HIV-related Issues Research Articles

Partnering and Programming for a Black, Indigenous, and People of Color Sexual and Gender Minority Pathway to HIV Research.

There is an urgent need to conduct innovative research on the health needs of populations whose intersecting identities, such as being Black, Indigenous, and other People of Color (BIPOC) and sexual and gender identity (SGM) persons, put them at greater risk of HIV infection. More so, as important as it is to train on the best practices, it is as important to train aspiring BIPOC SGM scholars in intersectional HIV science so that they can address the HIV-related issues of BIPOC SGM populations. In line with guidelines to increase diversity in the HIV workforce, we sought to (1) solidify the interest of BIPOC SGM trainees engaging in intersectional HIV science by piloting a 2-week Summer Intensive Program, (2) leverage the relationships and resources of our community partner to enhance our recruitment from HBCUs and MSIs, and (3) identify opportunities for postprogram training and mentoring activities. Our data suggest that participants gained a great deal from the instructional sessions. Participants commented on the quality of the sessions, effectiveness of the instructional faculty, and a confirmed interest in HIV science. We succeeded in promoting interest in and commitment to HIV science among early career BIPOC SGM scholars. An instructional program of this intensity is best suited to those with some experience in graduate school and existing interest in HIV science. As a program serving multiply minoritized populations, clarification of host institution policies and procedures, as well as administrative support, are essential for ensuring a smooth experience for scholars visiting from outside institutions.

Effectiveness of peer assisted learning in improving HIV knowledge, attitude, and perception among community health workers

Background: Community health workers (CHWs) act as a bridge between community and clinical care in caring for HIV patients. This study aimed to evaluate the effectiveness of peer education in improving HIV knowledge, attitude, and perception of CHWs in Babol, Iran in 2019. Methods: This was a quasi-experimental study conducted among CHWs in the health centers of Babol, Iran. The city was divided into two areas of the North and the South according to the geographical map. Then, based on the list of the health centers in each of the areas, one health center was randomly selected and assigned to either the experimental or the control group. Results: Following peer education, all study variables including knowledge score, attitude, and perception about HIV-related issues significantly improved in the experimental group compared to the pre-intervention phase (P=0.002, P=0.02, and P=0.00 respectively). The most significant change was in misconception score with a approximately large effect size (0.78), presenting an increase of 95.53% from 15 to 29.33 after the intervention, while attitude and knowledge respectively presented 85.04% and 81.07% increase with a smaller effect size of 0.57 and 0.52. Conclusion: In the study peer education proved to be an effective strategy in improving the knowledge, attitudes, and perception of CHWs concerning HIV/AIDS. Therefore, the peer-to-peer training model can fill a critical gap in the training of CHW based on the idea that not only do the CHWs themselves need to enhance their knowledge of related topics but they also need to train others. In turn, this will result in providing cost-effective health promotion and prevention services in a more culturally appropriate manner.

Health Behaviors and Attitudes Toward HIV Clinic Among Young Men who Have Sex with Men Living with HIV in Chiang Mai, Thailand: A Mixed Methods Study.

Today, many young men who have sex with men (YMSM) with a new HIV infection were diagnosed and successfully linked to HIV services. Studies on their health behaviors while living with HIV and their attitude toward the HIV clinic are scarce. We characterized common health behaviors of YMSM and assessed their perspective towards the existing HIV services. We collected data from a self-administered questionnaire and in-depth interviews (IDI) using a mixed-method cross-sectional study design. A hundred YMSM, aged 18-24, who attended the HIV clinic were enrolled. Their median age was 23 years (interquartile range, IQR 21-24). Eighty-four (84%) were gay men. Their common health behaviors included 15 (15%) being current smokers and 30 (30%) using alcohol regularly. Sixty-four (64%) reported > 95% antiretroviral treatment adherence, while 32 (32%) self-reported adherence at 80-95%. Fifty-three (53%) reported 100% condom use, while 30 (30%) reported using a condom in > 80% of their sexual activities. From the questionnaire respondents, individual characteristics of providers were the most critical factor affecting participants' willingness to attend HIV services. From the IDI, social disclosure of HIV status was their primary concern, with the presence of self- and anticipating HIV-related stigma issues. In summary, YMSM living with HIV who regularly attended the HIV clinic had a low frequency of health risk behaviors. Most did not socially disclose their serostatus but could manage their health. They were generally satisfied with patient-friendly services while calling to protect their confidentiality and privacy.

HIV-sensitive social protection: an assessment of east and southern Africa’s social protection policies and programmes

Despite notable political and financial commitment to fight the HIV epidemic, east and southern Africa (ESA) remains the world regions most affected. Given increasing calls for the implementation of HIV-sensitive social protection programmes to address the multiple individual, community and societal factors that heighten the risk of HIV infection, this article explores the extent to which social protection mechanisms in the region are HIV sensitive. The article is based on a two-phase project where the first phase entailed a desktop review of national social protection policies and programmes. In the second phase, multisectoral stakeholder consultations conducted were 15 fast-track countries in the region. The key findings suggest that social protection policies and social assistance programmes in ESA do not specifically target HIV issues or people living with, at risk of, or affected by HIV. Rather, and in line with the countries’ constitutional provisions, the programmes tend to be inclusive of the vulnerabilities of various populations including people living with HIV. To this end, the programmes can be seen as generally sufficient to encompass HIV-related issues and the needs of people infected and affected by the epidemic. However, a recurring argument from many stakeholders is that, to the extent that people living with HIV are often reluctant to either disclose their status and/or access social protection services, it is critical for social protection policies and programmes to be explicitly HIV sensitive. The article thus concludes by making recommendations in this regard as well as by making a class for multisectoral partners to work collaboratively to ensure that social protection policies and programmes are transformative.

Integration of Common Elements Treatment Approach (CETA) into public sector HIV clinics for unhealthy alcohol use in urban Zambia: Qualitative evaluation on acceptability and feasibility

BackgroundIn Sub-Saharan Africa, unhealthy alcohol use (UAU) is a growing threat to achieving ‘the last mile’ towards ending AIDS by 2030. Common Elements Treatment Approach (CETA) is a multisession transdiagnostic cognitive behavioral therapy protocol that can treat a range of common co-morbid mental and behavioral mental health problems, including UAU. In a randomized controlled trial (RCT), we previously reported that CETA was clinically effective in reducing UAU and mental health comorbidities among PWH in Zambia. In this qualitative evaluation we sought to explore health worker, key policymaker and patient perspectives on the acceptability and feasibility of integrating CETA within existing HIV services. MethodologyWe conducted focus group discussions (FGDs) with PWH who reported alcohol use, lay and profession HIV clinic staff, and key informant interviews with policy-makers. Following trial completion, we conducted in-depth interviews (IDIs) among people with HIV and UAU who received CETA, and HIV peer counsellors that provided CETA. Data were transcribed verbatim and analyzed in NVivo 12 using thematic analysis. Emerging themes were organized according to acceptability and feasibility. ResultsAll participant types reported CETA to be acceptable due to the perceived need and relevance to HIV-related behavioral health issues. HIV peer counselors, successfully provided CETA with a rigorous supervision structure using an apprenticeship model. Participants receiving CETA also remained motivated throughout the sessions as they learned new problem-solving skills, which they continued to use following the close of the study. Implementation factors related to limited behavioral health infrastructure, workloads, and human resources were seen as challenges to the scale-up and sustainability of CETA within HIV care. ConclusionCETA was feasible and acceptable at 2 urban sites in Zambia. Future studies integrating of CETA into HIV care should consider implementation factors such as infrastructure, workloads, and human resources to support integration into HIV care.

Scholarly literature in HIV-related lesbian, gay, bisexual, and transgender studies: A bibliometric analysis.

Lesbian, gay, bisexual, and transgendered (LGBT) people are marginalized and understudied. Analyzing research activity worldwide is vital to better understand their needs in confronting the HIV epidemic. This study aimed to evaluate the global literature to identify the research collaboration, content, and tendency in HIV-related issues among the LGBT populations. Peer-reviewed original articles and reviews were achieved from the Web of Science Core Collection database. Country's collaborations and co-occurrence of most frequent terms were illustrated by VOSviewer software. The Latent Dirichlet Allocation (LDA) and the linear regression model were utilized to uncover the hidden topics and examine the research trend. From 1990 to 2019, a total of 13,096 publications were found. Stigma, sexual risk behaviors and HIV testing were the major topics in the LGBT research during the study period. Among 15 topics, topics about HIV/Sexually transmitted infections (STIs) prevalence, Outcomes of HIV/AIDS care and treatment, and Opportunistic infections in HIV-positive LGBT people showed decreasing attention over years, while other topics had a slight to moderate increase. Our study underlined the exponential growth of publications on the LGBT population in HIV research, and suggested the importance of performing regional collaborations in improving research capacity. Moreover, further research should focus on examining the manner to increase the coverage of HIV testing and treatment, as well as implement HIV-interventions with low cost and easy to scale-up.

Patient-Friendly Information Giving in HIV Counselling through the Use of Metaphors

HIV counselling is a method of communication between patients and certified HIV nurse counsellors to discuss and help patients deal with HIV-related issues. Despite the training received by these nurses, communicating HIV-related issues remains a difficult task in Malaysia. Due to lack of research examining information giving in HIV counselling in Malaysia, this study investigated both the challenges and the strategies in providing information to HIV patients. Twenty-four audio recordings of actual HIV counselling sessions were gathered and six focus group discussions with HIV nurse counsellors from three government hospitals in Malaysia were recorded. The discourse analysis of revealed a prominent use of metaphors as part of information giving strategies to overcome the challenges faced by HIV nurse counsellors when communicating with HIV patients. The metaphors were embedded in HIV nurse counsellors’ information giving to HIV patients and their spouse/family as a way to represent some medical jargons pertaining to HIV. Since the HIV patients came from different educational background, it would be much easier for them to understand HIV-related information giving through the use of metaphors. Therefore, the acknowledgement and integration of metaphors can be an amazingly valuable tool for HIV nurse counsellors especially in managing the communication challenges during HIV counselling. It is hoped that the findings provided in this study will serve as a basis for integrating metaphors into counselling practices.

Internalized Homonegativity and Mental Health Among Chinese Gay and Bisexual Cisgender Men: Exploring the Moderating Influences of Psychosocial and Sexual Identity Factors.

Much research on Chinese gay and bisexual men has focused on sexual health and, in particular, HIV-related issues. However, relatively little research has considered psychosocial aspects of being a gay or bisexual man in China. The present study was designed to address this gap by examining psychosocial predictors of mental health from a minority stress perspective. Results from an online survey of 1,786 Chinese gay and bisexual cisgender men revealed that higher levels of internalized homonegativity predicted greater psychological distress and a lower sense of positive well-being. Higher self-esteem, social support, and resilience were strong predictors of lower psychological distress and higher well-being, but these psychosocial factors mostly did not moderate associations between internalized homonegativity and mental health. A stronger sense of sexual identity superiority weakened the associations between internalized homonegativity and both mental health measures, but sexual identity centrality only moderated the association between internalized homonegativity and positive well-being. This study is among the first to examine minority stressors and psychosocial factors, distinct from the HIV-focussed literature, in a Chinese context. These findings may inform interventions targeting increased self-esteem, social support, and resilience, which could be beneficial for the mental health of Chinese gay and bisexual cisgender men.

Stigmatizing Attitudes toward People Living with HIV among Young Women Migrant Workers in Vietnam.

Despite intensive HIV education and prevention efforts in the past few years, stigmatizing attitudes toward people living with HIV (PLWH) remain a major barrier to HIV prevention and treatment efforts in Vietnam. The purpose of this study was to examine the prevalence of stigmatizing attitudes regarding HIV and identify correlative factors that impact the perceptions of PLWH among a heretofore overlooked demographic in Vietnamese society: women who are migrant workers in designated industrial zones (IZs). A cross-sectional study was conducted among 1061 women migrant workers aged 18 to 29 from January 2020 to November 2020 in Hanoi, Vietnam. Stigmatizing attitudes toward PLWH were measured using a four-item scale. Multiple logistic regression was conducted to examine the factors associated with stigmatizing attitudes. Our findings indicate both substantial levels of stigma persisting among this demographic group as well as the influence of important mitigating factors on the expression of HIV-related stigma. Over seventy-six percent (76.2%) of the participants reported having at least one of the four stigmatizing attitudes. Greater levels of stigmatizing attitudes toward PLWH were significantly associated with lower HIV knowledge, lower levels of education, and identifying as Kinh (the ethnic majority in Vietnam). Additionally, this study found that questions framing HIV infection through a familial lens were significantly associated with lower rates of stigmatizing responses. The high overall levels of stigmatizing attitudes toward PLWH among the study participants suggests that there is an urgent need for the development of culturally appropriate interventions and outreach education activities to reduce stigmatizing attitudes toward PLWH among women who are migrant workers working in the IZs in Vietnam. This study adds to both the existing literature and current efforts and policies around HIV in Vietnam by empirically suggesting that familial-based messaging may be a powerful potential narrative for interventions addressing HIV-related issues such as stigma.

The relationship between acceptance of illness and quality of life among men who have sex with men living with human immunodeficiency virus: A cross-sectional study

ObjectivesTo explore the relationship between acceptance of illness and quality of life (QOL), and factors associated with acceptance of illness among men who have sex with men (MSM) living with human immunodeficiency virus (HIV). MethodsThree hundred and one MSM were recruited from an HIV clinic between August and December 2018. The battery of measurements consisted of the Acceptance of Illness Scale, World Health Organization Quality of Life Questionnaire for HIV brief version, HIV Cognitive Appraisal Scale and a self-designed questionnaire used to collect general information. Pearson correlation test was used to examine the relationship between acceptance of illness and QOL. Univariate and multivariate ordinal logistic regression analyses were used to examine whether the general data (demographic and HIV-related clinical data) and HIV cognitive appraisal were associated with acceptance of illness levels. ResultsDescriptive analysis showed the acceptance level among MSM living with HIV was moderate (Mean = 26.29, SD = 5.28). Those with a better acceptance of illness had a better QOL (r = 0.69, P < 0.01). In the multivariate ordinal logistic regression model, education level, threat appraisals (OR:1.09; 95%CI [1.06–1.13]), and controllability appraisals (OR: 0.82; 95%CI [0.71–0.94]) were significantly associated with acceptance of illness. ConclusionsResults showed acceptance level was moderate and had a positive correlation with QOL. High level of education, low threat appraisals and high controllability appraisals were related to high illness acceptance. This finding highlights the importance of focusing on HIV-infected MSM with low education and on their perceptions of threat and controllability about HIV-related issues when designing interventions to promote illness acceptance in this vulnerable population.

Uganda Public Health Fellowship Program's Contributions to the National HIV and TB Programs, 2015–2020

Despite remarkable progress in controlling HIV and TB, Uganda is one of the 30 high-burden TB/HIV countries. Approximately 53,000 Ugandans had a new HIV diagnosis in 2019, and approximately 88,000 Ugandans had a TB diagnosis in 2020. Fellows in the Uganda Public Health Fellowship Program (UPHFP) work directly with the Ministry of Health AIDS and TB Control Programs, the U.S. Centers for Disease Control and Prevention, UPHFP supervisors, and implementing partners to investigate and evaluate HIV-related and TB-related issues. These activities have contributed to the Uganda HIV and TB programs. UPHFP fellows complete projects in 7 competency domains, including outbreak investigations, surveillance evaluations, and data quality improvement. Priority HIV/AIDS/TB information gaps/topics are identified in consultation with key stakeholders, and fellows complete projects to guide program improvements and policy decisions. During 2015-2020, UPHFP fellows implemented 127 HIV and TB projects covering key program areas in AIDS and TB control programs, including care and treatment (16 projects), TB/HIV (18), prevention of mother-to-child HIV transmission (24), key and priority populations (9), pre-exposure and post-exposure prophylaxis (7), adolescent girls and young women (6), service delivery (13), and diagnosis of TB including drug-resistant TB and TB in high-risk groups (32). These projects have helped improve retention, quality of care, and treatment outcomes for people living with HIV, HIV and TB coinfected patients, and TB patients. They have also contributed to the decrease in pediatric TB and infant HIV positivity rates and improved service delivery for key populations. UPHFP results were disseminated to relevant stakeholders such as government departments, implementing partners, districts, and the general community and guided decision making. UPHFP has significantly improved HIV and TB control in Uganda. Other countries with similar programs could benefit from this approach and utilize program fellows to support HIV and TB control.

Individual and Community Level Factors Related to HIV Diagnosis, Treatment, and Stigma in Kumasi, Ghana: A Field Report

The human immunodeficiency virus (HIV) is a public health issue globally and in Ghana. While efforts are underway to reduce HIV prevalence in Ghana, there are still some HIV-related issues (duration lived with HIV, mode of HIV diagnosis, HIV status disclosure, HIV treatment, HIV knowledge, and HIV prevention and stigma) that need to be addressed. The purpose of the field study was to examine individual and community level factors related to HIV diagnosis, treatment, and stigma in Kumasi, Ghana. Specifically, we conducted a field-based comparison of HIV-related issues in Kumasi and the US to determine areas of similarities and differences. Since our focus was the Kumasi district in general, and the Suntreso Government Hospital in particular, we used convenient sampling. Thus, study results are not generalizable to the entire population of Ghana. Given the short duration of the entire field study (three weeks) and the fact that most information on the HIV-related issues focused in Ghana are available in the US, secondary data from various sources were used for the US comparison. Results from the study showed that 29.2% of participants in Kumasi had lived with HIV for seven or more years, while data from the US showed that people generally live with HIV for 20 years or more after testing positive for the disease. Most of the study participants in Kumasi (68.5%) stated that they were diagnosed with HIV through a laboratory blood sample test, while rapid antibody and ELISA (enzyme-linked immunosorbent assay) tests were found to be the most commonly used methods in HIV diagnosis in the US. The majority of participants living with HIV in Kumasi (71.7%) and the US (67%) were concerned about their friends and family knowing of their HIV status. Unlike the US where patient assisted programs administered by pharmaceutical companies offer free to lowly priced HIV medication to low-income people living with HIV (PLWH), 92.7% of PLWH in Kumasi had free access to HIV medication. HIV-related stigma was an issue in both Kumasi and the US. Copyright © 2022 Mosley et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Ngos, Sex Workers’ Movement and HIV: A Case of Bangladesh

Following eviction from several brothels, the sex workers of Bangladesh started their movement in the 1990s. Through their activism, the sex workers demanded their rights. Just about the same period, NGOs were working with the sex workers on HIV-related issues focusing on their empowerment alongside condom promotion. Through their involvement with the NGOs and HIV programmes, the sex workers have gained visibility in the public domain. Due to availability of funds from the NGOs sex workers were able to participate in international gatherings where they learnt about sex work as a form of labour. In claiming their rights, the sex workers exhibited active agency which corresponds to pro-sex work feminist discourse. However, despite some positive outcomes of the sex workers’ movement, the demand for their rights became blurred as they got more and more involved in the arena of HIV. Using a feminist methodology, this article draws on the experiences of women’s rights activists, sex worker activists as well as sex workers to understand the trajectory that the struggles of the sex workers have taken place due to their involvement with NGOs and HIV-related programmes. In doing so it explores the nature of such interrelationship from the perspective of the global south. Social Science Review, Vol. 38(1), June 2021 Page 157-174

HIV stigma in Kenya: A family medicine led community orientated primary care approach.

The Kenyan Ministry of Health envisages that family physicians should play an important role in the implementation of community orientated primary care (COPC) in collaboration with the community health team. The Kenyan Community Health Strategy forms a solid basis for the implementation of the COPC model. Residents and faculty of the Family Medicine department at the Aga Khan University Hospital Nairobi collaborated with the Kaloleni sub-county of Kilifi County government near Mombasa in a five-step COPC process to better understand and act against the high prevalence of HIV stigma in the coastal region. Firstly, a deeper understanding of human immunodeficiency virus (HIV) stigma was acquired through community visits and work in the comprehensive care clinic. Secondly, a collaborative implementation team was formed to design a targeted and feasible intervention. In a participatory approach, a two-step intervention was employed, firstly sensitising healthcare workers and community health volunteers (CHVs) on the high prevalence of HIV stigma in their community and educating them on HIV-related issues. Secondly, the information was disseminated to the community through home visits by CHVs, health talks and the set-up of an HIV support group at the facility. This short report illustrates the important contribution of family physicians to implementation of COPC and capacity building of the primary healthcare team.

Utilizing Big Data analytics and electronic health record data in HIV prevention, treatment, and care research: a literature review

ABSTRACT Propelled by the transformative power of modern information and communication technologies, digitalization of data, and the increasing affordability of high-performance computing, Big Data science has brought forth revolutionary advancement in many areas of business, industry, health, and medicine. The HIV research and care service community is no exception to the benefits from the availability and utilization of Big Data analytics. Electronic health record (EHR) data (e.g., administrative and billing data, electronic medical records, or other digital records of information pertinent to individual or population health) are an essential source of health and disease outcome data because of the large amount of real-world, comprehensive, and often longitudinal data, which provide a good opportunity for leveraging advanced Big Data analytics in addressing challenges in HIV prevention, treatment, and care. This review focuses on studies that apply Big Data analytics to EHR data with aims to synthesize the HIV-related issues that EHR data studies can tackle, identify challenges in the utilization of EHR data in HIV research and practice, and discuss future needs and directions that can realize the promising potential role of Big Data in ending the HIV epidemic.

The wound that closes doors: Lived experiences and complexities of injection-related injuries and infections among people who inject drugs through an ethnographic lens.

Besides HIV, people who inject drugs (PWID) experience other biomedical adversities, including injection-related injuries and infections. Yet, they are often inadequately addressed due to the prioritisation of HIV-related issues. This article explored the risk environment and socio-structural adversities of PWID living with injection-related injuries and infections, as well as existing management and treatment challenges of these conditions in harm reduction interventions. We undertook an ethnographic study from April 2018 to December 2019 in selected areas of Dhaka, Bangladesh. This component of the study involved 2500 hours of observations and informal conversations, 35 in-depth interviews and five focus group discussions with PWID experiencing injection-related injuries and infections. We also performed seven key-informant interviews with service providers and clinical experts. We applied thematic analysis and used various theoretical social scientific conceptualisations to analyse the relationship between the biomedical realities and socio-structural vulnerabilities of PWID. Our findings indicated that PWID's physical, legal and socio-economic environments predisposed PWID to risky practices which ultimately precipitated injection-related injuries and infections. These injection-related injuries and infections consequently displaced them in spheres of social exclusion, stigmatisation, physical pain and disability and, hence, fueled their feelings of distress and despondence. Our findings also presented limitations in the management strategy of these injection-related injuries and infections. Specifically, service providers misconstrued all these complexities as "abscesses", thus applying a simplistic "one-size-fits-all" approach without accounting for the diversity of these complexities. This led to a paucity of tailored care and management approaches which could precipitate unfavourable treatment outcomes, such as chronic and complicated cases with antibiotic resistance. Injection-related injuries and infections nestled PWID within various prongs of biomedical and socio-structural adversity, without viable and targeted treatment modalities. Thus, it is integral to nurture a multifaceted harm reduction intervention tailored to their biomedical and socio-structural needs.

Evaluation of an integrated treatment to address smoking cessation and anxiety/depressive symptoms among people living with HIV: Study protocol for a randomized controlled trial

BackgroundInterventions that target anxiety/depressive symptoms in the context of smoking treatment have shown promise irrespective of psychiatric diagnosis. Yet, these tailored treatments are largely absent for persons who smoke and are living with HIV (SLWH). ObjectiveTo evaluate a novel, smoking cessation intervention that addresses anxiety/depression and HIV-related health (QUIT) against a time-matched control (TMC) and a standard of care (SOC) condition. MethodsSLWH (N = 180) will be recruited and enrolled from 3 medical clinics in Boston, MA, and Houston, TX. The trial will consist of a baseline assessment, a 10-week intervention/assessment period, and follow-up assessments, accounting for a total study duration of approximately 8 months. All participants will complete a baseline visit and a pre-randomization standardized psychoeducation visit, and will then be randomized to one of three conditions: QUIT, TMC, or SOC. QUIT and TMC will consist of nine 60-min, cognitive behavioral therapy-based, individual weekly counseling sessions using standard smoking cessation counseling; additionally, QUIT will target anxiety and depressive symptoms by addressing underlying mechanisms related to mood and quit difficulty. SOC participants will complete weekly self-report surveys for nine weeks. All participants will be encouraged to quit at Session 7 and will be offered nicotine replacement therapy to help. ConclusionsQUIT is designed to improve smoking cessation in SLWH by addressing anxiety and depression and HIV-related health issues. If successful, the QUIT intervention would be ready for implementation and dissemination into “real-world” behavioral health and social service settings consistent with the four objectives outlined in NIDA's Strategic Plan.

Analysis of the Competence in Prevention of the Spread of HIV Infection among High School Students of the Nizhny Novgorod Region

Introduction: Solution of the problem of prevention of the spread of HIV infection among adolescents and young adults is associated, inter alia, with systemic implementation of primary prevention strategies in educational establishments aimed at developing the necessary level of expertise in health risk management in students. The objective of our study was to determine the level of competence of adolescents in the field of HIV spread prevention Materials and methods: The technique of an online survey was used to establish the competence of high school students aged 15–17 living in the Nizhny Novgorod Region and to compare its level between boys and girls. Results: The level of competence was determined by four basic scales (emotional, cognitive, practical, and the scale of actions) and the additional scale of erudition. The level of general competence of the respondents was found to be high. Girls had significantly higher scores by all scales (p &lt; 0.001) compared to boys. The erudition component was most prominent in both subgroups. The emotional component (empathy) was more important for girls. We noted differences in the significance of individual aspects of the assessed competence. Of the four priority strategies of HIV epidemic spread prevention, the respondents chose health care management and effective interaction of responsible structures as key factors in disease spread stop (р &lt; 0.001). Conclusion: Promoting competence in HIV spread prevention among students for their effective social interaction in HIV related issues is an important outcome of preventive activities at schools. The content and forms of their implementation should facilitate students’ ability and readiness to self-protection, self-improvement, and mastering skills of predictive behaviour. Evaluating the level of competence and intensity of its components, setting priorities in choosing areas of applying efforts to reduce the risk of HIV epidemic growth can make prevention efforts more targeted.

Epidemiology of HIV in Iran.

Iran has been one of the active countries fighting against HIV/AIDS in the Middle East during the last decades. Moreover, there is a strong push to strengthen the national health management system concerning HIV prevention and control. In Iran, HIV disease has its unique features, from changes in modes of transmission to improvement in treatment and care programs, which can make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from the first case diagnosed until prevention among different groups at risk and co-infections. Not only we addressed the key populations and community-based attempts to overcome HIV-related issues in clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific characteristics, and despite all the national efforts along with other countries in this region, Iran still needs to take extra measures to reduce HIV transmission, especially in health education. Although Iran is one of the pioneers in implementing applicable and appropriate policies in the MENA region, including harm reduction services to reduce HIV incidence, people with substance use disorder continue to be the majority of those living with HIV in the country. Similar to other countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate HIV infection and reduce the transmission, especially the mother-to-child transmission and among other key populations.

Prepared but unprepared: a qualitative study of provider perspectives on the preparation and adjustment of U.S. families who internationally adopt children with HIV

ABSTRACT An increasing number of U.S. families are adopting children with HIV born outside the country. This exploratory qualitative study seeks to understand providers’ perspectives on international adoptee and family preparation and adjustment to life in the U.S. Eleven psychosocial and five medical care providers participated in hour-long, semi-structured, recorded interviews focused on their experiences caring for internationally adopted children with HIV (IACH) and their adoptive parents. Transcribed interviews were analyzed to identify emergent themes. Providers described considerable variation among families who adopted children. Some had grown biological children and several adopted multiple children with special needs. Most were connected to communities of faith which served as an inspiration to adopt and offered support. Serious medical and HIV-related issues were minimal. Psychosocial concerns were more common and included attachment, adjustment, and behavioral issues. Participants noted that adoptive parents were well informed about HIV, but less prepared for cognitive delays and emotional challenges. Some providers experienced or expected to have challenges offering sexual and reproductive health education to adolescents due to their adoptive parents’ religious beliefs on sexuality. Additional support managing behavioral and emotional challenges, as well as sexual education, may be needed especially as IACH transition into adolescence and young adulthood.