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HIV stigma and its metaphors: Photos, symbols, and solutions 艾滋病毒污名及其隐喻:照片、符号和解决方案
IF 0.7 Q4 SOCIAL WORK Pub Date : 2021-01-02 DOI: 10.1080/15381501.2021.1911903
M. Teti, S. Epping, T. Myroniuk, R. Evans-Agnew
Abstract The objective of this study was to explore how PLWH use visual metaphors to describe and make sense of stigma. This study solicited PLWH’s experiences with stigma via photovoice—a participatory research method in which participants use images to identify, share, and advocate for their needs and experiences. Photographs and discussions centered on stigma as two-parted, including both challenge and resilience. Participants used eight different categories of visual metaphors to describe their experiences of stigma (e.g., how it felt, what it was like) and four different categories of visual metaphors to describe their resilience or resistance to stigma. Participant photography and photo-elicitation is an accessible method to combine arts and health, especially for discovering ways patients understand and explain their perceptions of difference. Creative photography can help patients express themselves, practitioners understand illness, and frame health promotion and prevention programs.
摘要本研究的目的是探讨PLWH如何使用视觉隐喻来描述和理解污名。这项研究通过照片语音收集了PLWH的污名经历,这是一种参与性研究方法,参与者使用图像来识别、分享和倡导他们的需求和经历。照片和讨论集中在两人分手时的耻辱感上,包括挑战和韧性。参与者使用八种不同类别的视觉隐喻来描述他们的污名体验(例如,感觉如何,是什么样子),并使用四种不同类型的视觉隐喻描述他们对污名的恢复力或抵抗力。参与者摄影和照片启发是一种将艺术和健康相结合的方法,尤其是对于发现患者理解和解释他们对差异的看法的方式。创造性的摄影可以帮助患者表达自己,从业者了解疾病,并制定健康促进和预防计划。
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引用次数: 4
A community-based study of clients’ lived experiences of going through the rural HIV care continuum 一项基于社区的研究,研究了客户在农村艾滋病毒护理连续过程中的生活经历
IF 0.7 Q4 SOCIAL WORK Pub Date : 2021-01-02 DOI: 10.1080/15381501.2021.1906819
Christopher Owens, Eva Voorheis, Nicole Struble, J. Lester, H. Green, D. Herbenick, R. Hubach, B. Dodge
Abstract This community-based study explored the lived experiences of being in and going through the rural HIV care continuum among 15 gay and bisexual men (GBM) with HIV who live in a rural area of a Midwestern state. Our analysis adapted a six-step interpretative phenomenological analysis. Five themes emerged that reflected the five continuum stages: 1) Diagnosis means death, 2) Linkage to care means uncertainty, 3) HIV care improves the quality of life lost pre- or peri-diagnosis, 4) ART implies life, and 5) Undetectable addresses the medical but not social aspects of HIV. Participants recalled they faced and continue to face social determinants, stigma, and chronic and mental health conditions. Findings provide future research directions and practical implications to address social determinants of health, promote chronic and mental health, and reduce interpersonal stigma throughout all HIV care continuum stages.
这项以社区为基础的研究探讨了生活在美国中西部一个州农村地区的15名感染艾滋病毒的男同性恋和双性恋男性(GBM)在农村艾滋病护理连续体中的生活经历。我们的分析采用了六步解释性现象学分析。出现了五个主题,反映了五个连续阶段:1)诊断意味着死亡,2)与护理的联系意味着不确定性,3)艾滋病毒护理改善了诊断前或诊断期间失去的生活质量,4)抗逆转录病毒治疗意味着生命,5)不可检测解决了艾滋病毒的医学而不是社会方面。与会者回忆说,他们曾经并将继续面临社会决定因素、耻辱以及慢性和精神健康状况。研究结果提供了未来的研究方向和实际意义,以解决健康的社会决定因素,促进慢性和精神健康,并减少在所有艾滋病毒护理连续阶段的人际耻辱。
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引用次数: 4
Unmet needs and barriers to services among people who inject drugs with HIV in the United States. 在美国,注射毒品的艾滋病毒感染者未满足的需求和服务障碍。
IF 0.7 Q4 SOCIAL WORK Pub Date : 2021-01-01 DOI: 10.1080/15381501.2021.1970684
Sharoda Dasgupta, Yunfeng Tie, Linda Beer, Dita Broz, Quan Vu

Data on use of and barriers to HIV ancillary care services among people who inject drugs (PWID) with HIV can inform interventions intended to improve access to care, but national estimates are lacking. We analyzed data on PWID with HIV from the CDC Medical Monitoring Project. Overall, 79% had an unmet need for ≥1 service. Services with the highest unmet need included: dental care (38%), drug/alcohol treatment (20%), transportation assistance (20%), and HIV peer group support (20%). Unmet needs for mental health services (13% vs. 23%) and HIV peer group support (15% vs. 29%) were lower among persons attending Ryan White HIV/AIDS Program (RWHAP)-funded facilities for HIV care. Barriers to care services varied by service type. Modeling components of the RWHAP structure in non-RWHAP funded facilities, including integration of support services and use of patient navigation services in the HIV medical care setting, may improve outcomes among PWID with HIV.

艾滋病毒注射吸毒者(PWID)使用艾滋病毒辅助护理服务的情况和障碍的数据可以为旨在改善护理可及性的干预措施提供信息,但缺乏国家估计数据。我们分析了来自疾病控制与预防中心医学监测项目的PWID伴HIV的数据。总体而言,79%的患者未满足≥1项服务的需求。未满足需求最高的服务包括:牙科护理(38%)、药物/酒精治疗(20%)、交通援助(20%)和艾滋病毒同伴团体支持(20%)。在瑞安·怀特艾滋病毒/艾滋病项目(RWHAP)资助的艾滋病毒护理设施中,未满足的心理健康服务需求(13%对23%)和艾滋病毒同伴团体支持需求(15%对29%)较低。获得护理服务的障碍因服务类型而异。在非RWHAP资助的设施中对RWHAP结构的组成部分进行建模,包括在艾滋病毒医疗保健环境中整合支持服务和使用患者导航服务,可能会改善感染艾滋病毒的PWID患者的结果。
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引用次数: 0
Implementation of HIV pre-exposure prophylaxis for women of color: Perspectives from healthcare providers and staff from three clinical settings. 有色人种妇女接触艾滋病毒前预防的实施:来自三个临床环境的医疗保健提供者和工作人员的观点。
IF 0.7 Q4 SOCIAL WORK Pub Date : 2021-01-01 Epub Date: 2021-02-22 DOI: 10.1080/15381501.2021.1887038
Allison L Kimmel, Lisa J Messersmith, Angela R Bazzi, Meg M Sullivan, Jacqueline Boudreau, Mari-Lynn Drainoni

Women of color (WOC) account for 83% of new HIV infections among women in the United States. While pre-exposure prophylaxis (PrEP) is a safe, effective HIV prevention method for women, WOC are less likely to be prescribed PrEP than other populations. Guided by an implementation science research framework, we investigated the implementation of a PrEP initiative for WOC in a US city with high HIV incidence. Across three clinical sites, only three WOC were prescribed PrEP after one year. Analysis of qualitative interviews with clinic staff and providers identified time constraints, reluctance to prescribe PrEP, and discomfort with counseling as implementation barriers. Implementation facilitators included staff and leadership support for PrEP, alignment of PrEP services with organizational missions, and having a centralized PrEP Coordinator. By addressing these identified implementation barriers and facilitators, clinic staff and providers can ensure that WOC are provided with the full range of HIV prevention options.

有色人种女性(WOC)占美国女性新感染艾滋病毒的83%。虽然暴露前预防(PrEP)对妇女来说是一种安全、有效的艾滋病毒预防方法,但妇女比其他人群更不可能得到处方PrEP。在实施科学研究框架的指导下,我们调查了在美国一个艾滋病毒高发城市实施妇女工作的PrEP倡议。在三个临床站点中,只有三个WOC在一年后开了PrEP。对诊所工作人员和提供者的定性访谈分析确定了时间限制、不愿开PrEP处方以及咨询时的不适是实施障碍。实施促进因素包括工作人员和领导对预防措施的支持,使预防措施服务与组织任务保持一致,并设立一名集中的预防措施协调员。通过解决这些已确定的实施障碍和促进因素,诊所工作人员和提供者可以确保向妇女社区提供全面的艾滋病毒预防选择。
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引用次数: 6
Increasing HIV/AIDS knowledge among urban ethnic minority youth: Findings from a community-based prevention intervention program. 城市少数民族青年对艾滋病毒/艾滋病知识的增加:基于社区的预防干预计划的发现。
IF 0.7 Q4 SOCIAL WORK Pub Date : 2021-01-01 Epub Date: 2021-04-21 DOI: 10.1080/15381501.2021.1910097
David T Lardier, Ijeoma Opara, Robert J Reid, Pauline Garcia-Reid, Andriana Herrera, Irene Cantu

HIV (Human Immunodeficiency Virus)/AIDs (Acquired immunodeficiency syndrome) prevention and research are imperative. Prevention-intervention programming is minimal in low-income communities of color. Additional research is needed that uncovers points of support and prevention to increase HIV knowledge and awareness and limit new HIV infections among adolescents of color. This study presents preliminary findings from a community-based HIV/AIDS, substance abuse, and viral hepatitis (VH) prevention education intervention for ethnic minority youth in a northeastern urban community. We evaluated HIV/AIDS knowledge and factors associated with knowledge. Participants (N = 599) completed a baseline survey followed by an exit survey measuring HIV/AIDS knowledge. Exit survey findings indicated that there was an increase in HIV/AIDs knowledge. Multivariate regression analyses showed that change scores in VH knowledge accuracy, sexual negotiation skills, risk perception, and ethnic identity were positively associated with change in HIV/AIDs knowledge score. The development and implementation of HIV/AIDS knowledge interventions can be crucial in alleviating new infections in the U.S.

艾滋病毒(人类免疫缺陷病毒)/艾滋病(获得性免疫缺陷综合征)的预防和研究势在必行。在低收入有色人种社区,预防干预方案很少。需要更多的研究来揭示支持和预防的要点,以提高对艾滋病毒的认识和认识,并限制有色人种青少年中新的艾滋病毒感染。本研究介绍了东北城市社区少数民族青年基于社区的艾滋病毒/艾滋病、药物滥用和病毒性肝炎(VH)预防教育干预的初步结果。我们评估了艾滋病毒/艾滋病知识以及与知识相关的因素。参与者(N=599)完成了一项基线调查,然后是一项测量艾滋病毒/艾滋病知识的退出调查。离职调查结果表明,对艾滋病毒/艾滋病的了解有所增加。多元回归分析显示,VH知识准确性、性谈判技能、风险感知和种族认同的变化分数与HIV/AIDs知识分数的变化呈正相关。制定和实施艾滋病毒/艾滋病知识干预措施对缓解美国的新感染至关重要。
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引用次数: 0
Factors associated with PrEP adherence among MSM living in Jackson, Mississippi. 生活在密西西比州杰克逊的男男性接触者中与PrEP依从性相关的因素。
IF 0.7 Q4 SOCIAL WORK Pub Date : 2021-01-01 DOI: 10.1080/15381501.2021.1956666
Laura Whiteley, Lacey Craker, Shufang Sun, Nicholas Tarantino, Dylan Hershkowitz, Jesse Moskowitz, Trisha Arnold, Kayla Haubrick, Elizabeth Olsen, Leandro Mena, Larry K Brown

Understanding the determinants of pre-exposure prophylaxis (PrEP) adherence is integral to reducing HIV incidence in the United States, especially for those at highest risk. To this end, the present study explored demographic, psychosocial, and behavioral factors related to adherence among 43 Southern, predominately Black, men who have sex with men (MSM). During the study months, 46% of the sample reported being nonadherent to PrEP. Those with more sexual partners (p = .05), greater self-efficacy for taking PrEP (p = .03), and those who felt condoms were less important (p = .02), were more likely to be adherent to PrEP at six-month follow-up. Further interventions that consider perceived sexual risk, condom use, and adherence self-efficacy are needed to improve PrEP adherence among Southern MSM.

了解暴露前预防(PrEP)依从性的决定因素对于降低美国的艾滋病毒发病率至关重要,特别是对高危人群。为此,本研究探讨了43名南方男男性行为者(主要是黑人)的人口统计学、社会心理和行为因素与依从性的关系。在研究的几个月里,46%的样本报告没有坚持使用PrEP。那些有更多性伴侣的人(p = 0.05),使用PrEP的自我效能更高(p = 0.03),以及那些认为避孕套不那么重要的人(p = 0.02),在六个月的随访中更有可能坚持使用PrEP。需要进一步的干预措施,考虑到感知性风险、避孕套使用和依从性自我效能,以提高南方MSM的PrEP依从性。
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引用次数: 3
Misconceptions about HIV infection and testing services: A qualitative pilot survey in Lagos 对艾滋病毒感染和检测服务的误解:拉各斯的一项定性试点调查
IF 0.7 Q4 SOCIAL WORK Pub Date : 2020-10-01 DOI: 10.1080/15381501.2020.1836543
K. Wright, M. Dairo, Babatunde A. Odugbemi, F. Adepoju, Bisola I Adebayo, Temitope O. Durojaiye, Y. Shogbamimu, O. Odusanya, O. Idris
Abstract Aim The aim of this study was to assess the perception and utilization of HIV services in Lagos Nigeria. Methods One focus group discussion (FGD) and three key informant interviews (KIIs) were conducted in each of the three LGAs in the state. Results A high level of awareness of HIV was observed among the participants. However, risk perception was varied with some members of the community refusing to believe that HIV is real and some misconceptions about risk factors. The availability of testing and treatment centers was not well known to a number of the respondents. Stigmatization of those infected is still high due to the perceived high transmissibility of the disease. Conclusion There is need for the Lagos State government to leverage on all existing health facilities in the state for the provision of HIV testing services and focus efforts on removing misconceptions and stigmatization of those infected with HIV.
摘要目的本研究的目的是评估尼日利亚拉各斯艾滋病服务的认知和利用。方法采用1次焦点小组讨论(FGD)和3次关键线人访谈(KIIs)。结果参试人群对艾滋病的认知水平较高。然而,对风险的认识各不相同,一些社区成员拒绝相信艾滋病毒是真实存在的,对风险因素存在一些误解。一些答复者并不十分了解检测和治疗中心的可用性。由于这种疾病的高传播性,对感染者的污名化程度仍然很高。拉各斯州政府有必要利用该州所有现有的卫生设施提供艾滋病毒检测服务,并集中精力消除对艾滋病毒感染者的误解和污名化。
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引用次数: 0
Perceptions of black men who have sex with men about accessing and taking PrEP: A qualitative study 与男性发生性关系的黑人男性对获得和服用PrEP的看法:一项定性研究
IF 0.7 Q4 SOCIAL WORK Pub Date : 2020-10-01 DOI: 10.1080/15381501.2020.1824843
L. Remy, W. Majee, M. Teti, M. Enriquez
Abstract Black men who have sex with men (MSM) have a 1 in 2 lifetime risk of acquiring HIV infection; yet are underrepresented in biomedical HIV prevention behaviors. In-depth interviews were conducted with Midwestern Black MSM (n = 12) taking PrEP for more than one year. A strength of this study was that it utilized qualitative methodology, which allows the revelation of perceptions that researchers cannot predict a priori. Black MSM in this study were educated and privately insured; even so, an overarching theme that emerged was that obtaining PrEP was a “long, hard road.” Facilitators to PrEP access included having an important person, insight into stigma, wariness of sexual partners, and desire to be a part of something greater than oneself. Findings have important implications for research and clinical practice. Strategies that decrease healthcare system barriers and simplify PrEP access are urgently needed for MSM at risk for HIV acquisition.
黑人男男性行为者(MSM)终生感染HIV的风险为1 / 2;但在艾滋病毒生物医学预防行为方面的代表性不足。对服用PrEP一年以上的中西部黑人男男性接触者(n = 12)进行深度访谈。这项研究的优势在于它采用了定性方法,这使得研究人员无法先验地预测感知。本研究中的黑人男男性接触者受过良好教育并有私人保险;即便如此,出现的一个主要主题是获得PrEP是一条“漫长而艰难的道路”。促进PrEP获得的因素包括有一个重要的人,对耻辱的洞察力,对性伴侣的警惕,以及成为比自己更重要的事情的一部分的愿望。研究结果对研究和临床实践具有重要意义。对于有感染艾滋病毒风险的男男性行为者来说,迫切需要减少卫生保健系统障碍和简化PrEP获取的战略。
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引用次数: 1
Students’ behaviors in the context of the risk of HIV infection 学生在HIV感染风险背景下的行为
IF 0.7 Q4 SOCIAL WORK Pub Date : 2020-07-02 DOI: 10.1080/15381501.2020.1806165
Maria Łukaszek
Abstract The HIV infection rate in Poland is 3.3 per 100,000 and concerns mostly young adults. 2,764 students from 12 universities in the Podkarpackie region were examined. A high percentage of students had experiences of sexual contacts without condoms: vaginal contacts—40%, oral—22%, anal—14%, with strangers (8.3%) or little-known persons (9.6%), while alcohol-intoxicated (both partners—20.3%, one partner—14.8%) or drug-intoxicated (both partners—4%, one—4.2%). 3.8% admitted to having injected drugs, 1.2%—tattooed, and 4.9%—pierced in non-sterile conditions. Students who were not tested also displayed risky behaviors.
波兰的艾滋病毒感染率为每10万人3.3人,主要是年轻人。来自Podkarpackie地区12所大学的2764名学生接受了调查。很高比例的学生有过不使用避孕套的性接触经历:与陌生人(8.3%)或不知名的人(9.6%)发生阴道接触(40%,口服- 22%,肛门- 14%),而醉酒(双方- 20.3%,一方- 14.8%)或吸毒(双方- 4%,一方- 4.2%)。3.8%的人承认自己注射过毒品,1.2%的人纹身,4.9%的人在非无菌条件下穿孔。未接受测试的学生也表现出危险行为。
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引用次数: 1
Human immunodeficiency virus (HIV) stigma among general population in Isfahan metropolis in Central Iran 伊朗中部伊斯法罕大都市普通人群对人类免疫缺陷病毒(HIV)的耻辱感
IF 0.7 Q4 SOCIAL WORK Pub Date : 2020-07-02 DOI: 10.1080/15381501.2020.1785365
F. Ebrahimi, Setayesh Sindarreh, M. Nasirian
Abstract Background This study was aimed to evaluate stigma-related to HIV infection among the general population in Isfahan as a representative of Iran. Methods In order to conduct the cross-sectional study, 800 people with an age range of 18–73 years from 14 municipal regions of Isfahan were selected based on a multistage sampling. A standard questionnaire was used to evaluate HIV stigma in the general population in December 2017. Results The mean score (SD) of stigma toward PLHIV was 45.49 (9.17) out of 90. The prevalence of stigmatized attitudes was 18.97% among participants. Stigma’s score was correlated with the score of HIV knowledge, gender, and age. Conclusion The level of stigmatized attitude toward PLHIV was low among the general population in Isfahan. Given that there is still a stigma toward PLHIV in Isfahan as the representative of Iranian population, it is recommended to implement the population-based educational programs for decreasing HIV stigma.
摘要背景本研究旨在评估作为伊朗代表的伊斯法罕普通人群中与艾滋病毒感染相关的污名。方法为了进行横断面研究,800名年龄在18-73岁之间的人 来自伊斯法罕14个城市地区的年份是基于多阶段抽样选择的。2017年12月,使用标准问卷对普通人群中的艾滋病毒污名进行了评估。结果PLHIV污名的平均得分(SD)为45.49(9.17)(满分90分)。受试者中污名化态度的发生率为18.97%。Stigma的得分与艾滋病知识、性别和年龄的得分相关。结论伊斯法罕市普通人群对PLHIV的污名化程度较低。鉴于作为伊朗人口的代表,伊斯法罕仍然存在对PLHIV的污名,建议实施基于人口的教育计划,以减少对艾滋病毒的污名。
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引用次数: 2
期刊
Journal of HIV-AIDS & Social Services
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