Journal of HIV-AIDS & Social Services最新文献

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The quandary of adolescent HIV: Perspectives of key informants in Accra, Ghana 青少年艾滋病毒的困境：加纳阿克拉主要信息提供者的观点

IF 0.7 Q4 SOCIAL WORK

Journal of HIV-AIDS & Social Services

Pub Date : 2021-04-03 DOI: 10.1080/15381501.2021.1928578

M. Dako‑Gyeke, A. Boateng

Abstract This study explored key informants’ perspectives about adolescents living with human immunodeficiency virus (HIV). Twenty-one participants were purposively selected and data were collected through face-to-face in-depth interviews using a semi-structured interview guide. The interviews were audio-recorded, transcribed, and analyzed to identify emerging themes. The findings indicated that adolescents living with HIV had concerns about disclosing their HIV status. Key informants reported that adolescents living with HIV’s responses to awareness about their status included anger, blame and social isolation. Also, it was found that the adolescents had challenges with adhering to scheduled medical appointments and the antiretroviral therapy. Evidence showed that financial constraints adversely affected adolescents’ clinic attendance and medication compliance. Several psychosocial support services (counseling, financial assistance, provision of basic needs, and cordial relationships) were identified by key informants as being available for adolescents living with HIV. Based on the findings of the study, conclusions were drawn and implications discussed.

摘要本研究探讨了主要信息提供者对感染人类免疫缺陷病毒（HIV）的青少年的看法。有目的地选择了21名参与者，并使用半结构化访谈指南通过面对面的深入访谈收集数据。访谈被录音、转录和分析，以确定新出现的主题。调查结果表明，感染艾滋病毒的青少年对披露自己的艾滋病毒状况表示担忧。主要线人报告说，感染艾滋病毒的青少年对自己状况的反应包括愤怒、指责和社会孤立。此外，研究发现，青少年在遵守预定的医疗预约和抗逆转录病毒疗法方面存在挑战。有证据表明，经济拮据对青少年的就诊和药物依从性产生了不利影响。关键信息提供者确定，艾滋病毒感染青少年可以获得一些心理社会支持服务（咨询、经济援助、提供基本需求和友好关系）。根据研究结果，得出了结论并讨论了其含义。

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引用次数: 0

Courtesy stigma and self-care practices among rural HIV/AIDS healthcare providers 农村艾滋病毒/艾滋病保健提供者的礼貌羞辱和自我保健做法

IF 0.7 Q4 SOCIAL WORK

Journal of HIV-AIDS & Social Services

Pub Date : 2021-04-03 DOI: 10.1080/15381501.2021.1922116

F. Parks, S. Smallwood

Abstract Stigma by association, or “courtesy stigma,” is defined as public disapproval for associating with a perceived stigmatized group. Using an audience response system (ARS), rural HIV/AIDS healthcare providers (n = 69) were asked about experiences of courtesy stigma and self-care practices for safeguarding their well-being. Qualitative responses were coded and themes identified. Forty-nine percent of respondents reported experiencing courtesy stigma (for example, others assuming they were HIV-positive because of their work). While respondents rated their quality of self-care as either “good” (43.5%) or “excellent” (14.5%), opportunities to increase providers’ capacity to practice quality self-care is strongly encouraged.

关联污名，或“礼貌污名”，被定义为公众不赞成与一个被认为是污名的群体联系。使用受众响应系统(ARS)，向农村艾滋病毒/艾滋病卫生保健提供者(n = 69)询问了礼貌耻辱的经历和维护其福祉的自我保健做法。对定性答复进行编码并确定主题。49%的答复者报告说，他们受到了礼貌性的羞辱(例如，其他人因为他们的工作而认为他们是艾滋病毒阳性)。虽然受访者将自我保健的质量评为“良好”(43.5%)或“优秀”(14.5%)，但强烈鼓励有机会提高提供者实践高质量自我保健的能力。

引用次数: 2

Access to healthcare services among heterosexual Black men in Ontario, Canada 加拿大安大略省异性恋黑人男性获得医疗服务的情况

IF 0.7 Q4 SOCIAL WORK

Journal of HIV-AIDS & Social Services

Pub Date : 2021-01-02 DOI: 10.1080/15381501.2021.1908923

Irenius Konkor, P. Mkandawire, I. Luginaah, W. Husbands, F. Omorodion, J. Wong, J. Etowa

Abstract While there is a growing body of literature on Black people’s access to HIV services in Canada, the question of how this access varies across Canada’s urban jurisdictions has hitherto never arisen in research and policy. This paper assesses HIV healthcare needs among heterosexual Black men in four Ontario cities of Windsor, London, Toronto and Ottawa. Multivariate results show that heterosexual Black men in Windsor (OR = 3.2; p < .01), London (OR = 2.5; p < .05), and Toronto (OR = 2.2; p < .05) were significantly more likely to experience difficulties getting HIV healthcare compared with those living in the nation’s capital—Ottawa. Also, experiences of discrimination (OR = 1.08; p < .001), not having a family doctor (OR = 1.7; p < .01) and difficulty with the English language (OR = 2.4; p < .01) predicted higher odds of difficulty accessing HIV health needs. These findings suggest that contextually sensitive policies within Canadian cities are needed to help marginalized populations meet their healthcare needs.

虽然关于加拿大黑人获得艾滋病毒服务的文献越来越多，但迄今为止，在研究和政策中从未出现过关于加拿大城市司法管辖区黑人获得艾滋病毒服务的问题。本文对安大略省温莎、伦敦、多伦多和渥太华四个城市的异性恋黑人男性艾滋病保健需求进行了评估。多变量结果显示，温莎市黑人异性恋男性(OR = 3.2;p < 0.01)，伦敦(OR = 2.5;p < 0.05)，多伦多(OR = 2.2;p < 0.05)与居住在首都渥太华的人相比，他们更有可能在获得艾滋病毒医疗保健方面遇到困难。同样，受歧视的经历(OR = 1.08;p < .001)，没有家庭医生(OR = 1.7;p < 0.01)和英语语言困难(OR = 2.4;p < 0.01)预测获得艾滋病毒健康需求的困难几率更高。这些研究结果表明，加拿大城市需要制定环境敏感的政策，以帮助边缘化人群满足他们的医疗保健需求。

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引用次数: 1

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

Journal of HIV-AIDS & Social Services

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。

引用次数: 4

IF 0.7 Q4 SOCIAL WORK

Journal of HIV-AIDS & Social Services

Pub Date : 2021-01-02 DOI: 10.1080/15381501.2021.1900975

Sadandaula Rose Muheriwa Matemba, R. Cianelli, B. McCabe, E. Chilemba

Abstract In sub-Saharan Africa, nearly 90% of youth living with HIV acquired it from their mothers, but evidence lacks for health-related interventions for this population. We describe health-related interventions for youth living with perinatally acquired HIV in sub-Saharan Africa. A Preferred Reporting Items for Systematic Reviews (PRISMA) statement guided this review. We searched in PubMed, CINAHL, ProQuest, PsychINFO, Science Direct, Embase, and Scopus databases for peer-reviewed articles addressing health-related interventions for youth living with perinatally acquired HIV in sub-Saharan Africa. Of the 4,139 articles, 11 met the inclusion criteria. We identified eight interventions targeting HIV prevention and care, ART adherence, disclosure, behavioral health, cognitive and academic function, sexual, reproductive, psychosocial, and physical health. Most of the interventions targeted psychosocial health. No intervention was holistic. Findings were diverse regarding intervention effectiveness. Providers need to devise interventions that combine behavioral, biomedical, and structural services to meet this population's complex health care needs.

在撒哈拉以南非洲，近90%的青年艾滋病毒感染者是从母亲那里感染的，但缺乏针对这一人群的健康相关干预措施的证据。我们描述了在撒哈拉以南非洲与围产期获得性艾滋病毒的青年健康相关的干预措施。系统评价的首选报告项目(PRISMA)声明指导了本次评价。我们在PubMed、CINAHL、ProQuest、PsychINFO、Science Direct、Embase和Scopus数据库中检索了同行评议的文章，内容涉及撒哈拉以南非洲地区围产期感染艾滋病毒的青少年的健康相关干预措施。在4139篇文章中，有11篇符合纳入标准。我们确定了针对艾滋病毒预防和护理、抗逆转录病毒治疗依从性、信息披露、行为健康、认知和学术功能、性、生殖、社会心理和身体健康的八种干预措施。大多数干预措施的目标是社会心理健康。没有任何干预是全面的。有关干预效果的研究结果各不相同。提供者需要设计结合行为、生物医学和结构服务的干预措施，以满足这一人群复杂的卫生保健需求。

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引用次数: 0

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

Journal of HIV-AIDS & Social Services

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。

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 0.4 Q4 SOCIAL WORK

Journal of HIV-AIDS & Social Services

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。

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

Journal of HIV-AIDS & Social Services

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

Journal of HIV-AIDS & Social Services

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

Journal of HIV-AIDS & Social Services

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。

引用次数: 3

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