Janac-Journal of the Association of Nurses in Aids Care最新文献

Abstract: People living with HIV (PLWH) may experience premature physical deficits, including walking, mobility, and balance problems. The purpose was to measure deficits in walking, mobility, balance, and dual tasking in PLWH. The secondary objective was to make recommendations regarding the use of rehabilitation outcome measures. CINAHL, PubMed, and SPORTDiscus databases were searched. Two independent reviewers screened titles/abstracts and full-text articles, extracted data, and performed a quality assessment. Fifty-six articles with 14,053 PLWH and 8,454 uninfected controls were included. A meta-analysis revealed significantly worse performance among PLWH on the five times sit to stand mobility test versus controls (Cohen d = 0.68, 95% confidence interval [CI 0.08-1.29], p = .03). Meta-analyses revealed no differences between PLWH and controls for usual gait speed (Cohen d = -0.47, 95% CI [-1.10 to 0.15], p = .14) and fast gait speed (Cohen d = -0.39, 95% CI [-0.87 to 0.08], p = .10). Ten of 12 studies comparing PLWH with controls found differences in balance outcomes. PLWH have significantly worse mobility than uninfected controls.

Abstract: There is a decreasing HIV care workforce in the United States, whereas the need for HIV care and prevention continues to increase. To better understand this issue, a quantitative, anonymous, one-time, self-administered survey was conducted. The survey was completed by 1,004 prescribing clinicians currently providing HIV-related health care. Clinicians of younger age and Black race, advanced practice registered nurses, and family medicine physicians were more likely to report continuing with the same number of patients or increasing the number of patients in their HIV practice in the next 5 years. The need for more prescribing HIV care clinicians is paramount because 17.8% reported plans to stop HIV clinical care wholly or to decrease the number of people living with HIV in their practice over the next 5 years. The most common reasons for leaving include retirement, administrative burden, and burnout.

Abstract: Loneliness confers a significant risk to numerous health outcomes, including cognitive impairment. This study assessed the relationship between loneliness subtypes (social and emotional) and cognition in older people with HIV (OPWH ≥ 50 years). Forty-two participants (STET = 61.5 years; 48% male; 74% Black) completed the six-item De Jong Gierveld Loneliness Scale and measures assessing objective and subjective cognition and depressive symptoms (Patient Health Questionnaire [PHQ-9]). Loneliness-cognition associations were examined using linear regression. Models were first adjusted for age, sex, race, and education, and then PHQ-9 score. Mean emotional and social loneliness scores were 1.24 ( SD = 1.22) and 1.21 ( SD = 1.14), respectively. After sociodemographic and PHQ-9 adjustment, emotional, but not social, loneliness was associated with poorer objective cognitive performance on processing speed (Digit Symbol) and executive function (CalCAP™). Findings have potential clinical importance for interventions that target specific loneliness subtypes to optimize cognitive performance in OPWH.

Abstract: The purpose of our integrative review was to synthesize the literature examining relationships between depressive symptoms, silencing the self (STS), sexual relationship power (SRP), and HIV vulnerability among women in the United States. Literature searches were conducted through CINAHL, MEDLINE, PsycINFO, SCOPUS, Sociological Abstracts, and SocINDEX. Integrative review methodology of Whittemore and Knafl guided the review process, and 37 articles met inclusion criteria. The Theory of Gender and Power, modified by Wingood and DiClemente, was the guiding framework to organize and synthesize findings. Primary findings suggest that depressive symptoms, STS, and SRP in relationships may individually influence women's vulnerability for acquiring HIV, yet research lags behind. Evidence documenting relationships between these factors is insufficient to draw generalizable conclusions. Findings suggest that the current literature on this topic does not reflect those women most highly affected by HIV and those who identify as African American or Black in the Southeast region of the United States.

Abstract: At the onset of the COVID-19 pandemic, clinicians and researchers were concerned about its impact on the health of people living with HIV (PLWH). Although mitigation measures during the early part of the pandemic used telehealth, it was uncertain whether PLWH would be amenable to this type of care and whether health outcomes would be affected. PLWH actively seeking treatment at a large urban outpatient practice in Essex County, New Jersey, were interviewed from October 2020 to June 2021 about their health-related experiences during COVID-19. The sample was dichotomized by age (< 55 and ≥ 55). In all, participants (69.2%, n = 92) used telehealth during this period, 85.0% ( n = 113) actively tested for COVID-19, with only 7% ( n = 8) testing positive at the time of interview. Our findings demonstrate that PLWH who engaged with health care before the COVID-19 pandemic continued doing that and had relatively favorable health outcomes with few differences by age.

Abstract: This study quantitatively examined factors related to young men who have sex with men (YMSM)'s decisions to use pre-exposure prophylaxis (PrEP) by their history of PrEP use and qualitatively elicited their perspectives on PrEP options. Higher proportions of YMSM who had never used (vs. ever used) PrEP considered the following factors as important in their decisions to use PrEP: (a) Returning to PrEP follow-up visits ( p = .02), (b) having to talk about sex/PrEP with providers ( p = .013), (c) people assuming they are infected with HIV ( p = .021), (d) family finding out about their PrEP use ( p = .001), and (e) friends finding out about their PrEP use ( p = .008). Through inductive content analysis, qualitative data showed that a higher proportion of YMSM who had never used PrEP (vs. ever used) expressed concerns about HIV stigma from nonaffirming health care providers and the potential risk of inadvertently revealing their LGBTQ+ identity to others, which were described as potential barriers to PrEP use. Overall, our findings suggest that future interventions may consider tailoring PrEP messaging to YMSM's history of PrEP use, which may ultimately increase PrEP uptake and adherence.

Abstract: Smoking is a myocardial infarction (MI) risk factor among people with HIV (PWH). Questions persist regarding the role of smoking behaviors and measurements (e.g., intensity, duration) on MI risk. We used Cox proportional hazards regression to compare the association of smoking parameterization with incidents of type 1 and type 2 MI and whether smoking intensity or duration improves MI risk prediction among PWH. Among 11,637 PWH, 37% reported currently smoking, and there were 346 MIs. Current smoking was associated with type 1 (84% increased risk) but not type 2 MI in adjusted analyses. The type 1 MI model with pack years had the best goodness of fit compared with other smoking parameterizations. Ever or never parameterization and smoking diagnosis data had significantly poorer model fit. These results highlight the importance of differentiating MI types and performing patient-based smoking assessments to improve HIV care and research rather than relying on smoking status from diagnoses.

Abstract: This study explored the path affecting the quality of life (QOL) of people with HIV in China and clarified the applicability and interpretability of the Self-Regulatory HIV/AIDS Symptom Management Model. We conducted a cross-sectional survey in nine regions of China and collected information about demographics, symptom experience, social support, perceived symptom manageability, self-efficacy, and QOL. A total of 711 patients participated in this survey. After four rounds of path analysis were conducted, the most fit indices met the standards (χ 2 /df = 2.633, Root Mean Square Error of Approximation = 0.081, Goodness-of-Fit Index/Adjusted Goodness-of-Fit Index/Comparative Fit Index/Incremental Fit Index/Tucker-Lewis Coefficient > 0.9), and the relationships between variables were statistically significant ( p < .05). Among all the pathways, social support had the most significant impact on the QOL, with a total path coefficient of 0.665. Symptom experience, as a negative factor, had a total effect value of -0.361. This study showed how all the factors influencing QOL were interconnected, serving as a crucial theoretical foundation for intervention strategies in future clinical practice.