4%) of them had negative relationship with their family members for demanding their husbands' property. Because of limited financial assistance, the women took two types of risks in order to survive in the communities. Twenty-five women (25.5%) earned their livelihood by acting as hired labourers to others in the farm. More that half (55.1%) of the HIV positive women were practicing unprotected sex. Although as high as 79.6% of women were aware of risks of unprotected sex, 54 (55%) of them practised it. The commonest reason for taking the risk was sex partners' dislike for condom use. The high proportion of HIV positive women who were denied access to family resources, could suggest lack of care and support. If this denial continues, Government's efforts to reduce HIV prevalence would yield no significant result. There is therefore need for organized community education programme that emphasizes the benefits of empowering women living positively with HIV/AIDS economically.

The Latino Migrant Worker HIV Prevention Program: Building a Community Partnership Through a Community Health Worker Training Program

OpenAIRE

Sánchez, Jesús; Silva-Suarez, Georgina; Serna, Claudia A.; De La Rosa, Mario

2012-01-01

There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article...

"In our stories": The perspectives of women living with HIV on an evidence-based group intervention.

Science.gov (United States)

Dale, Sannisha K; Grimes, Tiffany; Miller, Lauren; Ursillo, Alyssa; Drainoni, Mari-Lynn

2017-07-01

A qualitative study among women living with HIV assessed the aspects of an evidence-based intervention targeting HIV transmission risk reduction (Women Involved in Life Learning from Other Women [WiLLOW]) that women valued and how their lives were impacted. Thirty-one women (80.6% African American) completed interviews. Women valued the personal stories and positive group dynamics (i.e. safety, trust, openness, getting feedback, bonding, and socializing). As a result of WiLLOW, women embraced a strong woman image, joined groups, changed behaviors, accepted their HIV status, became optimistic, and spoke up/advocated in their relationships and communities. Interventions for HIV-positive women may benefit from incorporating the sharing of stories in their curricula and factors that build positive group dynamics.

Reducing HIV risk among Hispanic/Latino men who have sex with men: Qualitative analysis of behavior change intentions by participants in a small-group intervention.

Science.gov (United States)

Alonzo, Jorge; Mann, Lilli; Tanner, Amanda E; Sun, Christina J; Painter, Thomas M; Freeman, Arin; Reboussin, Beth A; Song, Eunyoung; Rhodes, Scott D

2016-05-01

The southeastern United States has the fastest-growing Hispanic/Latino population in the country and carries a disproportionate HIV burden. Among Hispanics/Latinos, men, and men who have sex with men (MSM) in particular, are at elevated risk of HIV infection; however, very few efficacious behavioral HIV prevention interventions are available for use with this vulnerable population. To address this shortage of prevention resources, our community-based participatory research (CBPR) partnership developed and is currently evaluating the efficacy of the HOLA en Grupos intervention to increase condom use and HIV testing among Hispanic/Latino MSM. We recruited 304 Hispanic/Latino MSM who were randomized to receive the small group HOLA en Grupo s intervention that was implemented during four 4-hour long sessions over four consecutive Sundays, or a 4-session small group general health education comparison intervention. At the end of the fourth session of the HOLA en Grupo s intervention, the intervention facilitators asked participants to write down the sexual health-related behaviors they intended to change as a result of their participation. Qualitative analysis of the participants' responses identified six types of intended behavior changes: increasing and maintaining condom use; identifying strategies to support correct and consistent condom use; increasing communication and negotiation with sexual partners about condom use; getting tested for HIV and other sexually transmitted infections; applying other sexual health promotion strategies; and sharing newly learned sexual health information with their peers. Most risk-reduction intentions aligned with the intervention's key messages of using condoms consistently and getting tested for HIV. However, participants' stated intentions may have also depended on which behavior changes they perceived as most salient after participating in the intervention. Participants' intentions to share information with their peers may

Life expectancy living with HIV: recent estimates and future implications.

Science.gov (United States)

Nakagawa, Fumiyo; May, Margaret; Phillips, Andrew

2013-02-01

The life expectancy of people living with HIV has dramatically increased since effective antiretroviral therapy has been available, and still continues to improve. Here, we review the latest literature on estimates of life expectancy and consider the implications for future research. With timely diagnosis, access to a variety of current drugs and good lifelong adherence, people with recently acquired infections can expect to have a life expectancy which is nearly the same as that of HIV-negative individuals. Modelling studies suggest that life expectancy could improve further if there were increased uptake of HIV testing, better antiretroviral regimens and treatment strategies, and the adoption of healthier lifestyles by those living with HIV. In particular, earlier diagnosis is one of the most important factors associated with better life expectancy. A consequence of improved survival is the increasing number of people with HIV who are aged over 50 years old, and further research into the impact of ageing on HIV-positive people will therefore become crucial. The development of age-specific HIV treatment and management guidelines is now called for. Analyses on cohort studies and mathematical modelling studies have been used to estimate life expectancy of those with HIV, providing useful insights of importance to individuals and healthcare planning.

Religious and spiritual coping in people living with HIV/Aids

Directory of Open Access Journals (Sweden)

Clarissa Mourão Pinho

Full Text Available ABSTRACT Objective: evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. Method: descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL, and the Religious/Spiritual Coping Scale (RCOPE. Results: the sample presented high indices of organizational religiosity (4.23±1.66, non-organizational religiosity (4.63±1.50, and intrinsic religiosity (13.13±2.84. Positive RCOPE was used in high mean scores (3.66±0.88, and negative RCOPE had low use (2.12 ± 0.74. In total, use of RCOPE was high (3.77±0.74, having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46. Conclusion: it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

Feasibility Analysis of an Evidence-Based Positive Prevention Intervention for Youth Living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo

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Parker, L.; Maman, S.; Pettifor, A.; Chalachala, J. L.; Edmonds, A.; Golin, C. E.; Moracco, K.; Behets, F.

2013-01-01

We evaluated the feasibility of a Positive Prevention intervention adapted for youth living with HIV/AIDS (YLWH) ages 15-24 in Kinshasa, Democratic Republic of the Congo. We conducted in-depth interviews and focus group discussions with intervention facilitators and YLWH participants on the following four areas of a feasibility framework:…

Beliefs and perceived norms concerning body image among African-American and Latino teenagers.

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Barroso, Cristina S; Peters, Ronald Joseph; Johnson, Regina Jones; Kelder, Steven H; Jefferson, Troy

2010-09-01

Focus groups, utilizing the Theory of Planned Behavior, examined the beliefs and perceived norms regarding body image in a sample of urban African-American and Latino teenagers (N = 83, 18-19 years old) from Texas. Cultural eating (behavioral belief) explained the acceptance and tolerance of overweight. Popularity of hip-hop fashion and limited income explicated peer and familial normative beliefs, respectively. Thinness equated HIV infection in African-Americans (parental normative belief). Barriers to healthy eating and active living (control beliefs) included willpower, laziness, fast food, and excessive work. Findings can guide the development and implementation of culturally appropriate obesity interventions for African-American and Latino adolescents.

Perceptions, motivations, and concerns about living organ donation among people living with HIV.

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Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Bollinger, Juli; Seaman, Shanti; Brown, Diane; Durand, Christine M; Segev, Dorry L; Sugarman, Jeremy

2018-05-03

Recent changes to United States law now permit people living with HIV (PLWH) to donate organs to HIV-infected (HIV+) recipients under research protocols. PLWH may have unique motivations for and concerns about living donation and understanding them is critical to ensuring the integrity of this novel approach to organ transplantation. We conducted in-depth interviews with PLWH from an urban HIV clinic who had previously indicated their willingness to be a living donor. Interviews elicited information on their motivations, perceived benefits, and concerns regarding living donation. Codes were identified inductively and then organized into themes and subthemes. Two coders independently analyzed the interviews and reconciled differences in coding by consensus. Thematic saturation was reached after 20 interviews. Motivations for living donation among PLWH included an altruistic desire to help others as well as HIV-specific motivations including solidarity with potential recipients and a desire to overcome HIV-related stigma. Perceived benefits of living donation included gratification from saving or improving the recipient's life and conferring a sense of normalcy for the HIV+ donor. Concerns about donation included the possibility of a prolonged recovery period, organ failure, and transmission of another strain of the virus to the recipients. PLWH had unique motivations, perceived benefits, and concerns about living donation in addition to those previously identified in the general population. These unique factors should be addressed in research protocols, informed consent processes, and the education and training of independent living donor advocates so that these endeavors are ethically sound.

Assessing Factors that affect Childbirth Choices of People living positively with HIV/AIDS in Abia State of Nigeria.

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Enwereji, Ezinne E; Enwereji, Kelechi O

2010-04-01

Poor interpersonal relationships with women especially those living positively with HIV/AIDS can make them take risks that would expose their new born and others to infection during childbirth. The factors that influence childbirth choices of people living positively with HIV/AIDS (PLWHA) deserve attention. Sometimes, women, especially PLWHA, for several reasons, resort to the use of other health care services instead of the general hospitals equipped for ante-natal care (ANC). This study aims to identify factors and conditions that determine childbirth choices of PLWHA in the Abia State of Nigeria. A cross-sectional descriptive study was carried out using a total sample of 96 PLWHA who attend meetings with the network of PLWHA and also a purposive convenience sample of 45 health workers. Data collection instruments were questionnaire, focus group discussions and interview guides. Data was analyzed both qualitatively and quantitatively using simple percentages. There was a low patronage for hospital services. A total of 79 (82%) PLWHA did not use hospital services due to the lack of confidentiality. In total, 61 (64%) PLWHA had their childbirth with Traditional Birth Attendants (TBAs) at home. Embarrassment, rejection, interpersonal conflicts with health workers, non-confidentiality, cultural stigma and stigmatization were among the factors that encouraged childbirth choices. On the whole, 82 (85%) of the PLWHA discontinued ANC services because of stigmatization. Poor interpersonal relationships between health workers and PLWHA facilitated PLWHA childbirth choices more than other factors. PLWHA and health workers termed management of belligerent tendencies against each other as their greatest concern. Therefore, concerted effort is needed to improve health workers/PLWHA relationship in hospitals. This would minimize factors and/or conditions that encourage HIV infection. Exposing PLWHA to factors that influence childbirth at home demonstrates high risks of mother

Assessing Factors that affect Childbirth Choices of People living positively with HIV/AIDS in Abia State of Nigeria

Directory of Open Access Journals (Sweden)

Ezinne E. Enwereji

2010-04-01

Full Text Available Objectives: Poor interpersonal relationships with women especially those living positively with HIV/AIDS can make them take risks that would expose their new born and others to infection during childbirth. The factors that influence childbirth choices of people living positively with HIV/AIDS (PLWHA deserve attention. Sometimes, women, especially PLWHA, for several reasons, resort to the use of other health care services instead of the general hospitals equipped for ante-natal care (ANC. This study aims to identify factors and conditions that determine childbirth choices of PLWHA in the Abia State of Nigeria.Methods:A cross-sectional descriptive study was carried out using a total sample of 96 PLWHA who attend meetings with the network of PLWHA and also a purposive convenience sample of 45 health workers. Data collection instruments were questionnaire, focus group discussions and interview guides. Data was analyzed both qualitatively and quantitatively using simple percentages.Results: There was a low patronage for hospital services. A total of 79 (82% PLWHA did not use hospital services due to the lack of confidentiality. In total, 61 (64% PLWHA had their childbirth with Traditional Birth Attendants (TBAs at home. Embarrassment, rejection, interpersonal conflicts with health workers, non-confidentiality, cultural stigma and stigmatization were among the factors that encouraged childbirth choices. On the whole, 82 (85% of the PLWHA discontinued ANC services because of stigmatization.Conclusion: Poor interpersonal relationships between health workers and PLWHA facilitated PLWHA childbirth choices more than other factors. PLWHA and health workers termed management of belligerent tendencies against each other as their greatest concern. Therefore, concerted effort is needed to improve health workers/PLWHA relationship in hospitals. This would minimize factors and/or conditions that encourage HIV infection. Exposing PLWHA to factors that influence

Stigma, social support, and treatment adherence among HIV-positive patients in Chiang Mai, Thailand.

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Li, Michael Jonathan; Murray, Jordan Keith; Suwanteerangkul, Jiraporn; Wiwatanadate, Phongtape

2014-10-01

Our study assessed the influence of HIV-related stigma on treatment adherence among people living with HIV in Chiang Mai, Thailand, and whether social support had a moderating effect on this relationship. We recruited 128 patients living with HIV from Sansai Hospital, a community hospital in Chiang Mai, Thailand, and collected data through structured interviews. All forms of HIV-related stigma considered in this study (personalized experience, disclosure, negative self-image, and public attitudes) were negatively correlated with adherence to anti-retroviral regimens. Multiple linear regression indicated that total HIV-related stigma was more predictive of treatment adherence than any individual stigma type, after adjusting for socio-demographic and health characteristics. Tests of interaction showed that social support did not appear to moderate the association between HIV stigma and treatment adherence. Our findings suggest that community and government efforts to improve public perceptions about people living with HIV might promote treatment adherence behaviors among HIV-positive patients.

US: developments in the treatment of HIV-positive prisoners in two states.

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Gibson, Katie

2005-08-01

Legal actions have been launched in Alabama and Mississippi to address living conditions and medical care of HIV-positive prisoners in state prisons. These were the only two states to allow complete segregation of HIV-positive prisoners in state prisons into the 1990s. The two cases highlight the ways in which the courts have been involved in supervising prison conditions in the United States.

Perceived Family Support and Antiretroviral Adherence in HIV-Positive Individuals: Results from a Community-Based Positive Living With HIV Study.

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Poudel, Krishna C; Buchanan, David R; Amiya, Rachel M; Poudel-Tandukar, Kalpana

2015-01-01

The purpose of this study was to examine the association between perceived family support, either positive or negative, and adherence to antiretroviral medication regimens among HIV-positive individuals in the Kathmandu Valley, Nepal. We measured past 3-month antiretroviral adherence among 233 HIV-positive individuals, in relation to perceived family support, both positive (in terms of emotional and instrumental support) and negative (in the form of negative interactions), using the 10-item Nepali Family Support and Difficulty Scale. Medium and high levels of perceived emotional support from family were associated with reduced risk of antiretroviral nonadherence, compared with low levels of perceived emotional support (adjusted odds ratio [AOR]  = 0.37, 95% confidence interval [CI] [0.16, 0.88], and AOR  = 0.23, 95% CI [0.08, 0.64], respectively). Conversely, higher levels of felt emotional distance (AOR  = 1.46, 95% CI [1.00, 2.14]) and experienced physical harm (AOR  = 2.04, 95% CI [1.07, 3.91]) were associated with increased risk of nonadherence. The results support the recommendation that service providers need to be aware of the significant role of family support in shaping antiretroviral adherence and to consider ways to strengthen positive family support while minimizing negative family interactions to increase adherence rates. © The Author(s) 2015.

A rapid assessment of post-disclosure experiences of urban HIV-positive and HIV-negative school-aged children in Kenya

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Grace Gachanja

2015-06-01

Full Text Available There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data, indicating that HIV-positive and negative children appear to have differing post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. Following disclosure, HIV-negative children accepted their parents’ illnesses within a few hours to a few weeks; HIV-positive children took weeks to months to accept their own illnesses. HIV-negative children knew of high levels of stigma and discrimination within the community; HIV-positive children reported experiencing indirect incidences of stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees so they could have a better life in the future; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. All but one preadolescent HIV-positive child had self-identified a person to speak

Shame, self-acceptance and disclosure in the lives of gay men living with HIV: an interpretative phenomenological analysis approach.

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Skinta, Matthew D; Brandrett, Benjamin D; Schenk, William C; Wells, Gregory; Dilley, James W

2014-01-01

HIV-related stigma is a major driver of poor prognosis for the treatment and reduced spread of HIV. The present article provides a qualitative analysis surrounding various themes related to stigma and shame as a result HIV. Eight gay men recruited from a community HIV clinic contacted the researchers in response to a study involving participation in a structured, eight-week group intervention for HIV-related stigma. Following this group, three men took part in open-ended interviews about their thoughts and experiences. Interpretative phenomenological analysis was used to examine the participants' experiences surrounding shame and stigma related to living with HIV. Three superordinate themes were identified: social support and the disclosure of serostatus, stigma associated with serosorting and attempts to negotiate a spoiled identity. In San Francisco, a city with a great deal of acceptance surrounding HIV and a large, politically active community of persons living with HIV, gay men continue to struggle with disclosure and stigma. This stigma may be an unexpected result of a high degree of HIV testing and attempts by both HIV-positive and negative gay men to practise serosorting.

Quality of life of people living with HIV and AIDS and antiretroviral therapy

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Oguntibeju OO

2012-08-01

Full Text Available Oluwafemi O OguntibejuOxidative Stress Research Centre, Cape Peninsula University of Technology, Bellville, South AfricaAbstract: The development of antiretroviral drugs has significantly changed the perception of HIV/AIDS from a very fatal to a chronic and potentially manageable disease, and the availability and administration of antiretroviral therapy (ART has significantly reduced mortality and morbidity associated with HIV and AIDS. There is a relationship between ART and quality of life of people living with HIV and AIDS, and several studies have reported a strong positive association between ART and improved quality of life in different domains among people living with HIV and AIDS in both developed and developing countries. However, a few studies have reported on the negative effects of ART, which directly or indirectly relate to the quality of life and longevity of HIV-infected persons. In this review, the effects and benefits of ART on people living with HIV and AIDS based on studies done in developed and developing countries is examined.Keywords: benefits, negative effects, oxidative stress, treatment, modifications of desires

HIV, Gender, Race, Sexual Orientation, and Sex Work: A Qualitative Study of Intersectional Stigma Experienced by HIV-Positive Women in Ontario, Canada

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Logie, Carmen H.; James, LLana; Tharao, Wangari; Loutfy, Mona R.

2011-01-01

Background HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada. Methods and Findings We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender) described stigma/discrimination and coping across micro (intra/interpersonal), meso (social/community), and macro (organizational/political) realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro), social networks and support groups (meso), and challenging stigma (macro). Conclusions HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being—as well as opportunities for coping—in HIV-positive women's lives. Understanding the

Aerobic endurance in HIV-positive young adults and HIV-negative ...

African Journals Online (AJOL)

Background: Aerobic endurance is an important aspect of physical fitness that enables individuals living with HIV to endure in the work place as well as in agricultural operations in order to earn a living and improve their quality of life. However, despite high HIV prevalence rates, the aerobic endurance status of young ...

The HIV Risk Profiles of Latino Sexual Minorities and Transgender Persons Who Use Websites or Apps Designed for Social and Sexual Networking.

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Sun, Christina J; Reboussin, Beth; Mann, Lilli; Garcia, Manuel; Rhodes, Scott D

2016-02-01

The use of websites and GPS-based mobile applications ("apps") designed for social and sexual networking has been associated with increased HIV risk; however, little is known about Latino sexual minorities' and transgender persons' use of these websites and apps and the risk profiles of those who use them compared with those who do not. Data from 167 participants who completed the baseline survey of a community-level HIV prevention intervention, which harnesses the social networks of Latino sexual minorities and transgender persons, were analyzed. One quarter of participants (28.74%, n = 48) reported using websites or apps designed for social and sexual networking, and 119 (71.26%) reported not using websites or apps designed for social and sexual networking. Those who used websites or apps were younger and reported more male sex partners, a sexually transmitted disease diagnosis, and illicit drug use other than marijuana. HIV prevention interventions for those who use websites or apps should consider addressing these risks for HIV. © 2015 Society for Public Health Education.

Non-infective pulmonary disease in HIV-positive children

International Nuclear Information System (INIS)

Theron, Salomine; Andronikou, Savvas; George, Reena; Plessis, Jaco du; Hayes, Murray; Mapukata, Ayanda; Goussard, Pierre; Gie, Robert

2009-01-01

It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30-40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease. (orig.)

Community engagement among men who have sex with men living with HIV/AIDS in Taiwan.

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Chuang, Deng-Min; Lacombe-Duncan, Ashley

2016-01-01

Community engagement was developed as a global principle in the provision of HIV/AIDS services, yet evidence-based research of implementation of the principle is lacking in Taiwan. This short report aims to understand factors associated with engagement in two types of activities with varying levels of visibility: HIV-related community events and HIV-related community action, in Taiwanese men who have sex with men (MSM) living with HIV. A cross-sectional survey was distributed to a purposive sample of participants recruited from AIDS service organizations (ASOs). Among participants (n = 178), 63.6% were involved in HIV-related community events, while less than half (47.7%) were involved in HIV-related community action. In multivariable analysis, age, involvement in ASOs, and AIDS knowledge were positively associated with engagement in community events, and living in the north of Taiwan, years of infection, and self-stigma were negatively associated with this type of engagement. Few factors, with the exception of involvement in ASOs, were positively associated with engagement in HIV-related community action. To this end, ASOs appear to play a strong role in improving and organizing both types of community engagement in Taiwan. Future studies should evaluate tailored programs delivered through ASOs for strengthening community connectedness among younger, stigmatized, and longer diagnosed MSM living with HIV.

Positive Reading Attitudes of Low-Income Bilingual Latinos

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Bussert-webb, Kathy M.; Zhang, Zhidong

2018-01-01

Many assume low-income, emergent bilingual Latinos have poor reading attitudes. To investigate this issue, we surveyed 1,503 Texas public high school students through stratified cluster sampling to determine their reading attitudes. Most represented Latinos and mixed-race Latinos/Whites who heard Spanish at home and whose mother tongue was…

Back to work: vocational issues and strategies for Canadians living with HIV/AIDS.

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McGinn, Fred; Gahagan, Jacqueline; Gibson, Elaine

2005-01-01

Much has been written since the first appearance of HIV/AIDS in 1981 about its effects on the Canadian health care and social services systems. However, researchers have given limited attention to issues of entry or re-entry to the competitive job market for HIV positive individuals. The emergence of highly active antiretroviral therapies (HAART) has allowed a significant number of persons who are HIV positive to experience a major recovery in health and energy. This increase in physical health has in turn led to a re-examination of the possibility of returning to former types and levels of activity, including the prospect of going back to work or entering the competitive workforce for the first time. The purpose of this paper is to outline some of the issues and concerns that impact HIV positive individuals' attempts to return to or enter the competitive workforce, particularly those relating to disability policies and public insurance. Data from in-depth interviews with a sample of people living with HIV/AIDS (PHAs) are used to help illustrate the disconnect between these policies and the lived experiences of PHAs. Also discussed are the opportunities for Canadian policies and practices to employ a functional definition of disability and a philosophy of early intervention in vocational rehabilitation.

Experiences of work among people with disabilities who are HIV-positive in Zambia.

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Njelesani, Janet; Nixon, Stephanie; Cameron, Deb; Parsons, Janet; Menon, Anitha

2015-01-01

This paper focuses on accounts of how having a disability and being HIV-positive influences experiences of work among 21 people (12 women, 9 men) in Lusaka, Zambia. In-depth semi-structured interviews were conducted in English, Bemba, Nyanja, or Zambian sign language. Descriptive and thematic analyses were conducted. Three major themes were generated. The first, a triple burden, describes the burden of having a disability, being HIV-positive, and being unemployed. The second theme, disability and HIV is not inability, describes participants' desire for work and their resistance to being regarded as objects of charity. Finally, how work influences HIV management, describes the practicalities of working and living with HIV. Together these themes highlight the limited options available to persons with disabilities with HIV in Lusaka, not only secondary to the effects of HIV influencing their physical capacity to work, but also because of the attendant social stigma of being a person with a disability and HIV-positive.

Homophobia and racism experienced by Latino men who have sex with men in the United States: correlates of exposure and associations with HIV risk behaviors.

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Mizuno, Yuko; Borkowf, Craig; Millett, Gregorio A; Bingham, Trista; Ayala, George; Stueve, Ann

2012-04-01

Using cross-sectional data collected from 1081 Latino men who have sex with men (MSM) recruited with respondent-driven sampling (RDS) techniques from Los Angeles and New York, we examined the extent to which Latino MSM reported exposure to social discrimination (i.e., experienced both homophobia and racism, homophobia only, racism only, or neither homophobia nor racism). More than 40% of respondents experienced both homophobia and racism in the past 12 months. Los Angeles participants, those with lower income, and those who reported being HIV-positive were more likely to report experiencing both types of social discrimination. Adjusting for potential confounders, men exposed to both homophobia and racism were more likely than men exposed to neither form of discrimination to report unprotected receptive anal intercourse with a casual sex partner (AOR = 1.92, 95% CI, 1.18-3.24) and binge drinking (AOR = 1.42, 95% CI, 1.02-1.98). Our findings suggest the presence of a syndemic of adverse social experiences and call for more intervention research to address both homophobia and racism experienced among Latino MSM in the United States.

Sexual and reproductive health services for people living with HIV: a systematic review.

Science.gov (United States)

Brickley, Deborah Bain; Almers, Lucy; Kennedy, Caitlin E; Spaulding, Alicen B; Mirjahangir, Joy; Kennedy, Gail E; Packel, Laura; Osborne, Kevin; Mbizvo, Michael; Collins, Lynn

2011-03-01

People living with HIV often have unmet needs for sexual and reproductive health (SRH) services. We present results of a systematic review of studies offering SRH services targeted to people living with HIV. Studies were selected from a broader SRH and HIV linkages review. Inclusion criteria included: (1) peer-reviewed journal articles with a pre-post or multiple-arm study design; (2) reported post-intervention evaluation data; and (3) published 1 January 1990 through 31 December 2007. Nine studies were identified with an average rigour score of 5.1 out of 9. Services included family planning (one study), sexually transmitted infection (STI) services (two studies), combined family planning and STI services (three studies) and multiple services (three studies). The review identified mostly positive effects on the outcomes measured, including condom and contraceptive use and quality of services. Yet gaps remain in the research to establish the best approaches for addressing needs and choices of people living with HIV. There is a need for high-quality intervention studies to determine the most successful and cost-effective strategies for providing SRH services to people living with HIV.

Latino Population Growth, Socioeconomic and Demographic Characteristics, and Implications for Educational Attainment

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Chapa, Jorge; De La Rosa, Belinda

2004-01-01

Data from the U.S. Census Bureau and the National Center for Education Statistics indicate that Latinos lag behind non-Latinos in education and in other socioeconomic characteristics. Although there are some positive indications such as the decrease of individuals and children living in poverty and an increase in the number of individuals working…

HIV stigma and social capital in women living with HIV

OpenAIRE

Cuca, Yvette P.; Asher, Alice; Okonsky, Jennifer; Kaihura, Alphoncina; Dawson-Rose, Carol; Webel, Allison

2016-01-01

Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total so...

Reducing HIV risk among Hispanic/Latino men who have sex with men: Qualitative analysis of behavior change intentions by participants in a small-group intervention

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Alonzo, Jorge; Mann, Lilli; Tanner, Amanda E.; Sun, Christina J.; Painter, Thomas M.; Freeman, Arin; Reboussin, Beth A.; Song, Eunyoung; Rhodes, Scott D.

2016-01-01

Objective The southeastern United States has the fastest-growing Hispanic/Latino population in the country and carries a disproportionate HIV burden. Among Hispanics/Latinos, men, and men who have sex with men (MSM) in particular, are at elevated risk of HIV infection; however, very few efficacious behavioral HIV prevention interventions are available for use with this vulnerable population. To address this shortage of prevention resources, our community-based participatory research (CBPR) partnership developed and is currently evaluating the efficacy of the HOLA en Grupos intervention to increase condom use and HIV testing among Hispanic/Latino MSM. Methods We recruited 304 Hispanic/Latino MSM who were randomized to receive the small group HOLA en Grupos intervention that was implemented during four 4-hour long sessions over four consecutive Sundays, or a 4-session small group general health education comparison intervention. At the end of the fourth session of the HOLA en Grupos intervention, the intervention facilitators asked participants to write down the sexual health-related behaviors they intended to change as a result of their participation. Results Qualitative analysis of the participants’ responses identified six types of intended behavior changes: increasing and maintaining condom use; identifying strategies to support correct and consistent condom use; increasing communication and negotiation with sexual partners about condom use; getting tested for HIV and other sexually transmitted infections; applying other sexual health promotion strategies; and sharing newly learned sexual health information with their peers. Conclusion Most risk-reduction intentions aligned with the intervention’s key messages of using condoms consistently and getting tested for HIV. However, participants’ stated intentions may have also depended on which behavior changes they perceived as most salient after participating in the intervention. Participants’ intentions to

Understanding the experience and manifestation of depression in adolescents living with HIV in Harare, Zimbabwe

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Mavhu, Webster; Wogrin, Carol; Mutsinze, Abigail; Kagee, Ashraf

2018-01-01

Background Studies have found that adolescents living with HIV are at risk of depression, which in turn affects adherence to medication. This study explored the experience and manifestation of depression in adolescents living with HIV in Zimbabwe in order to inform intervention development. Methods We conducted a body mapping exercise with 21 HIV positive 15–19 years olds who had been diagnosed with major depressive disorder. Participants created a painted map of their body to assist them in expressing their somatic and emotional experiences in qualitative interviews. The interviews were transcribed and thematically coded using NVivo 10. Results Participants attributed their experiences of depression to their relationships and interactions with significant people in their lives, primarily family members and peers. A sense of being different from others was common among participants, both due to their HIV status and the impact HIV has had on their life circumstances. Participants described a longing to be important or to matter to the people in their lives. A sense of isolation and rejection was common, as well as grief and loss, including ambiguous and anticipated loss. Participants’ idioms of distress included ‘thinking deeply’ (‘kufungisisa’), ‘pain’, darkness, ‘stress’ or a lack of hope and ambiguity for the future. Suicidal ideation was described, including slow suicide through poor adherence. Supportive factors were also relational, including the importance of supportive relatives and peers, clinic staff and psychosocial support programmes. Conclusions An understanding of HIV positive adolescents’ own narratives around depression can inform the development and integration of appropriate mental health interventions within HIV care and treatment programmes. Study findings suggest that family and peer-led interventions are potentially useful in the prevention and management of depression in adolescents living with HIV. PMID:29298326

Enhancement of a locally developed HIV prevention intervention for Hispanic/Latino MSM: A partnership of community-based organizations, a university, and the Centers for Disease Control and Prevention

Science.gov (United States)

Rhodes, Scott D.; Alonzo, Jorge; Mann, Lilli; Freeman, Arin; Sun, Christina J.; Garcia, Manuel; Painter, Thomas M.

2015-01-01

Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral interventions are currently available for use with this vulnerable population. We describe the development and enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated. Our enhancement process included incorporating local data on risks and context; identifying community priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If efficacious, HOLA en Grupos will be the first behavioral intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners. PMID:26241382

Resilience among asylum seekers living with HIV

Directory of Open Access Journals (Sweden)

Orton Lois

2012-10-01

Full Text Available Abstract Background A small body of evidence demonstrates the challenges faced by migrant communities living with HIV but has yet to consider in-depth the experience of asylum seekers whose residency status is undetermined. The overall aim of our study was to explore the experiences of those who are both living with HIV and seeking asylum. This paper focuses on the stressors precipitated by the HIV diagnosis and by going through the asylum system; as well as participants’ resilience in responding to these stressors and the consequences for their health and wellbeing. Methods We conducted an ethnographic study. Fieldwork took place in the UK between 2008–2009 and included: 350 hours of observation at voluntary services providing support to black and minority ethnic groups living with HIV; 29 interviews and four focus group discussions with those who were seeking asylum and living with HIV; and 15 interviews with their health and social care providers. Data were analysed using the constant comparative method. Results There were three main stressors that threatened participants’ resilience. First, migration caused them to leave behind many resources (including social support. Second, stigmatising attitudes led their HIV diagnosis to be a taboo subject furthering their isolation. Third, they found themselves trapped in the asylum system, unable to influence the outcome of their case and reliant on HIV treatment to stay alive. Participants were, however, very resourceful in dealing with these experiences. Resilience processes included: staying busy, drawing on personal faith, and the support received through HIV care providers and voluntary organisations. Even so, their isolated existence meant participants had limited access to social resources, and their treatment in the asylum system had a profound impact on perceived health and wellbeing. Conclusions Asylum seekers living with HIV in the UK show immense resilience. However, their isolation

[Stigma and discrimination: the experiences of HIV-positive women in poor neighborhoods of Maputo, Mozambique].

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Andrade, Rosário Gregório; Iriart, Jorge Alberto Bernstein

2015-03-01

The HIV/AIDS epidemic is a serious public health problem in Mozambique. The country has high prevalence rates, and the epidemic's impact is aggravated by the stigma affecting HIV-positive persons. This study takes a socio-anthropological perspective to analyze the experience of HIV-positive women in poor neighborhoods of Maputo and the ways they cope with stigma and discrimination. Semi-structured interviews were conducted with 10 HIV-positive women. The results show how gender inequalities increase women's vulnerability to HIV and contribute to their stigmatization and discrimination. In dealing with stigma, women try to keep their diagnosis confidential, seeking support in group meetings with others living with HIV. Public policies should focus on women's empowerment and the reduction of HIV/AIDS-related stigma.

Small-Group Randomized Controlled Trial to Increase Condom Use and HIV Testing Among Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex With Men.

Science.gov (United States)

Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Song, Eunyoung Y; Tanner, Amanda E; Arellano, Jorge Elias; Rodriguez-Celedon, Rodrigo; Garcia, Manuel; Freeman, Arin; Reboussin, Beth A; Painter, Thomas M

2017-06-01

To evaluate the HOLA en Grupos intervention, a Spanish-language small-group behavioral HIV prevention intervention designed to increase condom use and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men. In 2012 to 2015, we recruited and randomized 304 Hispanic/Latino men who have sex with men, aged 18 to 55 years in North Carolina, to the 4-session HOLA en Grupos intervention or an attention-equivalent general health education comparison intervention. Participants completed structured assessments at baseline and 6-month follow-up. Follow-up retention was 100%. At follow-up, relative to comparison participants, HOLA en Grupos participants reported increased consistent condom use during the past 3 months (adjusted odds ratio [AOR] = 4.1; 95% confidence interval [CI] = 2.2, 7.9; P < .001) and HIV testing during the past 6 months (AOR = 13.8; 95% CI = 7.6, 25.3; P < .001). HOLA en Grupos participants also reported increased knowledge of HIV (P < .001) and sexually transmitted infections (P < .001); condom use skills (P < .001), self-efficacy (P < .001), expectancies (P < .001), and intentions (P < .001); sexual communication skills (P < .01); and decreased fatalism (P < .001). The HOLA en Grupos intervention is efficacious for reducing HIV risk behaviors among Hispanic/Latino men who have sex with men.

Perceptions of HIV-related health services in Zambia for people with disabilities who are HIV-positive

Science.gov (United States)

Nixon, Stephanie A; Cameron, Cathy; Hanass-Hancock, Jill; Simwaba, Phillimon; Solomon, Patricia E; Bond, Virginia A; Menon, Anitha; Richardson, Emma; Stevens, Marianne; Zack, Elisse

2014-01-01

Introduction Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs), there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. Methods This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Results Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1) disability-related discrimination heightened when seeking HIV services, (2) communication barriers and related concerns with confidentiality, and (3) movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants’ profound concerns about poverty and unmet basic needs. Discussion This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Conclusions Despite the growing body of literature on increased

Perceptions of HIV-related health services in Zambia for people with disabilities who are HIV-positive.

Science.gov (United States)

Nixon, Stephanie A; Cameron, Cathy; Hanass-Hancock, Jill; Simwaba, Phillimon; Solomon, Patricia E; Bond, Virginia A; Menon, Anitha; Richardson, Emma; Stevens, Marianne; Zack, Elisse

2014-01-01

Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs), there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1) disability-related discrimination heightened when seeking HIV services, (2) communication barriers and related concerns with confidentiality, and (3) movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants' profound concerns about poverty and unmet basic needs. This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Despite the growing body of literature on increased risk of exposure to HIV among HIV-negative PWDs, this is

Factors related to the perceived stigmatization of people living with HIV.

Science.gov (United States)

Caliari, Juliano de Souza; Teles, Sheila Araujo; Reis, Renata Karina; Gir, Elucir

2017-10-09

Analyzing the factors related to perceived stigmatization of people living with HIV. A cross-sectional study conducted from September of 2014 to December 2015 with users from a specialized service in Minas Gerais. Data were collected through individual instrument application, organized in Microsoft Office Excel(r) 2010 spreadsheets and processed on IBM(r) SPSS 23.0. Descriptive statistics and multiple linear regression method were used for data analysis, adopting statistical significance set at 5.0% (p≤0.05). The study development met research ethics standards. 258 users participated in the study. Most were males between 40 and 49 years of age, single, with low educational level and income. Being between 40 and 49 years of age and having been hospitalized for complications related to HIV were positively associated predictors to increased stigmatization; while not having comorbidities and not being aware of exposure to HIV were predictors associated to reduced stigmatization. Given these results, we highlight that stigmatization can have an impact on the lives of people living with HIV, strengthening their feelings of guilt and shame, which can lead to depression, social isolation and abandoning treatment and clinical follow-up.

Living Conditions and Psychological Distress in Latino Migrant Day Laborers: The Role of Cultural and Community Protective Factors.

Science.gov (United States)

Organista, Kurt C; Ngo, Samantha; Neilands, Torsten B; Kral, Alex H

2017-03-01

The purpose of this study was to examine the relationship between typically difficult living conditions and psychological distress in Latino migrant day laborers (LMDLs), with attention to the potentially protective roles of contact with family in country of origin (i.e., communication, sending money, etc.), availability of local culture (i.e., food, music, people from one's country of origin), and utilization of community resources perceived to be culturally competent (i.e., services that are respectful, able to serve Latinos, able to solve problems, in Spanish, etc.). Participants were 344 LMDLs surveyed in the San Francisco Bay Area. As hypothesized: (a) difficult living conditions were related to depression, anxiety, and desesperación [desperation], the latter a popular Latino idiom of psychological distress recently validated on LMDLs; (b) contact with family moderated the relation between difficult living conditions and depression and desesperación but not anxiety and (c) access to local culture, and utilization of community resources, mediated the relation between difficult living conditions and depression and desesperación but not anxiety. Implications for intervening at local and larger levels in order to provide some protection against distress built into the LMDL experience in the United States are discussed. © Society for Community Research and Action 2016.

Adequacy of Mental Health Services for HIV-Positive Patients with Depression

DEFF Research Database (Denmark)

Choi, Stephanie K Y; Boyle, Eleanor; Cairney, John

2016-01-01

use and antidepressant use, as well as mental health care for depression in accordance with existing Canadian guidelines for HIV-positive patients with depression in Ontario, Canada. METHODS: We conducted a prospective cohort study linking data from the Ontario HIV Treatment Network Cohort Study...... income or educational attainment, or as non-native English speakers or immigrants to Canada were less likely to obtain care. Of 493 patients using mental health services, 250 (51%) received mental health care for depression in accordance with existing Canadian guidelines. CONCLUSIONS: Our results showed......BACKGROUND: Major depression can profoundly impact clinical and quality-of-life outcomes of people living with HIV, and this disease is underdiagnosed and undertreated in many HIV-positive individuals. Here, we describe the prevalence of publicly funded primary and secondary mental health service...

The impact of HIV-related stigma on older and younger adults living with HIV disease: does age matter?

Science.gov (United States)

Emlet, Charles A; Brennan, David J; Brennenstuhl, Sarah; Rueda, Sergio; Hart, Trevor A; Rourke, Sean B

2015-01-01

The purpose of this study was to examine the independent influence of age on levels of HIV-related stigma experienced by adults living with HIV/AIDS. To accomplish this, cross-sectional data from the Ontario HIV Treatment Network Cohort Study were used to determine whether older age is associated with overall stigma among HIV-positive adults living in Ontario, Canada (n = 960). The relationship was also tested for enacted, anticipated, and internalized stigma. Covariates included sociodemographic (e.g., gender, sexual orientation, race) and psychosocial variables (e.g., depression). Modifying effects of covariates were also investigated. Those 55 and older have significantly lower overall and internalized stigma than adults under age 40, even when accounting for gender, sexual orientation, income, time since diagnosis, depression, maladaptive coping, and social support. Age does not predict enacted or Anticipated Stigma when accounting for the demographic and psychosocial variables. A significant interaction between depression and age suggests that stigma declines with age among those who are depressed but increases to age 50 and then decreases in older age groups among those who are not depressed. Age matters when it comes to understanding stigma among adults living with HIV/AIDS; however, the relationship between age and stigma is complex, varying according to stigma type and depression level.

HIV testing in nonhealthcare facilities among adolescent MSM.

Science.gov (United States)

Marano, Mariette R; Stein, Renee; Williams, Weston O; Wang, Guoshen; Xu, Songli; Uhl, Gary; Cheng, Qi; Rasberry, Catherine N

2017-07-01

To describe the extent to which Centers for Disease Control and Prevention (CDC)-funded HIV testing in nonhealthcare facilities reaches adolescent MSM, identifies new HIV infections, and links those newly diagnosed to medical care. We describe HIV testing, newly diagnosed positivity, and linkage to medical care for adolescent MSM who received a CDC-funded HIV test in a nonhealthcare facility in 2015. We assess outcomes by race/ethnicity, HIV-related risk behaviors, and US geographical region. Of the 703 890 CDC-funded HIV testing events conducted in nonhealthcare facilities in 2015, 6848 (0.9%) were provided to adolescent MSM aged 13-19 years. Among those tested, 1.8% were newly diagnosed with HIV, compared with 0.7% among total tests provided in nonhealthcare facilities regardless of age and sex. The odds of testing positive among black adolescent MSM were nearly four times that of white adolescent MSM in multivariable analysis (odds ratio = 3.97, P adolescent MSM newly diagnosed with HIV, 67% were linked to HIV medical care. Linkage was lower among black (59%) and Hispanic/Latino adolescent MSM (71%) compared with white adolescent MSM (88%). CDC-funded nonhealthcare facilities can reach and provide HIV tests to adolescent MSM and identify new HIV infections; however, given the low rate of HIV testing overall and high engagement in HIV-related risk behaviors, there are opportunities to increase access to HIV testing and linkage to care for HIV-positive adolescent MSM. Efforts are needed to identify and address the barriers that prevent black and Hispanic/Latino adolescent MSM from being linked to HIV medical care in a timely manner.

HIV-positive men who have sex with men: biography, diversity in lifestyles, common experience of living with HIV. ANRS-EN12 VESPA Study, 2003.

Science.gov (United States)

Lert, France; Sitta, Rémi; Bouhnik, Anne-Deborah; Dray-Spira, Rosemary; Spire, Bruno

2010-01-01

The conceptualisation of male who have sex with male (MSM) to account for male homosexual behaviour has been developed to facilitate the endorsement of prevention message since the advent of HIV infection. Population studies performed to understand and monitor sexual and preventive behaviour usually recruit respondents through gay-friendly channels such as media, sexual venues or festivals, leading to recruitment bias. Few studies question possible differences according to varying sexual biography and current behaviour within the MSM population. The random sample of HIV+ individuals treated in specialised outpatient clinics (ANRS-EN12-VESPA study, 2003) provides the opportunity to question the MSM conceptualisation regarding sexual biography, social characteristics, current sexual behaviour, use of condom, living with HIV (quality of life, discrimination and participation in NGOs). Among the 2932 respondents, 1309 men reported a lifetime male sexual partner. Information regarding sexual biography (lifetime and current numbers of male and female sexual partners, lifetime number of male and female stable couples) was computed using cluster analysis and identified five profiles: exclusive gay (53.7%), gay with some bisexuality (21.8%), gay with mixed sexual history (8.1%), bisexual (7.8%) and heterosexual with male-to-male sex (8.6%). The profiles matched self-identification better among the most exclusive homosexuals than among men with current bisexuality. These five subgroups differed regarding demographic and social characteristics (except migration status), their period of diagnosis, age and CD4 count at diagnosis. Sexual activity, steady partnership, number of male and female partners, use of sexual venues and illegal substance use were different across subgroups. Reversely, these groups are homogenous regarding experience of discrimination and involvement in People living with HIV/AIDS (PLWHA) activities. These findings among men living with HIV support the MSM

Current and future contraceptive options for women living with HIV.

Science.gov (United States)

Patel, Rena C; Bukusi, Elizabeth A; Baeten, Jared M

2018-01-01

Among women living with HIV, half of the pregnancies are unintended. Effective contraception can prevent unintended pregnancies and consequently reduce maternal mortality and perinatal transmission of HIV. While contraceptive options available for all women also apply to women living with HIV, specific considerations exist to the use of contraception by women living with HIV. Areas covered: First, general principles guiding the use of contraception among women living with HIV are discussed, such as choice, method mix, relative effectiveness, and drug-drug interactions. Second, a detailed discussion of each contraceptive method and issues surrounding the use of that method, such as drug-drug interactions, follows. Third, future contraceptive options in advanced development for use by women or men are briefly discussed. Expert opinion: Contraceptive methods available to all women should also be accessible to women living with HIV. When the relative effectiveness of a contraceptive method is reduced, for example due to drug-drug interactions with antiretrovirals, the method should still be made available to women living with HIV with the appropriate information sharing and counseling. Greater research on various aspects of contraceptive use by women living with HIV and more comprehensive testing of co-administration of hormonal contraceptives and common medications used by these women are warranted.

HIV Serostatus Disclosure to Sexual Partners Among Sexually Active People Living with HIV in South Africa: Results from the 2012 National Population-Based Household Survey.

Science.gov (United States)

Simbayi, Leickness C; Zungu, Nompumelelo; Evans, Meredith; Mehlomakulu, Vuyelwa; Kupamupindi, Takura; Mafoko, Goitseone; Zuma, Khangelani

2017-01-01

This paper explores the prevalence and correlates of HIV seropositive status disclosure to sexual partners by people living with HIV (PLHIV) in South Africa. Secondary analysis of the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey was conducted on data obtained from 934 sexually active PLHIV aged 15 years and older who responded to the question about HIV seropositive status disclosure. Overall, a large majority of respondents (77.1 %) reported disclosing their HIV-positive status to all their current sex partners. Multiple regression analysis, after adjustments for sex, marital status and locality type, revealed that those who were living together, going steady, and those who were single were all 60 % [adjusted odds ratio (AOR) = 0.4, 95 % CIs 0.20-0.78; AOR = 0.4, 95 % CIs 0.24-0.77; and AOR = 0.4, 95 % CIs 0.19-1.00, all ps < 0.05] less likely to disclose their HIV positive status to their partners compared to those who were married. Those who lived in rural formal areas were 70 % less likely to disclose their HIV status to their partners compared to those who stayed in urban formal areas (AOR = 0.3, 95 % CI 0.17-0.69, p < 0.001). Those who had correct HIV knowledge and rejection of myths were 2.0 times more likely to disclose their HIV status to their partners compared to those who did not have correct HIV knowledge and rejection of myths (AOR = 2.0, 95 % CI 1.04-3.68, p < 0.05). In conclusion, intervention programmes which help improve HIV seropositive status disclosure are needed by PLHIV who are not married, live in rural formal areas, and have incorrect HIV knowledge and rejection of myths.

HIV Status Disclosure in the Workplace: Positive and Stigmatizing Experiences of Health Care Workers Living with HIV.

Science.gov (United States)

Stutterheim, Sarah E; Brands, Ronald; Baas, Ineke; Lechner, Lilian; Kok, Gerjo; Bos, Arjan E R

We explored workplace experiences of 10 health care providers with HIV in the Netherlands. We used semi-structured interviews to discuss motivations for disclosure and concealment, reactions to disclosures, the impact of reactions, and coping with negative reactions. Reasons for disclosure were wanting to share the secret, expecting positive responses, observing positive reactions to others, wanting to prevent negative reactions, and being advised to disclose. Reasons for concealment included fearing negative reactions, observing negative reactions, previous negative experiences, having been advised to conceal, and considering disclosure unnecessary. Positive reactions included seeing HIV as a nonissue; showing interest, support, and empathy; and maintaining confidentiality. Negative reactions included management wanting to inform employees, work restrictions, hiring difficulties, gossip, and hurtful comments, resulting in participants being upset, taken aback, angry, depressed, or feeling resignation. Participants coped by providing information, standing above the experience, attributing reactions to ignorance, seeking social support, or leaving their jobs. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Oral Health Condition of Children Living with HIV

Directory of Open Access Journals (Sweden)

Natália Spillere Rovaris

2014-01-01

Full Text Available AIDS progression is faster in children than adults. Little is known about the oral health status of children living with HIV. Aim: To carry out a literature review about the oral health conditions of children living with HIV in order to observe if this specific population presents different oral health conditions compared to children without HIV infection. Methods: A documental study of literature review was carried out. Studies were searched at PubMed using “oral health”, “children”, “HIV” and “AIDS” as keywords. Papers published between 2001 and 2011 were included. After applying the exclusion criteria and complete reading of the selected studies, other articles were selected from the references lists of the first ones. Results: Firstly, 24 studies were identified. Among them, 65.5% were excluded according to the exclusion criteria. From the five selected articles, another five from the references of these were included. Only one article compared the oral health conditions of children living with HIV with controls without HIV infection. Conclusions: Only 10 papers contained information on the oral health conditions of children living with HIV, and just one compared the results with controls. The few studies found were insufficient to establish the oral health condition profile of children living with HIV. This lack of information could represent the lack of interest of researchers and health authorities in more integrative care and can result in neglect with this specific population of children.

Identification of psychobiological stressors among HIV-positive women. HIV Neurobehavioral Research Center (HNRC) Group.

Science.gov (United States)

Semple, S J; Patterson, T L; Temoshok, L R; McCutchan, J A; Straits-Tröster, K A; Chandler, J L; Grant, I

1993-01-01

This research describes major stressors in the lives of women who have been infected with the human immunodeficiency virus (HIV). Thirty-one HIV antibody positive (HIV+) women infected primarily through heterosexual contact participated in a two hour semi-structured interview detailing the circumstances, context, and consequences of all stressful life events and difficulties experienced within the preceding six months. Qualitative methods of data analyses were utilized (Miles & Huberman, 1984). HIV-related life events and difficulties were classified into primary and secondary stressors based on the stress process model (Pearlin et al., 1981). Problems arising directly from one's seropositivity were defined as primary stressors. Stressful life events and difficulties occurring in other role areas were defined as secondary stressors. Six categories of HIV-related stressors were identified and quantified. Primary stressors were health-related, and included both gynecological problems (e.g., amenorrhea) and general symptoms of HIV infection (e.g., fatigue). Secondary stressors related to child and family (e.g., future guardianship of children), marital/partner relations (e.g., disclosure of HIV+ status), occupation (e.g., arranging time-off for medical appointments), economic problems (e.g., insurance "hassles"), and social network events (e.g., death of friends from AIDS). This research indicates that HIV-positive women are exposed to multiple stressors; some may be viewed as unique to women, whereas others may be considered common to both sexes. Identification of stressors has implications for the design of medical and psychiatric interventions for women.

Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009-2014.

Science.gov (United States)

Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R Luke

2018-01-01

To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.

Radiological differences between HIV-positive and HIV-negative children with cholesteatoma.

Science.gov (United States)

McGuire, J K; Fagan, J J; Wojno, M; Manning, K; Harris, T

2018-07-01

HIV-positive children are possibly more prone to developing cholesteatoma. Chronic inflammation of the middle ear cleft may be more common in patients with HIV and this may predispose HIV-positive children to developing cholesteatoma. There are no studies that describe the radiological morphology of the middle ear cleft in HIV-positive compared to HIV-negative children with cholesteatoma. Compare the radiological differences of the middle ear cleft in HIV-positive and HIV-negative children with cholesteatoma. A retrospective, cross-sectional, observational analytical review of patients with cholesteatoma at our institute over a 6 year period. Forty patients were included in the study, 11 of whom had bilateral cholesteatoma and therefore 51 ears were eligible for our evaluation. HIV-positive patients had smaller (p=0.02) mastoid air cell systems (MACS). Forty percent of HIV-positive patients had sclerotic mastoids, whereas the rate was 3% in HIV-negative ears (p<0.02). Eighty-two percent of the HIV-positive patients had bilateral cholesteatoma compared to 7% of the control group (p<0.02). There was no difference between the 2 groups with regards to opacification of the middle ear cleft, bony erosion of middle ear structures, Eustachian tube obstruction or soft tissue occlusion of the post-nasal space. HIV-positive paediatric patients with cholesteatoma are more likely to have smaller, sclerotic mastoids compared to HIV-negative patients. They are significantly more likely to have bilateral cholesteatoma. This may have implications in terms of surveillance of HIV-positive children, as well as, an approach to management, recurrence and follow-up. HIV infection should be flagged as a risk factor for developing cholesteatoma. Copyright © 2018. Published by Elsevier B.V.

HIV-positive migrants’ encounters with the Swedish health care system

DEFF Research Database (Denmark)

Mehdiyar, Manijeh; Andersson, Rune; Hjelm, Katarina

2016-01-01

of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated......Background: There is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients....... Objective: The aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden. Design: This is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years. Results: ‘A hybrid...

Vital Signs-HIV Care Saves Lives: Viral Suppression is Key

Centers for Disease Control (CDC) Podcasts

This podcast is based on the December 2014 CDC Vital Signs report. For people living with HIV, Viral suppression is critical. By getting tested and taking HIV medicines, individuals living with HIV can achieve very low levels of HIV in the body.

To tell or not to tell: disclosure to children and family amongst Thai women living with HIV/AIDS.

Science.gov (United States)

Liamputtong, Pranee; Haritavorn, Niphattra

2016-03-01

HIV disclosure is a complex phenomenon. The choice of disclosure or non-disclosure is a reflection of how each HIV-positive person experiences and deals with HIV/AIDS in their everyday life. In this study, we qualitatively explore the experiences of disclosing HIV status to family members and children among HIV-positive women living in Thailand. Due to fear of stigma and discrimination, the women decided to tell only a few people, usually their significant others including parents and children. Although most women received good support from their family members, some were rejected and discriminated against by their family members. This stems from lack of knowledge about HIV/AIDS among family members. Women found disclosure to their children a difficult decision to make. Only some women told their children about their HIV status. They wished to protect their children from emotional burden. This protection also appeared in their attempts to prepare their children for dealing with HIV/AIDS. Support from family members played a major role in the lives of HIV-positive women. Although disclosure has been promoted as a means of ending stigma and discrimination, our data suggested that disclosure may not be positive for some women. This has implications for health promotion in HIV health care. Healthcare providers need to appreciate the ramifications of promoting disclosure to HIV-positive women who are mothers. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Perception of sexuality and fertility in women living with HIV

DEFF Research Database (Denmark)

Wessman, Maria; Aho, Inka; Thorsteinsson, Kristina

2015-01-01

INTRODUCTION: As the human immunodeficiency virus (HIV)-positive population ages, issues concerning sexuality and fertility, among others, are becoming relevant. HIV is still surrounded by stigma and taboos, and there have been few studies conducted in industrialized settings concerning...... these questions. We therefore wanted to investigate the perception of sexuality and fertility in women living with HIV (WLWH) in an industrialized setting, using a questionnaire. METHODS: WLWH were recruited at their regular outpatient clinic visits, at the major Departments of Infectious Diseases in Denmark...... Finland) or from a national HIV cohort (in Denmark). Statistical analysis was performed using STATA, version 11. RESULTS: In total, 560 women were included in the study. The median age was 44 years. The majority were of white European origin, with fully suppressed HIV viral load, CD4 cell count >350 µ...

Living with HIV infection: perceptions of patients with access to care at a non-governmental organization in Chennai, India.

Science.gov (United States)

Tarakeshwar, Nalini; Krishnan, A K; Johnson, Sethulakshmi; Solomon, Suniti; Sikkema, Kathleen; Merson, Michael

2006-01-01

Through interviews, we examined explanatory frameworks of living with HIV infection among 50 HIV-positive individuals (23 women, 27 men) receiving care at a non-governmental organization in Chennai, India. Results were analysed according to three sets of issues, all of which were found to differ by gender: causal beliefs about HIV, impact of HIV, and care/treatment of HIV. HIV-positive participants attributed their infection to biological, moral and social causes, and the physical, financial and relationship dimensions of their lives were impacted upon by the infection. Furthermore, HIV-related stigma evoked fears about isolation and discrimination. Regarding care/treatment, men were most usually first initiated into the healthcare system while women often entered as a consequence of their partner's condition. Non-adherence to medication was reported by 32% of the participants due to financial constraints or side-effects. Although all participants were hopeful about a cure for HIV, women were less positive than men about treatment. Results highlight the importance of a gender-sensitive approach to HIV care, nuanced to accommodate an individual's gender, marital status and social background.

HIV Care Saves Lives: Viral Suppression is Key PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second Public Service Announcement is based on the December 2014 Vital Signs. For people living with HIV, Viral suppression is critical. By getting tested and taking HIV medicines, individuals living with HIV can achieve very low levels of HIV in the body.

'Just talking about it opens your heart': meaning-making among Black African migrants and refugees living with HIV.

Science.gov (United States)

Henrickson, Mark; Brown, Derek Brian; Fouché, Christa; Poindexter, Cynthia C; Scott, Kay

2013-01-01

Meaning-making has emerged as a core construct in addressing trauma, loss or crisis. This paper considers how diasporic Black Africans living with HIV, who come from interdependent collectivist cultures where the norm is one of implicit support, extend their meaning-making strategies when faced with a diagnosis of HIV. In this qualitative study, 13 Black African migrants and refugees living with HIV in New Zealand were interviewed and the transcripts analysed. After their diagnosis, participants began a journey of reconceptualising situational and global meaning. They extended their meaning-making strategies to include a community of like others to gain explicit support. Caregivers in host countries must understand the meaning-making processes of HIV-positive Black African migrants in order to provide competent services that lead to good social and health outcomes. All healthcare and social services workers should regularly assess Black African migrants and refugees living with HIV for positive social connectedness as well as medication adherence and more specific health concerns.

Validation of Six Short and Ultra-short Screening Instruments for Depression for People Living with HIV in Ontario

DEFF Research Database (Denmark)

Choi, Stephanie KY; Boyle, Eleanor; Burchell, Ann

2015-01-01

Objective Major depression affects up to half of people living with HIV. However, among HIV-positive patients, depression goes unrecognized 60–70% of the time in non-psychiatric settings. We sought to evaluate three screening instruments and their short forms to facilitate the recognition...... acceptance. This could lead to clinical benefits in fast-paced speciality HIV care settings and better management of depression in HIV-positive patients....

Body image and anthropometric indicators in adolescents living with HIV

Directory of Open Access Journals (Sweden)

Luiz Rodrigo Augustemak de Lima

2018-03-01

Full Text Available The aim of this study was to compare body image and anthropometric indicators among adolescents living with HIV and healthy adolescents (control group. In addition, we verified the associations of anthropometric indicators, infection/treatment, sexual maturity, and sociodemographic characteristics with body image in adolescents living with HIV. One hundred and eleven adolescents aged 10 to 15 years were divided into those living with HIV (n = 57 and a control group (n = 54. Body image was investigated using an eight-point body silhouette scale. Body weight, height, circumferences, and skinfolds were measured. Body image dissatisfaction was found in 54.4% of the adolescents living with HIV, with 38.6% of them wishing to increase their body size. Conversely, body image dissatisfaction was due to the desire to reduce body size in the control group (40.7%. No difference between the HIV and control groups was found for the anthropometric indicators analyzed. Gender (β = -0.52, age (β = 0.18, body weight (β = 0.07, body mass index (β = -0.19, and upper arm muscle area (β = -0.08 explained 42% of the variation in the body image score of adolescents living with HIV. Thinness is the main reason for body image dissatisfaction in adolescents living with HIV. Almost half the body dissatisfaction of adolescents living with HIV was explained by demographic and anthropometric variables.

Voices of Experience: Living with HIV. ODell.

Centers for Disease Control (CDC) Podcasts

2009-06-07

This podcast showcases ODell, a man living with HIV, as he tells his story.  Created: 6/7/2009 by Division of HIV and AIDS Prevention (DHAP), National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention ( NCHHSTP).   Date Released: 6/7/2009.

Voices of Experience: Living with HIV. Denise.

Centers for Disease Control (CDC) Podcasts

2009-06-07

This podcast showcases Denise, a woman living with HIV, as she tells her story.  Created: 6/7/2009 by Division of HIV and AIDS Prevention (DHAP), National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention ( NCHHSTP).   Date Released: 6/7/2009.

Voices of Experience: Living with HIV. Doug.

Centers for Disease Control (CDC) Podcasts

2009-06-07

This podcast showcases Doug, a man living with HIV, as he tells his story.  Created: 6/7/2009 by Division of HIV and AIDS Prevention (DHAP), National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention ( NCHHSTP).   Date Released: 6/7/2009.

Voices of Experience: Living with HIV. Pamela.

Centers for Disease Control (CDC) Podcasts

2009-06-07

This podcast showcases Pamela, a woman living with HIV, as she tells her story.  Created: 6/7/2009 by Division of HIV and AIDS Prevention (DHAP), National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention ( NCHHSTP).   Date Released: 6/7/2009.

Identity management strategies among HIV-positive Colombian gay men in London.

Science.gov (United States)

Jaspal, Rusi; Williamson, Iain

2017-12-01

This study set out to explore the social-psychological aspects of living with HIV among a group of HIV-positive Colombian gay men in London, and the strategies that they deployed to manage ensuing threats to their identities. Focus group and individual interview data were collected from 14 Colombian gay men living with HIV, and were analysed using qualitative thematic analysis and identity process theory. The following themes are discussed: (1) identity struggles and conflicts in Colombia, (2), managing multiple layers of social stigma in England, and (3) changing interpersonal and intergroup dynamics, which highlight the inter-connections between sexual prejudice, sexual risk-taking and HIV stigma. Identity may be chronically threatened due to the multiple layers of stigma, which can limit the coping strategies available to individuals. Findings strongly support the need for action and programmes to highlight and tackle both racism and HIV stigma on the gay scene and to fund more specific resources for sub-communities of gay, bisexual and other men who have sex with men, which employ appropriately trained and culturally competent staff.

The Relationship Between Online Social Network Use, Sexual Risk Behaviors, and HIV Sero-Status Among a Sample of Predominately African American and Latino Men Who have Sex with Men (MSM) Social Media Users.

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Chiu, ChingChe J; Young, Sean D

2015-06-01

Social networking technologies have emerged as potential platforms to reach HIV(+) MSM in HIV interventions. This study sought to compare use of online social networking sites (SNSs) and sexual risk behaviors between HIV(+) and HIV(-) individuals among a sample of predominately African American and Latino SNS-using MSM. A total of 112 MSM Facebook users were recruited online and offline and completed an online survey. We performed regression models to assess the association between HIV status, SNS use, and sexual risk behaviors. After adjusting for age, race, and employment status, being HIV positive was significantly associated with a greater number of sexual partners (ARR = 2.84, p = 0.0017) and lower comfort levels of discussing HIV/STI status on SNSs (AOR: 0.23, p = 0.011). Findings suggest that HIV status is associated with sexual risk behaviors and SNS use among SNS-using MSM. We discuss the implications for online HIV prevention.

Structural Determinants of Antiretroviral Therapy Use, HIV Care Attendance, and Viral Suppression among Adolescents and Young Adults Living with HIV.

Directory of Open Access Journals (Sweden)

Shoshana Y Kahana

Full Text Available The authors examined associations between structural characteristics and HIV disease management among a geographically diverse sample of behaviorally and perinatally HIV-infected adolescents and young adults in the United States.The sample included 1891 adolescents and young adults living with HIV (27.8% perinatally infected; 72.2% behaviorally infected who were linked to care through 20 Adolescent Medicine Trials Network for HIV/AIDS Interventions Units. All completed audio computer-assisted self-interview surveys. Chart abstraction or blood draw provided viral load data. Geographic-level variables were extracted from the United States Census Bureau (e.g., socioeconomic disadvantage, percent of Black and Latino households, percent rural and Esri Crime (e.g., global crime index databases as Zip Code Tabulation Areas. AIDSVu data (e.g., prevalence of HIV among youth were extracted at the county-level. Using HLM v.7, the authors conducted means-as-outcomes random effects multi-level models to examine the association between structural-level and individual-level factors and (1 being on antiretroviral therapy (ART currently; (2 being on ART for at least 6 months; (3 missed HIV care appointments (not having missed any vs. having missed one or more appointments over the past 12 months; and (4 viral suppression (defined by the corresponding assay cutoff for the lower limit of viral load at each participating site which denoted nondetectability vs. detectability.Frequencies for the 4 primary outcomes were as follows: current ART use (n = 1120, 59.23%; ART use for ≥6 months (n = 861, 45.53%; at least one missed HIV care appointment (n = 936, 49.50; and viral suppression (n = 577, 30.51%. After adjusting for individual-level factors, youth living in more disadvantaged areas (defined by a composite score derived from 2010 Census indicators including percent poverty, percent receiving public assistance, percent of female, single-headed households, percent

Hombres Sanos: evaluation of a social marketing campaign for heterosexually identified Latino men who have sex with men and women.

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Martínez-Donate, Ana P; Zellner, Jennifer A; Sañudo, Fernando; Fernandez-Cerdeño, Araceli; Hovell, Melbourne F; Sipan, Carol L; Engelberg, Moshe; Carrillo, Hector

2010-12-01

We evaluated the effectiveness of Hombres Sanos [Healthy Men] a social marketing campaign to increase condom use and HIV testing among heterosexually identified Latino men, especially among heterosexually identified Latino men who have sex with men and women (MSMW). Hombres Sanos was implemented in northern San Diego County, California, from June 2006 through December 2006. Every other month we conducted cross-sectional surveys with independent samples of heterosexually identified Latino men before (n = 626), during (n = 752), and after (n = 385) the campaign. Respondents were randomly selected from 12 targeted community venues to complete an anonymous, self-administered survey on sexual practices and testing for HIV and other sexually transmitted infections. About 5.6% of respondents (n = 98) were heterosexually identified Latino MSMW. The intervention was associated with reduced rates of recent unprotected sex with both females and males among heterosexually identified Latino MSMW. The campaign was also associated with increases in perception of HIV risk, knowledge of testing locations, and condom carrying among heterosexual Latinos. Social marketing represents a promising approach for abating HIV transmission among heterosexually identified Latinos, particularly for heterosexually identified Latino MSMW. Given the scarcity of evidence-based HIV prevention interventions for these populations, this prevention strategy warrants further investigation.

Determinants of subjective health status of HIV positive mothers in ...

African Journals Online (AJOL)

BACKGROUND: Acquired immune deficiency syndrome (AIDS) caused by human immune deficiency virus (HIV), once dominated by infected males has become feminized especially in sub-Saharan Africa where the majority of adults living with the condition are females. Positive life styles, belonging to social support ...

On the Road to HIV/AIDS Competence in the Household: Building a Health-Enabling Environment for People Living with HIV/AIDS

Directory of Open Access Journals (Sweden)

Caroline Masquillier

2015-03-01

Full Text Available When aiming to provide chronic disease care within the context of human resource shortages, we should not only consider the responsibility of the individual person living with HIV/AIDS (PLWHA but also the capacity of the social environment to actively encourage a lifestyle that fosters health. In this social environment, extensive efforts are thus required to increase HIV/AIDS knowledge, reduce stigma, stimulate HIV testing, improve health care-seeking behavior, and encourage safe sexual practices—described in the literature as the need for AIDS competence. In accordance with socio-ecological theory, one cannot restrict the research focus to communities, as AIDS competence studies should also incorporate the intermediate household level. In responding to this research need, the aim of this article is to conceptualize an “HIV/AIDS competent household” based on qualitative interviews and focus group discussions conducted in a township on the outskirts of Cape Town, South Africa. Our results show that a household’s supportive response to disclosure allows a patient to live openly as HIV positive in the household concerned. This may mark the start of the road to HIV/AIDS competence in the household, meaning the PLWHA receives sustainable support throughout the care continuum and positive living becomes the norm for the PLWHA and his or her household. A feedback loop might also be created in which other household members are encouraged to be tested and to disclose their status, which is an important step towards a sustainable response to HIV/AIDS-related challenges. Despite the fact that this road to HIV/AIDS competence at the household level is fragile and prone to various barriers, this article shows that the household has the potential to be a health-enabling environment for PLWHA.

Selected cultural factors associated with physical activity among Latino women.

Science.gov (United States)

Jurkowski, Janine M; Mosquera, Margarita; Ramos, Blanca

2010-01-01

In the United States, Latinos are the largest ethnic group after non-Hispanic whites. Latinos currently represent 15% of the U.S. population and their numbers are growing in nontraditional areas. Latino women (Latinas) disproportionately experience chronic disease risk factors and report low levels of leisure time physical activity. This study examined cultural factors associated with leisure time physical activity among Latinas living in a new Latino destination in northeastern New York. Community-based participatory research, a collaborative approach in which community members are equitably and actively involved in the research process, was employed for this study. The Latina Health Survey was administered in Spanish and English to 289 Latina adults through snowball sampling. Women reported that their national origin was predominantly Puerto Rican (58.7%) or Dominican (18.2%). Only 6.6% of women met American College of Sports Medicine's physical activity recommendations of exercising 5 days a week; 25% participated in physical activity two or more times per week. Acculturation and religious service attendance at least once a week was positively associated and fast food consumption one or more times a week was negatively associated with physical activity. This study implicates the need for physical activity promotion efforts among Latinas who are culturally responsive and that address fast food consumption. In addition to acculturation, other, more specific cultural factors need to be examined to understand physical activity correlates among Latinas. Research among Latinas living in new Latino destinations is important for understanding behavior and tailoring health interventions among Latinos living in nontraditional areas. Copyright 2010 Jacobs Institute of Women

A qualitative exploration of parental experiences of stigma while living with HIV in Bangladesh.

Science.gov (United States)

Islam, Md Shahidul; Scott, John; Minichiello, Victor

2016-01-01

With much of the focus on the "risk" groups, families have often been less studied in HIV research. Further, because of a focus on the aetiology and epidemiology of HIV, the social impacts associated with HIV on families and neighbours are sometimes overlooked. This study examined parental experiences of stigma and discrimination while living with HIV within a family context in Bangladesh. A qualitative research design using a grounded theory approach was used for this research. Data was collected through in-depth interviews with 19 HIV-positive parents, recruited with the support of two self-help groups of HIV-positive people, in two settings namely Khulna and Dhaka in Bangladesh. The findings indicate that HIV-positive parents held the view that they continue to experience significant stigma and their narratives clearly show how this affected them and their children. A range of informal practices were enacted in everyday contexts by extended family and community members to identify, demarcate and limit the social interaction of HIV-positive parents. Parents highlighted a number of factors including negative thoughts and behaviours, rejection, isolation and derogatory remarks as manifestations of stigma and discrimination, impacting upon them and their children because of their association with HIV.

Behaviors Influencing Human Immunodeficiency Virus Transmission in the Context of Positive Prevention among People Living with HIV/Acquired Immunodeficiency Syndrome in Iran: A Qualitative Study

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Seyed Ramin Radfar

2014-01-01

Full Text Available Background: Identifying factors, which influence health behaviors is critical to designing appropriate and effective preventive programs. Human immunodeficiency virus (HIV transmission is highly related to people behaviors and understanding factors influencing healthy behaviors among Iranian people living with HIVs (PLHIVs/acquired immunodeficiency syndrome (AIDS is very important to tailor an effective response to HIV/AIDS epidemic. Methods: This study was conducted as a qualitative study by methods of focus group discussion and in-depth interview in six provinces of Iran with 64 PLHIVs to determine factors influence engagement in positive prevention. Results: Knowledge and education, feelings of responsibility and positive prevention practices were identified as the primary domains of engagement. These domains were found to be influenced by feelings of ostracism and frustration, poverty, barriers to disclosure of HIV status, access to and utilization of drug abuse treatment services and antiretroviral therapy, adherence to treatment, age, religiousness, sex work, singleness, and incarceration. Conclusions: Designing new interventions and updating current interventions directed toward the aforementioned factors should be addressed by responsible Iranian authorities in order to have a national effective response on the HIV/AIDS epidemic.

Prevalence and significance of Mycoplasma genitalium in women living with HIV in Denmark

DEFF Research Database (Denmark)

Madsen, Anne Marie Rosendahl; Thorsteinsson, Kristina; Lebech, Anne-Mette

2017-01-01

has been suggested as part of HIV prevention strategies. The objective of this study was to determine the prevalence of M. genitalium in women living with HIV (WLWH) in Denmark, and to compare the result with data on symptoms from the lower abdomen, sexual habits and immune status. 234 women......, recruited from Danish HIV centres as part of a larger observational study on aspects of living with HIV as a woman (the SHADE study), were included. RESULTS: We tested cervical samples for M. genitalium by specific PCR. We found three samples positive (1.3%). The women were between 30 and 50 years old, all...... were of Asian origin, sexually active, and on antiretroviral treatment with supressed HIV RNA and CD4 count >350 cells/µL. None reported symptoms from the lower abdomen. The prevalence of M. genitalium infection in WLWH in Denmark is low, thus systematic screening for M. genitalium in this group does...

Implementation and assessment of a prevention with positives intervention among people living with HIV at five hospitals in Thailand.

Science.gov (United States)

Baipluthong, Benjamas; Anekthananon, Thanomsak; Munsakul, Warangkana; Jirajariyavej, Supunnee; Asavapiriyanont, Suvanna; Hancharoenkit, Ubonsri; Roongpisuthipong, Anuvat; Pattanasin, Sarika; Martin, Michael; Guntamala, Lisa; Lolekha, Rangsima

2017-01-01

We implemented a hospital-based prevention with positives (PwP) intervention among people living with HIV (PLHIV) that included HIV transmission risk screening, short HIV prevention messages, family planning, HIV disclosure counseling, and partner HIV testing at five hospitals in Thailand. We assessed changes in sexual risk behaviors among PLHIV who received the PwP services at the hospitals. From January 2008-March 2009, we systematically selected a subset of PLHIV receiving care at the five hospitals to offer participation in the PwP intervention. We collected demographic, risk behavior, and laboratory data using a standardized questionnaire. We analyzed data from PLHIV who completed at least four visits, using generalized estimating equations to identify baseline participant characteristics that were associated with adopting sexual practices less likely to be associated with HIV transmission during follow-up. A total of 830 PLHIV were interviewed and 756 (91.1%) completed four visits. The median age of these 756 participants was 37 years, 400 (52.9%) were women, and 475 (62.8%) had a steady partner. At baseline, 353 (74.3%) of the steady partners had been tested for HIV and 132 (37.4%) had tested negative. Among the 756 PLHIV, 427 (56.5%) reported having sex in the 3 months before enrollment and 413 (54.6%) in the 3 months before the fourth visit. The proportion reporting having vaginal or anal sex without a condom decreased from 20.8% at baseline to 5.1% at the fourth visit (p<0.001). Factors associated (p<0.05) with abstinence or 100% condom use at follow-up visits included: completing ≥ two visits, being diagnosed with HIV for longer than 3 months, and receiving HIV prevention messages from a doctor (versus a nurse or counselor). Safe sex behaviors increased among PLHIV receiving PwP services, suggesting that expansion of hospital-based PwP services may reduce the number of new HIV infections in Thailand.

Gender and ethnicity differences in HIV-related stigma experienced by people living with HIV in Ontario, Canada.

Science.gov (United States)

Loutfy, Mona R; Logie, Carmen H; Zhang, Yimeng; Blitz, Sandra L; Margolese, Shari L; Tharao, Wangari E; Rourke, Sean B; Rueda, Sergio; Raboud, Janet M

2012-01-01

This study aimed to understand gender and ethnicity differences in HIV-related stigma experienced by 1026 HIV-positive individuals living in Ontario, Canada that were enrolled in the OHTN Cohort Study. Total and subscale HIV-related stigma scores were measured using the revised HIV-related Stigma Scale. Correlates of total stigma scores were assessed in univariate and multivariate linear regression. Women had significantly higher total and subscale stigma scores than men (total, median = 56.0 vs. 48.0, pwomen, Black individuals had the highest, Aboriginal and Asian/Latin-American/Unspecified people intermediate, and White individuals the lowest total stigma scores. The gender-ethnicity interaction term was significant in multivariate analysis: Black women and Asian/Latin-American/Unspecified men reported the highest HIV-related stigma scores. Gender and ethnicity differences in HIV-related stigma were identified in our cohort. Findings suggest differing approaches may be required to address HIV-related stigma based on gender and ethnicity; and such strategies should challenge racist and sexist stereotypes.

Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men.

Science.gov (United States)

Overstreet, Nicole M; Earnshaw, Valerie A; Kalichman, Seth C; Quinn, Diane M

2013-01-01

Black men who have sex with men (BMSM) are severely affected by the HIV epidemic, yet research on the relationship between HIV stigma and status disclosure is relatively limited among this population. Within this epidemic, internalized HIV stigma, the extent to which people living with HIV/AIDS endorse the negative beliefs associated with HIV as true of themselves, can negatively shape interpersonal outcomes and have important implications for psychological and physical health. In a sample of HIV-positive BMSM (N=156), the current study examined the effect of internalized stigma on HIV status disclosure to sexual partners, which can inform sexual decision-making in serodiscordant couples, and HIV status disclosure to family members, which can be beneficial in minimizing the psychological distress associated with HIV. Results revealed that greater internalized stigma was associated with less HIV status disclosure to participants' last sexual partner and to family members. Findings from this study provide evidence that internalized negative beliefs about one's HIV status are linked to adverse interpersonal consequences. Implications of these findings are discussed with regard to prevention and intervention efforts to reduce HIV stigmatization.

Barriers and facilitators of HIV prevention with heterosexual Latino couples: beliefs of four stakeholder groups.

Science.gov (United States)

Pérez-Jiménez, David; Seal, David W; Serrano-García, Irma

2009-01-01

Although HIV prevention interventions for women are efficacious, long-term behavior change maintenance within power-imbalanced heterosexual relationships has been difficult. To explore the feasibility, content, and format of an HIV intervention for Latino couples, the authors conducted 13 focus groups with HIV/AIDS researchers, service providers, and heterosexual men and women in Puerto Rico, the Dominican Republic, and Mexico. Reasons that participants thought that men should be involved in prevention efforts included promotion of shared responsibility, creation of a safe environment for open conversation about sex, and increased sexual negotiation skills. Perceived barriers to men's involvement included cultural taboos, sexual conservatism associated with Catholicism and machismo, and power-imbalanced relationships. Participants stressed the need for recruitment of men within naturally occurring settings or by influential community leaders. Participants indicated that couples-level interventions would be successful if they used strong coed facilitators, included both unigender and mixed-gender discussion opportunities, and addressed personally meaningful topics. Implications of these findings are discussed.

Barriers and Facilitators of HIV Prevention With Heterosexual Latino Couples: Beliefs of Four Stakeholder Groups

Science.gov (United States)

Pérez-Jiménez, David; Seal, David W.; Serrano-García, Irma

2012-01-01

Although HIV prevention interventions for women are efficacious, long-term behavior change maintenance within power-imbalanced heterosexual relationships has been difficult. To explore the feasibility, content, and format of an HIV intervention for Latino couples, the authors conducted 13 focus groups with HIV/AIDS researchers, service providers, and heterosexual men and women in Puerto Rico, the Dominican Republic, and Mexico. Reasons that participants thought that men should be involved in prevention efforts included promotion of shared responsibility, creation of a safe environment for open conversation about sex, and increased sexual negotiation skills. Perceived barriers to men’s involvement included cultural taboos, sexual conservatism associated with Catholicism and machismo, and power-imbalanced relationships. Participants stressed the need for recruitment of men within naturally occurring settings or by influential community leaders. Participants indicated that couples-level interventions would be successful if they used strong coed facilitators, included both unigender and mixed-gender discussion opportunities, and addressed personally meaningful topics. Implications of these findings are discussed. PMID:19209976

Stigma and suicide among gay and bisexual men living with HIV.

Science.gov (United States)

Ferlatte, Olivier; Salway, Travis; Oliffe, John L; Trussler, Terry

2017-11-01

HIV positive gay and bisexual men (GBM) continue to struggle with the pervasiveness of HIV stigma, but little is known about the health effects of stigma. In this article, suicidal ideation and attempts are measured among GBM living with HIV, evaluating the extent to which these experiences are associated with stigma and suicide. Drawing from an online national survey of Canadian GBM completed by 7995 respondents, a sub-set of data provided by respondents self-reporting HIV-positive status was used for the current study. The associations between suicidal ideation (SI) and attempts (SA) and four measures of HIV stigma were measured: social exclusion, sexual rejection, verbal abuse and physical abuse. A total of 673 HIV-positive men completed the survey (8% of total sample). Among this group, 22% (n = 150) reported SI and 5% (n = 33) SA in the last 12 months. After adjusting for sociodemographic factors, SI and SA were associated with each of the four measures of HIV stigma: being excluded socially for being HIV positive (SI adjusted odds ratio, AOR 2.0 95% CI 1.4-3.1; SA AOR 3.8 95% CI 1.9-7.9), rejected as a sexual partner (SI AOR 1.6 95% CI 1.1-2.4; SA AOR 2.6 95% CI 1.1-6.0), verbally abused (SI AOR 2.9 95% CI 1.9-4.5; SA AOR 2.4 95% CI 1.1-5.1), and physically abused (SI AOR 4.5 95% CI 1.8-11.7; SA AOR 6.4 95% CI 2.0-20.1). Furthermore, experiencing multiple forms of stigma was associated with significantly increased risk of SI and SA. The authors conclude that HIV positive GBM experience significant levels of stigma that are associated with heightened risk for suicide. The findings affirm the need for targeted interventions to prevent suicide amid public health efforts to de-stigmatize HIV and mental illness.

Screening for human papillomavirus, cervical cytological abnormalities and associated risk factors in HIV-positive and HIV-negative women in Rwanda.

Science.gov (United States)

Mukanyangezi, M F; Sengpiel, V; Manzi, O; Tobin, G; Rulisa, S; Bienvenu, E; Giglio, D

2018-02-01

Cervical cancer is the major cause of death from cancer in Africa. We wanted to assess the prevalence of human papillomavirus (HPV) infections and associated risk factors and to determine whether HPV testing could serve as a screening method for squamous intraepithelial lesions (SILs) in Rwanda. We also wanted to obtain a broader understanding of the underlying risk factors for the establishment of HPV infection in Rwanda. A total of 206 HIV-positive women, 172 HIV-negative women and 22 women with unknown HIV status were recruited at the University Teaching Hospitals of Kigali (UTHK) and of Butare (UTHB) in Rwanda. Participants underwent an interview, cervical sampling for a Thinprep Pap test and a screening test analysing 37 HPV strains. Only 27% of HIV-positive women and 7% of HIV-negative women had been screened for cervical cancer before. HPV16 and HPV52 were the most common HPV strains. HIV-positive women were more commonly infected with high-risk (HR) HPV and multitype HPV than HIV-negative women. The sensitivity was 78% and the specificity 87% to detect high-grade SIL (HSIL) with HPV screening. Among HIV-negative women, being divorced was positively associated with HR-HPV infection, while hepatitis B, Trichomonas vaginalis infection and HR-HPV infection were factors positively associated with SILs. Ever having had gonorrhoea was positively associated with HR-HPV infection among HIV-positive women. HR-HPV infection and the number of live births were positively associated with SILs. The currently used quadrivalent vaccine may be insufficient to give satisfactory HPV coverage in Rwanda. HPV Screening may be effective to identify women at risk of developing cervical cancer, particularly if provided to high-risk patients. © 2017 British HIV Association.

From 'half-dead' to being 'free': resistance to HIV stigma, self-disclosure and support for PMTCT/HIV care among couples living with HIV in Kenya.

Science.gov (United States)

Spangler, Sydney A; Abuogi, Lisa L; Akama, Eliud; Bukusi, Elizabeth A; Helova, Anna; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Wanga, Iris; Turan, Janet M

2018-05-01

In sub-Saharan Africa, self-disclosure of HIV-positive status may be a pivotal action for improving access to prevention of mother-to-child transmission services. However, understanding of HIV stigma and disclosure, and their effects on demand for care remains incomplete - particularly in the current context of new antiretroviral therapy guidelines. The purpose of this study was to explore these issues among self-disclosed couples living in southwest Kenya. We conducted 38 in-depth interviews with HIV-positive pregnant or postpartum women and their male partners. Of the 19 couples, 10 were HIV seroconcordant and 9 were serodiscordant. The textual analysis showed that HIV stigma continues to restrict full participation in community life and limit access to care by promoting fear, isolation and self-censorship. Against this backdrop, however, participants' narratives revealed varying forms and degrees of resistance to HIV stigma, which appeared to both produce and emerge from acts of self-disclosure. Such disclosure enabled participants to overcome fears and gain critical support for engaging in HIV care while further resisting HIV stigma. These findings suggest that programme interventions designed explicitly to stimulate and support processes of HIV stigma resistance and safe self-disclosure may be key to improving demand for and retention in HIV services.

Reading the Bible Positively Popular Reading of the Bible with people living with HIV/AIDS in Brazil

Directory of Open Access Journals (Sweden)

Schroder, Elisa Fenner

2015-12-01

Full Text Available In the early 60s, it began to emerge, in Latin America and Brazil, political movements that sought to raise awareness about their situation of oppression and theneed for ruptures with the dominant society. The Bible had been given to the people and was read from the experience and reality of men and women in situations ofoppression. The situations of oppression and exclusion experienced in Latin America broaden the understanding about the poor and the excluded and challenges newreadings of the Bible from each context. Prejudice and stigma affects the lives of people with HIV, causing them suffering. The situation of social vulnerability affecting a major portion of this population complicates the lives of these people even further. We seek to read the Bible through the context of lives of women with HIV by using popular bible reading methodology. This article bring some introductions reflection on the method and on the experience of a women group in Brazil.

Access to employment among African migrant women living with HIV in France: opportunities and constraints.

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Gerbier-Aublanc, Marjorie; Gosselin, Anne

2016-08-01

HIV in France particularly affects sub-Saharan migrants as they accounted for 31% of the new diagnoses in 2013. The objective of this study is to investigate the access to and the experience of employment among migrant women living with HIV in France. We use a mixed-method approach. The quantitative data come from the ANRS Parcours study, a life-event survey conducted in 2012-2013 in 70 health centres which collected year-by-year detailed information on living conditions about 755 sub-Saharan women migrants in the greater Paris region (470 with HIV and 285 without HIV). The qualitative data have been collected independently in the same region through socio-ethnographic observations and interviews conducted in 8 HIV-positive migrant organisations and among 35 women-members from 2011 to 2013. Two main results are noteworthy. First, being HIV-positive unexpectedly gives sub-Saharan migrant women a quicker access to employment thanks to the social support they find in migrant organisations: in the third year in France in median (versus 5th year among HIV-negative group). This effect of being HIV-positive on the access to employment remains all things being equal in a discrete-time logistic regression (aOR [95% CI] HIV+: 1.4[1.1;1.8]). Second, their employment situation remains strongly shaped by the racial division of work existing in France and they develop individual strategies to negotiate this constraint: for example, temporary jobs and working as health mediators. The type of jobs they find, mainly in the care sector, force them to carefully hide their HIV status because they fear discrimination at work. Not only migrant women endure structural discrimination in a segmented labour market, but they also anticipate HIV-related discrimination related to caring activities. Thus, the design and implementation of programmes that address stigma should consider structural discrimination to improve PLWHA's working experiences.

Oral manifestations among people living with HIV/AIDS in Tanzania

DEFF Research Database (Denmark)

Fabian, F M; Kahabuka, F K; Petersen, P E

2009-01-01

BACKGROUND: This study aimed to determine the prevalence of various oral and peri-oral manifestations in people living with HIV/AIDS in Tanzania. METHODS: A cross sectional study. A total of 187 persons with HIV infection were recruited from non-governmental organisations serving people living...... associated with low body mass index (BMI). CONCLUSION: This community survey carried out in an African sub-Saharan country showed that oral lesions are frequent among people living with HIV/AIDS. As emphasised by the World Health Organization Global Oral Health Programme, national HIV/AIDS programmes should...

The intersection of antiretroviral therapy, peer support programmes, and economic empowerment with HIV stigma among HIV-positive women in West Nile Uganda.

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Kellett, Nicole Coffey; Gnauck, Katherine

2016-12-01

HIV stigma remains a major problem of the AIDS epidemic in sub-Saharan Africa. Women fear impending social stigma including blame, isolation and abuse. HIV infection and HIV stigma interact cyclically, creating and reinforcing economic and social exclusion for individuals living with HIV. Evidence suggests that interventions for people living with HIV infection that include, in combination, antiretroviral therapy (ART), peer support and economic empowerment are likely to be more effective than if used alone. We report a qualitative study in West Nile Uganda that explored perceptions of HIV stigma among fifty-four HIV-positive women who had similar access to ART and HIV peer support programmes, but varying levels of participation (full-time, intermittent, none) in economic empowerment programmes. Our study found that access to ART, peer support groups, and economic empowerment programmes helped to curb perceptions of deep-seated HIV stigma for participants. More expressions of usefulness, hope and psychological well-being prevailed with participants who had increased participation in economic empowerment programmes. Our findings underscore the value of HIV outreach programmes which combine ART, peer support and economic empowerment to alleviate HIV stigma. Further research to quantify the interaction of these factors is warranted.

The health literacy needs of women living with HIV/AIDS

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Judy Thompson

2015-10-01

Full Text Available Women in Sub-Saharan Africa are disproportionately affected by the virus and constitute 60% of the total HIV/AIDS infections in this region. Current recommendations endorse the involvement of people living with HIV in the development of programmes for people living with the virus. The purpose of the study was to explore and describe the health literacy needs of women living with HIV. The research design was qualitative, explorative, descriptive and contextual. After women living with HIV/AIDS were sampled purposively, semi-structured interviews were conducted with eight women and qualitative content analysis done. The findings revealed that the women expressed a need to increase their knowledge about HIV/AIDS. The knowledge they needed ranged from basic pathophysiology about HIV/AIDS, to the impact of HIV/AIDS on their health, to an awareness of the modes of HIV transmission and methods of protecting others from being infected. Other important health literacy needs related to self-care and correct antiretroviral use. A need for psychosocial skills was also identified in order for women to build and maintain their relationships. Recommendations were made for nursing practice, education and further research, based on these findings.

The impact of client-counselor similarity on acceptance of counseling services for women living with HIV.

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Mehnert, Linn; Siem, Birte; Stürmer, Stefan; Rohmann, Anette

2018-04-01

This study investigates the effect of similarity of health status between counselors and clients on the acceptance of counseling services among women living with HIV (WLWH). We hypothesized that WLWH should be more willing to seek counseling from an HIV-positive counselor as opposed to one living free of HIV or with another stigmatized disease like Hepatitis C, because a counselor with HIV should be perceived as more empathetic and credible. Moreover, the positive effect of similarity on acceptance should be particularly pronounced among WLWH who perceive high levels of HIV-related stigmatization and low levels of social support. Participants were 89 WLWH in Germany. In an online scenario experiment, we varied the similarity of health status between participants and a fictitious female counselor by presenting participants with one of three counselor profiles: The profile either stated that she was living with HIV but not Hepatitis C, with Hepatitis C but not HIV, or with neither HIV nor Hepatitis C. We then measured participants' perceptions of the counselor's similarity, empathy, and credibility, and their willingness to accept counseling with her. Results from an ANOVA with planned contrasts supported our assumption that participants presented with an HIV-positive counselor perceived her to be more similar to themselves and were more willing to accept the counseling than participants exposed to a HIV-negative counselor (either with or without Hepatitis C), for all relevant contrasts, η 2 s ≥ .08. Regression analyses corroborated that this effect was mediated by the counselor's perceived empathy and credibility, total indirect effect = .36, 95%CI [0.22, 0.53]. Moreover, moderated regression analyses revealed that the similarity effect on acceptance was particularly strong when participants experienced high levels of stigmatization and low levels of social support, for both interaction terms, ΔR 2 s   ≥ .04, F(1, 85)s ≥ 5.03, ps�

Latinos Need to Stay in Their Place: Differential Segregation in a Multi-Ethnic Suburb

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Celia Lacayo

2016-08-01

Full Text Available While Latinos face high levels of segregation, there is scant research specifically addressing whites’ attitudes towards Latinos regarding their preferences. This study draws from 40 in-depth interviews with whites in Orange County California, an area with a large Latino and Asian population. I demonstrate that white respondents choose to segregate themselves from Latinos. Most studies have used Blumer’s group position theory to explain white attitudes and neighborhood preference towards Blacks. My findings supports Blumer’s group position theory by revealing why white respondents feel threatened by an increase in the Latino population. Yet, the Asian population has also grown, but white respondents convey positive sentiments towards Asians, and express they feel comfortable living and interacting with them. I argue that white respondents’ preferences with regards to integration are not solely based on the size of a group, but rather whether they characterize the group as inferior. Integration has been touted as an American principle. Yet, as the country becomes more diverse, this case study illustrates that white respondents prefer to share space with those they feel similar to, and consequently contribute to Latino segregation.

Vital Signs-HIV Care Saves Lives: Viral Suppression is Key

Centers for Disease Control (CDC) Podcasts

2014-11-25

This podcast is based on the December 2014 CDC Vital Signs report. For people living with HIV, Viral suppression is critical. By getting tested and taking HIV medicines, individuals living with HIV can achieve very low levels of HIV in the body.  Created: 11/25/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/25/2014.

HIV Care Saves Lives: Viral Suppression is Key PSA (:60)

Centers for Disease Control (CDC) Podcasts

2014-11-25

This 60 second Public Service Announcement is based on the December 2014 Vital Signs. For people living with HIV, Viral suppression is critical. By getting tested and taking HIV medicines, individuals living with HIV can achieve very low levels of HIV in the body.  Created: 11/25/2014 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 11/25/2014.

Associated Factors of Suicidal Thoughts in HIV-Positive Individuals

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Fatemeh Dabaghzadeh

2015-11-01

Full Text Available  Objective: As a first study, suicidal ideation and its correlates have been evaluated in Iranian HIV positive population .  Methods:One hundred and fifty HIV-positive individuals were recruited in this cross-sectional study. The Hospital Anxiety and Depression Scale (HADS, Positive and Negative Suicide Ideation (PANSI, Pittsburgh Sleep Quality Inventory (PSQI and Somatization subscale of Symptom Checklist 90 (SCL 90 as self- reported questionnaires were used to assess the patients’ anxiety and depression status, suicidal thoughts, sleep quality and physiological factors, respectively . Results:Antiretroviral therapy and efavirenz intake did not show any significant effects on the patients’ suicidal ideation. Anxiety (p<0.001, depression (p<0.001, poor physical activity (P<0.001 and sleep quality (p<0.001 were significantly associated with the patients’ negative suicidal ideation. From the patients’ demographic data, unemployment (p = 0.04, living alone (p = 0.01, and lack of family support (p = 0.01 were correlated with the patients’ negative suicidal thoughts . Conclusion:Although hospitals are the main referral centers for providing care for HIV-positive individuals in Tehran, Iran, conducting a multi-center study with sufficient sample size from different areas of our country that include individuals with different behaviors and cultures is essential to confirm the results of this study.

HIV stigma and social capital in women living with HIV

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Cuca, Yvette P.; Asher, Alice; Okonsky, Jennifer; Kaihura, Alphoncina; Dawson-Rose, Carol; Webel, Allison

2016-01-01

Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total social capital was not. Women with lower Value of Life social capital scores had significantly higher total stigma scores (p = .010) and higher Negative Self-image stigma scores (p = .001). Women who felt less valued in their social worlds may have been more likely to perceive HIV stigma, which could have negative health consequences. This work begins to elucidate the possible relationships between social capital and perceived HIV stigma. PMID:27697368

Factors Associated with the Failure to Seek HIV Care and Treatment Among HIV-Positive Women in a Northern Province of Vietnam

DEFF Research Database (Denmark)

Nguyen T., Nam; Bygbjerg, Ib Christian; Mogensen, Hanne Overgaard

2010-01-01

-positive women living a Haiphong, a northern province of Vietnam. The women were recruited through a network of people living with HIV/AIDS (HPN+) by means of snowball sampling and through the local, governmental HIV registration system (Provincial AIDS Centre [PAC]). Approximately 26.3% of the study......This cross-sectional survey examines the utilization of HIV care and treatment services after HIV diagnosis among women in Vietnam and describes factors that may be associated with failure in seeking services. From May 2007 to November 2007, we conducted structured interviews with 353 HIV...... status (OR: 4.0; 95% CI: 2.0–8.1), and factors associated with the testing situation, whereby women who were tested by chance had a 4.0 times increased OR (95% CI: 1.4–11.7) and women who were tested in relation to antenatal care or delivery had 3.0 times increased OR (95% CI: 1.1–8.5) for failure...

Relationships between neighbourhood characteristics and current STI status among HIV-infected and HIV-uninfected women living in the Southern USA: a cross-sectional multilevel analysis.

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Haley, Danielle F; Kramer, Michael R; Adimora, Adaora A; Haardörfer, Regine; Wingood, Gina M; Ludema, Christina; Rubtsova, Anna; Hickson, DeMarc A; Ross, Zev; Golub, Elizabeth; Bolivar, Hector; Cooper, Hannah Lf

2017-12-01

Neighbourhood characteristics (eg, high poverty rates) are associated with STIs among HIV-uninfected women in the USA. However, no multilevel analyses investigating the associations between neighbourhood exposures and STIs have explored these relationships among women living with HIV infection. The objectives of this study were to: (1) examine relationships between neighbourhood characteristics and current STI status and (2) investigate whether the magnitudes and directions of these relationships varied by HIV status in a predominantly HIV-infected cohort of women living in the Southern USA. This cross-sectional multilevel analysis tests relationships between census tract characteristics and current STI status using data from 737 women enrolled at the Women's Interagency HIV Study's southern sites (530 HIV-infected and 207 HIV-uninfected women). Administrative data (eg, US Census) described the census tract-level social disorder (eg, violent crime rate) and social disadvantage (eg, alcohol outlet density) where women lived. Participant-level data were gathered via survey. Testing positive for a current STI was defined as a laboratory-confirmed diagnosis of chlamydia, gonorrhoea, trichomoniasis or syphilis. Hierarchical generalised linear models were used to determine relationships between tract-level characteristics and current STI status, and to test whether these relationships varied by HIV status. Eleven per cent of participants tested positive for at least one current STI. Greater tract-level social disorder (OR=1.34, 95% CI 0.99 to 1.87) and social disadvantage (OR=1.34, 95% CI 0.96 to 1.86) were associated with having a current STI. There was no evidence of additive or multiplicative interaction between tract-level characteristics and HIV status. Findings suggest that neighbourhood characteristics may be associated with current STIs among women living in the South, and that relationships do not vary by HIV status. Future research should establish the

"La Familia" HIV prevention program: a focus on disclosure and family acceptance for Latino immigrant MSM to the USA.

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Melendez, Rita M; Zepeda, Jorge; Samaniego, Rafael; Chakravarty, Deepalika; Alaniz, Gabriela

2013-01-01

The objective of this study was to pilot test and evaluate a HIV prevention program that used a Freirean approach to engage Latino immigrant MSM (men who have sex with men) on issues of sexual orientation, family acceptance, stigma as well as HIV prevention and sexual risk behaviors. Participants were evaluated using a survey before and after participation in the program and compared to a control group. Focus groups where participants discussed their experiences in the program as well as perceptions of the program were held and analyzed. Survey results indicate that after their participation in the program, participants increased their safer sex behaviors, comfort disclosing their sexual orientation and support from friends. HIV prevention needs to incorporate cultural, social and structural factors.

The effect of sympathy on discriminatory attitudes toward persons living with HIV/AIDS in Puerto Rico: a hierarchical analysis of women living in public housing.

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Norman, Lisa R; Abreu, Silkha; Candelaria, Erika; Sala, Ana

2009-02-01

As the number of persons living with HIV/AIDS (PLWHA) continues to increase in Puerto Rico, it becomes increasingly important to address the issues of stigma and other discriminatory attitudes. Therefore, the objective of the present study is to examine the attitudes toward PLWHA of a large sample of women living in public housing in Puerto Rico, including sympathy and support for PLWHA in the workplace and in school. A total of 1138 women completed a self-administered 218-item survey made up of questions that measured HIV-related knowledge, attitudes and behaviors. Levels of sympathy varied depending upon the target group, with HIV-infected drug users receiving the least sympathy. Most women reported that HIV-positive teachers should be allowed to teach and that HIV-positive children should be allowed to attend school. However, a significantly lower percentage reported that HIV-infected nurses should be allowed to continue working. Women who were more sympathetic toward PLWHA were more tolerant of PLWHA in the workplace and school, while those with inaccurate knowledge concerning HIV transmission were less tolerant. Also, those who knew a PLWHA were more tolerant. Levels of discriminatory attitudes in Puerto Rico are high and warrant both individual- and societal-level interventions.

After the fall from grace: negotiation of new identities among HIV-positive women in Peru.

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Valencia-Garcia, Dellanira; Starks, Helene; Strick, Lara; Simoni, Jane M

2008-10-01

Despite increasing rates of HIV infection among heterosexual women in Peru, married women remain virtually invisible as a group at risk of HIV or requiring treatment. This study analyzed the intersections of HIV with machismo and marianismo, the dominant discourses in Latin America that prescribe gender roles for men and women. Data sources include recent literature on machismo and marianismo and interviews conducted with 14 HIV-positive women in Lima, Peru. Findings indicate how the stigma associated with HIV constructs a discourse that restricts the identities of HIV-positive women to those of 'fallen women' whether or not they adhere to social codes that shape and inform their identities as faithful wives and devoted mothers. Lack of public discourse concerning HIV-positive marianas silences women as wives and disenfranchises them as mothers, leaving them little room to negotiate identities that allow them to maintain their respected social positions. Efforts must be aimed at expanding the discourse of acceptable gender roles and behaviour for both men and women within the context of machismo and marianismo so that there can be better recognition of all persons at risk of, and living with, HIV infection.

Living Day by Day: The Meaning of Living With HIV/AIDS Among Women in Lebanon.

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Kaplan, Rachel L; Khoury, Cynthia El; Field, Emily R S; Mokhbat, Jacques

2016-01-01

We examined the meaning of living with HIV/AIDS among women in Lebanon. Ten women living with HIV/AIDS (WLWHA) described their experiences via semistructured in-depth interviews. They navigated a process of HIV diagnosis acceptance that incorporated six overlapping elements: receiving the news, accessing care, starting treatment, navigating disclosure decisions, negotiating stigma, and maintaining stability. Through these elements, we provide a framework for understanding three major themes that were constructed during data analysis: Stand by my side: Decisions of disclosure; Being "sick" and feeling "normal": Interacting with self, others, and society; and Living day by day: focusing on the present. We contribute to the existing literature by providing a theoretical framework for understanding the process of diagnosis and sero-status acceptance among WLWHA. This was the first study of its kind to examine the meaning of living with HIV/AIDS among women in a Middle Eastern country.

Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa.

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Yeatman, Sara; Eaton, Jeffrey W; Beckles, Zosia; Benton, Lorna; Gregson, Simon; Zaba, Basia

2016-09-01

Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and to planning resource needs and coverage of prevention of mother-to-child transmission services in sub-Saharan Africa. In the light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. We searched Medline, Embase, Popline, PubMed and African Index Medicus. Studies were included if they were conducted in sub-Saharan Africa and provided estimates of fertility outcomes (live births or pregnancies) among women on ART relative to a comparison group. Of 2070 unique references, 18 published papers met all eligibility criteria. Comparisons fell into four categories: fertility of HIV-positive women relative to HIV-negative women; fertility of HIV-positive women on ART compared to those not yet on ART; fertility differences by duration on ART; and temporal trends in fertility among HIV-positive women. Evidence indicates that fertility increases after approximately the first year on ART and that while the fertility deficit of HIV-positive women is shrinking, their fertility remains below that of HIV-negative women. These findings, however, were based on limited data mostly during the period 2005-2010 when ART scaled up. Existing data are insufficient to characterise how ART has affected the fertility of HIV-positive women in sub-Saharan Africa. Improving evidence about fertility among women on ART is an urgent priority for planning HIV resource needs and understanding HIV epidemic trends. Alternative data sources such as antenatal clinic data, general population cohorts and population-based surveys can be harnessed to understand the issue. © 2016 John Wiley & Sons Ltd.

Direct and dynamic detection of HIV-1 in living cells.

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Jonas Helma

Full Text Available In basic and applied HIV research, reliable detection of viral components is crucial to monitor progression of infection. While it is routine to detect structural viral proteins in vitro for diagnostic purposes, it previously remained impossible to directly and dynamically visualize HIV in living cells without genetic modification of the virus. Here, we describe a novel fluorescent biosensor to dynamically trace HIV-1 morphogenesis in living cells. We generated a camelid single domain antibody that specifically binds the HIV-1 capsid protein (CA at subnanomolar affinity and fused it to fluorescent proteins. The resulting fluorescent chromobody specifically recognizes the CA-harbouring HIV-1 Gag precursor protein in living cells and is applicable in various advanced light microscopy systems. Confocal live cell microscopy and super-resolution microscopy allowed detection and dynamic tracing of individual virion assemblies at the plasma membrane. The analysis of subcellular binding kinetics showed cytoplasmic antigen recognition and incorporation into virion assembly sites. Finally, we demonstrate the use of this new reporter in automated image analysis, providing a robust tool for cell-based HIV research.

Chorioamnionitis in pregnancy: a comparative study of HIV-positive and HIV-negative parturients.

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Ocheke, Amaka N; Agaba, Patricia A; Imade, Godwin E; Silas, Olugbenga A; Ajetunmobi, Olanrewaju I; Echejoh, Godwins; Ekere, Clement; Sendht, Ayuba; Bitrus, James; Agaba, Emmanuel I; Sagay, Atiene S

2016-03-01

Chorioamnionitis is an important risk factor for vertical transmission of HIV/AIDS. We compared the prevalence and correlates of histologic chorioamnionitis (HCA) in HIV-positive and HIV-negative pregnant women. HIV-positive and -negative parturients were interviewed, examined and had their placentas examined histologically for chorioamnionitis. Data regarding HIV were also retrieved from their hospital records. A total of 298 parturients (150 HIV positive and 148 HIV negative) were enrolled. The two groups were similar in socio-demographic and obstetric parameters except for age. The prevalence of HCA was 57.1% in HIV-positive women and 61.6% in HIV-negative women (p = 0.43). HCA staging was associated with the number of intrapartum vaginal examinations in HIV-positive subjects and nulliparity in HIV-negative subjects. The number of intrapartum vaginal examinations and coitus in the week prior to delivery significantly affected the grade of HCA in HIV-negative subjects. The prevalence of HCA in both HIV-positive and HIV-negative is high. Most variables did not affect the occurrence of HCA in both groups studied except number of intrapartum examinations, coitus in the preceding one week and nulliparity, which were related to severity of the disease. © The Author(s) 2016.

Re-entry experiences of Black men living with HIV/AIDS after release from prison: Intersectionality and implications for care.

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Sun, Shufang; Crooks, Natasha; Kemnitz, Rebecca; Westergaard, Ryan P

2018-06-12

Both the HIV epidemic and incarceration disproportionately affect Black men in the United States. A critical period for incarcerated Black men living with HIV/AIDS is re-entry into the community, which is often associated with adverse health outcomes. Additionally, Black men living with HIV/AIDS involved in the criminal justice system are burdened by multiple, intersecting disadvantaged identities and social positions. This study aimed to examine community re-entry experiences among Black men living with HIV/AIDS from an intersectional perspective. In-depth, semi-structured interviews were conducted with 16 incarcerated Black men in Wisconsin, at pre-release from prison and six months after re-entry. Thematic analysis guided by intersectionality theory was used to analyze interview transcripts. Seven emerged themes included Intersectional Identities and Social Positions, Family Support, Neighborhood Violence, Relationship with Law Enforcement, Employment, Mental Health Concerns, and Medical Care and Medication Management. Intersecting identities and social positions interact with factors at multiple levels to inform health and HIV care. A conceptual framework was developed to illustrate relationships among themes. Findings demonstrate the relevance of intersectionality theory in HIV care with Black men involved in criminal justice system. Incorporating a social-ecological perspective into intersectionality framework could be useful in theoretical and empirical research. Disenfranchised communities may particularly benefit from interventions that address community- and systemic-level issues. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mental health challenges among adolescents living with HIV.

Science.gov (United States)

Vreeman, Rachel C; McCoy, Brittany M; Lee, Sonia

2017-05-16

Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV-infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living with HIV, including access to mental health services, the role of mental health challenges during transition from paediatric to adult care services and responsibilities, and the impact of mental health interventions. For each of the topics included in this review, individual searches were run using Medline and PubMed, accompanied by scans of bibliographies of relevant articles. The topics on which searches were conducted for HIV-infected adolescents include depression and anxiety, transition from paediatric to adult HIV care and its impact on adherence and mental health, HIV-related, mental health services and interventions, and the measurement of mental health problems. Articles were included if the focus was consistent with one of the identified topics, involved HIV-infected adolescents, and was published in English. Mental and behavioural health challenges are prevalent in HIV-infected adolescents, including in resource-limited settings where most of them live, and they impact all aspects of HIV prevention and treatment. Too little has been done to measure the impact of mental health challenges for adolescents living with HIV, to evaluate interventions to best sustain or improve the mental health of this population, or to create healthcare systems with personnel or resources to promote mental health. Mental health issues should be addressed proactively during adolescence for all HIV-infected youth. In addition, care systems need to pay greater attention to how mental health support is integrated into the care management for HIV

The relationship between negative responses to HIV status disclosure and psychosocial outcomes among people living with HIV.

Science.gov (United States)

Cama, Elena; Brener, Loren; Slavin, Sean; de Wit, John

2017-07-01

This report examines rates of HIV status disclosure and negative responses to disclosure among people living with HIV in Australia. Among 697 people living with HIV, most (>90%) had disclosed their status to friends, sexual partners and health providers. Almost a third had not disclosed to family, and half had not told any work colleagues. Negative responses to disclosure (e.g. blame, rejection) by all groups were associated with increased HIV-related stigma, psychological distress and diminished social support and health satisfaction. These results shed light on rates of disclosure among people living with HIV in Australia and the adverse health impacts of negative responses to disclosure.

What do men who serve as lay health advisers really do?: Immigrant Latino men share their experiences as Navegantes to prevent HIV.

Science.gov (United States)

Vissman, Aaron T; Eng, Eugenia; Aronson, Robert E; Bloom, Fred R; Leichliter, Jami S; Montaño, Jaime; Rhodes, Scott D

2009-06-01

HoMBReS was a lay health adviser (LHA) intervention designed to reduce sexual risk among recently arrived, nonEnglish-speaking Latino men who were members of a multicounty soccer league in central NC. Our community-based participatory research (CBPR) partnership collected, analyzed, and interpreted qualitative life-story narratives to characterize the roles of male LHAs known as Navegantes. Nine Navegantes were interviewed. Their mean age was 39 years (range: 26-62 years); six were from Mexico and three from El Salvador. Navegantes described the function and facilitators of serving as LHAs and identified leverage points for future HIV and STD prevention strategies. They highlighted psychosocial and sociocultural influences on HIV risk, settings for risky behavior, and personal changes from serving as Navegantes. This study provides preliminary evidence that an LHA approach is feasible and appropriate for Latino men, and can be effective in reaching men who might otherwise be difficult to reach.

DATING AND SEXUAL CHALLENGES FACED BY HIV-POSITIVE PEOPLE IN KWAZULU-NATAL, SOUTH AFRICA

Directory of Open Access Journals (Sweden)

Mulqueeny, Delarise

2013-05-01

Full Text Available According to the 2010 UNAIDS Report, an estimated 320 000 (or 20% fewer people died of AIDS-related causes in 2009 when compared to figures in 2004 in sub-Saharan Africa, when antiretroviral therapy was markedly expanded (UNAIDS, 2010. This decreased mortality rate offers hope for HIV-infected people to plan a future, part of which will include dating and sexual relationships. The Report cites KwaZulu-Natal in South Africa as being at the heart of the HIV/AIDS epidemic; this article is based on research on dating and sexuality among HIV-positive people in KwaZulu-Natal. Dating and sexuality are an integral part of living. Yet HIV-positive persons are denied intimacy at a time when this is most needed (Kasiram in Kasiram, Partab & Dano, 2006. Little is known about the full range of sexual adaptations that HIV-infected individuals choose (Schiltz & Sandfort, 2000. Kasiram, Partab, Dano and Van Greunen (2003:9 cite interaction and intimacy among HIV-positive persons as a neglected research focus, while Painter (2001 adds that insufficient attention is afforded to couple relationships for infected people. An important reason that motivated this study on dating and sexual challenges faced by HIV-positive people was the first author’s (the main researcher’s personal experience of being HIV positive and counselling and life coaching HIV-positive people. She is confronted regularly with variations of the question “Will I be normal?”, which often translates to: “Will I be able to date and have sex.

How important are human immunodeficiency virus (HIV) clinical markers to the long-term formal employment among people living with HIV in developing countries? A study in South Africa.

Science.gov (United States)

Odek, W O; Glendinning, A; Charalambous, S

2014-01-01

To examine the relationship of Human Immunodeficiency Virus (HIV) clinical markers and socio-demographic characteristics with long-term formal employment among people living with HIV (PLHIV). 554 adults, 55% females, on HIV treatment for at least two years at two public hospitals in Johannesburg, South Africa. A retrospective cohort design, tracing changes in study participants' formal employment status since the first HIV-positive diagnosis. Data collection included historical medical records review and interviewer-administered questionnaires. 44% of all study participants (39% and 49% among males and females, respectively) were formally employed at the time of the study, primarily in low-skilled jobs in the private sector. The majority (83%) of males and 60% of females remained in formal employment since being diagnosed as HIV-positive. Female gender, education to grade 12 or higher, a smaller household size and being married were significantly associated with current formal employment. Formal employment was unrelated to HIV treatment indicators (CD4 count, viral load and duration since diagnosis). Of those in formal employment, 68 (28%) were aware of HIV policies at their workplaces, which was also positively associated with the duration in their current employment. PLHIV in developing country contexts can enter into and maintain formal employment, especially when treatment and workplace support are available. Thus, employer organisations should implement effective workplace HIV policies to enhance employment experiences of their workforce living with HIV. Care and support services for people on HIV treatment should also address their career development needs.

Sources of Social Capital for Malawi People Living With HIV

Directory of Open Access Journals (Sweden)

Sally H. Rankin

2016-11-01

Full Text Available With one of the highest rates of poverty and HIV in the world, Malawi faith-based organizations (FBOs, non-governmental organizations (NGOs, and community-based organizations (CBOs are expected to provide tangible and emotional support to people living with HIV (PLWH. Using Lin’s social capital theoretical approach, we examine the perspective of PLWH regarding the adequacy of support responses. Forty-six rural Malawi HIV+ adults provided interviews that were recorded digitally, translated, and transcribed by Malawi research assistants. Atlas.ti was used to organize the data and to aid in the analytic process. Participants expressed disappointment in the lack of resources that could be accessed through the FBOs although their expectations may have been unrealistic. Outcomes from accessing and mobilizing the FBO network were negative in terms of stigmatization by FBO leaders and members, whereas outcomes related to CBOs and NGOs were generally positive in terms of empowerment through HIV information and attendance at support groups.

Financial situation of people living with HIV in Europe

NARCIS (Netherlands)

Schrooten, W.; Dreezen, C.; Borleffs, J.; Dijkgraaf, M.; Borchert, M.; de Graeve, D.; Hemmer, R.; Fleerackers, Y.; Colebunders, R.

2002-01-01

The objective was to investigate the financial situation of people living with HIV in Europe. Two surveys using an anonymous questionnaire were organized in Europe among people living with HIV, the first in 1996-97 and the second in 1998-99. One thousand one hundred and sixty-one people from the

Gynaecological surgery in the HIV-positive patient

African Journals Online (AJOL)

Africa approximately 5 500 women are newly infected with HIV and more than 3 000 die from AIDS-related illnesses. In this ... of triple antiretroviral therapy, women living with HIV can now enjoy longer life ... There is a paucity of literature about the rate of complications after .... p=0.08) than their HIV-negative controls.6.

HIV infection duration, social support and the level of trauma symptoms in a sample of HIV-positive Polish individuals.

Science.gov (United States)

Rzeszutek, Marcin; Oniszczenko, Włodzimierz; Żebrowska, Magdalena; Firląg-Burkacka, Ewa

2015-01-01

The aim of this study was to investigate the relationship between the average HIV infection duration and the level of quantitatively rated post-traumatic stress disorder (PTSD) symptoms and social support dimensions in a sample of 562 Polish HIV+ adults. Possible moderating effects of social support on the relationship between the average HIV infection duration and the level of PTSD symptoms were also analysed. The results of this study suggest that the average HIV infection duration may intensify PTSD symptoms and deteriorate the perceived availability of social support in HIV+ individuals. However, a positive relationship between HIV infection duration and the level of trauma symptoms was observed only in the group of HIV+ individuals with low perceived available social support, but not in the group of HIV-infected individuals with high perceived available social support. This research provided some new insight into the psychological and social aspects of living with HIV. In particular, our results suggest that although HIV infection duration may intensify trauma symptoms and deteriorate social support, perceived available social support may act as a buffer against HIV-related trauma symptoms.

HIV Futures 8: Protocol for a Repeated Cross-sectional and Longitudinal Survey of People Living with HIV in Australia

OpenAIRE

Power, Jennifer; Brown, Graham; Lyons, Anthony; Thorpe, Rachel; Dowsett, Gary W.; Lucke, Jayne

2017-01-01

Introduction More than 27,000 Australians currently live with HIV. Most of these people have access to quality clinical care and antiretroviral treatment (ART) and can expect good general health. However, HIV-related stigma is a problem and many people living with HIV experience poorer than average mental health. Issues of aging are also of increasing concern. This paper describes the methods and sample for the HIV Futures 8 study, a national survey of people living with HIV in Australia that...

Disclosure experience in a convenience sample of Quebec-born women living with HIV: a phenomenological study.

Science.gov (United States)

Rouleau, Geneviève; Côté, José; Cara, Chantal

2012-10-18

In Canada, there has been a considerable increase in the number of women infected with the human immunodeficiency virus (HIV). Within a stigmatized social context, disclosure of HIV positivity is still a prevailing concern among women. Little is known about the global understanding of how French-speaking, Quebec-born women living with HIV, live their serostatus disclosure experience. The aim of this qualitative study is to describe and understand the disclosure experience of these women. We conducted semi-structured interviews with seven women. A convenience sample of French-speaking, Quebec-born women was chosen because they all responded to the criteria of wishing to share their disclosure experience. The mean age of the participants was 46 years old (SD±12). They lived with HIV for an average of 10 years; time since diagnosis varied from 8 months to 23 years. Two out of four mothers had given birth to HIV positive children. Data analysis proposed by van Manen was performed to discover the essential themes of the experience. Seven themes were identified to understand the experience of disclosure in women: 1) Respecting for self and confidants; 2) Feeling apprehension; 3) Exercising control to ensure protection; 4) Deliberately engaging in a process of disclosure/non-disclosure; 5) Exposing oneself to stigma and social exclusion; 6) Suffering internally; and 7) Benefitting from the positive effects of one's decision. For these women, disclosing their HIV status meant: Living the ambivalence of a paradoxical process of revealing/concealing, in a state of profound suffering, exacerbated by stigma, while also being enriched by the benefits attained. Understanding the experience of disclosure in WLHIV is important to guide actions in the practice to support and accompany these women in their unique reality. Health professionals have to broaden their role and work on individual, interpersonal, inter-organizational and intersectoral levels. Mobilization of actors from

Disclosure experience in a convenience sample of quebec-born women living with HIV: a phenomenological study

Science.gov (United States)

2012-01-01

Background In Canada, there has been a considerable increase in the number of women infected with the human immunodeficiency virus (HIV). Within a stigmatized social context, disclosure of HIV positivity is still a prevailing concern among women. Little is known about the global understanding of how French-speaking, Quebec-born women living with HIV, live their serostatus disclosure experience. The aim of this qualitative study is to describe and understand the disclosure experience of these women. Methods We conducted semi-structured interviews with seven women. A convenience sample of French-speaking, Quebec-born women was chosen because they all responded to the criteria of wishing to share their disclosure experience. The mean age of the participants was 46 years old (SD±12). They lived with HIV for an average of 10 years; time since diagnosis varied from 8 months to 23 years. Two out of four mothers had given birth to HIV positive children. Data analysis proposed by van Manen was performed to discover the essential themes of the experience. Results Seven themes were identified to understand the experience of disclosure in women: 1) Respecting for self and confidants; 2) Feeling apprehension; 3) Exercising control to ensure protection; 4) Deliberately engaging in a process of disclosure/non-disclosure; 5) Exposing oneself to stigma and social exclusion; 6) Suffering internally; and 7) Benefitting from the positive effects of one’s decision. For these women, disclosing their HIV status meant: Living the ambivalence of a paradoxical process of revealing/concealing, in a state of profound suffering, exacerbated by stigma, while also being enriched by the benefits attained. Conclusions Understanding the experience of disclosure in WLHIV is important to guide actions in the practice to support and accompany these women in their unique reality. Health professionals have to broaden their role and work on individual, interpersonal, inter-organizational and

Disclosure experience in a convenience sample of quebec-born women living with HIV: a phenomenological study

Directory of Open Access Journals (Sweden)

Rouleau Geneviève

2012-10-01

Full Text Available Abstract Background In Canada, there has been a considerable increase in the number of women infected with the human immunodeficiency virus (HIV. Within a stigmatized social context, disclosure of HIV positivity is still a prevailing concern among women. Little is known about the global understanding of how French-speaking, Quebec-born women living with HIV, live their serostatus disclosure experience. The aim of this qualitative study is to describe and understand the disclosure experience of these women. Methods We conducted semi-structured interviews with seven women. A convenience sample of French-speaking, Quebec-born women was chosen because they all responded to the criteria of wishing to share their disclosure experience. The mean age of the participants was 46 years old (SD±12. They lived with HIV for an average of 10 years; time since diagnosis varied from 8 months to 23 years. Two out of four mothers had given birth to HIV positive children. Data analysis proposed by van Manen was performed to discover the essential themes of the experience. Results Seven themes were identified to understand the experience of disclosure in women: 1 Respecting for self and confidants; 2 Feeling apprehension; 3 Exercising control to ensure protection; 4 Deliberately engaging in a process of disclosure/non-disclosure; 5 Exposing oneself to stigma and social exclusion; 6 Suffering internally; and 7 Benefitting from the positive effects of one’s decision. For these women, disclosing their HIV status meant: Living the ambivalence of a paradoxical process of revealing/concealing, in a state of profound suffering, exacerbated by stigma, while also being enriched by the benefits attained. Conclusions Understanding the experience of disclosure in WLHIV is important to guide actions in the practice to support and accompany these women in their unique reality. Health professionals have to broaden their role and work on individual, interpersonal, inter

Positive prevention: reducing HIV transmission among people living with HIV/AIDS

National Research Council Canada - National Science Library

Kalichman, Seth C

2005-01-01

... of New South Wales, Australia Rise Goldstein, Center for HIV Identification, Prevention, and Treatment Services, Department of Psychiatry University of California, Los Angeles Lauren K. Gooden,...

MIRRORING THE CRITICAL BIOETHICS: THE REFLECTED IMAGE FROM THE VULNERABILITY OF PEOPLE LIVING WITH HIV/AIDS AND THE ONES INVOLVED WITH THEM

Directory of Open Access Journals (Sweden)

Onã Silva

2013-09-01

Full Text Available Introduction: in the bioethical mirror there are such vulnerabilities which strike those who live with HIV/Aids and the ones involved with them. The social construction of this disease faces the representation and morality related to sexual practice, values, myths and beliefs that lead to prejudice and bioethical implications. Objective: to identify the main bioethical conflicts and the stressful factors developed by people living with HIV/Aids and the ones involved with them, and ways of facing a positive diagnosis in Brazilian publications. Methodological description: the conduction of this essay was supported by the Theory of Feminist Inspiration. The references were obtained on Scientific Electronic Library On-line data basis (SciELO. Four analytical categories were elaborated. Social construction of HIV/Aids infection; bioethical conflicts, vulnerabilities and stressful factors experienced by people living with HIV/Aids and the ones involved with them; the dealing with dilemmatic situations involving people living with HIV/Aids and the ones involved with them in Health care as well policies addressing to that matter. Results and discussion: about the analyzed categories, significant results came up which revealed under the feminist bioethics perspective, the vulnerabilities faced by people with HIV/Aids. The social representation of the disease, regardless scientific and technological developments and human rights, HIV-positive people are still vulnerable in relation to social attitudes of panic, intolerance and prejudice. Conclusion: the dramatic reality of HIV-positive people, who are vulnerable as a consequence of prejudicial and inhuman behaviors, requires bioethical studies, inspired in theoretical currents, discussing the power relationships – from where moralities, stigmas and prejudices arise. The bioethical debate upon the values that characterize the stigmatizing issues about this epidemic, would assist to dismantle a negative

Returning to life, the Lived Experiences of Pregnancy in Women with HIV: A Phenomenological study

Directory of Open Access Journals (Sweden)

Z Khalajinia

2016-08-01

Full Text Available Background & aim: Pregnancy is every woman's stage of life. During this period, women experience physical, mental and social changes. It is very sensitive, challenging and therefore a critical period for every woman particularly in HIV-positive women. During pregnancy, an HIV-positive mother is facing a psychological crisis which includes fear of transmission to children, death, leaving children to the family or a guardian, adverse effects during pregnancy and the effects of pregnancy on their health. Therefore, HIV-positive pregnant women are vulnerable and require supportive interventions.  Care for pregnant women with HIV negative women are unique and different. However, no more information about experience of pregnancy in HIV positive women exists. Therfore, the aim of the present study was to explore the lived experience of pregnancy in HIV-positive women. Methods: The present qualitative study with hermeneutic phenomenological approach included 12 HIV-infected pregnant women who referred to the counseling center for behavioral diseases at Imam Khomeini Hospital of Tehran University of Medical Sciences who were recruited through purposive sampling. Data were collected through semi-structured interviews. Data saturation was achieved after 16 interviews, each 40 to 90 min of duration with participants and then was analyzed by the method proposed by Diekelmann (1989. Results: The participants in the present study were of 22- 39 years of age. After data analysis, the main themes and 3 sub-themes emerged. These themes included: “return to life” with the three sub-themes of experience of motherhood, stability and protection, and gratification. Conclusion: The results revealed that although the experience of pregnancy in HIV-positive women was associated with a deep sense of fear of transmission of the disease and having children was viewed as a way of hope. Motherhood gave their lives meaning and provided for them to return to life

Strategies for improving mental health and wellbeing used by older people living with HIV: a qualitative investigation.

Science.gov (United States)

Rosenfeld, Dana; Catalan, Jose; Ridge, Damien

2018-05-30

Recent research into "successful ageing" and "resilience" in the context of ageing with HIV highlights older people living with HIV's (OPLWH) adaptations and coping strategies hitherto neglected by early research's emphasis on difficulties and challenges. Yet "resilience" and "successful ageing" are limited by their inconsistent definition, conflation of personal traits and coping strategies, normative dimension, and inattention to cultural variation and the distinctive nature of older age. This article thus adopts an interpretivist approach to how OPLWH manage the challenges to their mental health and wellbeing of ageing with HIV. Drawing on interviews with 76 OPLWH (aged 50+) living in the United Kingdom, we document both the strategies these participants use (for example, "accentuating the positive" and accessing external support) and the challenges to these strategies' success posed by the need to manage their HIV's social and clinical dimensions and prevent their HIV from dominating their lives. This points to (a) the complex overlaps between challenges to and strategies for improving or maintaining mental health and wellbeing in the context of ageing with HIV, and (b) the limitations of the "resilience" and "successful ageing" approaches to ageing with HIV.

Realizing Women Living with HIV's Reproductive Rights in the Era of ART: The Negative Impact of Non-consensual HIV Disclosure on Pregnancy Decisions Amongst Women Living with HIV in a Canadian Setting.

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Duff, Putu; Kestler, Mary; Chamboko, Patience; Braschel, Melissa; Ogilvie, Gina; Krüsi, Andrea; Montaner, Julio; Money, Deborah; Shannon, Kate

2018-04-07

To better understand the structural drivers of women living with HIV's (WLWH's) reproductive rights and choices, this study examined the structural correlates, including non-consensual HIV disclosure, on WLWH's pregnancy decisions and describes access to preconception care. Analyses drew on data (2014-present) from SHAWNA, a longitudinal community-based cohort with WLWH across Metro-Vancouver, Canada. Multivariable logistic regression was used to model the effect of non-consensual HIV disclosure on WLWH's pregnancy decisions. Of the 218 WLWH included in our analysis, 24.8% had ever felt discouraged from becoming pregnant and 11.5% reported accessing preconception counseling. In multivariable analyses, non-consensual HIV disclosure was positively associated with feeling discouraged from wanting to become pregnant (AOR 3.76; 95% CI 1.82-7.80). Non-consensual HIV disclosure adversely affects WLWH's pregnancy decisions. Supporting the reproductive rights of WLWH will require further training among general practitioners on the reproductive health of WLWH and improved access to women-centred, trauma-informed care, including non-judgmental preconception counseling.

Humanizing HIV/AIDS and its (re)stigmatizing effects: HIV public 'positive' speaking in India.

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Finn, Mark; Sarangi, Srikant

2009-01-01

Social stigma has been inextricably linked with HIV and AIDS since the epidemic erupted in the early 1980s. The stigma that has built up around HIV and AIDS is generally regarded as having a negative impact on the quality of life of HIV-positive people and on general prevention efforts. Current attempts to combat HIV-related stigma focus on increasing the acceptance of HIV among the stigmatizing public and stigmatized individuals alike. In this, the global HIV-positive community is being increasingly called upon to ;humanize' the virus, not least through public displays of HIV 'positive' health and public ;positive' speaking. This article critically explores the constitutive effects and inherent power relations of HIV Positive Speakers' Bureaus (PSBs) as a platform for such a display. Adopting a post-structuralist discourse analytic approach, we explore accounts of positive-speaking and HIV health from HIV-related non-government organizations in India and in PSB training manuals. In particular, we highlight ways in which positive-speaking in India can be seen to have significant (re)stigmatizing effects by way of ambivalent and hyper-real configurations of HIV 'positive' identity and life.

Determinants of subjective health status of HIV positive mothers in NAUTH Nnewi.

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Nwabueze, S A; Adogu, P O U; Adinma, E D; Ifeadike, C O; Nnebue, C C; Ilika, A L; Ikechebelu, J I

2012-01-01

Acquired immune deficiency syndrome (AIDS) caused by human immune deficiency virus (HIV), once dominated by infected males has become feminized especially in sub-Saharan Africa where the majority of adults living with the condition are females. Positive life styles, belonging to social support groups and stigma-free HIV services by providers may have good impact on the quality of life of HIV-positive mothers. This study was aimed at assessing the determinants of subjective health status of HIV-positive mothers accessing prevention-of-mother-to-child-transmission (PMTCT) of HIV services in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. This is a descriptive study in which 288 consenting HIV positive mothers were selected using the systematic sampling technique. Data on demographics, life style, social support, contraceptive use and subjective feeling about current health status were collected from the subjects using a pre-tested, structured, interviewer-administered questionnaire. The mean age of the respondents was 30.46 +/- 4.86 years. Majority (89.2%) of them were married while 55.2% were traders. A significantly higher proportion of the mothers on highly active anti retroviral therapy (HAART) (70.8%) than non users (29.2%) described their current health status as 'excellent' (p<0.001). Also a significantly higher proportion of condom users (99%) than pill users (1%) described their health status as 'excellent' (p<0.02). The same significantly higher proportions of 'excellent' response were given by subjects who engage in social support activities (p<0.001), who practice good feeding (p<0.01) andpersonal hygiene (p<0.01). Access to family planning services and HAART, participation in support group activities and positive lifestyle practices tend to improve subjective health status and should be comprehensively encouraged among the HIV positive mothers.

Detection of HIV-RNA-positive monocytes in peripheral blood of HIV-positive patients by simultaneous flow cytometric analysis of intracellular HIV RNA and cellular immunophenotype.

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Patterson, B K; Mosiman, V L; Cantarero, L; Furtado, M; Bhattacharya, M; Goolsby, C

1998-04-01

Determinations of plasma HIV viral RNA copy numbers help to define the kinetics of HIV-1 infection in vivo and to monitor antiretroviral therapy. However, questions remain regarding the identity of various infected cell types contributing to this free virus pool and to the in vivo lifecycle of HIV during disease progression. Characterization of a novel fluorescence in situ hybridization (FISH) assay employing a pool of labeled oligonucleotide probes directed against HIV RNA was done followed by coupling of the FISH assay with simultaneous surface immunophenotyping to address these questions. In vitro characterizations of this assay using tumor necrosis factor-alpha stimulated and unstimulated ACH-2 cells demonstrated the ability to detect < 5% HIV RNA positive cells with a sensitivity of < 30 RNA copies per cell. Peripheral blood mononuclear cells from 39 HIV-seropositive patients on no, single, combination, or triple drug therapy and 8 HIV-seronegative patients were examined. The majority of HIV-positive patients (24/39) harbored monocytes positive for HIV RNA and a significantly higher fraction of patients with high plasma viral load carried positive monocytes (13/16) than did patients in the low plasma viral load group (11/23). These results demonstrate the effectiveness of a novel FISH assay for identifying and monitoring HIV-infected cell populations in the peripheral blood of HIV-positive patients. In addition, monocytes are a major source of cellular HIV virus in the peripheral blood of HIV patients, even with progression of disease.

HIV-Related Self-Stigma and Health-Related Quality of Life of People Living With HIV in Finland

OpenAIRE

Nobre, Nuno; Pereira, Marco; Roine, Risto P.; Sutinen, Jussi; Sintonen, Harri

2017-01-01

We examined how HIV-related self-stigma was associated with different domains of quality of life (QoL), as measured by the World Health Organization Quality of Life in HIV-infected persons instrument (WHOQOL-HIV-Bref), and health-related quality of life (HRQoL) as measured by the generic 15D (15-dimensional measure of HRQoL), to identify the factors associated with self-stigma of people living with HIV (PLWH). The study sample included 440 patients living with HIV followed at the Infectious D...

HIV-Related Self-Stigma and Health-Related Quality of Life of People Living With HIV in Finland.

Science.gov (United States)

Nobre, Nuno; Pereira, Marco; Roine, Risto P; Sutinen, Jussi; Sintonen, Harri

We examined how HIV-related self-stigma was associated with different domains of quality of life (QoL), as measured by the World Health Organization Quality of Life in HIV-infected persons instrument (WHOQOL-HIV-Bref), and health-related quality of life (HRQoL) as measured by the generic 15D (15-dimensional measure of HRQoL), to identify the factors associated with self-stigma of people living with HIV (PLWH). The study sample included 440 patients living with HIV followed at the Infectious Disease Clinic of Helsinki University Hospital. Participants with more severe self-stigma reported significantly lower QoL and HRQoL. Male gender, cohabiting with a partner, and disclosure of HIV status were associated with less self-stigma; high education level and financial difficulties were associated with greater self-stigma. Having lived longer with HIV, being unemployed, and living alone were also predictors of self-stigma via financial difficulties. The findings suggest that self-stigma is a complex and multidimensional phenomenon that impacts the HRQoL of PLWH. Psychosocial interventions to enhance the well-being of PLWH are increasingly needed. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

HIV Stigma and Social Capital in Women Living With HIV.

Science.gov (United States)

Cuca, Yvette P; Asher, Alice; Okonsky, Jennifer; Kaihura, Alphoncina; Dawson-Rose, Carol; Webel, Allison

Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total social capital was not. Women with lower Value of Life social capital scores had significantly higher total stigma scores (p = .010) and higher Negative Self-image stigma scores (p = .001). Women who felt less valued in their social worlds may have been more likely to perceive HIV stigma, which could have negative health consequences. This work begins to elucidate the possible relationships between social capital and perceived HIV stigma. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

TB Testing for People Living with HIV

Centers for Disease Control (CDC) Podcasts

2012-07-23

Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, explains why it is important for people living with HIV to be tested for TB.  Created: 7/23/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 7/23/2012.

Modern contraceptive use among women living with HIV/AIDS at the Korle Bu Teaching Hospital in Ghana.

Science.gov (United States)

Samba, Ali; Mumuni, Kareem; Adu, Joseph A; Sefogah, Promise E; Kudzi, William; Nartey, Edmund T

2018-04-01

To examine factors influencing contraceptive use among women living with HIV/AIDS. The present cross-sectional study included a randomly selected sample of sexually active females aged 15-60 years who were living with HIV/AIDS and receiving care at the HIV Clinic, Korle Bu Teaching Hospital, Accra, Ghana, between September 1 and November 31, 2016. Data were collected via a structured interviewer-administered questionnaire. Among 202 women who completed the survey, 50 (24.7%) were using contraceptives. Of the women using contraception, 39 (78%) were married and 6 (12%) were cohabiting. Twenty-eight (56%) reported that their primary sexual partners were HIV-positive, 14 (28%) had HIV-negative partners, and 8 (16%) did not know their partner's HIV status. Condoms were used by 42 (84%) women and the majority (41 [82%]) wanted to have more children; almost all (47 [94%]) had received counseling on contraceptive use. Overall, 133 (65.8%) and 45 (22.3%) women reported that they would prefer to share their family planning concerns with a doctor and nurse, respectively, at the HIV clinic. Women living with HIV/AIDS desired more children but preferred to share their family planning concerns with their clinician at the HIV clinic. Integrating HIV care and reproductive health services could help these women achieve childbearing goals safely. © 2018 International Federation of Gynecology and Obstetrics.

Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review

OpenAIRE

Kennedy, Caitlin E; Haberlen, Sabina; Amin, Avni; Baggaley, Rachel; Narasimhan, Manjulaa

2015-01-01

Introduction: Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. Methods: We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violenc...

Hopefulness Fosters Affective and Cognitive Constructs for Actions to Cope and Enhance Quality of Life among People Living with HIV in Dar Es Salaam, Tanzania.

Science.gov (United States)

Siril, Hellen; Fawzi, Mary C Smith; Todd, Jim; Wyatt, Monique; Kilewo, Japheth; Ware, Norma; Kaaya, Sylvia

The aims of this study were to describe how people living with HIV (PLWH) perceive hope and illustrate implications for HIV care and treatment. This is a qualitative study done to explore perceptions and meanings of hope among PLWH attending care and treatment clinics in Dar es Salaam, Tanzania. In all, 10 focus group discussions and 9 in-depth interviews were conducted. People living with HIV described the following 3 dimensions of hope: cognitive, positive emotions, and normalization. Being cognizant of the effectiveness of antiretroviral treatment (ART) often led to positive emotions, such as feeling comforted or strengthened, which in turn was related to positive actions toward normalizing life. Improved treatment outcomes facilitated hope, while persistent health problems, such as ART side effects, were sources of negative emotions contributing to loss of hope among PLWH. Hope motivated positive health-seeking behaviors, including adherence to ART, and this may guide interventions to help PLWH cope and live positively with HIV.

Latino sexual and gender identity minorities promoting sexual health within their social networks: Process evaluation findings from a lay health advisor intervention

Science.gov (United States)

Sun, Christina J.; García, Manuel; Mann, Lilli; Alonzo, Jorge; Eng, Eugenia; Rhodes, Scott D.

2015-01-01

The HOLA intervention was a lay health advisor intervention designed to reduce the disproportionate HIV burden borne by Latino sexual and gender identity minorities (gay, bisexual, and other men who have sex with men, and transgender persons) living in the United States. Process evaluation data were collected for over a year of intervention implementation from 11 trained Latino male and transgender lay health advisors (Navegantes) to document the activities each Navegante conducted to promote condom use and HIV testing among his or her 8 social network members enrolled in the study. Over 13 months, the Navegantes reported conducting 1,820 activities. The most common activity was condom distribution. Navegantes had extensive reach beyond their enrolled social network members, and they engaged in health promotion activities beyond social network members enrolled in the study. There were significant differences between the types of activities conducted by Navegantes depending on who was present. Results suggest that lay health advisor interventions reach large number of at-risk community members and may benefit populations disproportionately impacted by HIV. PMID:25416309

Talk radio as the soundtrack of our lives: Participatory HIV/AIDS communication, public self-expression and Positive Talk.

Science.gov (United States)

Burger, Mariekie

2015-01-01

article explores a wider range of participatory principles and the potential workings of these in an internally initiated communication initiative aimed at addressing the epidemic. More specifically, this article investigates ways in which radio listeners experience the reality broadcast genre--the talk radio show, Positive Talk--as participatory communication. Positive Talk is not an externally initiated project, as it is not part of a pre-planned, goal-oriented project that is owned and controlled outside the target community. In contrast, it has been initiated by Criselda Kananda, an individual not linked to any of the existing initiatives outside the community. She started the show to earn a living. She became a well-known person, is fairly knowledgeable in the field and was granted this opportunity as she is HIV-positive. In order to investigate how radio listeners use the show to engage in HIV/AIDS communication, 20 in-depth interviews were held with avid listeners of the show. The respondents indicated that they appreciate ordinary people phoning in. When expressing their opinions about the show, they found Kananda's life story credible, believed her public and private life to be congruent, valued Kananda's personality and respectful manner and could identify with the views expressed. In the article, it is argued that these ideas are largely in line with the principles of participatory communication tied to democracy, the participatory turn, the ordinary, validation of identity and respectful dialogue. Although the findings of this qualitative study cannot be generalised to the whole listening population of the show, they indicate that it is worth investigating the value of communication initiatives that emerge spontaneously from communities (instead of those strategically engineered from outside the general population) as a future direction of HIV/AIDS communication in the country.

Associations between positive parenting practices and child externalizing behavior in underserved Latino immigrant families.

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Holtrop, Kendal; McNeil Smith, Sharde'; Scott, Jenna C

2015-06-01

This study examined whether five specific parenting practices (i.e., monitoring, discipline, skill encouragement, problem solving, and positive involvement) were associated with reduced child externalizing behaviors among a sample of Latino immigrant families. It utilized baseline data from 83 Latino couples with children participating in a larger randomized controlled trial of a culturally adapted parenting intervention. Results reveal that monitoring, discipline, skill encouragement, and problem solving each made independent contributions to the prediction of child externalizing behavior, although not all in the expected direction. Further analyses examining mothers and fathers separately suggest that mother-reported monitoring and father-reported discipline practices uniquely contributed to these findings. These results may have important implications for prevention and clinical intervention efforts with Latino immigrant families, including the cultural adaptation and implementation of parenting interventions with this underserved population. © 2014 Family Process Institute.

Protective factors for HIV infection among Mexican American men who have sex with men.

Science.gov (United States)

Meyer, Mark A; Champion, Jane Dimmitt

2010-01-01

Latinos in the United States have been disproportionately affected by the HIV epidemic. The purpose of this study was to identify potential themes for inclusion in effective HIV prevention interventions for Mexican American men who have sex with men (MSM). The authors used a phenomenological design to explore the lived experiences of Mexican American MSM who had grown up in Dallas, Texas, regarding protective factors for HIV infection. A total of 20 30- to 60-year-old Mexican American MSM participated in semistructured interviews. During data analysis, the following themes concerning protective behaviors for HIV emerged: (a) accepting one's sexuality; (b) machismo; (c) being in love; (d) respect for family, self, and life; and (e) having HIV-living now. Strategies for potential inclusion in HIV prevention interventions geared toward Mexican American MSM were identified based on these themes. The recommendations encompass modification of behavioral interventions and related social policies.

Factors influencing HIV-risk behaviors among HIV-positive urban African Americans.

Science.gov (United States)

Plowden, Keith O; Fletcher, Audwin; Miller, J Lawrence

2005-01-01

Urban African Americans are disproportionately affected by HIV, the virus associated with AIDS. Although incidence and mortality appear to be decreasing in some populations, they continue to remain steady among inner-city African Americans. A major concern is the number of HIV-positive individuals who continue to practice high-risk behaviors. Understanding factors that increase risks is essential for the development and implementation of effective prevention initiatives. Following a constructionist epistemology, this study used ethnography to explore social and cultural factors that influence high-risk behaviors among inner-city HIV-positive African Americans. Leininger's culture care diversity and universality theory guided the study. Individual qualitative interviews were conducted with HIV-positive African Americans in the community to explore social and cultural factors that increase HIV-risky behaviors. For this study, family/kinship, economic, and education factors played a significant role in risky behaviors. Reducing HIV disparity among African Americans is dependent on designing appropriate interventions that enhance protective factors. Clinicians providing care to HIV-positive individuals can play a key role in reducing transmission by recognizing and incorporating these factors when designing effective prevention interventions.

A Structural Equation Model of HIV-Related Stigma, Racial Discrimination, Housing Insecurity and Wellbeing among African and Caribbean Black Women Living with HIV in Ontario, Canada.

Directory of Open Access Journals (Sweden)

Carmen H Logie

Full Text Available African and Caribbean Black women in Canada have new HIV infection rates 7 times higher than their white counterparts. This overrepresentation is situated in structural contexts of inequities that result in social, economic and health disparities among African and Caribbean Black populations. Economic insecurity is a distal driver of HIV vulnerability, reducing access to HIV testing, prevention and care. Less is known about how economic insecurity indicators, such as housing security, continue to influence the lives of women living with HIV following HIV-positive diagnoses. The aim of this study was to test a conceptual model of the pathways linking HIV-related stigma, racial discrimination, housing insecurity, and wellbeing (depression, social support, self-rated health. We implemented a cross-sectional survey with African and Caribbean Black women living with HIV in 5 Ontario cities, and included 157 participants with complete data in the analyses. We conducted structural equation modeling using maximum likelihood estimation to evaluate the hypothesized conceptual model. One-fifth (22.5%; n = 39 of participants reported housing insecurity. As hypothesized, racial discrimination had significant direct effects on: HIV-related stigma, depression and social support, and an indirect effect on self-rated health via HIV-related stigma. HIV-related stigma and housing insecurity had direct effects on depression and social support, and HIV-related stigma had a direct effect on self-rated health. The model fit the data well: χ2 (45, n = 154 = 54.28, p = 0.387; CFI = 0.997; TLI = 0.996; RMSEA = 0.016. Findings highlight the need to address housing insecurity and intersecting forms of stigma and discrimination among African and Caribbean Black women living with HIV. Understanding the complex relationships between housing insecurity, HIV-related stigma, racial discrimination, and wellbeing can inform multi-level interventions to reduce stigma and enhance

Audiological manifestations in HIV-positive adults

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Carla Gentile Matas

2014-07-01

Full Text Available OBJECTIVE:To characterize the findings of behavioral hearing assessment in HIV-positive individuals who received and did not receive antiretroviral treatment.METHODS:This research was a cross-sectional study. The participants were 45 HIV-positive individuals (18 not exposed and 27 exposed to antiretroviral treatment and 30 control-group individuals. All subjects completed an audiological evaluation through pure-tone audiometry, speech audiometry, and high-frequency audiometry.RESULTS:The hearing thresholds obtained by pure-tone audiometry were different between groups. The group that had received antiretroviral treatment had higher thresholds for the frequencies ranging from 250 to 3000 Hz compared with the control group and the group not exposed to treatment. In the range of frequencies from 4000 through 8000 Hz, the HIV-positive groups presented with higher thresholds than did the control group. The hearing thresholds determined by high-frequency audiometry were different between groups, with higher thresholds in the HIV-positive groups.CONCLUSION:HIV-positive individuals presented poorer results in pure-tone and high-frequency audiometry, suggesting impairment of the peripheral auditory pathway. Individuals who received antiretroviral treatment presented poorer results on both tests compared with individuals not exposed to antiretroviral treatment.

Audiological manifestations in HIV-positive adults.

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Matas, Carla Gentile; Angrisani, Rosanna Giaffredo; Magliaro, Fernanda Cristina Leite; Segurado, Aluisio Augusto Cotrim

2014-07-01

To characterize the findings of behavioral hearing assessment in HIV-positive individuals who received and did not receive antiretroviral treatment. This research was a cross-sectional study. The participants were 45 HIV-positive individuals (18 not exposed and 27 exposed to antiretroviral treatment) and 30 control-group individuals. All subjects completed an audiological evaluation through pure-tone audiometry, speech audiometry, and high-frequency audiometry. The hearing thresholds obtained by pure-tone audiometry were different between groups. The group that had received antiretroviral treatment had higher thresholds for the frequencies ranging from 250 to 3000 Hz compared with the control group and the group not exposed to treatment. In the range of frequencies from 4000 through 8000 Hz, the HIV-positive groups presented with higher thresholds than did the control group. The hearing thresholds determined by high-frequency audiometry were different between groups, with higher thresholds in the HIV-positive groups. HIV-positive individuals presented poorer results in pure-tone and high-frequency audiometry, suggesting impairment of the peripheral auditory pathway. Individuals who received antiretroviral treatment presented poorer results on both tests compared with individuals not exposed to antiretroviral treatment.

HIV, violence, blame and shame: pathways of risk to internalized HIV stigma among South African adolescents living with HIV.

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Pantelic, Marija; Boyes, Mark; Cluver, Lucie; Meinck, Franziska

2017-08-21

Internalized HIV stigma is a key risk factor for negative outcomes amongst adolescents living with HIV (ALHIV), including non-adherence to anti-retroviral treatment, loss-to-follow-up and morbidity. This study tested a theoretical model of multi-level risk pathways to internalized HIV stigma among South African ALHIV. From 2013 to 2015, a survey using t otal population sampling of ALHIV who had ever initiated anti-retroviral treatment (ART) in 53 public health facilities in the Eastern Cape, South Africa was conducted. Community-tracing ensured inclusion of ALHIV who were defaulting from ART or lost to follow-up. 90.1% of eligible ALHIV were interviewed ( n  = 1060, 55% female, mean age = 13.8, 21% living in rural locations). HIV stigma mechanisms (internalized, enacted, and anticipated), HIV-related disability, violence victimization (physical, emotional, sexual abuse, bullying victimization) were assessed using well-validated self-report measures. Structural equation modelling was used to test a theoretically informed model of risk pathways from HIV-related disability to internalized HIV stigma. The model controlled for age, gender and urban/rural address. Prevalence of internalized HIV stigma was 26.5%. As hypothesized, significant associations between internalized stigma and anticipated stigma, as well as depression were obtained. Unexpectedly, HIV-related disability, victimization, and enacted stigma were not directly associated with internalized stigma. Instead significant pathways were identified via anticipated HIV stigma and depression. The model fitted the data well (RMSEA = .023; CFI = .94; TLI = .95; WRMR = 1.070). These findings highlight the complicated nature of internalized HIV stigma. Whilst it is seemingly a psychological process, indirect pathways suggest multi-level mechanisms leading to internalized HIV stigma. Findings suggest that protection from violence within homes, communities and schools may interrupt risk pathways from HIV

Breaking the Glass Ceiling: Increasing the Meaningful Involvement of Women Living With HIV/AIDS (MIWA) in the Design and Delivery of HIV/AIDS Services.

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Carter, Allison; Greene, Saara; Nicholson, Valerie; O'Brien, Nadia; Sanchez, Margarite; de Pokomandy, Alexandra; Loutfy, Mona; Kaida, Angela

2015-01-01

The meaningful involvement of women living with HIV/AIDS (MIWA) is a key feature of women-centred HIV care, yet little is known about transforming MIWA from principle to practice. Drawing on focus group data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), we explored HIV-positive women's meaningful involvement in the design and delivery of HIV/AIDS services in British Columbia, Canada. In this article, we highlight the benefits and tensions that emerge as women traverse multiple roles as service users and service providers within their care communities, and the impact this has on their access to care and overall health.

Neighborhoods and Mental Health: Exploring Ethnic Density, Poverty, and Social Cohesion among Asian Americans and Latinos

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Hong, Seunghye; Zhang, Wei; Walton, Emily

2014-01-01

This study examines the associations of neighborhood ethnic density and poverty with social cohesion and self-rated mental health among Asian Americans and Latinos. Path analysis is employed to analyze data from the 2002–2003 National Latino and Asian American Study (NLAAS) and the 2000 U.S. Census (N=2095 Asian Americans living in N=259 neighborhoods; N=2554 Latinos living in N=317 neighborhoods). Findings reveal that neighborhood ethnic density relates to poor mental health in both groups. Social cohesion partially mediates that structural relationship, but is positively related to ethnic density among Latinos and negatively related to ethnic density among Asian Americans. Although higher neighborhood poverty is negatively associated with mental health for both groups, the relationship does not hold in the path models after accounting for social cohesion and covariates. Furthermore, social cohesion fully mediates the association between neighborhood poverty and mental health among Latinos. This study highlights the necessity of reconceptualizing existing theories of social relationships to reflect complex and nuanced mechanisms linking neighborhood structure and mental health for diverse racial and ethnic groups. PMID:24769491

Spirituality and Dignity of Thai Adolescents Living with HIV

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Karnsunaphat Balthip

2017-11-01

Full Text Available (1 Background: Adolescents are a key asset and resource for the social and economic development of any country, with the potential to make a significant contribution to their families, communities and countries. Healthy and educated adolescents are important. However, there are still significant rates of death, illness and disease among adolescents in some countries, where HIV is one of the most prevalent causes of death in this group. Adolescents living with HIV may experience and encounter social restrictions and physiological limitations. Therefore, this investigation explored whether the concepts of spirituality and dignity had any relevance to participants sense of meaning and purpose and whether these had any impact upon their health and well-being (2 Methods: A qualitative descriptive design was used involving twenty-two adolescents living with HIV attending one regional hospital in Southern Thailand. One to one interviews and descriptive diaries were used to collect the data and thematic analysis enabled the identification of attributes of spirituality and dignity. (3 Results: The findings revealed that spirituality and dignity were present in the lives of Thai adolescents living with HIV expressed in the main category of living life responsibly. This comprised of six themes: (a Understanding the disease and accepting the truth about life, (b Maintaining hope for a cure, (c Focusing on life’s purposes, (d Making life choices, (e Caring for oneself and (f Responsibility towards other. (4 Conclusions: The findings provide helpful insights for parents, nurses, and other health professionals supporting adolescents living with HIV to obtain a holistic, dignified approach to care that includes attention to the spiritual dimension.

Correlates of HIV and STI testing among Latino men who have sex with men in New York City.

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Spadafino, Joseph T; Martinez, Omar; Levine, Ethan C; Dodge, Brian; Muñoz-Laboy, Miguel; Fernandez, M Isabel

2016-01-01

We assessed the extent to which sociodemographic, personal, and behavioral factors are associated with human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing among a diverse group of Latino men who have sex with men (MSM) in New York City. The triangulation approach was used to synthesize data from 176 MSM who completed an in-person or phone questionnaire about substance use, alcohol consumption, sexual behaviors, and HIV/STI testing history and 40 participants who participated in focus groups. Correlates of testing significant in univariable analyses (p Spanish-speaking only subjects were less likely to get tested for HIV and STI; however, this association was not significant. Our study demonstrates the need for further study of predictors of STI testing as well as the potential role of language barriers and education in routine testing for HIV. Social and behavioral factors may intensify these obstacles. Future research and interventions should address the role of language barriers and perceived issues of immigration status in the decision to get tested.

Care and secrecy: being a mother of children living with HIV in Burkina Faso.

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Hejoaka, Fabienne

2009-09-01

Home care has become a central component of the response to the HIV/AIDS epidemic, displacing caregiving work onto women. While increasing interest has been paid to HIV/AIDS care with a focus on ailing adults and orphan foster care, the issue of caring for children living with HIV has received little attention in the social sciences. Based on ethnographic material gathered in Burkina Faso between November 2005 and December 2006, the aim of this paper was to gain understanding of women who mother and care for children living with HIV in resource-limited countries. The study involved participant observation in community-based organizations in Burkina Faso and semi-structured interviews with 20 women mothering HIV-positive children as well as 15 children infected with HIV, aged between 8 and 18 years. In daily care mothers face many great challenges, ranging from the routine of pill-taking to disturbing discussions with children asking questions about their health or treatment. The results also show how HIV/AIDS-related stigma adds an additional layer to the burden of care, compelling mothers to deal with the tension between secrecy surrounding the disease and the openness required in providing care and receiving social support. As mothers live in fear of disclosure, they have to develop concealment strategies around children's treatment and the nature of the disease. Conversely, some mothers may share their secret with kin members, close relatives or their children to gain social support. As HIV/AIDS care is shaped by secrecy, these findings shed light on mothers' isolation in child care within a context of changing patterns of family bonds and lack of formal psychosocial support addressing child-related issues. Finally, women's engagement in child care invites us to look beyond the essentialist approach of women's vulnerability conveyed by international discourse to characterise the situation of women facing the HIV/AIDS impact.

The HoMBReS and HoMBReS Por un Cambio Interventions to Reduce HIV Disparities Among Immigrant Hispanic/Latino Men

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Rhodes, Scott D.; Leichliter, Jami S.; Sun, Christina J.; Bloom, Fred R.

2016-01-01

Hispanics/Latinos in the United States are affected disproportionately by human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), and other sexually transmitted diseases (STDs); however, few effective evidence-based prevention interventions for this population exist. This report describes the Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships) (HoMBReS) intervention, which was developed by a community-bas...

Comorbidity is more common and occurs earlier in persons living with HIV than in HIV-uninfected matched controls, aged 50 years and older: A cross-sectional study.

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Maciel, Rafael Aguiar; Klück, Helena Moreira; Durand, Madeleine; Sprinz, Eduardo

2018-05-01

At present, data are limited on the comorbidity profiles associated with aging people with HIV in the developing world, where most such people live. The aim of this study was to compare the disease burden between older HIV-positive subjects and HIV-negative matched controls in Brazil. This was a cross-sectional analysis of the South Brazilian HIV Cohort. Individuals aged 50 years and older were enrolled at Hospital de Clínicas de Porto Alegre and matched with HIV-negative controls from the primary practice unit of the same hospital. Multimorbidity (the presence of two or more comorbid conditions) and the number of non-infectious comorbidities were compared. Poisson regression was used to identify factors associated with multimorbidity. A total of 208 HIV-positive subjects were matched to 208 HIV-negative controls. Overall, the median age was 57 years and 56% were male. The prevalence of multimorbidity was higher in HIV-positive subjects than in HIV-negative controls (63% vs. 43%, p<0.001), and the median number of comorbidities was 2, compared to 1 in controls (p<0.001). The duration of HIV infection (p=0.02) and time on treatment in years (p=0.015) were associated with greater multimorbidity in HIV-positive persons. In this large cohort from the developing world, multimorbidity was found to be more common in HIV-positive subjects than in HIV-negative controls. The duration of HIV and time on antiretrovirals were associated with multimorbidity. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Missed opportunities for HIV control: Gaps in HIV testing for partners of people living with HIV in Lima, Peru.

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Ana L Vasquez

Full Text Available Based on the hypothesis that HIV programs struggle to deliver health services that harmonize necessities of treatment and prevention, we described the outcomes of routinely provided HIV testing to partners of people living with HIV (PLWH through a secondary analysis of routine data collected at a public hospital in Lima, Peru.Among PLWH enrolled in the study center's HIV program between 2005 and 2014, we identified index cases (IC: PLWH who reported a unique partner not previously enrolled. We grouped partners according to their HIV status as reported by IC and collected data on HIV testing, clinical characteristics and admissions. The main outcome was the frequency of HIV testing among partners with reported unknown/seronegative HIV status.Out of 1586 PLWH who reported a unique partner at enrollment, 171 had a previously enrolled partner, leaving 1415 (89% IC. HIV status of the partner was reported as unknown in 571 (40%, seronegative in 325 (23% and seropositive in 519 (37%. Out of 896 partners in the unknown/seronegative group, 72 (8% had HIV testing, 42/72 (58% tested within three months of IC enrollment. Among the 49/72 (68% who tested positive for HIV, 33 (67% were enrolled in the HIV program. The proportion in WHO clinical stage IV was lower in enrolled partners compared to IC (37% vs 9%, p = 0.04. Non-tested partners (824 were likely reachable by the hospital, as 297/824 (36% of their IC were admitted in the study center at least once, 51/243 (21% female IC had received pregnancy care at the study center, and 401/692 (64% of IC on antiretroviral therapy had achieved viral suppression, implying frequent visits to the hospital for pill pick-up.In this setting, HIV testing of partners of PLWH was suboptimal, illustrating missed opportunities for HIV control. Integration of HIV strategies in primarily clinical-oriented services is a challenging need.

Healthy Aging in Older Women Living with HIV Infection: a Systematic Review of Psychosocial Factors.

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Rubtsova, Anna A; Kempf, Mirjam-Colette; Taylor, Tonya N; Konkle-Parker, Deborah; Wingood, Gina M; Holstad, Marcia McDonnell

2017-02-01

Due to life-enhancing effects of antiretroviral therapy, HIV-positive persons have the potential for long life comparable to their uninfected peers. Older women (age 50+) living with HIV (OWLH) are often an under-recognized aging group. We conducted a systematic review to examine psychosocial factors that impact how OWLH live, cope, and age with HIV. Initial key word search yielded 1527 records, and 21 studies met our inclusion criteria of original quantitative or qualitative research published between 2013 and 2016 with results specific to OWLH. These focused on health care and self-management, sexual health and risk, stigma, loneliness, mental health (depression, substance use), and protective factors (coping, social support, well-being). Due to the scarcity of studies on each topic and inconclusive findings, no clear patterns of results emerged. As the number of OWLH continues to grow, more research, including longitudinal studies, is needed to fully characterize the psychosocial factors that impact aging with HIV.

Effects of an exercise programme with people living with HIV ...

African Journals Online (AJOL)

Effects of an exercise programme with people living with HIV: research in a disadvantaged setting. Clemens Ley, Lloyd Leach, María Rato Barrio, Susan Bassett. Abstract. This study aimed to analyse the physical health effects of a community based 10-week physical activity programme with people living with HIV.

Relationships matter: contraceptive choices among HIV-positive ...

African Journals Online (AJOL)

Efforts to eliminate mother-to-child transmission of HIV in Tanzania are guided by a four-prong strategy advocated by the World Health Organization (WHO). Prong 2, prevention of unintended pregnancies among women living with HIV, has, however, received the least attention and contraceptive use to prevent unintended ...

Potential for false positive HIV test results with the serial rapid HIV testing algorithm.

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Baveewo, Steven; Kamya, Moses R; Mayanja-Kizza, Harriet; Fatch, Robin; Bangsberg, David R; Coates, Thomas; Hahn, Judith A; Wanyenze, Rhoda K

2012-03-19

Rapid HIV tests provide same-day results and are widely used in HIV testing programs in areas with limited personnel and laboratory infrastructure. The Uganda Ministry of Health currently recommends the serial rapid testing algorithm with Determine, STAT-PAK, and Uni-Gold for diagnosis of HIV infection. Using this algorithm, individuals who test positive on Determine, negative to STAT-PAK and positive to Uni-Gold are reported as HIV positive. We conducted further testing on this subgroup of samples using qualitative DNA PCR to assess the potential for false positive tests in this situation. Of the 3388 individuals who were tested, 984 were HIV positive on two consecutive tests, and 29 were considered positive by a tiebreaker (positive on Determine, negative on STAT-PAK, and positive on Uni-Gold). However, when the 29 samples were further tested using qualitative DNA PCR, 14 (48.2%) were HIV negative. Although this study was not primarily designed to assess the validity of rapid HIV tests and thus only a subset of the samples were retested, the findings show a potential for false positive HIV results in the subset of individuals who test positive when a tiebreaker test is used in serial testing. These findings highlight a need for confirmatory testing for this category of individuals.

Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study

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Turan, Bulent; Stringer, Kristi L; Onono, Maricianah; Bukusi, Elizabeth A; Weiser, Sheri D; Cohen, Craig R; Turan, Janet M

2014-01-01

Background While studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effect...

Burden, Determinants, and Pharmacological Management of Hypertension in HIV-Positive Patients and Populations: A Systematic Narrative Review.

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Nguyen, Kim Anh; Peer, Nasheeta; Mills, Edward J; Kengne, Andre Pascal

2015-01-01

Hypertension among HIV-positive populations has emerged as a new threat to the health and well being of people living with HIV, particularly among those receiving antiretroviral therapy. We reviewed the global evidence on the burden of disease (including prevalence and incidence), determinants of hypertension among HIV-positive populations, and the pharmacological management of hypertension in HIV-positive patients. We systematically searched PubMed-MEDLINE and EMBASE from January 2000 through February 2015 for relevant studies and traced their citations through the ISI Web of Science. We also searched the websites of the World Health Organisation, the International Society of Hypertension, and the International AIDS Society and constructed a narrative data synthesis. Hypertension is common in HIV-positive populations, with prevalence estimates ranging from 4.7 to 54.4% in high-income countries, and from 8.7 to 45.9% in low- and middle-income countries. The role of HIV-specific factors including disease severity, duration of disease, and treatments on the presence of hypertension in HIV-positive patients is reported, but patterns remain unclear. The clinical management of hypertension in HIV-positive patients is similar to those with hypertension in the general population; however, additional considerations should be given to potential drug interactions between antihypertensive agents and antiretroviral drugs to inform the clinician's selection of these therapies. Hypertension is common in HIV-positive populations and remains an important comorbidity affecting mortality outcomes. Further research examining the development of hypertension and its associated care in HIV-positive patients is required to optimize management of the dual conditions.

Women Living with HIV over Age of 65: Cervical Cancer Screening in a Unique and Growing Population

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Alexandra Aserlind

2017-01-01

Full Text Available Objective. Women living with HIV are at increased risk of human papillomavirus (HPV infection, which can lead to cervical cancer. New guidelines recommend indefinite screening. The objective of this study is to describe cervical cancer screening practices and colposcopy results in a cohort of women living with HIV over age of 65 who were followed before the new guidelines. Comorbidities, sexually transmitted infections (STIs, and other risk factors were evaluated. Methods. We conducted a retrospective chart review on 75 women aged 65 or older living with HIV with at least one Pap smear. Results. The mean age of the cohort was 66.5 and at HIV diagnosis was 56. The majority of women were immunocompetent. 80% had serial Pap smears. Of these, 86% of 238 were negative or ASCUS. No women progressed to HSIL. 92% of colposcopies had negative or CIN I results. Three women were treated successfully for high-grade dysplasia. More than half of women had other STIs. 72% were screened for HPV; 50% were positive. Conclusion. The majority of women had negative and low-grade Pap smears. Questions remain regarding the utility of continued Pap screening and the added value of HPV testing in this unique population of older women living with HIV.

The HIV Risk Profiles of Latino Sexual Minorities and Transgender Persons Who Use Websites or Apps Designed for Social and Sexual Networking

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Sun, Christina J.; Reboussin, Beth; Mann, Lilli; Garcia, Manuel; Rhodes, Scott D.

2016-01-01

The use of websites and GPS-based mobile applications ("apps") designed for social and sexual networking has been associated with increased HIV risk; however, little is known about Latino sexual minorities' and transgender persons' use of these websites and apps and the risk profiles of those who use them compared with those who do not.…

Estimates of the Number of People Living with HIV in Italy

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Laura Camoni

2014-01-01

Full Text Available Objective. To estimate the HIV prevalence and the number of people living with HIV (PLHIV in Italy with a projection for 2020. Methods. Two methods elaborated by Joint United Nations Programme on HIV/AIDS (UNAIDS were used: Estimate and Projection Package and Spectrum. Results. A total of 123,000 (115,000–145,000 individuals aged 15 or more were estimated to be living with HIV in Italy at the end of 2012 and the estimated HIV prevalence was 0.28 (0.24–0.32 per 100 residents aged 15 or more. In 2012, the estimated number of new HIV infections among adults was 3,000 (2,700–4,000, and the number of adults in need for ART was 93,000 (80,000–110,000. The projection estimates that 130,000 (110,000–150,000 adults will live with HIV/AIDS in 2020 in Italy. Conclusion. Estimates of PLHIV in Italy stress the high number of PLHIV in need of care and treatment, as well as the need for more information and prevention campaigns.

Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa.

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Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael

2014-01-01

Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large.

Social Capital, Depressive Symptoms, and HIV Viral Suppression Among Young Black, Gay, Bisexual and Other Men Who Have Sex with Men Living with HIV.

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Hussen, Sophia A; Easley, Kirk A; Smith, Justin C; Shenvi, Neeta; Harper, Gary W; Camacho-Gonzalez, Andres F; Stephenson, Rob; Del Rio, Carlos

2018-04-04

Social capital, the sum of an individual's resource-containing social network connections, has been proposed as a facilitator of successful HIV care engagement. We explored relationships between social capital, psychological covariates (depression, stigma and internalized homonegativity), and viral suppression in a sample of young Black gay, bisexual and other men who have sex with men (YB-GBMSM). We recruited 81 HIV-positive YB-GBMSM 18-24 years of age from a clinic setting. Participants completed a cross-sectional survey, and HIV-1 viral load (VL) measurements were extracted from the medical record. Sixty-five percent (65%) were virally suppressed (HIV-1 VL ≤ 40 copies/ml). Forty-seven percent (47%) had a positive depression screen. Depressive symptoms affected viral suppression differently in YB-GBMSM with lower vs. higher social capital (p = 0.046, test for statistical interaction between depression and social capital). The odds of viral suppression among YB-GBMSM with lower social capital was 93% lower among those with depressive symptoms (OR 0.07, p = 0.002); however, there was no association between depressive symptoms and viral suppression among those with higher social capital. Our results suggest that social capital may buffer the strong negative effects of depressive symptoms on clinical outcomes in YB-GBMSM living with HIV. In addition to treating depression, there is a role for interventions to augment social capital among YB-GBMSM living with HIV as a strategy for enhancing care engagement.

Comorbidity is more common and occurs earlier in persons living with HIV than in HIV-uninfected matched controls, aged 50 years and older: A cross-sectional study

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Rafael Aguiar Maciel

2018-05-01

Full Text Available Objectives: At present, data are limited on the comorbidity profiles associated with aging people with HIV in the developing world, where most such people live. The aim of this study was to compare the disease burden between older HIV-positive subjects and HIV-negative matched controls in Brazil. Methods: This was a cross-sectional analysis of the South Brazilian HIV Cohort. Individuals aged 50 years and older were enrolled at Hospital de Clínicas de Porto Alegre and matched with HIV-negative controls from the primary practice unit of the same hospital. Multimorbidity (the presence of two or more comorbid conditions and the number of non-infectious comorbidities were compared. Poisson regression was used to identify factors associated with multimorbidity. Results: A total of 208 HIV-positive subjects were matched to 208 HIV-negative controls. Overall, the median age was 57 years and 56% were male. The prevalence of multimorbidity was higher in HIV-positive subjects than in HIV-negative controls (63% vs. 43%, p < 0.001, and the median number of comorbidities was 2, compared to 1 in controls (p < 0.001. The duration of HIV infection (p = 0.02 and time on treatment in years (p = 0.015 were associated with greater multimorbidity in HIV-positive persons. Conclusions: In this large cohort from the developing world, multimorbidity was found to be more common in HIV-positive subjects than in HIV-negative controls. The duration of HIV and time on antiretrovirals were associated with multimorbidity. Keywords: HIV, AIDS, Multimorbidity, Comorbidities, Aging, Developing countries, Brazil

Details for Manuscript Number SSM-D-06-00290R2 “Internalized Stigma, Discrimination, and Depression among Men and Women Living with HIV/AIDS in Cape Town, South Africa”

OpenAIRE

Simbayi, Leickness C.; Strebel, Anna; Cloete, Allanise; Henda, Nomvo; Mqeketo, Ayanda

2007-01-01

AIDS stigmas interfere with HIV prevention, diagnosis and treatment and can become internalized by people living with HIV/AIDS. However, the effects of internalized AIDS stigmas have not been investigated in Africa, home to two-thirds of the more than 40 million people living with AIDS in the world. The current study examined the prevalence of discrimination experiences and internalized stigmas among 420 HIV positive men and 643 HIV positive women recruited from AIDS services in Cape Town, So...

Potential for false positive HIV test results with the serial rapid HIV testing algorithm

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Baveewo Steven

2012-03-01

Full Text Available Abstract Background Rapid HIV tests provide same-day results and are widely used in HIV testing programs in areas with limited personnel and laboratory infrastructure. The Uganda Ministry of Health currently recommends the serial rapid testing algorithm with Determine, STAT-PAK, and Uni-Gold for diagnosis of HIV infection. Using this algorithm, individuals who test positive on Determine, negative to STAT-PAK and positive to Uni-Gold are reported as HIV positive. We conducted further testing on this subgroup of samples using qualitative DNA PCR to assess the potential for false positive tests in this situation. Results Of the 3388 individuals who were tested, 984 were HIV positive on two consecutive tests, and 29 were considered positive by a tiebreaker (positive on Determine, negative on STAT-PAK, and positive on Uni-Gold. However, when the 29 samples were further tested using qualitative DNA PCR, 14 (48.2% were HIV negative. Conclusion Although this study was not primarily designed to assess the validity of rapid HIV tests and thus only a subset of the samples were retested, the findings show a potential for false positive HIV results in the subset of individuals who test positive when a tiebreaker test is used in serial testing. These findings highlight a need for confirmatory testing for this category of individuals.

Social Stigma and Childbearing for Women Living With HIV/AIDS.

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Cuca, Yvette P; Rose, Carol Dawson

2016-09-01

As more women become infected with HIV, the issue of childbearing becomes increasingly salient. A more nuanced understanding of women's situations is needed to provide high-quality and relevant services and support. We examined reproductive decision making among 20 women living with HIV through in-depth interviews. These women made decisions within situations of chaos, instability, and trauma, which often limited their ability to make truly informed choices about their lives and childbearing. Despite their HIV, many of the women wanted children, but experienced stigmatization related both to their HIV and to their decisions to have children. This stigmatization came from multiple sources, including health care providers, some of whom encouraged their patients to abort pregnancies because of their HIV. Participants, however, demonstrated resistance to stigmatization, through building supportive communities and developing trusting relationships with HIV providers. These results support the need for specialized HIV care for women of childbearing age. © The Author(s) 2015.

HIV-positive and HIV-negative consumers accept an instant soy ...

African Journals Online (AJOL)

HIV-positive and HIV-negative consumers accept an instant soy maize porridge. ... Health SA Gesondheid ... The objective of this study was to assess consumer acceptability, preference and consumption intent of an instant soy ... as a food supplement for HIV subjects in a subsequent nutrition intervention trial, to improve

Relationships matter: contraceptive choices among HIV-positive women in Tanzania.

Science.gov (United States)

Nyanja, Tabitha Alexandria Njeri; Tulinius, Charlotte

2017-07-01

Efforts to eliminate mother-to-child transmission of HIV in Tanzania are guided by a four-prong strategy advocated by the World Health Organization (WHO). Prong 2, prevention of unintended pregnancies among women living with HIV, has, however, received the least attention and contraceptive use to prevent unintended pregnancies remains low. This study explored the perceived barriers to the use of modern methods of contraception, and factors influencing contraceptive choice among HIV-positive women in urban Dar-es-Salaam, Tanzania. A qualitative multi-site study was conducted, utilising in-depth interviews and focus group discussions with 37 sexually active HIV-positive women aged between 20 and 44 years, attending three health facilities within Dar-es-Salaam. The theoretical framework was a patient centred model. Four barriers were identified: the influence of the women's spousal relationships; personal beliefs and the relationship of these in understanding her disease; the influence of the social demands on the woman and her relationships; and the importance of a woman's relationship with her healthcare provider/healthcare system. Being the bearers of bad news (HIV-positive status) the pregnant women experienced conflicts, violence, abandonment and rejection. The loss in negotiating power for the women was in relation to their intimate partners, but also in the patient-healthcare provider relationship. The role of the male partner as a barrier to contraceptive use cannot be understated. Therefore, the results suggest that healthcare providers should ensure patient-focused education and provide support that encompasses the importance of their relationships. Additional research is required to elucidate the functional association between contraceptive choices and personal and social relationships.

The impact of social context on self-management in women living with HIV.

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Webel, Allison R; Cuca, Yvette; Okonsky, Jennifer G; Asher, Alice K; Kaihura, Alphoncina; Salata, Robert A

2013-06-01

HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicted all domains of HIV self-management including daily health practices (F = 5.40, adjusted R(2) = 0.27, p traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women's social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of this population. Copyright © 2013 Elsevier Ltd. All rights reserved.

24-month HIV-free survival among infants born to HIV-positive women enrolled in Option B+ program in Kigali, Rwanda: The Kabeho Study.

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Gill, Michelle M; Hoffman, Heather J; Ndatimana, Dieudonne; Mugwaneza, Placidie; Guay, Laura; Ndayisaba, Gilles F; Bobrow, Emily A; Asiimwe, Anita; Mofenson, Lynne M

2017-12-01

Lifelong antiretroviral therapy (ART) provision to all pregnant HIV-positive women ("Option B+") has been recommended by the World Health Organization since 2013, but there remain limited data on the effects of Option B+ on long-term HIV-free survival in breastfeeding HIV-exposed infants. The Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) study enrolled HIV-positive women from the third trimester of pregnancy to 2 weeks postpartum in 14 heath facilities implementing Option B+ in Kigali, Rwanda. Mother-child pairs in the longitudinal observational cohort were followed until 24 months postpartum, with HIV diagnostic testing at 6 weeks, and 9, 18 and 24 months. The Kaplan-Meier method was used to estimate HIV transmission, survival, and HIV-free survival through 24 months. We enrolled 608 HIV-positive women in 2013-2014; birth outcome data were available for 600 women and 597 live-born infants. By 6 weeks, 11 infants had died and 3 infants had confirmed HIV infection (0.5% transmission; 95% confidence interval [CI] 0.2-1.6). At 9 months, there were 9 additional deaths and 2 new infections (cumulative transmission 0.9%, 95% CI 0.4-2.2). At 18 months, there were 6 additional deaths and no new infant infections. At 24 months, there were no additional child deaths and 1 new infection (cumulative 2.2%, 95% CI 0.7-7.0), for an overall 24-month HIV-free survival of 93.2% (95% CI 89.5-95.6). Low transmission rates and high HIV-free survival at 24 months were achieved in breastfeeding infants of HIV-positive mothers receiving universal ART in urban health facilities in Rwanda, though vigilance on maintaining viral suppression for ART-experienced women is needed. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Demand for modern family planning among married women living with HIV in western Ethiopia.

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Feyissa, Tesfaye Regassa; Melka, Alemu Sufa

2014-01-01

People living with HIV (PLHIV) have diverse family planning (FP) needs. Little is reported on FP needs among women living with HIV in Ethiopia. Thus, the objective of the study was to assess the demand for modern FP among married women living with HIV in western Ethiopia. A facility-based cross-sectional survey was conducted on 401 married women living with HIV selected from Nekemte Referral Hospital and Health Center, Nekemte, Oromia, Ethiopia. Convenience sampling of every other eligible patient was used to recruit respondents. Data were collected using a pretested, structured questionnaire. We first calculated frequency and percentage of unmet need, met need and total demand by each explanatory variable, and performed chi-squared testing to assess for differences in groups. We then fitted logistic regression models to identify correlates of unmet need for modern FP at 95% CL. The proportion of respondents with met need for modern FP among married women living with HIV was 61.6% (30.7% for spacing and 30.9% for limiting). Demand for family planning was reported in 77.0% (38.2% for spacing and 38.8% for limiting), making unmet need for modern FP prevalent in 15.4% (7.5% for spacing and 7.9% for limiting). Whereas age 25-34 years [adjusted odds ratio (AOR) (95% confidence interval (CI)) = .397 (.204-.771)] was protective against unmet need for modern FP, not having knowledge of MTCT [AOR (95% CI) = 2.531 (1.689-9.290)] and not discussing FP with a partner [AOR (95% CI) = 3.616(1.869-6.996)] were associated with increased odds of unmet need for modern FP. There is high unmet need for modern FP in HIV-positive married women in western Ethiopia. Health care providers and program managers at a local and international level should work to satisfy the unmet need for modern family planning.

Medication adherence among transgender women living with HIV

OpenAIRE

Baguso, Glenda N.; Gay, Caryl L.; Lee, Kathryn A.

2016-01-01

Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the U.S. report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transg...

The relationship between social roles and self-management behavior in women living with HIV/AIDS.

Science.gov (United States)

Webel, Allison R; Higgins, Patricia A

2012-01-01

The social roles that women perform can be complicated and may affect their health. While there is some evidence describing traditional social roles of women, there is little evidence exploring the impact of those roles on how a woman manages a chronic condition. The purpose of this paper is to identify and examine the main social roles of 48 HIV infected women, and to explore how these roles relate to their self-management of HIV/AIDS. Forty-eight HIV infected, adult women were recruited from HIV clinics and AIDS service organizations in Northeast Ohio. All participants participated in one of 12 digitially recorded focus groups. All data were analyzed using qualitative description methodology. The participants were predominantly middle-aged (mean = 42 years), African American (69%), and single (58%). Analysis revealed six social roles that these women experience and which affect their self-management. These social roles are: Mother/Grandmother, Believer, Advocate, Stigmatized Patient, Pet Owner, and Employee. These roles had both a positive and negative effect on a woman's self-management of her HIV disease and varied by age and time living with HIV. Women living with HIV/AIDS struggle to manage the many daily tasks required to live well with this disease. The social context in which this self-management happens is important, and the various social roles that women perform can facilitate or hinder them from completing these tasks. Healthcare and social service providers should learn about these roles in their individual patients, particularly how these roles can be developed to increase HIV/AIDS self-management. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

What Latino Puerto Ricans and non-Latinos say when they talk about Alzheimer's disease.

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Karlawish, Jason; Barg, Frances K; Augsburger, Deborah; Beaver, James; Ferguson, Allison; Nunez, Jessica

2011-03-01

To discover whether Latino Puerto Rican and non-Latino communities differ in the words they use to talk about Alzheimer's disease (AD). Four groups of 30 persons per group defined by self-identified ethnicity and caregiver status: Latino Puerto Ricans and non-Latino Whites, who were either caregivers or non-caregivers completed free-listing exercises to identify the words they use when they describe AD causes, symptoms, caregiving, and research risks and benefits. Both Latino Puerto Ricans and non-Latino Whites recognize AD as a disease of memory loss and other cognitive problems. Although both groups used the term "sadness" to describe AD, non-Latino Whites did not feature emotional, behavioral, or psychological problems as among the causes of AD. Although all the groups' descriptions of a person who lives with and cares for a person with AD shared the word "loving," Latino Puerto Ricans focused on a good spouse who exercises intelligence, patience, and attention on behalf of the person with AD and did not use the term "caregiver." In contrast, non-Latino Whites typically used the term "caregiver." Both groups' lists shared words that describe research as presenting harms to an AD patient and requiring a commitment of time. Latino Puerto Ricans' lists suggested an understanding of research benefits akin to clinical care. Notable differences exist in how Latino Puerto Ricans and non-Latino Whites talk about AD and AD research. Clinicians, clinical investigators, and patient educators need to consider these differences when they conduct clinical care and research and design outreach and educational materials. Copyright © 2011 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Risk Factors of Active Tuberculosis in People Living with HIV/AIDS ...

African Journals Online (AJOL)

BACKGROUND: Determinants of active tuberculosis among People Living with HIV/AIDS (PLHA) are not well elucidated in countries with limited resources. The objective of this study was to assess distal and proximate determinants of active tuberculosis among people living with HIV/AIDS in southwest. Ethiopia.

Metacognitions mediate HIV stigma and depression/anxiety in men who have sex with men living with HIV

Directory of Open Access Journals (Sweden)

Esben Strodl

2015-04-01

Full Text Available The study examined whether the relationships between HIV stigma and depression and anxiety would be mediated by metacognitive beliefs and thought control strategies in men who have sex with men living with HIV. Men who have sex with men living with HIV completed an online survey that measured 30-item Metacognitions Questionnaire, thought control strategies (Thought Control Questionnaire, as well as symptoms of depression (Patient Health Questionnaire-9 and anxiety (generalized anxiety disorder-7. The relationships between internalised and anticipated HIV stigma with depressive symptoms were mediated by Negative Metacognitive Beliefs and the use of Worry and Social thought control strategies. Negative Metacognitive Beliefs mediated the association between internalised HIV stigma and anxiety symptoms.

Being an HIV-positive mother: meanings for HIV-positive women and for professional nursing staff

OpenAIRE

Monticelli, Marisa; Santos, Evanguelia Kotzias Atherino dos; Erdmann, Alacoque Lorenzini

2007-01-01

OBJECTIVES: To comprehend the meanings of being an HIV-positive mother for HIV-positive women and for professional nursing staff of shared in-patient maternity wards, and to identify similarities and contrasts present in these meanings. METHODS: This was a descriptive and comparative secondary analysis study of data from two previous larger studies conducted in Public Hospitals of the Greater Florianopolis Area, Santa Catarina, Brazil. Data was collected through observation and interviews. RE...

Strategies for improving the lives of US women aged 40 and above living with HIV/AIDS: an evidence map.

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Adam, Gaelen P; Di, Mengyang; Cu-Uvin, Susan; Halladay, Christopher; Smith, Bryant T; Iyer, Suchitra; Trikalinos, Thomas A

2018-02-02

While in its early years the HIV epidemic affected primarily the male and the young, nowadays, the population living with HIV/AIDS is approximately 24% women, and its age composition has shifted towards older ages. Many of the older women who live with HIV/AIDS also live with the medical and social conditions that accompany aging. This work aims to identify and characterize empirical studies of strategies for the comprehensive management of women over 40, including transgender women, who live with HIV/AIDS. Forty was chosen as an operational age cutoff to identify premenopausal women who are less likely to bear children, as well as peri- and postmenopausal women. We conducted a literature search after discussions with a diverse panel of content experts and other stakeholders and developed an evidence map that identified 890 citations that address questions having to do with programs and barriers to engaging with programs, as well as the role of insurance and comorbidities, and have enrolled older women who live with HIV/AIDS. Of these, only 37 (4%) reported results of interest for women over 40 who live with HIV/AIDS, or examined interactions between gender and older age that would allow predictions in this subgroup. Few of the 37 eligible studies focused on women facing obvious challenges, such as immigrants, transgender, physically abused, or those recently released from prison. No studies focused on women caring for dependents, including children and grandchildren, or those diagnosed after age 40. The evidence base that is directly applicable to women over 40 who live with HIV/AIDS in the USA is limited, and the research need is broad. We propose research prioritization strategies for this population.

HIV-related stigma in pregnancy and early postpartum of mothers living with HIV in Ontario, Canada.

Science.gov (United States)

Ion, Allyson; Wagner, Anne C; Greene, Saara; Loutfy, Mona R

2017-02-01

HIV-related stigma is associated with many psychological challenges; however, minimal research has explored how perceived HIV-related stigma intersects with psychosocial issues that mothers living with HIV may experience including depression, perceived stress and social isolation. The present study aims to describe the correlates and predictors of HIV-related stigma in a cohort of women living with HIV (WLWH) from across Ontario, Canada during pregnancy and early postpartum. From March 2011 to December 2012, WLWH ≥ 18 years (n = 77) completed a study instrument measuring independent variables including sociodemographic characteristics, perceived stress, depression symptoms, social isolation, social support and perceived racism in the third trimester and 3, 6 and 12 months postpartum. Multivariable linear regression was employed to explore the relationship between HIV-related stigma and multiple independent variables. HIV-related stigma generally increased from pregnancy to postpartum; however, there were no significant differences in HIV-related stigma across all study time points. In multivariable regression, depression symptoms and perceived racism were significant predictors of overall HIV-related stigma from pregnancy to postpartum. The present analysis contributes to our understanding of HIV-related stigma throughout the pregnancy-motherhood trajectory for WLWH including the interactional relationship between HIV-related stigma and other psychosocial variables, most notably, depression and racism.

The effect of perceived and actual social support on the mental health of HIV-positive persons

OpenAIRE

MCDOWELL, T. L.; SEROVICH, J. M.

2007-01-01

The purpose of this paper is to compare the ways in which perceived and actual social support affect the mental health of gay men, straight or bisexual men, and women living with HIV/AIDS. Participants included 125 women and 232 men with an HIV-positive or AIDS diagnosis involved in three larger investigations of HIV, disclosure and mental health. Results suggest each sub-group experienced perceived social support as significantly predictive of better mental health while the effect of actual ...

Early repeated infections with Trichomonas vaginalis among HIV-positive and HIV-negative women.

Science.gov (United States)

Kissinger, Patricia; Secor, W Evan; Leichliter, Jami S; Clark, Rebecca A; Schmidt, Norine; Curtin, Erink; Martin, David H

2008-04-01

The purpose of the study was to examine whether early repeated infections due to Trichomonas vaginalis among human immunuodeficiency virus (HIV)-positive and HIV-negative women are reinfections, new infections, or cases of treatment failure. Women attending an HIV outpatient clinic and a family planning clinic in New Orleans, Louisiana, who had culture results positive for T. vaginalis were treated with 2 g of metronidazole under directly observed therapy. At 1 month, detailed sexual exposure and sexual partner treatment information was collected. Isolates from women who had clinical resistance (i.e., who tested positive for a third time after treatment at a higher dose) were tested for metronidazole susceptibility in vitro. Of 60 HIV-positive women with trichomoniasis, 11 (18.3%) were T. vaginalis positive 1 month after treatment. The 11 recurrences were classified as 3 probable reinfections (27%), 2 probable infections from a new sexual partner (18%), and 6 probable treatment failures (55%); 2 of the 6 patients who experienced probable treatment failure had isolates with mild resistance to metronidazole. Of 301 HIV-negative women, 24 (8.0%) were T. vaginalis positive 1 month after treatment. The 24 recurrences were classified as 2 probable reinfections (8%) and 22 probable treatment failures (92%); of the 22 patients who experienced probable treatment failure, 2 had strains with moderate resistance to metronidazole, and 1 had a strain with mild resistance to metronidazole. HIV-positive women were more likely to have sexual re-exposure than were HIV-negative women, although the rate of treatment failure was similar in both groups. High rates of treatment failure among both HIV-positive and HIV-negative women indicate that a 2-g dose of metronidazole may not be adequate for treatment of some women and that rescreening should be considered.

Enhancing psychosocial support for HIV positive adolescents in Harare, Zimbabwe.

Directory of Open Access Journals (Sweden)

Webster Mavhu

Full Text Available There is a recognized gap in the evidence base relating to the nature and components of interventions to address the psycho-social needs of HIV positive young people. We used mixed methods research to strengthen a community support group intervention for HIV positive young people based in Harare, Zimbabwe.A quantitative questionnaire was administered to HIV positive Africaid support group attendees. Afterwards, qualitative data were collected from young people aged 15-18 through tape-recorded in-depth interviews (n=10, 3 focus group discussions (FGDs and 16 life history narratives. Data were also collected from caregivers, health care workers, and community members through FGDs (n=6 groups and in-depth interviews (n=12. Quantitative data were processed and analysed using STATA 10. Qualitative data were analysed using thematic analysis.229/310 young people completed the quantitative questionnaire (74% participation. Median age was 14 (range 6-18 years; 59% were female. Self-reported adherence to antiretrovirals was sub-optimal. Psychological well being was poor (median score on Shona Symptom Questionnaire 9/14; 63% were at risk of depression. Qualitative findings suggested that challenges faced by positive children include verbal abuse, stigma, and discrimination. While data showed that support group attendance is helpful, young people stressed that life outside the confines of the group was more challenging. Caregivers felt ill-equipped to support the children in their care. These data, combined with a previously validated conceptual framework for family-centred interventions, were used to guide the development of the existing programme of adolescent support groups into a more comprehensive evidence-based psychosocial support programme encompassing caregiver and household members.This study allowed us to describe the lived experiences of HIV positive young people and their caregivers in Zimbabwe. The findings contributed to the enhancement of

Ageing and healthy sexuality among women living with HIV.

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Narasimhan, Manjulaa; Payne, Caitlin; Caldas, Stephanie; Beard, John R; Kennedy, Caitlin E

2016-11-01

Populations around the world are rapidly ageing and effective treatment for HIV means women living with HIV (WLHIV) can live longer, healthier lives. HIV testing and screening programmes and safer sex initiatives often exclude older sexually active WLHIV. Systematically reviewing the literature to inform World Health Organization guidelines on the sexual and reproductive health and rights (SRHR) of WLHIV, identified four studies examining healthy sexuality among older WLHIV. In Uganda, WLHIV reported lower rates of sexual activity and rated sex as less important than men. In the United States, HIV stigma, disclosure, and body image concerns, among other issues, were described as inhibiting relationship formation and safer sexual practices. Sexual activity declined similarly over time for all women, including for WLHIV who reported more protected sex, while a significant minority of WLHIV reported unprotected sex. A single intervention, the "ROADMAP" intervention, demonstrated significant increases in HIV knowledge and decreases in HIV stigma and high risk sexual behaviour. WLHIV face ageist discrimination and other barriers to remaining sexually active and maintaining healthy sexual relationships, including challenges procuring condoms and seeking advice on safe sex practices, reduced ability to negotiate safer sex, physical and social changes associated with menopause, and sexual health challenges due to disability and comorbidities. Normative guidance does not adequately address the SRHR of older WLHIV, and while this systematic review highlights the paucity of data, it also calls for additional research and attention to this important area. Copyright © 2016 Elsevier Inc. All rights reserved.

Condom Use among Heterosexual Immigrant Latino Men in the Southeastern United States

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Knipper, Emily; Rhodes, Scott D.; Lindstrom, Kristen; Bloom, Fred R.; Leichliter, Jami S.; Montano, Jaime

2007-01-01

Latinos in the United States have been disproportionately affected by the intersecting epidemics of HIV and sexually transmitted diseases (STDs). We examined correlates of condom use among adult heterosexual Latino men who are members of a large multicounty soccer league in rural North Carolina. Of 222 participants, the mean (plus or minus SD) age…

Paying to waste lives: the affordability of reducing mother-to-child transmission of HIV in South Africa.

Science.gov (United States)

Skordis, Jolene; Nattrass, Nicoli

2002-05-01

It is estimated that each HIV-positive child in South Africa costs the government more in terms of health and welfare expenses than it does to reduce mother-to-child transmission (MTCT) of HIV through the use of antiretroviral regimens (where the mother continues to breast-feed). Programmes to reduce MTCT of HIV/AIDS are, thus, clearly affordable. Using Nevirapine (according to the HIVNET 012 Protocol) saves more lives and [corrected] is more cost-effective than using Zidovudine (CDC 2 weeks regime).

Sources of Information on HIV and Sexual and Reproductive Health for Couples Living with HIV in Rural Southern Malawi

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Belinda Chimphamba Gombachika

2013-01-01

Full Text Available With wider access to antiretroviral therapy, people living with HIV are reconsidering their reproductive decisions: remarrying and having children. The purpose of the paper is to explore sources of information for reproductive decision used by couples living with HIV in patrilineal and matrilineal districts of Malawi. Data were collected from forty couples from July to December 2010. Our results illuminate five specific issues: some of the informants (1 remarry after divorce/death of a spouse, (2 establish new marriage relationship with spouses living with HIV, and (3 have children hence the need for information to base their decisions. There are (4 shared and interactive couple decisions, and (5 informal networks of people living with HIV are the main sources of information. In addition, in matrilineal community, cultural practices about remarriage set up structures that constrained information availability unlike in patrilineal community where information on sexual and reproductive health, HIV, and AIDS was disseminated during remarriage counselling. However, both sources are not able to provide comprehensive information due to complexity and lack of up to date information. Therefore, health workers should, offer people living with HIV comprehensive information that takes into consideration the cultural specificity of groups, and empower already existing and accepted local structures with sexual and reproductive health, HIV, and AIDS knowledge.

Willingness and acceptability of cervical cancer screening among HIV positive Nigerian women

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Ezechi Oliver C

2013-01-01

Full Text Available Abstract Background The proven benefit of integrating cervical cancer screening programme into HIV care has led to its adoption as a standard of care. However this is not operational in most HIV clinics in Nigeria. Of the various reasons given for non-implementation, none is backed by scientific evidence. This study was conducted to assess the willingness and acceptability of cervical cancer screening among HIV positive Nigerian women. Methods A cross sectional study of HIV positive women attending a large HIV treatment centre in Lagos, Nigeria. Respondents were identified using stratified sampling method. A pretested questionnaire was used to obtain information by trained research assistants. Obtained information were coded and managed using SPSS for windows version 19. Multivariate logistic regression model was used to determine independent predictor for acceptance of cervical cancer screening. Results Of the 1517 respondents that returned completed questionnaires, 853 (56.2% were aware of cervical cancer. Though previous cervical cancer screening was low at 9.4%, 79.8% (1210 accepted to take the test. Cost of the test (35.2% and religious denial (14.0% were the most common reasons given for refusal to take the test. After controlling for confounding variables in a multivariate logistic regression model, having a tertiary education (OR = 1.4; 95% CI: 1.03-1.84, no living child (OR: 1.5; 95% CI: 1.1-2.0, recent HIV diagnosis (OR: 1.5; 95% CI: 1.1-2.0 and being aware of cervical cancer (OR: 1.5; 95% CI: 1.2-2.0 retained independent association with acceptance to screen for cervical cancer. Conclusions The study shows that HIV positive women in our environment are willing to screen for cervical cancer and that the integration of reproductive health service into existing HIV programmes will strengthen rather than disrupt the services.

HIV Stigma and Unhealthy Alcohol Use Among People Living with HIV in Russia.

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Lunze, Karsten; Lioznov, Dmitry; Cheng, Debbie M; Nikitin, Ruslan V; Coleman, Sharon M; Bridden, Carly; Blokhina, Elena; Krupitsky, Evgeny; Samet, Jeffrey H

2017-09-01

Unhealthy alcohol use, highly prevalent in the Russian Federation (Russia), is associated with HIV risk behaviors among people living with HIV (PLWH). HIV stigma contributes to the HIV risk environment in Russia. To examine HIV stigma among Russian PLWH and to explore its association with unhealthy alcohol use, we conducted a longitudinal analysis of 700 PLWH in St. Petersburg, Russia. We assessed the association between alcohol dependence and HIV stigma measured at baseline and 12 months follow-up. Participants with alcohol dependence (n = 446) reported significantly higher HIV stigma scores over time than those without dependence (n = 254) (adjusted mean difference 0.60, 95% CI 0.03-1.17; p = 0.04). In secondary analyses, we examined recent risky alcohol use and did not detect an association with HIV stigma. Alcohol dependence is associated with high HIV stigma among Russian PLWH but the nature of the association is conjectural. HIV prevention efforts in Russia that address alcohol use disorders hold potential to mitigate HIV-related stigma and its possible adverse effects among PLWH.

The impact of HIV-related stigma on the lives of HIV-positive women: an integrated literature review.

Science.gov (United States)

Ho, Szu-Szu; Holloway, Aisha

2016-01-01

To critically explore how Human Immunodeficiency Virus-related stigma impacts on the lives of Human Immunodeficiency Virus-positive women through an integrative review of the literature. Throughout history Human Immunodeficiency Virus infection has been associated with sex trade, injecting drug use and other deviant behaviours within society. These historical associations can lead to the generation of negative perceptions of Human Immunodeficiency Virus-positive women. As such, women who contract Human Immunodeficiency Virus infection can be susceptible to societal stigma. An integrative literature review. To identify the publications on the impact of Human Immunodeficiency Virus-related stigma among women, a search was performed using the following databases: CINAHL, Medline, PsycINFO, EMBASE, and Applied Social Sciences Index and Abstract covering the period from 2000-2014. The following key words were included in the search: 'women', 'Human Immunodeficiency Virus', and 'stigma'. Twenty-six articles were retrieved and reviewed. From the results, four key themes merged in relation to the impact of Human Immunodeficiency Virus-related stigma on Human Immunodeficiency Virus-positive women's lives: the individual, relationships, work and the community. Despite great advances in the management and treatment of those who are Human Immunodeficiency Virus positive, it appears the lives of many women living with Human Immunodeficiency Virus remain greatly affected by their Human Immunodeficiency Virus infection with gender-specific stigma and stereotypes. Having a holistic understanding of this impact offers the potential for those responsible for the funding and draws the attention of researchers and policy makers on promoting medical services specifically for Human Immunodeficiency Virus-positive women, minimising social stigmatisation towards this client group, and optimising their health outcomes. In an attempt to amplify Human Immunodeficiency Virus-positive women

Status Disclosure among People Living With HIV/AIDS in Ilorin ...

African Journals Online (AJOL)

Background: HIV/AIDS is a disease that is characterised by discrimination and stigmatisation particularly in Africa. Objective: To determine rate of disclosure of HIV status among People Living with HIV/AIDS (PLWHA) in Ilorin, Nigeria. Methods: A semi-structured, interviewer administered questionnaire containing 40 items ...

Effects Of HIV stigma reduction interventions in diasporic communities: insights from the CHAMP study.

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Li, Alan Tai-Wai; Fung, Kenneth Po-Lun; Maticka-Tyndale, Eleanor; Wong, Josephine Pui-Hing

2018-06-01

Racialized diasporic communities in Canada experience disproportionate burden of HIV infection. Their increased vulnerabilities are associated with interlocking challenges, including barriers in accessing resources, migration and settlement stress, and systemic exclusion. Further, people living with HIV (PLHIV) in these diasporic communities face stigma and discrimination in both mainstream Canadian society as well as their own ethno-racial communities. HIV stigma negatively impacts all aspects of HIV care, from testing to disclosure to treatment and ongoing care. In response to these challenges, a Toronto based community organization developed and implemented the CHAMP project to engage people living with HIV/AIDS (PLHIV) and leaders from different service sectors from the African/Caribbean, Asian and Latino communities to explore challenges and strategies to reduce HIV stigma and build community resilience. The study engaged 66 PLHIV and ethno-racial leaders from faith, media and social justice sectors in two stigma-reduction training programs: Acceptance Commitment Therapy Training (ACT) and Social Justice Capacity Building (SJCB). Data collection included pre-and post- intervention surveys, focus groups and monthly activity logs. Participants were followed for a year and data on changes in the participants' attitudes and behaviors as well as their actual engagement in HIV prevention, PLHIV support and stigma reduction activities were collected. CHAMP results showed that the interventions were effective in reducing HIV stigma and increasing participants' readiness to take action towards positive social change. Participants' activity logs over a period of 9 months after completing the training showed they had engaged in 1090 championship activities to advocate for HIV related health equity and social justice issues affecting racialized and newcomer PLHIV and communities.

Croatian Recommendations for Dialysis of HIV-Positive Patients

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Gulin Marijana

2016-06-01

Full Text Available Human immunodeficiency virus (HIV infection may be associated with renal impairment since about 0.4% of all HIV-positive patients develop end-stage renal disease. The share of patients with HIV infection in hemodialysis centers throughout the world ranges from 0.3% to as high as 38%. In Croatia, renal replacement therapy was needed by 1% of all the HIV-positive patients from 1985 until the end of 2014. Healthcare professionals (HP should be aware of the risks of occupational exposure to blood-borne infections in their daily work. Performing dialysis in HIV-positive patients increases the risk of exposure to HIV during the extracorporeal circulation of the infected blood. However, post-exposure prophylaxis (PEP with effective antiretroviral drugs significantly reduces the risk of infection after occupational exposure. On behalf of the Croatian Society of Nephrology, Dialysis and Transplantation, the authors of this paper have proposed recommendations for the management of HIVpositive patients on dialysis, which aim to prevent the transmission of HIV among patients and HPs. The important recommendations include the following: 1. when the need arises, it is necessary to provide HIV-positive patients with dialysis in the vicinity of their place of residence. 2. HIV-positive patients should be dialyzed with a separate hemodialysis machine in an isolated area. Alternatively, they can be dialyzed in an area for the hemodialysis of HCV-positive and/or HBVpositive patients. 3. Specialized and trained personnel should be provided during the hemodialysis procedure, together with strict compliance with the standard precautions for the prevention of blood-borne infections. 4. There should be a good and prompt cooperation with the National Referral Center for HIV infection.

Adolescents Living with HIV: An Indian Profile

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Sravya Kurapati

2012-01-01

Full Text Available Purpose. Although there have been studies on the presence of Human Immunodeficiency Virus (HIV among the adult and even pediatric population, the adolescent population has been neglected. The main objective of this study was to understand and describe the profile of adolescents accessing the Integrated Counseling and Testing Centre (ICTC at a tertiary healthcare centre in north India. This was a retrospective analysis of the data collected where, in addition to the analysis of the presence of HIV among the target population, a comparative analysis of HIV-positive and negative individuals was also carried out. Methods. Counselors at the ICTC of All India Institute of Medical Sciences recorded responses of the patients, and pre- and posttest counseling was performed appropriately. Also, HIV testing was performed using rapid tests (EIA and ELISA. Both pre- and posttest counseling was performed for most of the patients. Also, the data collected from 2005 to May, 2011 was then retrospectively analyzed using various statistical tests, such as, Chi-square test and odds ratios. Results. Out of 979, 84 tested HIV positive. Discrimination at multiple levels was observed.The 10–14 years age group was 0.56 times more likely to be HIV positive than 15–19 year old. HIV serostatus was strongly associated with risk behavior (P=0.003 with heterosexual transmission being the most common. Conclusion. These findings highlight the profile of adolescents in India and their equation with HIV on demographic and psychosocial levels.

Factors associated with the quality of life of people living with HIV in Finland.

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Nobre, Nuno; Pereira, Marco; Roine, Risto P; Sintonen, Harri; Sutinen, Jussi

2017-08-01

In recent years, the concept of quality of life (QoL) has received significant attention in the HIV/AIDS literature. In Finland, however, the factors associated with the QoL of people living with HIV/AIDS (PLWHA) still remain unknown. The aim of this study was to identify the sociodemographic and HIV-related factors associated with the different domains of QoL of PLWHA in Finland. The sample of this cross-sectional study consisted of 453 HIV-infected patients (Mean age = 46.5 years; 76.5% male) followed at the Infectious Disease Clinic of Helsinki University Hospital. Participants completed a self-reported questionnaire covering sociodemographic and HIV-related information, and the Finnish version of the WHOQOL-HIV-Bref questionnaire. Participants reported rather high scores in the six QoL domains, which ranged between 68.48 (Social relationships) and 78.05 (Environment) on a 0-100 scale. Multiple regression analyses revealed that male gender, being married or living in a partnered relationship, being employed, having fewer financial concerns, and not having depression and other medical comorbidities were the main factors positively and consistently associated with higher scores in the different domains of the QoL. HIV-related variables were not significantly associated with QoL ratings. Sociodemographic factors were independently associated with the QoL of PLWHA in Finland. Psychosocial support should reflect these factors in order to improve the health status and well-being of PLWHA.

CDC Vital Signs: HIV Care Saves Lives

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... gov . Vital Signs Topics Covered Alcohol Antibiotic Resistance Cancer Cardiovascular Diseases Diseases & Conditions Food Safety Healthcare-associated Infections Healthy Living HIV / AIDS Injury, Violence & Safety Motor Vehicle Safety Obesity ...

Prevalence and predictors of severe menopause symptoms among HIV-positive and -negative Nigerian women.

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Agaba, Patricia A; Meloni, Seema T; Sule, Halima M; Ocheke, Amaka N; Agaba, Emmanuel I; Idoko, John A; Kanki, Phyllis J

2017-11-01

We compared the prevalence of menopause symptoms between women living with HIV to their HIV-negative peers and determined predictors of severe menopause symptoms in Jos, Nigeria. This descriptive cross-sectional study included 714 women aged 40-80 years. We compared prevalence and severity of menopause symptoms using the menopause rating scale (MRS). Logistic regression analysis was used to determine the predictors of severe symptoms. Six-hundred and seven (85.0%) were HIV-positive, with a mean duration of infection of 5.6 ± 2.7 years. The mean age of the cohort was 46 ± 5 years. The most prevalent menopause symptoms were hot flushes (67.2%), joint and muscle discomfort (66.2%), physical/mental exhaustion (65.3%), heart discomfort (60.4%), and anxiety (56.4%). The median MRS score was higher for HIV-positive compared to HIV-negative women (p = 0.01). Factors associated with severe menopause symptoms included HIV-positive status (aOR: 3.01, 95% CI: 1.20-7.54) and history of cigarette smoking (aOR: 4.18, 95% CI: 1.31-13.26). Being married (aOR: 0.49, 95% CI: 0.32-0.77), premenopausal (aOR: 0.60, 95% CI: 0.39-0.94), and self-reporting good quality of life (aOR: 0.62. 95% CI: 0.39-0.98) were protective against severe menopause symptoms. We found HIV infection, cigarette smoking, quality of life, and stage of the menopause transition to be associated with severe menopause symptoms. As HIV-positive populations are aging, additional attention should be given to the reproductive health of these women.

A Method to Estimate the Size and Characteristics of HIV-positive Populations Using an Individual-based Stochastic Simulation Model

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Nakagawa, Fumiyo; van Sighem, Ard; Thiebaut, Rodolphe

2016-01-01

% plausibility range: 39,900-45,560) men who have sex with men were estimated to be living with HIV in the UK, of whom 10,400 (6,160-17,350) were undiagnosed. There were an estimated 3,210 (1,730-5,350) infections per year on average between 2010 and 2013. Sixty-two percent of the total HIV-positive population......It is important not only to collect epidemiologic data on HIV but to also fully utilize such information to understand the epidemic over time and to help inform and monitor the impact of policies and interventions. We describe and apply a novel method to estimate the size and characteristics of HIV-positive...... populations. The method was applied to data on men who have sex with men living in the UK and to a pseudo dataset to assess performance for different data availability. The individual-based simulation model was calibrated using an approximate Bayesian computation-based approach. In 2013, 48,310 (90...

The usefulness of traditional birth attendants to women living with HIV in resource-poor settings: the case of Mfuwe, Zambia.

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Muzyamba, Choolwe; Groot, Wim; Tomini, Sonila M; Pavlova, Milena

2017-01-01

Although there is increased attention on the role of trained traditional birth attendants (TBAs) in maternal care, most of the research has mainly focused on providing evidence of the relevance of trained TBAs to women in general without a specific focus on women who are HIV positive, despite them being most vulnerable. Therefore, the aim of this study is to fill this gap by assessing the relevance of trained TBAs to women living with HIV in resource-poor settings by using Zambia as a case study. Our data collection consisted of two focus group discussions, one involving HIV-positive women utilizing trained TBAs and the other with women not utilizing TBAs. Additionally, in-depth interviews were conducted with trained TBAs and health workers. Thematic analysis was used to analyze the data. In general, women living with HIV positively characterized the services of TBAs. In the face of an inefficient health system, trained TBAs were seen to be useful in providing efficient, cheap and quality care, counseling, and referral and logistical support, including treatment adherence support. In Zambia, trained TBAs and professional care are not mutually exclusive but complementary. There is no doubt that HIV-positive women need professionals to handle complications and offer antiretroviral treatment to ensure prevention of mother to child transmission (PMTCT). However, additional "soft" services offered by trained TBAs are equally important in the promotion of maternal health care among HIV-positive women. Thus, it seems there is more to gain by systematically allowing trained TBAs to work alongside professionals in a well-coordinated and complementary manner.

Incidence and predictors of pregnancy among a cohort of HIV-positive women initiating antiretroviral therapy in Mbarara, Uganda.

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Angela Kaida

Full Text Available Many people living with HIV in sub-Saharan Africa desire biological children. Implementation of HIV prevention strategies that support the reproductive goals of people living with HIV while minimizing HIV transmission risk to sexual partners and future children requires a comprehensive understanding of pregnancy in this population. We analyzed prospective cohort data to determine pregnancy incidence and predictors among HIV-positive women initiating antiretroviral therapy (ART in a setting with high HIV prevalence and fertility.Participants were enrolled in the Uganda AIDS Rural Treatment Outcomes (UARTO cohort of HIV-positive individuals initiating ART in Mbarara. Bloodwork (including CD4 cells/mm(3, HIV viral load and questionnaires (including socio-demographics, health status, sexual behavior, partner dynamics, HIV history, and self-reported pregnancy were completed at baseline and quarterly. Our analysis includes 351 HIV-positive women (18-49 years who enrolled between 2005-2011. We measured pregnancy incidence by proximal and distal time relative to ART initiation and used multivariable Cox proportional hazards regression analysis (with repeated events to identify baseline and time-dependent predictors of pregnancy post-ART initiation.At baseline (pre-ART initiation, median age was 33 years [IQR: 27-37] and median prior livebirths was four [IQR: 2-6]. 38% were married with 61% reporting HIV-positive spouses. 73% of women had disclosed HIV status to a primary sexual partner. Median baseline CD4 was 137 cells/mm(3 [IQR: 81-207]. At enrolment, 9.1% (31/342 reported current pregnancy. After ART initiation, 84 women experienced 105 pregnancies over 3.8 median years of follow-up, yielding a pregnancy incidence of 9.40 per 100 WYs. Three years post-ART initiation, cumulative probability of at least one pregnancy was 28% and independently associated with younger age (Adjusted Hazard Ratio (AHR: 0.89/year increase; 95%CI: 0.86-0.92 and HIV

Gender differences in posttraumatic stress symptoms and social support in a sample of HIV-positive individuals.

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Rzeszutek, Marcin; Oniszczenko, Włodzimierz; Firląg-Burkacka, Ewa

2017-08-01

The aim of the authors of the present study was to investigate gender differences in the levels of posttraumatic stress symptoms (PTSS) and social support in a Polish sample of HIV+ men (n = 613) and women (n = 230). This was an anonymous cross-sectional study, and participation was voluntary. The research questionnaires were distributed in paper form among patients of Warsaw's Hospital for Infectious Diseases from January to October 2015. The level of PTSS was assessed using the PTSD Factorial Version Inventory. Social support was assessed using the Berlin Social Support Scales. HIV+ women scored higher on all PTSS dimensions compared to HIV+ men. HIV+ women were characterized by a higher need for support and more support actually received compared to HIV+ men. We observed a positive association between HIV infection duration and AIDS phase and the global trauma score only among HIV+ men. The moderation analysis also revealed a positive relationship between actual received support and the global trauma score among HIV+ women only. Increased clinician awareness is needed about the role of PTSS and social support among people living with HIV, especially taking gender differences into account.

Pregnancy decision-making among HIV-positive women in Northern Vietnam

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Gammeltoft, Tine; Rasch, Vibeke; Bui Kim, Chi

2011-01-01

The global HIV epidemic confronts pregnant women with hard reproductive choices. This paper offers a theoretically innovative and ethnographically sensitive exploration of the social processes through which 20 HIV positive women living in Northern Vietnam decide whether to continue or terminate...... their pregnancies. Arguing that human agency must be seen as an outcome of intersubjective engagements in shared social worlds, this paper explores how these women came to the decisions that they had to make and shows that women's choices were configured through everyday social relations, shaped through intimate...... engagements with husbands, parents, siblings, and in-laws. Based on the findings, it is recommended that pregnancy counseling is offered not only to the woman herself, but also, if she desires, involves members of her extended family....

Community voices: barriers and opportunities for programmes to successfully prevent vertical transmission of HIV identified through consultations among people living with HIV.

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Anderson, Ginna; Caswell, Georgina; Edwards, Olive; Hsieh, Amy; Hull, Beri; Mallouris, Christoforos; Mason, Naisiadet; Nöstlinger, Christiana

2012-07-11

In 2010, two global networks of people living with HIV, the International Community of Women Living with HIV (ICW Global) and the Global Network of People living with HIV (GNP+) were invited to review a draft strategic framework for the global scale up of prevention of vertical transmission (PVT) through the primary prevention of HIV and the prevention of unintended pregnancies among women living with HIV. In order to ensure recommendations were based on expressed needs of people living with HIV, GNP+ and ICW Global undertook a consultation amongst people living with HIV which highlighted both facilitators and barriers to prevention services. This commentary summarizes the results of that consultation. The consultation was comprised of an online consultation (moderated chat-forum with 36 participants from 16 countries), an anonymous online e-survey (601 respondents from 58 countries), and focus-group discussions with people living with HIV in Jamaica (27 participants). The consultation highlighted the discrepancies across regions with respect to access to essential packages of PVT services. However, the consultation participants also identified common barriers to access, including a lack of trustworthy sources of information, service providers' attitudes, and gender-based violence. In addition, participant responses revealed common facilitators of access, including quality counselling on reproductive choices, male involvement, and decentralized services. The consultation provided some understanding and insight into the participants' experiences with and recommendations for PVT strategies. Participants agreed that successful, comprehensive PVT programming require greater efforts to both prevent primary HIV infection among young women and girls and, in particular, targeted efforts to ensure that women living with HIV and their partners are supported to avoid unintended pregnancies and to have safe, healthy pregnancies instead. In addition to providing the insights

The health literacy needs of women living with HIV/AIDS | Thompson ...

African Journals Online (AJOL)

Women in Sub-Saharan Africa are disproportionately affected by the virus and constitute 60% of the total HIV/AIDS infections in this region. Current recommendations endorse the involvement of people living with HIV in the development of programmes for people living with the virus. The purpose of the study was to explore ...

(Re)visioning U.S. Latino Literatures in High School English Classrooms

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Rojas, Mary Alexandra

2010-01-01

The term "Latino" in this paper adopts a U.S. definition to refer to those persons born/living in the United States who are of Latin American ancestry. U.S. Latino literature is defined as literature that is originally composed mostly in English, but not exclusively, by authors of U.S. Latino background. Selections of Latino literature…

Stigmatization and discrimination towards people living with or affected by HIV/AIDS by the general public in Malaysia.

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Wong, L P; Syuhada, A R Nur

2011-09-01

Globally, HIV/AIDS-related stigma and discriminatory attitudes deter the effectiveness of HIV prevention and care programs. This study investigated the general public's perceptions about HIV/AIDS-related stigma and discrimination towards people living with or affected by HIV/AIDS in order to understand the root of HIV/AIDS-related stigma and discriminatory attitudes. Study was carried out using qualitative focus group discussions (FGD). An interview guide with semi-structured questions was used. Participants were members of the public in Malaysia. Purposive sampling was adopted for recruitment of participants. A total 14 focus group discussions (n = 74) was carried out between March and July 2008. HIV/AIDS-related stigma and discrimination towards people living with HIV/AIDS (PLWHA) was profound. Key factors affecting discriminatory attitudes included high-risk taking behavior, individuals related to stigmatized identities, sources of HIV infection, stage of the disease, and relationship with an infected person. Other factors that influence attitudes toward PLWHA include ethnicity and urban-rural locality. Malay participants were less likely than other ethnic groups to perceive no stigmatization if their spouses were HIV positive. HIV/AIDS-related stigma and discrimination were stronger among participants in rural settings. The differences indicate attitudes toward PLWHA are influenced by cultural differences.

Breast Gangrene in an HIV-Positive Patient

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Venkatramani, V; Pillai, S; Marathe, S; Rege, SA; Hardikar, JV

2009-01-01

Introduction Breast gangrene has been reported as a complication following puerperal sepsis, breast surgery, nipple piercings, warfarin toxicity, etc. We report a case of primary breast gangrene in an HIV-positive individual which, to the best of our knowledge, is the first of its kind. Case report A 40-year-old previously healthy woman presented with fulminating left breast gangrene. She was detected to be HIV positive. Mastectomy was performed. The detailed management of the condition is discussed. Conclusion Severe necrotising infections may be initial manifestations of HIV infection and patients with such infections should be screened for HIV. PMID:19622255

Brainstem Auditory Evoked Potential in HIV-Positive Adults.

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Matas, Carla Gentile; Samelli, Alessandra Giannella; Angrisani, Rosanna Giaffredo; Magliaro, Fernanda Cristina Leite; Segurado, Aluísio C

2015-10-20

To characterize the findings of brainstem auditory evoked potential in HIV-positive individuals exposed and not exposed to antiretroviral treatment. This research was a cross-sectional, observational, and descriptive study. Forty-five HIV-positive individuals (18 not exposed and 27 exposed to the antiretroviral treatment - research groups I and II, respectively - and 30 control group individuals) were assessed through brainstem auditory evoked potential. There were no significant between-group differences regarding wave latencies. A higher percentage of altered brainstem auditory evoked potential was observed in the HIV-positive groups when compared to the control group. The most common alteration was in the low brainstem. HIV-positive individuals have a higher percentage of altered brainstem auditory evoked potential that suggests central auditory pathway impairment when compared to HIV-negative individuals. There was no significant difference between individuals exposed and not exposed to antiretroviral treatment.

Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men.

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Wagner, Glenn J; Bogart, Laura M; Klein, David J; Green, Harold D; Mutchler, Matt G; McDavitt, Bryce; Hilliard, Charles

2016-08-01

We examined whether internalized HIV stigma and perceived HIV stigma from social network members (alters), including the most popular and most similar alter, predicted condomless intercourse with negative or unknown HIV status partners among 125 African American HIV-positive men. In a prospective, observational study, participants were administered surveys at baseline and months 6 and 12, with measures including sexual behavior, internalized HIV stigma, and an egocentric social network assessment that included several measures of perceived HIV stigma among alters. In longitudinal multivariable models comparing the relative predictive value of internalized stigma versus various measures of alter stigma, significant predictors of having had condomless intercourse included greater internalized HIV stigma (in all models), the perception that a popular (well-connected) alter or alter most like the participant agrees with an HIV stigma belief, and the interaction of network density with having any alter that agrees with a stigma belief. The interaction indicated that the protective effect of greater density (connectedness between alters) in terms of reduced risk behavior dissipated in the presence of perceived alter stigma. These findings call for interventions that help people living with HIV to cope with their diagnosis and reduce stigma, and inform the targets of social network-based and peer-driven HIV prevention interventions.

Caffeine and Insomnia in People Living With HIV From the Miami Adult Studies on HIV (MASH) Cohort.

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Ramamoorthy, Venkataraghavan; Campa, Adriana; Rubens, Muni; Martinez, Sabrina S; Fleetwood, Christina; Stewart, Tiffanie; Liuzzi, Juan P; George, Florence; Khan, Hafiz; Li, Yinghui; Baum, Marianna K

We explored the relationship between caffeine consumption, insomnia, and HIV disease progression (CD4+ T cell counts and HIV viral loads). Caffeine intake and insomnia levels were measured using the Modified Caffeine Consumption Questionnaire and the Pittsburgh Insomnia Rating Scale (PIRS) in 130 clinically stable participants who were living with HIV, taking antiretroviral therapy, and recruited from the Miami Adult Studies on HIV cohort. Linear regressions showed that caffeine consumption was significantly and adversely associated with distress score, quality-of-life score, and global PIRS score. Linear regression analyses also showed that global PIRS score was significantly associated with lower CD4+ T cell counts and higher HIV viral loads. Caffeine could have precipitated insomnia in susceptible people living with HIV, which could be detrimental to their disease progression states. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

The role of children in their HIV-positive parents' management of antiretroviral therapy in Uganda.

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Nalugya, Ruth; Russell, Steven; Zalwango, Flavia; Seeley, Janet

2018-03-01

Adjustment to life on antiretroviral therapy (ART) and living with HIV as a long-term chronic condition, pose significant medical, social and economic challenges. We investigated children's role in supporting HIV-positive parents to self-manage life on ART. Between 2010 and 2012, we conducted a qualitative study using semi-structured interviews with 38 HIV-positive parents who had been on ART for over a year. They were randomly selected from people accessing ART from three delivery sites in Wakiso district, Uganda. Data were analysed thematically. Participants reported children between the ages of 1 and 47 years providing support. Children were a source of happiness, self-worth, encouragement, and comfort. Both younger and older children supported parents' adherence to treatment through reminding them to take the drugs and honour clinic appointments. Older children provided money to buy medication, food and shelter. Parents reported that the encouragement they received after they disclosed to their children enhanced their survival. After HIV disclosure to their children many of their fears about the future were allayed. Thinking about their children's future brought hope. However, looking after younger children while on ART could be burdensome since some parents could not work to their full capacity due to reduced physical health. Children are an important resource in their parents' adjustment to living with HIV while taking ART. There is a need for children to be supported by appropriate policy and other social and health development structures.

[HIV infection and associated factors in HIV-antibody positive clients of female sex workers recently reported in Shaanxi province].

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Hu, T; Chang, W H; Zhang, M Y

2017-03-10

Objective: To investigate the current status of HIV infection and the related factors in HIV antibody positive clients of female sex workers (FSWs) recently reported in Shaanxi province. Methods: The HIV/AIDS cases newly diagnosed in males living in Shaanxi from January 1th of 2013 to June 30th of 2014 were selected and those infected through " commercial heterosexual behavior" were identified. The information about their demographic characteristics, previous unprotected heterosexual sex and the sample sources were collected, and serum or plasma samples were collected from them and tested with BED-CEIA. The proportion of recent HIV infections and associated factors were investigated. Results: The proportion of recent HIV infection and HIV-antibody detection rate in 212 HIV antibody positive male clients of FSWs were 25.5% and 6.6% respectively. The cases who had the educational level of junior middle school or high middle school were wore likely to have long term HIV infections than those with lower educational level (a OR =0.28, 95 % CI : 0.08-0.93). Compared with patients identified by hospitals or sexually transmitted diseases clinics, recent HIV infections were more likely to be found through preoperative test or blood transfusion test (a OR =3.14, 95 % CI : 1.06-9.30) and blood donation test (a OR =4.19, 95 % CI :1.01-17.42). Compared with the cases who had commercial sex only in Xi' an or other province or both in Xi' an and other province, the cases who had commercial sex in other cities in Shaanxi were more likely to be infected recently (a OR =0.19, 95 %CI : 0.07-0.57). Compared with the cases had temporary heterosexual sex partner, those who had no temporary sex partners were more likely to be infected recently (a OR =9.03, 95 % CI : 3.00-27.18) ( P HIV infections among HIV antibody positive clients of FSWs was high and the HIV-antibody detection rate among them was low. The educational level, sample source, geographic area and temporary heterosexual

The Lived Experience of Domestic Violence in Iranian HIV-Infected Women

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Mohammadi, Nooredin; Kochak, Hamid Emadi; Gharacheh, Maryam

2015-01-01

Domestic violence is one of the most prevalent problems linked to HIV. Domestic violence in HIV-infected women has not been sufficiently explored, particularly in developing countries including Iran. This study aimed to explore the lived experience of domestic violence in Iranian HIV-infected women. A qualitative approach was used to conduct the study. Data were collected through semi-structured, in-depth interviews with ten HIV-infected women and were analyzed using content analysis. During the data analysis, four main themes emerged including, “regretful past”, “disappointing future”, “loneliness”, and “no other option”, which refer to the condition that the participants experienced in their lives due to challenges that mainly stem from the experience of HIV-related domestic violence. HIV infection can be a risk factor for domestic violence. Health care providers need to address domestic violence during the assessment of HIV-infected women and make appropriate referrals for abused women. PMID:26156897

Children Living with HIV-Infected Adults: Estimates for 23 Countries in sub-Saharan Africa.

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Short, Susan E; Goldberg, Rachel E

2015-01-01

In sub-Saharan Africa many children live in extreme poverty and experience a burden of illness and disease that is disproportionately high. The emergence of HIV and AIDS has only exacerbated long-standing challenges to improving children's health in the region, with recent cohorts experiencing pediatric AIDS and high levels of orphan status, situations which are monitored globally and receive much policy and research attention. Children's health, however, can be affected also by living with HIV-infected adults, through associated exposure to infectious diseases and the diversion of household resources away from them. While long recognized, far less research has focused on characterizing this distinct and vulnerable population of HIV-affected children. Using Demographic and Health Survey data from 23 countries collected between 2003 and 2011, we estimate the percentage of children living in a household with at least one HIV-infected adult. We assess overlaps with orphan status and investigate the relationship between children and the adults who are infected in their households. The population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high; in Southern Africa, the percentage exceeded 10% in all countries and reached as high as 36%. This population is largely distinct from the orphan population. Among children living in households with tested, HIV-infected adults, most live with parents, often mothers, who are infected; nonetheless, in most countries over 20% live in households with at least one infected adult who is not a parent. Until new infections contract significantly, improvements in HIV/AIDS treatment suggest that the population of children living with HIV-infected adults will remain substantial. It is vital to on-going efforts to reduce childhood morbidity and mortality to consider whether current care and outreach sufficiently address the distinct vulnerabilities of these children.

Children Living with HIV-Infected Adults: Estimates for 23 Countries in sub-Saharan Africa.

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Susan E Short

Full Text Available In sub-Saharan Africa many children live in extreme poverty and experience a burden of illness and disease that is disproportionately high. The emergence of HIV and AIDS has only exacerbated long-standing challenges to improving children's health in the region, with recent cohorts experiencing pediatric AIDS and high levels of orphan status, situations which are monitored globally and receive much policy and research attention. Children's health, however, can be affected also by living with HIV-infected adults, through associated exposure to infectious diseases and the diversion of household resources away from them. While long recognized, far less research has focused on characterizing this distinct and vulnerable population of HIV-affected children.Using Demographic and Health Survey data from 23 countries collected between 2003 and 2011, we estimate the percentage of children living in a household with at least one HIV-infected adult. We assess overlaps with orphan status and investigate the relationship between children and the adults who are infected in their households.The population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high; in Southern Africa, the percentage exceeded 10% in all countries and reached as high as 36%. This population is largely distinct from the orphan population. Among children living in households with tested, HIV-infected adults, most live with parents, often mothers, who are infected; nonetheless, in most countries over 20% live in households with at least one infected adult who is not a parent.Until new infections contract significantly, improvements in HIV/AIDS treatment suggest that the population of children living with HIV-infected adults will remain substantial. It is vital to on-going efforts to reduce childhood morbidity and mortality to consider whether current care and outreach sufficiently address the distinct vulnerabilities of these

Fundamental concerns of women living with HIV around the implementation of Option B+.

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Matheson, Rebecca; Moses-Burton, Suzette; Hsieh, Amy C; Dilmitis, Sophie; Happy, Margaret; Sinyemu, Eunice; Brion, Sophie O; Sharma, Aditi

2015-01-01

In 2011, the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive was launched to scale up efforts to comprehensively end vertical HIV transmission and support mothers living with HIV in remaining healthy. Amidst excitement around using treatment as prevention, Malawi's Ministry of Health conceived Option B+, a strategy used to prevent vertical transmission by initiating all pregnant and breastfeeding women living with HIV on lifelong antiretroviral therapy, irrespective of CD4 count. In 2013, for programmatic and operational reasons, the WHO officially recommended Option B+ to countries with generalized epidemics, limited access to CD4 testing, limited partner testing, long breastfeeding duration or high fertility rates. While acknowledging the opportunity to increase treatment access globally and its potential, this commentary reviews the concerns of women living with HIV about human rights, community-based support and other barriers to service uptake and retention in the Option B+ context. Option B+ intensifies many of the pre-existing challenges of HIV prevention and treatment programmes. As women seek comprehensive services to prevent vertical transmission, they can experience various human rights violations, including lack of informed consent, involuntary or coercive HIV testing, limited treatment options, termination of pregnancy or coerced sterilization and pressure to start treatment. Yet, peer and community support strategies can promote treatment readiness, uptake, adherence and lifelong retention in care; reduce stigma and discrimination; and mitigate potential violence stemming from HIV disclosure. Ensuring available and accessible quality care, offering food support and improving linkages to care could increase service uptake and retention. With the heightened focus on interventions to reach pregnant and breastfeeding women living with HIV, a parallel increase in vigilance to secure their

HIV Status Disclosure Among People Living with HIV in the Era of Combination Antiretroviral Therapy (cART).

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Madi, Deepak; Gupta, Parul; Achappa, Basavaprabhu; Bhaskaran, Unnikrishnan; Ramapuram, John T; Rao, Satish; Mahalingam, Soundarya

2015-08-01

As patients with HIV live longer due to Combination Anti-Retroviral Therapy (cART) serostatus disclosure becomes an important issue. Disclosure can have both positive and negative outcomes. Disclosure of HIV status has been associated with better adherence to medication and reduction in levels of psychological distress. Stigma and disruption of family relationships are barriers for disclosure. Most studies regarding disclosure status have been conducted in West. There are many cultural differences in Indian society when compared to west. There is a dearth of research in the field of disclosure of HIV infection in India. To determine the prevalence of HIV status disclosure among people living with HIV (PLHIV) in South India. This descriptive cross-sectional study was done in the hospital attached to Kasturba Medical College (KMC), Mangalore, India from May-June 2013. PLHIV of age more than 18 years were included. During the study period 111 consecutive patients who consented for the study were enrolled. Data was collected using a pre-tested interviewer administered semi structured questionnaire. Data collected was analysed using SPSS Version 11.5 statistical software. Descriptive statistics were done and the results are presented as proportions and mean. The mean age of the study population was 44.86 ± 10.8 years. Majority of the study subjects were men 76 (68.4%). Out of 111 study subjects, 102 (91.9%) had disclosed their HIV status to at least one person while 9 (8.1%) had not disclosed their HIV status to anyone. Disclosure on doctor's advice was the main reason for 56 (54.9%) participants to disclose their HIV status. The main reason for non-disclosure was fear of shame in family. Disclosure rate was high in our study in the era of cART. Society must stop discriminating against PLHIV so that they can disclose their serostatus and gain access to care and treatment services without any fear of stigma. In our study the main reason for disclosure was doctor

Subtypes of depressive symptoms and inflammatory biomarkers: An exploratory study on a sample of HIV-positive patients.

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Norcini Pala, A; Steca, P; Bagrodia, R; Helpman, L; Colangeli, V; Viale, P; Wainberg, M L

2016-08-01

Depressive symptoms cause major impairment and may accelerate HIV progression despite the use of antiretroviral medication. The somatic symptoms criteria for HIV infection and depression partially overlap, which can make differential diagnosis challenging. Because of chronic inflammation caused by HIV infection, HIV-positive patients may develop somatic and affective-cognitive symptoms of depression. Inflammation-related depression is primarily characterized with severe somatic symptoms such as fatigue and sleep disturbance. This study sought to explore the patterns of somatic and cognitive-affective depressive symptoms that characterize HIV-positive patients. Our specific aims were (1) to identify subtypes of depressive symptoms in a sample of HIV-positive patients; and (2) to test the subtypes' difference on inflammatory and HIV disease progression biomarkers. HIV-positive men and women (N=102) with and without depressive symptoms were randomly selected from an Italian HIV clinic. Depressive symptoms (PHQ-9), viral load (VL), CD4+, Il-6, TNF-α, and monocytes were assessed. The three subtypes formed using Latent Class Analysis (LCA) identified patients with (1) severe cognitive-affective and somatic depressive symptoms; (2) severe/moderate somatic symptoms; and (3) absent or low depressive symptoms. The subtype with severe/moderate somatic symptoms was characterized with elevated levels of Il-6 and monocytes. No difference on HIV progression biomarkers was found. The subtypes of depressive symptoms might help differentiating depressive symptoms from HIV- and inflammatory-related somatic symptoms. When present, cognitive-affective and/or somatic symptoms cause significant impairment to patients' lives and thus warrant further assessment and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Diversity management: the treatment of HIV-positive employees.

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Yap, Matthew H T; Ineson, Elizabeth M

2012-01-01

Socio-demographic dimensions such as age, gender, sexual orientation, race and ethnicity are commonly included in diversity studies. With a view to helping Asian hospitality managers to manage HIV-positive employees in their workplaces through diversity management (DM) theory, this research extends the boundaries of previous diversity studies by considering Human Immunodeficiency Virus (HIV) infection as a diverse characteristic. Both quantitative and qualitative primary data were collected from purposively selected Asian hospitality managers through postal questionnaire and follow-up telephone interviews. Transformed raw data were analysed using summary statistics and template analysis. Asian hospitality managers agreed that DM would be appropriate in the management of HIV-positive employees and that it could generate substantial benefits for employees and employers. However, they believe that the successful adoption and implementation of DM is not easy; it requires training and, ideally, the recruitment of experienced directors. Nevertheless, Asian hospitality managers are confident that implementing DM to manage HIV-positive employees can enhance tolerance, improve understanding and promote equality. The purposive sampling technique and the small number of respondents have impacted the external validity of the study. However, this exploratory study initiates an equality discussion to include HIV-positive employees in DM discourse beyond antidiscrimination legislation. It also supplements the sparse literature addressing HIV-positive employees in the Asian hospitality workplace. Asian hospitality managers are advised to understand and employ DM to treat HIV-positive employees fairly to overcome hospitality workplace marginalisation, discrimination and stigmatisation.

Contraception in HIV-positive female adolescents

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Ananworanich Jintanat

2011-06-01

Full Text Available Abstract Sexual behavior of HIV-positive youths, whether infected perinatally, through risky behavior or other ways, is not substantially different from that of HIV-uninfected peers. Because of highly active antiretroviral therapy, increasing number of children, infected perinatally, are surviving into adolescence and are becoming sexually active and need reproductive health services. The objective of this article is to review the methods of contraception appropriate for HIV-positive adolescents with a special focus on hormonal contraceptives. Delaying the start of sexual life and the use of two methods thereafter, one of which is the male condom and the other a highly effective contraceptive method such as hormonal contraception or an intrauterine device, is currently the most effective option for those who desire simultaneous protection from both pregnancy and sexually transmitted diseases. Health care providers should be aware of the possible pharmacokinetic interactions between hormonal contraception and antiretrovirals. There is an urgent need for more information regarding metabolic outcomes of hormonal contraceptives, especially the effect of injectable progestins on bone metabolism, in HIV-positive adolescent girls.

Attitudes of women and men living with HIV and their healthcare ...

African Journals Online (AJOL)

Therefore, pronatalist attitudes remain in place in the face of HIV infection. Keywords: attitudes towards childbearing and abortion, stigma scales against HIV-positive women's pregnancies, stigma scales against HIV-positive women having abortions, healthcare providers' attitudes about HIV-positive women's reproduction, ...

Mucocutaneous disorders in Hiv positive patients

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Kar H

1996-01-01

Full Text Available Twenty eight HIV positive patients were included in this study. They were evaluated for their mucocutaneous disorders, sexually transmitted diseases and other systemic disorders between 1994-95 in the department of Dermatology and STD Dr R M L Hospital of New Delhi. The heterosexual contact with commercial sex workers (CSWs was the most common route of HIV transmission. Chancroid, syphilis and genital warts were common STDs found in HIV positive patients. Oral thrush (67.9% was the commonest mucocutaneous disorder found in these patients followed by herpes zoster (25% and seborrhoeic dermatitis (21.4%. There was no unusual clinical presentation seen in mucocutaneous disorders and STDs.

Clients' experiences of HIV positive status disclosure to sexual ...

African Journals Online (AJOL)

The purpose of the study was to describe the experiences of HIV positive clients as they disclose their HIV positive status to their sexual partners. A qualitative descriptive and phenomenological design was used. Purposive sampling was used to select 15 HIV positive clients to participate in the study. Semi-structured ...

Impulsivity, Sensation Seeking, and Risk-Taking Behaviors among HIV-Positive and HIV-Negative Heroin Dependent Persons

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Koosha Paydary

2016-01-01

Full Text Available Objective. The aim of this study was to compare impulsivity and risky decision making among HIV-positive and negative heroin dependent persons. Methods. We compared different dimensions of impulsivity and risky decision making in two groups of 60 HIV-positive and 60 HIV-negative male heroin dependent persons. Each group was comprised of equal numbers of current (treatment seeker and former (abstinent heroin addicts. Data collection tools included Balloon Analogue Risk Task (BART, Iowa Gambling Task (IGT, Barratt Impulsiveness Scale (BIS, and Zuckerman Sensation Seeking Scale (SSS. Results. In SSS, comprised of four subscales including thrill and adventure seeking (TAS, experience seeking (ES, disinhibition (DIS, and boredom susceptibility (BS, there was a borderline difference in DIS (P=0.08 as HIV-positive group scored higher than HIV-negative group. Also, ES and total score were significantly higher among HIV-positive patients. In BART, HIV-positive subjects scored higher in risk taking than HIV-negative subjects as reflected in higher Average Number of puffs in Successful Balloons (ANSB. In BIS, HIV-positive group scored significantly higher in cognitive impulsivity (CI (P=0.03 and nonplanning impulsivity (NPI (P=0.05 in comparison to HIV-negative group. Also, current heroin addicts scored significantly higher in NPI compared to former addict HIV-negative participants (P=0.015. IGT did not show any significant difference between groups. Conclusion. Higher levels of impulsivity and risk taking behaviors among HIV-positive heroin addicts will increase serious concerns regarding HIV transmission from this group to other opiate dependents and healthy people.

Impulsivity, Sensation Seeking, and Risk-Taking Behaviors among HIV-Positive and HIV-Negative Heroin Dependent Persons

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Paydary, Koosha; Mahin Torabi, Somayeh; SeyedAlinaghi, SeyedAhmad; Noori, Mehri; Noroozi, Alireza; Ameri, Sara; Ekhtiari, Hamed

2016-01-01

Objective. The aim of this study was to compare impulsivity and risky decision making among HIV-positive and negative heroin dependent persons. Methods. We compared different dimensions of impulsivity and risky decision making in two groups of 60 HIV-positive and 60 HIV-negative male heroin dependent persons. Each group was comprised of equal numbers of current (treatment seeker) and former (abstinent) heroin addicts. Data collection tools included Balloon Analogue Risk Task (BART), Iowa Gambling Task (IGT), Barratt Impulsiveness Scale (BIS), and Zuckerman Sensation Seeking Scale (SSS). Results. In SSS, comprised of four subscales including thrill and adventure seeking (TAS), experience seeking (ES), disinhibition (DIS), and boredom susceptibility (BS), there was a borderline difference in DIS (P = 0.08) as HIV-positive group scored higher than HIV-negative group. Also, ES and total score were significantly higher among HIV-positive patients. In BART, HIV-positive subjects scored higher in risk taking than HIV-negative subjects as reflected in higher Average Number of puffs in Successful Balloons (ANSB). In BIS, HIV-positive group scored significantly higher in cognitive impulsivity (CI) (P = 0.03) and nonplanning impulsivity (NPI) (P = 0.05) in comparison to HIV-negative group. Also, current heroin addicts scored significantly higher in NPI compared to former addict HIV-negative participants (P = 0.015). IGT did not show any significant difference between groups. Conclusion. Higher levels of impulsivity and risk taking behaviors among HIV-positive heroin addicts will increase serious concerns regarding HIV transmission from this group to other opiate dependents and healthy people. PMID:27051528

Exploring fertility decisions among pregnant HIV- positive women on ...

African Journals Online (AJOL)

making, and practices among HIV-positive pregnant women attending antenatal clinic at ... HIV/AIDS continues to be a major public health challenge, as it directly and ..... Community groups conduct nutrition education for HIV- positive people.

The effects of HIV stigma on health, disclosure of HIV status, and risk behavior of homeless and unstably housed persons living with HIV.

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Wolitski, Richard J; Pals, Sherri L; Kidder, Daniel P; Courtenay-Quirk, Cari; Holtgrave, David R

2009-12-01

HIV-related stigma negatively affects the lives of persons living with HIV/AIDS (PLWHA). Homeless/unstably housed PLWHA experience myriad challenges and may be particularly vulnerable to the effects of HIV-related stigma. Homeless/unstably housed PLWHA from 3 U.S. cities (N = 637) completed computer-assisted interviews that measured demographics, self-assessed physical and mental health, medical utilization, adherence, HIV disclosure, and risk behaviors. Internal and perceived external HIV stigma were assessed and combined for a total stigma score. Higher levels of stigma were experienced by women, homeless participants, those with a high school education or less, and those more recently diagnosed with HIV. Stigma was strongly associated with poorer self-assessed physical and mental health, and perceived external stigma was associated with recent non-adherence to HIV treatment. Perceived external stigma was associated with decreased HIV disclosure to social network members, and internal stigma was associated with drug use and non-disclosure to sex partners. Interventions are needed to reduce HIV-related stigma and its effects on the health of homeless/unstably housed PLWHA.

Perceptions of intersectional stigma among diverse women living with HIV in the United States.

Science.gov (United States)

Rice, Whitney S; Logie, Carmen H; Napoles, Tessa M; Walcott, Melonie; Batchelder, Abigail W; Kempf, Mirjam-Colette; Wingood, Gina M; Konkle-Parker, Deborah J; Turan, Bulent; Wilson, Tracey E; Johnson, Mallory O; Weiser, Sheri D; Turan, Janet M

2018-05-04

Attitudes and behavior that devalue individuals based upon their HIV status (HIV-related stigma) are barriers to HIV prevention, treatment, and wellbeing among women living with HIV. Other coexisting forms of stigma (e.g., racism, sexism) may worsen the effects of HIV-related stigma, and may contribute to persistent racial and gendered disparities in HIV prevention and treatment. Few studies examine perceptions of intersectional stigma among women living with HIV. From June to December 2015, we conducted 76 qualitative interviews with diverse women living with HIV from varied socioeconomic backgrounds enrolled in the Women's Interagency HIV Study (WIHS) in Birmingham, Alabama; Jackson, Mississippi; Atlanta, Georgia; and San Francisco, California. Interview guides facilitated discussions around stigma and discrimination involving multiple interrelated identities. Interviews were audio-recorded, transcribed verbatim, and coded using thematic analysis. Interviewees shared perceptions of various forms of stigma and discrimination, most commonly related to their gender, race, and income level, but also incarceration histories and weight. Women perceived these interrelated forms of social marginalization as coming from multiple sources: their communities, interpersonal interactions, and within systems and structures. Our findings highlight the complexity of social processes of marginalization, which profoundly shape life experiences, opportunities, and healthcare access and uptake among women living with HIV. This study highlights the need for public health strategies to consider community, interpersonal, and structural dimensions across intersecting, interdependent identities to promote the wellbeing among women living with HIV and to reduce social structural and health disparities. Copyright © 2018 Elsevier Ltd. All rights reserved.

Living in rural New England amplifies the risk of depression in patients with HIV

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Jensen Paul T

2009-03-01

Full Text Available Abstract Background The importance of depression as a complication of HIV infection is increasingly understood, and people living in rural areas are at increased risk for depression. However, it is not known whether living in rural areas amplifies the risk of depression in patients with HIV. Methods We compared the prevalence of depression between rural and metropolitan HIV patients seen at the Dartmouth-Hitchcock HIV Program in a retrospective cohort study. Using the validated Rural-Urban Commuting Area Score, we categorized patients as living in small town/rural areas, micropolitan or metropolitan towns. Then, using a multivariate logistic regression model to adjust for demographic factors that differed between rural and metropolitan patients, we estimated the impact of living in rural areas on the odds of depression. Results Among 646 patients with HIV (185 small town/rural, 145 micropolitan, 316 metropolitan, rural patients were older, white, male, and men who have sex with men (ANOVA, F-statistic Conclusion HIV-infected patients living in rural areas, particularly those on antiretroviral therapy, are highly vulnerable to depression.

Renegotiating intimate relationships with men: how HIV shapes attitudes and experiences of marriage for South African women living with HIV: 'Now in my life, everything I do, looking at my health'

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Cooper, Diane; Moore, Elena; Mantell, Joanne E

2013-01-01

This paper explores marriage attitudes and practices among Xhosa-speaking women living with HIV (WLHIV) in Cape Town, South Africa. It reports on a study that assessed the fertility intentions of a cohort of people living with HIV, aimed at informing an HIV care intervention. It draws on qualitative data generated from 30 successive interviews with WHLIV in wave 1, 23 interviews in wave 2 and 20 follow-up interviews in wave 3. Gender inequality, marriage and HIV are strongly intertwined. Broader layers of South Africa's history, politics and socio-economic and cultural contexts have consequences for the fluidity in intimate relations, marriage and motherhood for WLHIV. Key and conflicting themes emerge that impact on marriage and motherhood. Firstly, marriage is the 'last on a list of priorities' for WLHIV, who wish to further their children's education, to work, to earn money, and to achieve this rapidly because of their HIV-positive status. We demonstrate that the pressure women face in marriage to bear children creates a different attitude to and experience of marriage for WLHIV. Some WLHIV wish to avoid marriage due to its accompanying pressure to have children. Other WLHIV experience difficulties securing intimacy. WLHIV may find it easier to seek partners who are also living with HIV. A partner living with HIV is perceived as sharing similar fertility goals. In this study, HIV accentuates existing issues and highlights new ones for WLHIV negotiating intimacy. The findings contribute to the existing knowledge base regarding the fluidity of marriage and fertility intentions within the dynamic context of living with HIV. These are likely to have broader relevance in currently rapidly urbanising and economically developing countries with high HIV prevalence in southern Africa.

Employment discrimination and HIV stigma: survey results from civil society organisations and people living with HIV in Africa.

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Sprague, Laurel; Simon, Sara; Sprague, Courtenay

2011-01-01

The article presents findings from three surveys of people living with HIV (PLHIV) and civil society organisations about the experience of employment discrimination and stigma in the workplace. The work seeks to contribute to efforts by businesses and other organisations to effectively respond to the HIV epidemic within the world of work, and to deepen our understanding of the ways in which HIV stigma and employment discrimination persist in the workplace. The findings of global and regional surveys indicate the existence of high levels of employment discrimination based on HIV status worldwide, including forced disclosure of HIV status, exclusion in the workplace, refusals to hire or promote, and terminations of people known to be living with HIV. The survey findings show that employment discrimination based on HIV status is experienced in all African subregions. Country-level surveys conducted in Kenya and Zambia indicated that PLHIV face marked barriers to employment, including discrimination in hiring, loss of promotions, and termination because of HIV status. Additionally, large variances were found in the degree of support versus discrimination that employees living with HIV in those two countries received following their disclosure. The discussion emphasises the importance of the workplace as a site for intervention and behaviour change. To address this, we introduce a conceptual framework - the employment continuum - that maps multiple points of entry within the workplace to address HIV-related stigma and discrimination. Additional recommendations include: actions to ensure equal opportunity in hiring for PLHIV; ensuring that HIV testing is voluntary, never mandatory, and that disclosure is not necessary for employment; ensuring confidentiality of HIV status; communicating and enforcing HIV-related antidiscrimination policies; establishing support groups in the workplace; providing safe and confidential processes for resolving complaints of employment

Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study

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Payán, Denise D.; Fulcar, María Altagracia; Terrero, Sergio; Acevedo, Ramón; Farías, Hugo; Palar, Kartika

2017-01-01

Background Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity. Methods We examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes. Results Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress. Conclusions Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce

Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study.

Science.gov (United States)

Derose, Kathryn P; Payán, Denise D; Fulcar, María Altagracia; Terrero, Sergio; Acevedo, Ramón; Farías, Hugo; Palar, Kartika

2017-01-01

Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity. We examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes. Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress. Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce existing laws designed to protect the

Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study.

Directory of Open Access Journals (Sweden)

Kathryn P Derose

Full Text Available Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity.We examined factors contributing to food insecurity among women living with HIV (WLHIV in the Dominican Republic (DR. Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes.Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress.Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce existing laws designed to

Are people living with HIV less productive at work?

NARCIS (Netherlands)

K. Verbooy (Kaya); M.N. Wagener (Marlies); M. Kaddouri (Meriam); P.D.D.M. Roelofs (Pepijn); H.S. Miedema (Harald); E.C.M. van Gorp (Eric); W.B.F. Brouwer (Werner); N.J.A. van Exel (Job)

2018-01-01

textabstractHealth problems may cause decreased productivity among working people. It is unclear if this also applies for people living with HIV (PLWH). This cross-sectional study compares data of PLWH of one of the main HIV treatment centres in the Netherlands (n = 298) to data of the general

Older people living with HIV in Uganda: understanding their ...

African Journals Online (AJOL)

HIV-prevention, treatment and care programmes should seek to meet the special needs of older people through focused and innovative approaches. Further research with larger samples is needed to explore the impact of these healthcare needs on the quality of life of older people living with HIV. Keywords: ageing ...

Internet use and the network composition of people living with HIV/AIDS in an urban area in Peru.