Δευτέρα 21 Οκτωβρίου 2019

Thoughts on Nursing
No abstract available
Looking to the Future!
No abstract available
Transitions and Welcomes
No abstract available
Adverse Childhood Event Scores Associated With Likelihood of Missing Appointments and Unsuppressed HIV in a Southeastern U.S. Urban Clinic Sample
No abstract available
A Minority Within a Minority? Identity and Sexual Health in Black and Minority Ethnic Men Who Have Sex With Men in the United Kingdom
No abstract available
Tobacco, Alcohol, Drug Use, and Intimate Partner Violence Among MSM Living With HIV
imageMen who have sex with men (MSM) and are living with HIV have reported high rates of intimate partner violence (IPV) and substance use. We examined relationships between accumulative IPV, incidents of IPV, and numbers of substances used. One hundred twenty Taiwanese MSM living with HIV completed a cross-sectional survey. Accumulative IPV was assessed by summing the number of 15 types of IPV experienced in the previous year; substance use was measured by any use of alcohol, tobacco, or other drugs during the previous week. In multivariate analysis, IPV was not associated with tobacco use but was positively associated with alcohol and other drug use and significantly associated with the probability of using multiple substances. MSM living with HIV who experienced greater IPV were more likely to use alcohol and other drugs and were more likely to use more than one substance. Health care providers screening for IPV should also screen for substance use.
Adolescents in Scotland: Challenges and Opportunities for Sexual Risk Reduction
imageSexually transmitted infections, HIV, and unplanned pregnancy challenge the health of Scottish teens. We conducted focus groups with teens (ages 16–19 years) recruited from an urban youth cafe in Edinburgh and assessed sexual risk-taking and protective behaviors. A trained facilitator, using a semi-structured interview guide, led the groups. We taped and transcribed data verbatim for coding and theming. The teens revealed similar concerns despite differences in gender and/or sexual histories. Despite school-based sex education, sex was rarely discussed with peers or adults outside classrooms; the ability to practice communication and negotiation skills was minimal. Much risky behavior occurred in public spaces and was often linked to drug or alcohol intake. There was a glaring lack of teen planning for, or contemplating, future adult lives. Findings highlight the challenges these teens faced in practicing safer sex and limited opportunities to tailor intervention strategies to address the cultural realities of their lives.
Health Care Provider Perspectives on Pre-exposure Prophylaxis: A Qualitative Study
imageAlthough pre-exposure prophylaxis (PrEP) requires a prescription from a health care provider, we lack unanimity in guidelines for the identification of the ideal provider type to prescribe PrEP. The purpose of our study was to understand clinician perspectives on provider categories to determine who is best suited to prescribe this medication to HIV-uninfected patients. We conducted 28 in-depth interviews between September 2017 and January 2018 with current prescribers of PrEP. Qualitative findings indicated that providers were split on recommended PrEP prescriber type. Five themes emerged that centered on the explicit identification of the issue of opportunity for providers to educate their patients on PrEP and offer this medication to at-risk populations. To effectively maximize presentation for care and subsequently amplify uptake of PrEP, growing the base of providers who offer PrEP to eligible patients can provide a meaningful public health impact on reducing HIV incidence.
Occupational Stress and Burnout Among Health Care Workers Caring for People Living With HIV in Eswatini
imageWe used the Effort-Reward Imbalance Questionnaire and Copenhagen Burnout Inventory in our cross-sectional study to examine associations between occupational stress and burnout among 368 health care workers (HCW) who cared for people living with HIV (PLWH) in Eswatini. Chi-square and logistic regression analyses were conducted. HCW caring for PLWH reported high efforts, imbalanced effort-reward ratios, overcommitment, and low rewards. Health care managers, physicians, and nurses reported higher work efforts, effort-reward ratios, overcommitment, and personal, work-related, and client-related burnout than laboratory staff or peer counselors. HCW with high work efforts, effort-reward ratios, and overcommitment had significantly higher risks of having personal (odds ratio [OR] = 4.60), work-related (OR = 3.96), and client-related burnout (OR = 2.20). HCW with low rewards had a significant risk of having personal (OR = 3.13) and work-related (OR = 2.08) burnout. Our results suggested the need for policies to reduce work stress for HCW caring for PLWH.
A South African Couple-Based HIV Prevention Program: Preliminary Evidence of the Long-Term Effects
imageThe goal of our study was to provide qualitative data on the long-term effects of a couple-based HIV prevention program, the Couples Health Co-Op (CHC), in South Africa. Qualitative focus group discussions were conducted with nonrandomly selected Black South African men (n = 27) and women (n = 23) who had participated in the Couples Health Co-Op 4 to 6 years prior to our study. The study evaluated: (a) salient content and skills learned, (b) long-term changes and challenges, and (c) recommendations for intervention improvement. Findings revealed (a) communication/problem-solving, safe sexual behaviors, and negative effects of alcohol were most salient; (b) long-term changes occurred in communication and healthier sexual behavior; alcohol use remained challenging; and (c) participants recommended continuing the couple format and suggested targeting teenage couples. We offer preliminary evidence of the strengths and weaknesses of the Couples Health Co-Op and provide a basis for future studies to build on these results.

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