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

Abstract: The return of a migrant partner can negatively impact the sexual health of women who stayed in their communities. Understanding their sexual health needs is crucial for developing targeted interventions and support systems. Our study used a critical ethnographic approach in Agua Dulce, a rural community in Mexico, involving 50 key informants: women who stayed behind ( n = 20), returnees ( n = 12), community leaders ( n = 12), and health care professionals ( n = 6). We used participant observation, policy analysis, and interviews, using purposeful and snowball sampling methods. A gender-based thematic analysis revealed economic hardships and early separations affect the sexual well-being of women who stay behind. Infidelity, discovered through social media or calls, causes emotional distress and family disruptions. Male migrants spend an average of 8.85 years abroad, leading to fears of risky sexual behaviors. Our study highlights the urgent need for specialized support centers and comprehensive health interventions.

Abstract: Undetectable = Untransmittable (U=U) is a key message emphasizing that antiretroviral therapy suppresses HIV and prevents its sexual transmission. However, dissemination of U=U varies among health care providers, potentially leading to knowledge gaps among patients. Little research exists on the understanding of U=U among active duty men who have sex with men (MSM) in the U.S. military. Our cross-sectional, online study examines 222 active duty MSM to determine prevalence of accurate knowledge of U=U and demographic predictors of misinformation. Participants received a pre-exposure prophylaxis (PrEP) overview and were asked to indicate if the statement "Undetectable equals Untransmittable" was true or false. Although the majority accurately understood U=U (70%; n = 156), approximately 30% did not ( n = 66); a binary logistic regression revealed lower U=U understanding among White, bisexual, unmarried, and Marines/Navy participants. Standardized education on U=U is crucial for resolving knowledge gaps and combating stigmas surrounding HIV treatment.

Abstract: Stress and HIV disproportionately affect Latinx adults in the United States, contributing to numerous health inequities. Among people living with HIV (PLWH), increased stress is associated with decreased medication adherence, effectiveness, and higher rates of immunosuppression and comorbidities. Our study ( N = 126) examined the relationship between perceived stress and HIV-related health among Latinx ( n = 83) and non-Latinx White ( n = 43) PLWH. Latinx PLWH reported better HIV-related health outcomes than non-Latinx White PLWH, despite higher viral load (all p 's < .05). An interaction effect showed that higher perceived distress was associated with worse health outcomes and lower CD4+ T cell count only in Latinx PLWH ( p 's < .05). Our findings highlight the consequences of stress on HIV-related health. Notably, higher stress may be especially detrimental among Latinx PLWH, underscoring the need for more culturally tailored interventions in HIV-related care. Future research should include additional sociocultural factors and longitudinal assessment in a larger sample.

Abstract: Older adults account for one in every five new HIV infections in the United States yet are often overlooked in tailored pre-exposure prophylaxis (PrEP) messaging. The aim of this study was to evaluate the original PrEP messaging source and its influence on PrEP use among a cohort of older adults. The Columbus Health Aging Project data (N = 794) were used to examine the initial PrEP information source and PrEP use in the past 6 months, adjusting for demographics and sexually transmitted infection (STI) status. Forty-six percent reported an STI, and 11.5% used PrEP. The main sources of PrEP information were peers (42.2%) and health care providers (40.2%); media (17.6%) sources were less common. Compared with those who received PrEP information from their health care provider, those informed by peers (adjusted odds ratio [aOR] = 0.58; 95% confidence interval [CI]: 0.34-0.99) or media (aOR = 0.17; 95% CI: 0.07-0.42) were less likely to use PrEP. Adjusting for STI-, media-informed remained less likely to have used PrEP compared with those informed by providers (aOR = 1.14; 95% CI: 0.55-2.35). These findings highlight the importance of tailored PrEP messaging for older adults for Ending the HIV Epidemic efforts. Media appears less impactful as a messaging approach for older adults.

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.