Journal of healthcare, science and the humanities最新文献

The new epicenter of the ongoing HIV epidemic in the United States is the South. Specifically, South Carolina (SC) is listed a priority state as part of the CDC's Ending the Epidemic Plan for America. A novel opt-out HIV screening program was implemented in one rural and one urban Emergency Department (ED) within a large SC health system. Leveraging both public and private funding sources, which made both the testing and linkage processes cost neutral, ED based screening was provided for 2304 Black patients which represents an 44% increase. As part of this screening program a total of 50 individuals were linked to care of which 29 were Black. The rate of HIV positivity for Black patients using this ED based screening program was nearly double that of the baseline health system screening. This program's utilization of the health system electronic health record (EHR) and funding from various sources may provide a model for legislative and public health entities to combat the HIV epidemic in the South.

With 118,000 cases in 114 countries and 4291 global mortalities, the World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020. The origins were believed to be from Wuhan, China, and SARS CoV-2, a coronavirus, was quickly identified as the causative organism. Researchers at the National Institute of Health Vaccine Research Center identified the spike protein as the critical portion of the virus that allows for attachment to human cells. In just 66 days after identifying the genetic sequence, the first COVID-19 vaccine candidate began the enrollment of human subjects into a Phase I clinical trial. This accelerated effort was due to a collective and collaborative global response. Currently, one COVID-19 vaccine has been approved and two others have received an emergency use authorization (EUA) from the United States Food and Drug Administration (FDA). Thus, there has been a clear comparison of the COVID-19 response efforts and that which was utilized in addressing the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. For over four decades, the HIV/AIDS epidemic has been historically defined by a disproportionate number of infections and related mortalities amongst racially and ethnically minoritized individuals, including those that identify as homosexual. While novel drug therapies have been developed for the treatment of HIV/AIDS; there have been key components employed amid the global health response to COVID-19, that have been absent from the management of the HIV/AIDS epidemic. Majorly, the development and availability of vaccine against HIV/AIDS. Many of the ideas and initiatives that have resulted in a positive COVID-19 response and the eventual successful vaccination development; have been those learned from the trial and error of mitigating increasing global rates of HIV/AIDS infections. Hence, the question remains as to whether the lessons and approaches learned during the COVID-19 pandemic, namely vaccination development, will be applied to managing the HIV/AIDS epidemic. Herein, we aim to compare the HIV/AIDS epidemic and COVID-19 pandemic, by describing how the fight against HIV/AIDs equipped global scientific leaders with effective strategies to overcome future public health crises (COVID-19), discuss the ethical considerations associated with the differences in the global health responses to the HIV/ AIDS epidemic versus the COVID-19 pandemic, and finally, identify lessons learned from the COVID-19 pandemic that can be applied to the quest for an HIV/AIDS vaccine..

Black women in the United States continue to be disproportionately affected by HIV. HIV testing is an important preventative step in the HIV continuum of care, however there is little known about HIV testing among these groups. Therefore, the purpose of this study is to examine the HIV testing behaviors of Black transgender women and explore differences in predictors of HIV testing among Black cisgender and transgender women. This study uses secondary data from the 2014-2017 modules of the Behavioral Risk Factor Surveillance System. Analyses included multiple hierarchical regression. There are no major differences in HIV testing between Black cisgender and transgender women. A number of sociodemographic characteristics have been shown to predict HIV testing among Black cisgender women, but only employment status and age were significant predictors of HIV testing among Black transgender women. A moderation analysis suggested that gender identity significantly moderates the association between employment status and HIV testing such that the relationship between employment status and receiving an HIV test differs by gender identity. The findings of this study highlight nuances in HIV testing among Black cisgender and transgender women that are useful for improving HIV testing as a mode of HIV prevention. Overall, the findings contribute to our understanding of HIV testing practices among Black cisgender and transgender women.

This study was conducted in Alabama's Black Belt Counties to examine the association between household food insecurity and self-reported health status. Data were collected from 400 households to measure household food insecurity and self-reported general health status using the U.S. Food Security Module. In bivariate analyses, household food insecurity was Policy changes to increase economic resources and access to federal food programs are needed to reduce household food insecurity in this region. Gendered experiences in the context of consequences of poverty should not be ignored.

Communications is a vital component of everyday life. Without it, many people may find it hard to survive in today's society. There is a multiplicity of ways to communicate, be it verbal or non-verbal. However, if the constructs of communication are misconstrued, it is worthless. Especially, when there is an urgency to save lives using communications. Health communications is one aspect that is critical for population health. If used properly, it can reduce the risk of epidemics and pandemics. Globally, HIV/AIDS became a pandemic in the early 1980s. The World Health Organization (WHO) reported by 2020, there were more than 55.9 million confirmed cases of HIV/AIDS and 36.3 million died from the dread disease worldwide. Out of these grave statistics, Black women are affected more than any other group by the HIV/AIDS pandemic. This article aims to shed light on this growing issue and set in motion an understanding how adequate health communications can eradicate Black women from the growing demise of HIV/AIDS.

African American women accounted for approximately 60% of new HIV diagnoses among women in the United States, with the greatest burden occurring in the South. Past efforts to prevent HIV focused on behavioral interventions aimed at reducing sexual risk behavior. More recent HIV prevention methods have included oral pre-exposure prophylaxis (PrEP) with antiretroviral drugs. Although PrEP has been designated as an effective HIV prevention method since 2012, awareness and uptake of PrEP remains low among African American women. Our study explored African American women's knowledge, perceptions, and willingness of PrEP use. Four focus groups were held in April 2019, consisting of 27 women, who identified as African American and resided in South Carolina. Focus group topics focused on participants' awareness, perceptions, and potential use of PrEP. The majority of women had heard of PrEP; however, over half of the participants were in the HIV or health field. Overall, participants believed that the "lay woman" would be unaware of PrEP. Participants' perceptions of PrEP included stigma of PrEP use, benefits to non-monogamous couples, and experiences with PrEP clients. The majority of women were willing to use PrEP, but major concerns around short and long-term side effects were expressed. Participants provided recommendations to improve PrEP uptake among African American women that included targeted campaigns and spokespersons. African American women are interested and supportive of PrEP use for HIV prevention in the South, where HIV rates remain highest. Past PrEP implementation efforts have not been relatable to African American women; therefore, awareness and uptake rates remain low. Future efforts to increase PrEP awareness and uptake among African American women should be relevant, and should provide comprehensive information on potential side effects, purpose of use, and eligibility criteria.

Despite increased life expectancy, mortality rates among women infected with HIV are 3-15 times higher than those in the overall population, HIV-infected women are also excessively affected by HPV and have increased risks of HPV-associated developments. This study's objective is to examine the relation between the ART treatment, CD4 levels, Pap, HPV and VIA tests with p16 detection among HIV-infected women. The data used in this study was collected by survey questionnaire instruments in 2009 in Kenya. Descriptive and explanatory statistics using frequency and chi-square/fisher's exact tests were performed for analysis using SAS-software. The data was stratified by age groups (30-39, 40-49, and 50 years and older). 75.28% of single HIV-positive women between the ages 30-39 participated significantly in the study, with a p-value of <0.0001. 52.24% of HIV-positive women 30-39 years old were most likely to receive ART treatment for less than two years by a margin of 11.2% compared to those who received the treatment for more than two years and those who were off treatment by a margin of 2.24% (p-value of 0.03). The HIV-positive women 30-39 years old had lower CD4 counts of less than 350 cells/μl (44%) and higher CD4 counts of 500 cells/μl or higher (46.64%). 45.3% of the HIV-positive women 30-39 years old were more likely to have positive VIA tests with a p-value of 0.05. 65.87% of HIV-positive women 30-39 years old were most likely to have positive VIA tests with a p-value of <0.05. HIV-positive women 30-39 years old were most likely to have high-risk HPV compared to their older counterparts. This study shows that incorporating screening strategies (Pap tests, VIA tests and HPV genotyping) in conjunction with ART treatment were more effective in preventing cervical cancer in HIV-positive young women 30-39 years old.

Background: Assuring health equity throughout the U.S. continues to challenge the public and private research enterprise. Even with some progress, racial and ethnic health disparities continue, particularly among African Americans. Health equity for African Americans is improbable unless participation in clinical trials is measurably increased.

Method: To inform efforts to enhance participation, interviews were conducted with three African American leadership groups from across the country to document their perceptions of why the research community is unable to engage African Americans effectively in clinical trials. The results of thirty-five interviews, conducted from three leadership groups, were analyzed and are reported in this article. The leadership groups include health/education, faith, and civic society.

Ethical considerations: This research was conducted based upon the ethical protocols of the National Center for Bioethics in Research and Health Care, research ethics, and confidentiality.

Results: Findings indicate that trustworthiness must precede trust; both are essential in enhancing African American participation in research, especially in less understood clinical trials.

Conclusion: Respondents agreed that the research community must demonstrate trustworthiness before trust can be established. They also indicated the importance of increasing the number of African American researchers in leadership roles. Also, suggestions were made regarding the need to develop short and long-term positive relationships between the research community and the African American population, at various levels, if increases in participation in clinical trials are expected. With the likely development of new clinical research and the attention to increasing excess deaths among African Americans, there must be representative numbers of African Americans and other underserved populations in leadership roles if health disparities are to be eliminated and health equity is to be achieved.