Fear Of Transmission Research Articles

The Role of Literature in Curbing the Spread of COVID-19

Coronavirus is one pandemic that has thrown the entire world into misery, fear and untold hardship. It has caused the death of many people all over the world. Unlike the dreaded HIV, coronavirus has no definite cause and its mode of spread is almost mystery. When contacted, HIV can be managed by those living with the virus and they can go about their normal businesses without fear of transmission. Coronavirus brought panic into the world, leading to total lockdown all over the world. The entire world was thrown into confusion and since 2020, efforts have been on top gear to demystify the virus as well as stop the spread. The researchers are of the view that literature is the effective means of fighting the virus and in this article, they have chronicled the dangers of the illness and proffered solution on how the spread of the virus could be tackled using Literature.

Stressors faced by healthcare professionals and coping strategies during the early stage of the COVID-19 pandemic in Germany.

BackgroundThe COVID-19 pandemic has exerted great pressure on national health systems, which have aimed to ensure comprehensive healthcare at all times. Healthcare professionals working with COVID-19 patients are on the frontline and thereby confronted with enormous demands. Although early reports exist on the psychological impact of the pandemic on frontline medical staff working in Asia, little is known about its impact on healthcare professionals in other countries and across various work sectors. The present cross-sectional, online survey sought to investigate common work stressors among healthcare professionals, their psychological stress as well as coping resources during the pandemic.MethodsA sample of 575 healthcare professionals (57% male) in three different sectors (hospital, prehospital emergency care, and outpatient service) reported their experiences concerning work and private stressors, psychological stress, and coping strategies between April 17, 2020 and June 5, 2020. To capture pandemic-specific answers, most of the items were adapted or newly developed. Exploratory factor analyses (EFA) were conducted to detect underlying latent factors relating to COVID-specific work stressors. In a next step, the effects of these latent stressors across various work sectors on psychological stress (perceived stress, fatigue, and mood) were examined by means of structural equation models (SEM). To add lived experience to the findings, responses to open-ended questions about healthcare professionals’ stressors, effective crisis measures and prevention, and individual coping strategies were coded inductively, and emergent themes were identified.ResultsThe EFA revealed that the examined work stressors can be grouped into four latent factors: “fear of transmission”, “interference of workload with private life”, “uncertainty/lack of knowledge”, and “concerns about the team”. The SEM results showed that “interference of workload with private life” represented the pivotal predictor of psychological stress. “Concerns about the team” had stress-reducing effects. The latent stressors had an equal effect on psychological stress across work sectors. On average, psychological stress levels were moderate, yet differed significantly between sectors (all p < .001); the outpatient group experienced reduced calmness and more stress than the other two sectors, while the prehospital group reported lower fatigue than the other two sectors. The prehospital group reported significantly higher concerns about the team than the hospital group (p < .001). In their reports, healthcare professionals highlighted regulations such as social distancing and the use of compulsory masks, training, experience and knowledge exchange, and social support as effective coping strategies during the pandemic. The hospital group mainly mentioned organizational measures such as visiting bans as effective crisis measures, whereas the prehospital sector most frequently named governmental measures such as contact restrictions.ConclusionThe study demonstrated the need for sector-specific crisis measures to effectively address the specific work stressors faced by the outpatient sector in particular. The results on pandemic-specific work stressors reveal that healthcare professionals might benefit from coping strategies that facilitate the utilization of social support. At the workplace, team commitment and knowledge exchange might buffer against adverse psychological stress responses. Schedules during pandemics should give healthcare workers the opportunity to interact with families and friends in ways that facilitate social support outside work. Future studies should investigate cross-sector stressors using a longitudinal design to identify both sector- and time-specific measures. Ultimately, an international comparison of stressors and measures in different sectors of healthcare systems is desirable.

The experience of pregnancy among women living with HIV in Nordic countries: A qualitative narrative enquiry.

Objective:The success of antiretroviral therapy has resulted in the normalization of pregnancy among women living with HIV and a very low risk of perinatal transmission of HIV. Despite these advances, women living with HIV still face complex medical and psychosocial issues during pregnancy. The purpose of this study is to describe experiences of pregnancy and the relevance of social support among women living with HIV in Nordic countries.Methods:This qualitative study examined data from pregnant women living with HIV from sites in Denmark, Sweden and Finland from 2019 to 2020. Data were collected in the third trimester via individual interviews using a hybrid, narrative/semistructured format. The transcribed interviews were analyzed using narrative thematic analysis.Results:In total, 31 women living with HIV were enrolled, of whom 61% originated from an African country and 29% from a Nordic country. The analysis generated four primary narrative themes: just a normal pregnancy, unique considerations and concerns, interactions with healthcare, and social support. Women living with HIV have a strong desire to have normal pregnancies and to be treated like any other pregnant woman. However, this normality is fragile, and being pregnant and living with HIV does come with unique considerations and concerns, such as fear of transmission, antiretroviral therapy, and the need for specialized care, which are fundamental to the women’s experiences. Interactions with healthcare providers and social support influence their experiences in both positive and negative ways.Conclusion:The findings emphasize a sense of normality in pregnancy among women living with HIV. However, pregnancy does come with unique considerations and concerns, which highly influence the women’s experience of pregnancy. Healthcare providers should focus on person-centered care, ensuring continuity and that women living with HIV do not feel discriminated against throughout their pregnancy.

706. Effect of the Covid-19 Pandemic on Rates of Recurrent Clostridiodes difficile Infection in the Veterans Affairs System

Background Clostridiodes difficile infection (CDI) is common and classified as an urgent threat by the US Centers for Disease Control and Prevention. Recurrence (rCDI) occurs in 30% of cases and increases with subsequent episodes. As part of a trial of fecal microbiota transplantation vs. placebo for the prevention of rCDI, rCDI is identified using a case-finding algorithm that screens for potential cases across all Veterans Affairs facilities, a key component of which is a stool test confirming the presence of C. difficile. With the emergence of Covid-19 in the Unites States in early 2020, study personnel observed a decreasing number of rCDI cases. We hypothesized that Covid restrictions and fear of transmission prevented patients from coming to a VA facility to submit a confirmatory stool sample, the standard method of diagnosing rCDI. Accordingly, the algorithm was modified to also identify cases where rCDI was empirically treated, without confirmatory testing. Here we report on the prevalence of empiric treatment of rCDI during the Covid pandemic and changes in lab-conformed cases over time.MethodsCases of potentially rCDI are identified by a weekly query of VA data, using an algorithm that includes laboratory testing results, diagnostic codes, and prescriptions. The ource database is updated daily from every VA facility, encompassing over 8 million Veterans. Potential cases are reviewed by research coordinators using the medical record to determine study eligibility. Beginning June 2020, the algorithm was adjusted to also identify patients with lab confirmation of their first CDI episode but none for their recurrence and identified those who were prescribed treatment for rCDI.ResultsWe observed a reduction in both the number of weekly cases (22.2 vs. 17.4; P < 0.001) which is a 22% decrease after the Covid-19 emergency declaration (figure). Post-declaration, empiric treatment was prescribed to 159 Veterans (mean, 3.3/week).Potential cases of rCDI/week pre- and post Covid-19 pandemic declaration ConclusionThere was a significant drop in laboratory-confirmed rCDI associated with Covid-19. Recurrent CDI was frequently empirically treated during the Covid-19 pandemic, potentially exposing many patients with non-CDI diarrhea to unnecessary antimicrobial use and its attendant risks.Disclosures All Authors: No reported disclosures

A survey to explore the psychological impact of the COVID-19 pandemic on radiation therapists in Norway and Canada: A tale of two countries.

IntroductionSeveral studies have demonstrated the psychological impact of the COVID‐19 pandemic on health care providers. However, there is little known about how the COVID‐19 pandemic has impacted radiation therapists (RTs) in Norway or Canada. The aim of this investigation was to study the psychological impact of working during the COVID‐19 pandemic among RTs in Canada and Norway.MethodsOnline surveys were administered to a convenience sample of RTs and RT department managers. Approximately 2000 and 300 RTs were invited to participate from Canada and Norway, respectively. The RT survey collected information on demographics, work‐related stressors, psychological impact, quality of life, and workplace support programmes. The RT manager survey collected information on departmental changes, patient volumes, staff shortages and redeployment, personal protective equipment, and infection control measures. Descriptive analysis, group comparisons and logistic regression were used to examine the impact of COVID‐19 on RTs in the two countries, while open‐ended questions were examined through thematic analysis.ResultsWork‐related stress and anxiety were prevalent among Canadian (n = 155) and Norwegian RTs (n = 124), with Canadian RTs reporting higher levels. Fear of transmission, changes in PPE usage, and changes in staffing were reported as the most frequent work‐related stressors. Themes related to working during the pandemic included: generalised anxiety; physical, emotional and cognitive symptoms of stress; and loneliness, as well as negative impact on health and quality of relationships. Survey findings from RT department managers in Canada (n = 12) and Norway (n = 13) suggest that the pandemic had an organisational impact on RT departments due to implemented infection control measures and changes in staffing.ConclusionThe COVID‐19 pandemic has led to similar stressors amongst Canadian and Norwegian RTs but relatively higher levels of psychological impact among Canadian RTs. Findings demonstrate the importance of mental health support programmes in the workplace to mitigate the psychological impact of the COVID‐19 pandemic on RTs.

The effect of COVID-19 on schoolteachers’ emotional reactions and mental health

BackgroundSchoolteachers play a major role in the society's response to the COVID-19 pandemic. When schools are open teachers are responsible for hindering spread of SARS-CoV-2, while carrying out their core task of teaching. This double role as well as the risk of infection may affect mental health in this occupational group. Therefore, we investigated schoolteachers' emotional reactions to COVID-19 and mental health during three phases of the COVID-19 pandemic in Denmark. We further analyzed if teachers, who belonged to a COVID-19 risk group, had more emotional reactions and poorer mental health than “non-risk” groups.MethodsWe collected questionnaire data in May, June, and November-December 2020 and used data from 2665 teachers employed at public schools (871 individuals participated in all three surveys). Participants reported their fear of infection, fear of transmission of infection to their home or pupils, perceived burnout and stress, and worries about their ability to manage the working conditions. We also had information about COVID-19 risk group status, sex, age, organization of teaching (physical presence or remote teaching), and the pupils' grade. We estimated prevalence ratios and took repeated measures into account.ResultsFear of infection and transmission of infection as well as burnout, stress, and worries increased statistically significantly with 27-84% from May to November-December 2020 (p < 0.05). We also found that teachers, who were particularly vulnerable to the adverse consequences of COVID-19, had the highest prevalence of fear of infection and poor mental health.ConclusionsThe dual role of teaching and virus control along with concerns regarding the health consequences of an infection may contribute to the observed increase in emotional reactions to COVID-19 and poor mental health from the beginning of the pandemic to the beginning of the second wave.Key messages The results raise attention to the working conditions, exposure to infection and mental health of teachers being in the frontline when schools were open during the COVID-19 pandemic.School teachers play a major role in pandemic control along with teaching obligations, which warrants allocation of resources, clear guidelines, and possibilities for protection from infection.

Rethinking Interior Design Approach for Shop House Food and Beverage Retails to Embrace New Normal Protocol

The 2020 COVID-19 outbreak has deeply redefined our relationship to public spaces. Fear of transmission (both direct and indirect) has strucked all sectors and put down public facilities such as schools, restaurants, and offices. The implementation of restrictions on community activities in Jakarta alone has resulted in 1030 restaurants permanently closed and 400 restaurants to temporary closed from early 2020 to 2021. Public preference has shifted to outdoor area with open air space to reduce the possibility of transmision. Therefore, shop house food and beverage retails that operated in big cities may find a challenge to keep the costumers' comfort. Keywords: shop house, new normal, food and beverage, retails

Quality of Life among Varanasi based Ayurveda Junior Resident Doctors Engaged in Covid-19 Care using WHO-BREF - A Cross-Sectional Survey

During the Coronavirus Pandemic, the Varanasi based Ayurveda junior resident doctors experiencing challenges in their quality of life following the covid19 related challenges. The challenges include; loss of many patients, deaths and illnesses of colleagues, fear of transmission to family members, personal risk of infection, inability to cope, personal isolation, population restrictions, and long shifts of work which affect their QOL and have received less attention from scholars. The study aimed at evaluating the quality of life of Ayurvedic medicine practitioners during COVID-19 pandemic. Methods and Material: Varanasi based Ayurveda junior residents from both urban and rural settings were approached for the cross-sectional survey. An online cross-sectional survey was conducted to collect the data and WHOQOL-BREF questionnaire was made available online on Google forms to the junior residents. The study population involved individuals within the range of 24-80 years. A sample size of 100 was selected from the target population using a convenience sampling procedure. The study identified two or more categories for each variable in the dataset; therefore, the chi-square test was used to examine the relationship between two or more unconditional variables. SAS 9.4 (Statistical Analysis System, Carry, NC, USA) tool was used to analyse the relationship between the categorical variables. P values were obtained for each variable.

Psychological Burden among Community-dwelling Older Adults with and without a History of a Recent Covid-19 Infection

ABSTRACT Objectives: The outbreak of Covid-19’s psychological burden to recovered vs. non-infected older individuals has not been compared yet. We aimed to perform a comparative analysis of psychological symptoms in community-dwelling older adults with and without a history of a Covid-19 infection. Methods: In this study, we utilized a geriatric care unit’s outpatient registry to prospectively enroll older adults with and without a history of Covid-19. An interviewer administered generalized anxiety disorder-2 (GAD-2), patient health questionnaire-2 (PHQ-2), six-item cognitive impairment (6-CIT), and post-traumatic stress disorder-5 (PTSD-5) tests over the phone. Correlation and multivariate logistic regression analyses were used to examine associations. Results: The study included 120 older subjects, 46 (38.3%) reported past Covid-19 infection. Anxiety and depression were both significantly more prevalent among subjects without a history of Covid-19. Having no history of Covid-19, female gender, and psychoactive medication use showed independent associations with the risk of depression symptoms among all subjects, and female gender was additionally associated with anxiety symptoms. Conclusion: This study showed that the risk of depression symptoms was higher in a sample of older adults who were not infected with Covid-19 compared to those recovering from the disease. Clinical implications: The impact of “fear of transmission” on the mental health of the elderly may be a significant issue to deal with. Older women are more prone to mental health risks by Covid-19.

Factors associated with work performance and mental health of healthcare workers during pandemics: a systematic review and meta-analysis.

Introduction Healthcare workers’ work performance and mental health are associated with positive mental health outcomes and directly related to increased productivity and decreased disability costs. Methods We conducted a systematic review to identify factors associated with work performance of healthcare workers during a pandemic and conducted a meta-analysis of the prevalence of mental health outcomes in this context. Primary papers were collected and analysed using the Population/Intervention/Comparison/Outcome framework and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To critically appraise the studies included in the review, we used the AXIS appraisal tool to assess each cross-sectional study’s quality. Results The study identified nine factors associated with the work performance and mental health of healthcare workers, including experiencing feelings of depression, anxiety, having inadequate support, experiencing occupational stress, decreased productivity, lack of workplace preparedness, financial concerns associated with changes in income and daily living, fear of transmission and burnout/fatigue. Conclusion There is a rapidly rising need to address the work performance and mental health of healthcare workers providing timely care to patients. Regular and sustained interventions, including the use of information and communication technologies such as telehealth, are warranted.

“I did not plan … that is what hurts”: Pregnancy intentions and contraceptive use among pregnant young women in KwaZulu-Natal, South Africa

Unintended pregnancy impacts many young women in South Africa, and rates of consistent contraceptive use among this population are suboptimal. Limited empirical work has investigated reasons for inconsistency between pregnancy intention and contraceptive use behaviour with data collected during pregnancy. We explored pregnancy intentions and discordance between intentions and contraceptive use prior to conception among young pregnant women in KwaZulu-Natal, South Africa. In-depth qualitative interviews were conducted with 35 women during pregnancy (mean age = 19.3; range = 18–21) in 2011 and 2012. Data were analysed using content analysis. All participants reported unintended pregnancies; almost half were not using contraception near conception. Reasons for not intending to become pregnant spanned personal, social, health, and economic domains. Participants living with HIV (n = 13) expressed specific concerns related to impacts of pregnancy on HIV disease management and fear of transmission of HIV to the infant. Discordance between pregnancy intentions and contraceptive use prior to conception was attributed to personal, social, health and structural domains. Findings indicate a need for interventions that address barriers to contraceptive use in order to minimise unintended pregnancy and support safe, desired pregnancies among young women.

"If I Get Cured, My Whole Quality of Life Will Change": Patients' Anticipated and Actualized Benefits Following Cure from Chronic Hepatitis C.

Patients' motivations for undergoing direct-acting antiviral (DAA) therapy for chronic hepatitis C may include anticipation of treatment benefits not well described in the literature. Evaluate patients' anticipated and actualized improvements in several domains of functioning before and after viral cure. Pre-post-study utilizing in-depth interviews with 28 patients prior to, and several months after, DAA therapy. Interviews were audio-recorded, transcribed, coded, and analyzed by two qualitative experts. Patients had a median age of 54years, 43% were male, 57% white, 25% had cirrhosis, and 71% were treated with sofosbuvir/ledipasvir. Pre-treatment, patients hoped for improvements in several domains including psychological, emotional, physical, social, and occupational functioning. After viral cure, increased energy and less fear of transmission were pathways to better quality of life. Psychological and emotional improvements positively affected physical, social, and occupational functioning. Social improvements were due to better mood and motivation, fewer symptoms, and reduced fear of stigma and transmission. Occupational benefits were linked to increased stamina, self-confidence, and less pain, anxiety, and stigma. Reduced fear of stigma had a pervasive impact on all life improvements after cure. Patient characteristics such as the presence of cirrhosis or psychiatric issues influence treatment motivations. Qualitative data correspond with change in pre-post-survey scores. Tremendous hope is placed on the ability of DAA therapy to bring about substantial improvements in life functioning after viral cure. Highly interconnected effects on quality of life worked synergistically through improved physical and psychological well-being. Stakeholders should appreciate the multi-dimensional benefits that viral eradication bestows upon individuals and society.

Positive Psychology in Times of Adversity: Pandemic and Well-being in Daily Life

Abstract&#x0D; Our life on earth often is dashed by hardships, losses, and crises. Naturally, these adverse life events and tragedies create doubt and disbelief about the meaning of life, and our human mind engaged with helplessness, despair, and negativity. However, human's physical and psychological immune systems have programmed through the evolutionary process of survival of the fittest. It makes us capable of overcoming the threats and adversities and showing greater resilience and courage to respond to the demand. At present, the COVID -19 pandemic has paralyzed human life in all aspects irrespective of the social, economic status across the world in 216 countries, areas, or territories. Pandemic causes panic, insecure feelings about life and death, fear of transmission of infection, and so on. The field of positive psychology studies human strengths and potentials that are the ingredients of our well-being, resilience, adjustment, and adaptation to any adverse situations of life. This review article attempts to show the relevance of positive psychology and how positive psychological adaptation and its constructs help to strengthen humankind in times of adversity.

PIN161 Validation of a Sexual Quality of Life Questionnaire in HIV and Hepatitis C (PROQOL-SEXLIFE)

Existing tools for sexual life are focused on erectile dysfunction and do not measure other domains, such as stigma, fear of transmission, or satisfaction, that are important for people living with HIV/AIDS or Hepatitis C. A 46-item pilot questionnaire was created based on interviews and then validated. Subjects were included in 5 countries (Australia, Brazil, Canada, France, USA). Sociodemographic and clinical data were collected. Besides the PROQOL-Sexlife, subjects completed questionnaires on sexuality (MSHQ, SRQ, FSFI) and the generic SF-12. Analysis was performed according to 3 different language groups (English, French and Portuguese) and different population subgroups (HIV+, HCV+, women, men having sex with men (MSM) and heterosexual men. An analysis by hierarchical classification was performed to explain the differences of sexual orientation. 1164 subjects were included (Australia: 175; Brazil: 360; Canada: 102, France: 393; USA: 134). Their infections were: 673 HIV, 365 HCV, 126 co-infection HIV/HCV and 92 HIV/HBV. 63% were female. Mean age was 49. 639 subjects were heterosexual, 465 homosexual, and 57 bisexual. High floor/ceiling effect, inter-item correlation, cross-loading or no clear loading were reasons to delete 23 items. Confirmatory analyses revealed different structure according to sexual practice: 4-factor structure with 23 items for women, 5-factor (23 items) for heterosexual, and 6-factor (22) items for MSM. PROQOL-Sexlife and SF-12 and other scores were logically correlated according to the concepts captured. PROQOL-Sexlife analysis highlighted the impairment of sexual quality of life and different structure in sub-populations. The questionnaire specific to HIV and HCV is available for use as an endpoint in clinical trials and epidemiological studies.

Challenges and strategies for effective plastic waste management during and post COVID-19 pandemic

The advent of the COVID-19 pandemic has enhanced the complexities of plastic waste management. Our improved, hyper-hygienic way of life in the fear of transmission has conveniently shifted our behavioral patterns like the use of PPE (Personal protective equipment), increased demand for plastic-packaged food and groceries, and the use of disposable utensils. The inadequacies and inefficiencies of our current waste management system to deal with the increased dependence on plastic could aggravate its mismanagement and leakage into the environment, thus triggering a new environmental crisis. Mandating scientific sterilization and the use of sealed bags for safe disposal of contaminated plastic wastes should be an immediate priority to reduce the risk of transmission to sanitation workers. Investments in circular technologies like feedstock recycling, improving the infrastructure and environmental viability of existing techniques could be the key to dealing with the plastic waste fluxes during such a crisis. Transition towards environmentally friendly materials like bioplastics and harboring new sustainable technologies would be crucial to fighting future pandemics. Although the rollbacks and relaxation of single-use plastic bans may be temporary, their likely implications on the consumer perception could hinder our long-term goals of transitioning towards a circular economy. Likewise, any delay in building international willingness and participation to curb any form of pollution through summits and agendas may also delay its implementation. Reduction in plastic pollution and at the same time promoting sustainable plastic waste management technologies can be achieved by prioritizing our policies to instill individual behavioral as well as social, institutional changes. Incentivizing measures that encourage circularity and sustainable practices, and public-private investments in research, infrastructure and marketing would help in bringing the aforementioned changes. Individual responsibility, corporate action, and government policy are all necessary to keep us from transitioning from one disaster to another.

Lessons Learned: Mitigating the Challenges of Urgently Threatening Antibiotic Resistant Pathogens in a Large Academic Medical Center

<h3>Background</h3> Care of urgently threatening antibiotic resistant pathogens such as Vancomycin Intermediate/Resistant Staphylococcus aureus (VISA/VRSA) and Carbapenem-resistant Enterobacteriaceae (CRE) poses unique challenged in managing care of critically ill patients in intensive care units (ICUs). Care of the patient, care of the environment, and compliance of infection control policies are priorities to uphold safety of the patient and the healthcare worker. <h3>Methods</h3> The Infection Prevention Program was notified from the laboratory of VISA positive and CRE positive patients residing in the hospital's Medical-Respiratory ICU. Patient's cases were individually reviewed for culture results, comorbidity, presence of invasive devices, laboratory values, and intact skin. Epidemiologic risk assessment was completed and the VISA/VRSA Policy was initiated in both instances. The policy includes recommendations consistent with Centers for Disease Control and Prevention's "Multi-drug resistant organisms (MDRO) Management Guidelines." (CDC, 2015). Several escalated interventions were determined to be prudent as a result of the epidemiologic risk assessment: addition of a 24-hour door monitor outside the patients' rooms, wearing sterile gown and trauma boots during wound care for the CRE-positive patient, and restriction of movement within the facility. <h3>Results</h3> Initial activation of the VISA/VRSA Policy was met with resistance from bedside staff secondary to staffing constraints, fear of transmission, confusion of risk involved, and misunderstanding of patient movement restriction. Resistance was lessened through timely intervention from Infection Preventionists, who formulated action plan as follows: consult help from hospital administration and allocate additional staff from the supplemental department, create and disperse education video on contact precautions, and develop schematics to guide actions when patient must leave floor for diagnostic exams. <h3>Conclusions</h3> Safe management of patients with high-risk MDRO's requires collaboration between Epidemiology, nursing, physicians, laboratory, environmental services, bed management, radiology, supplemental staffing and hospital leadership.

Treatment as prevention (TasP) and perceived sexual changes in behavior among HIV-positive persons: a French survey in infectious diseases departments in Paris

ABSTRACT We evaluated awareness of treatment as prevention (TasP) among adults people living with HIV (PLHIV) in five infectious disease departments in Paris, then how they perceived its impact on their sexual well-being. This cross-sectional multicenter survey was conducted in 2014 during scheduled clinical appointments using a self-administered questionnaire. We analyzed 520 questionnaires (42% women, 54% men of whom 57% were MSM [men who have sex with men]). 75% of women were born abroad, most commonly in sub-Saharan Africa, whereas 64% of men were French-born. The mean time since HIV diagnosis was 12.8 ± 7.8 years. Eighty-seven percent [84−90%]95 % reported being aware of the impact of ART on HIV transmission, 94% MSM, 86% women, 83% heterosexual men. PLHIV reported that they gained awareness of TasP through medical doctors (86%). The fear of transmission was perceived as alleviated for 73% [69%;78%]95%, more often among MSM; the sexual life was reported to be improved for 28% [24%;33%]95%; and ART adherence to be improved for 45% [40%;50%]95%, more often among women. The awareness of TasP was relatively high, but it seems important to understand the features of male and female populations of PLHIV to adapt counseling during follow-up appointments, as women's answers differed in various regards.

Satisfaction with sexual life in people living with HIV/AIDS: the persistent weight of the fear of transmission

ABSTRACTSexual life is an important dimension of quality of life, which may be affected by the fear of transmission in people living with HIV/AIDS (PLWHA), despite the fact that antiretroviral therapy prevents person-to-person transmission. We, therefore, aimed to explore the sexual life satisfaction of PLWHA and its correlation with their fear of HIV transmission and self-esteem. Consecutive adult PLWHA from seven HIV care facilities in the Rhone-Alpes region, France, were asked to complete a self-administered, anonymous questionnaire concerning sociological and medical data, satisfaction with sexual life (18 questions), and self-esteem (Rosenberg score). Overall, 690 PLWHA answered the questionnaire (mean age 49.2 ± 11 years); 74.9% were men, of which 75.1% had sex with men. Overall, 68.0% of respondents feared transmitting HIV (a lot/a bit). A lower satisfaction with sexual life was significantly associated with being female, not having a stable sexual partner, being unemployed, having a low income, experiencing a fear of HIV transmission, having lower self-esteem, and not reporting an excellent/very good health status. These results strongly suggest that the information concerning the antiretroviral-induced suppression of infectivity should be widely diffused, as this may enhance the quality of sexual life in PLWHA.

Preparedness and the importance of meeting the needs of healthcare workers: a qualitative study on Ebola

SummaryBackgroundHealthcare workers (HCWs) face specific challenges in infectious disease outbreaks, which provide unusual, new events with exposure risk. The fear of infection or new, unknown tasks in an unfamiliar setting, for example, may complicate outbreak management.AimTo gain insight into how healthcare organizations can prepare to meet the needs of their HCWs by capturing the experiences of HCWs with patients with suspected Ebola virus disease.MethodsWe conducted 23 in-depth interviews with HCWs, of whom 20 worked in a Dutch university hospital and three worked in a regional ambulance service. We invited HCWs who cared for patients with suspected Ebola or who were on the team preparing for admission of such patients in the period 2014–2015.FindingsThe HCWs were stressed and anxious, but most rated their overall experience as positive. We categorized the reported experiences in three main themes, namely, experiences related to: (i) the novelty of the threat, (ii) the risk of infection and fear of transmission, and (iii) the excessive attention. Our results underline the importance of a supportive working environment suitable for crises.ConclusionThe experiences of HCWs dealing with patients with suspected Ebola can direct improvements in generic preparedness for highly transmissible diseases.

HIV Treatment as Prevention: Implications for Health Promotion.

Evidence has been accumulating in recent years that individuals with HIV who are effectively treated with antiretroviral drugs are highly unlikely to transmit the virus to their sexual partners. This approach has great potential to contribute to ongoing prevention efforts and has been termed 'treatment as prevention'. International political momentum has been building in recent years to attempt to significantly reduce new HIV infections globally and end the epidemic by 2030. In pursuit of such aims a number of local health authorities and communities have adopted intensified 'test and treat' strategies to quickly diagnose infections and reduce the risk of onward transmission through an immediate offer of treatment. These have most commonly been driven through enhancements to clinical services and health promoters have been engaged in limited ways. People with HIV often have high rates of health literacy and are now expressing interest in knowing more about how treatment as prevention might work to reduce their individual risk of sexual transmission. For some this represents an added risk reduction measure and for others it may replace condoms. There is currently an opportunity for health promotors to engage with this approach both to exploit its prevention benefits and to counter the stigma that attaches to HIV infectiousness. It is hoped that any reduction in stigma and fear of transmission will help improve the quality of social and sexual relationships among affected groups.