Download or read book Individual and Social Network Influences on Potential Use of Pre exposure Prophylaxis for HIV Prevention Among Adult Black Women written by Whitney Chivonne Sewell and published by . This book was released on 2019 with total page 195 pages. Available in PDF, EPUB and Kindle. Book excerpt: Oral daily pre-exposure prophylaxis (PrEP) is a single tablet that is >90% effective in reducing HIV transmission among women. Despite evidence of PrEP's efficacy and safety, levels of awareness, prescription, and uptake of PrEP among Black women are disproportionately low. There is evidence suggesting that the influence of peers and sexual partners in the social networks of Black women are potential facilitators and barriers to the intent to use PrEP. However, there has been limited study examining how these individual and social network level factors influence the intent to use PrEP in this population. This dissertation collected used survey data from Black women, aged 18-44, to conduct advanced statistical analysis, including social network analysis, to identify critical individual and network level factors that influence PrEP uptake. This study found strong associations between PrEP support from sexual partners and healthcare providers and intent to use PrEP in this sample. This study builds upon existing research on PrEP and women by contributing to discussions about the importance of social connections in making the decision to engage in PrEP care and services.
Download or read book Depression and HIV Pre exposure Prophylaxis Use Among Sub Saharan African Women written by Jennifer Velloza and published by . This book was released on 2019 with total page 140 pages. Available in PDF, EPUB and Kindle. Book excerpt: Daily, oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) is a highly efficacious HIV prevention strategy for key populations at high risk of HIV, including women, in sub-Saharan Africa. However, open-label studies and demonstration projects have reported that young women have difficulty adhering to PrEP over time, which limits its effectiveness as a prevention option. PrEP projects are now exploring modifiable barriers to adherence among women to maximize its public health benefit as it is being rapidly rolled out worldwide. Mental health factors, including depression, traumatic stress symptoms, and stigma, are highly prevalent among women at high risk of HIV acquisition and are barriers to medication use and health promotion behaviors. However, there has been little consideration until now of how such factors might also influence PrEP adherence among women in sub-Saharan Africa. The aims in this dissertation attempt to fill this research gap by: 1) exploring the impact of depressive symptoms on PrEP adherence among women; 2) examining the mechanisms by which depressive symptoms influence PrEP adherence; 3) describing the broader context of HIV-related stigma and empowerment on PrEP use; and 4) integrating depression screening into HIV care delivery to improve mental health and HIV outcomes. Two studies have examined the influence of depression on PrEP adherence and found that depressive symptoms have a negative effect on daily PrEP use for transgender women and men who have sex with men. Ours is the first study to examine links between depression and PrEP adherence among cisgender women in sub-Saharan Africa. We used marginal structural models to estimate the association between depressive symptoms and PrEP adherence while adjusting for time-varying confounding by sexual behavior, stigma, and social support. We found that probable depression was significantly associated with poor PrEP adherence among women, but not men, suggesting that mental health and depression experiences have differential impact on HIV prevention behaviors by gender. This work also led to questions about the mechanism of this association and whether there were important mediators of the relationship between depression and PrEP adherence that could explain at least some of this total effect. We conducted a mediation analysis using marginal structural models to estimate the controlled direct effect of depression on PrEP adherence, after accounting for the potentially mediating influence of HIV-related stigma, social support, and optimism about PrEP effectiveness. We found a significant negative direct influence of depression on PrEP adherence but this relationship was not strongly mediated by other psychosocial factors. Future research is needed to explore additional potential mediators of this relationship and identify areas for intervention. Qualitative research methods allow us to explore narratives around PrEP use, experiences of stigma, and concerns about mental health that are not captured by quantitative data. We analyzed serial in-depth interview data from a cohort of young women using PrEP to understand the broader context around their pill-taking, mental health, and relationships. In this study, we found that women described experiences of HIV-related stigma when they began taking PrEP which influenced their ability to take PrEP and their feelings about themselves. However, over time, women became more empowered to use PrEP and combat HIV-related stigma by becoming "ambassadors" of PrEP in their communities. This work highlights the potential for empowerment-based interventions to improve PrEP adherence and reduce community stigma and the richness of serially collected qualitative data. In Aims 1-3, we found evidence of a strong negative impact of depression on PrEP adherence and high rates of depression among women at risk of HIV. This work suggests that integrated depression screening and treatment with HIV prevention service delivery could improve mental health outcomes and PrEP effectiveness for women. To support the design of future integrated interventions, we conducted cognitive interviews assessing comprehensibility and acceptability of a widely used depression screening tool in the context of a PrEP delivery intervention among pregnant and postpartum women in Thika, Kenya. We found that the tool was largely acceptable and well-understood, but several minor changes to item wording and instructions would improve symptom screening and linkage to mental health care. These changes are part of our recommendations for the future use of this tool. The collective results presented in this dissertation illustrate the negative influence of depression and related psychosocial factors on consistent PrEP use for women, opportunities for stigma-reduction and empowerment-based intervention approaches to improve mental health symptoms and PrEP use in this population, and the potential to administer depression screening within the context of HIV prevention service delivery. This work contributes to a better understanding of the links between mental health and HIV risk for women and highlights the importance of integrating mental health and empowerment-based interventions with PrEP delivery to improve mental health screening and treatment and PrEP effectiveness for women in sub-Saharan Africa.
Download or read book Rose s Strategy of Preventive Medicine written by Geoffrey Arthur Rose and published by . This book was released on 2008 with total page 190 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Strategy of Preventive Medicine by Geoffrey Rose, first published in 1993, remains a key text for anyone involved in preventive medicine. Rose's insights into the inextricable relationship between ill health, or deviance, in individuals and populations they come from, have transformed our whole approach to strategies for improving health. His personal and unique book, based on many years research, sets out the case that the essential determinants of the health of society are to be found in its mass characteristics. The deviant minority can only be understood when seen in its societal context, and effective prevention requires changes which involve the population as a whole. He explores the options for prevention, considering them from various viewpoints - theoretical and scientific, sociological and political, practical and ethical. The applications of his ideas are illustrated by a variety of examples ranging from heart disease to alcoholism to road accidents. His pioneering work focused on a population wide approach to the prevention of common medical and behavioral disorders has become the classic text on the subject. This reissue brings the original text to a new generation involved in preventive medicine. Kay-Tee Khaw and Michael Marmot retain the original text intact, but have added their own perspective on the work. They examine what relevance Rose's ideas might have in the era of the human genome project and other major scientific advances, they consider examples of how the theory might be applied and generalised in medicine and beyond, and discuss what implications it holds for the future. There is also an explanation of the population perspective, clarifying the often confused thinking and arguments about determinants of individual cases and determinants of population incidence. Rose's Strategy of Preventive Medicine will ensure that this seminal work continues to be read by future generations.
Download or read book Disease Control Priorities Third Edition Volume 6 written by King K. Holmes and published by World Bank Publications. This book was released on 2017-11-06 with total page 1027 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Download or read book Community Collaborative Partnerships written by Mary M. McKay and published by Routledge. This book was released on 2012-12-06 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: Find out how best to develop HIV prevention programs that work Community Collaborative Partnerships: The Foundation for HIV Prevention Research Efforts is a must read for anyone interested in developing prevention programs within high-risk urban environments. Illustrative case studies, quality research, revealing personal stories, and helpful tables and figures provide valuable insights on innovative ways to partner in the prevention of the spread of HIV in youths. Leading experts in the field offer practical strategies to dissolve the distrust individuals in a community hold for researchers not a part of that community, fostering an effective collaboration to deal with problems. The book also describes ways to go beyond the United States’ model to reveal how to replicate the same dynamic relationships in international communities. Active participation with the community and families has been found to be vital for the success of HIV/AIDS prevention efforts. Community Collaborative Partnerships: The Foundation for HIV Prevention Research Efforts solves the common problem of forcing ineffective program models onto an unreceptive community. Program developers get the necessary tools to develop relationships and cultivate substantive input from those in the community to help ensure better program results. The research here is up-to-date, and the suggestions invaluable. Topics in Community Collaborative Partnerships: The Foundation for HIV Prevention Research Efforts include: the role of parenting in mental health and HIV risk research findings about frequency of sexual intercourse among adolescents racial socialization and family role in HIV knowledge family influences on exposure to situations of sexual possibility preadolescent risk behavior influence on parental monitoring strategies for collaboration between community and academic HIV prevention researchers involving urban parents as collaborators in HIV prevention research motivatorsand barriersto participation of minority families in a prevention program transferring a university-led HIV prevention program to the community Trinidad and Tobago HIV/AIDS prevention using a family-based program and much more! Community Collaborative Partnerships: The Foundation for HIV Prevention Research Efforts is valuable reading for researchers, program developers, community-based organizations, public policy/advocacy organizations, community organizers, educators, and students in the fields of social work, public health, public administration, and community medicine.
Download or read book Modeling to Inform the Delivery of HIV Pre exposure Prophylaxis in Sub Saharan Africa written by David Allen Roberts and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Daily oral tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) as HIV pre-exposure prophylaxis (PrEP) is a safe and effective method for HIV prevention and offers potential to substantially reduce HIV incidence in sub-Saharan Africa. Mathematical models are commonly used to project the cost-effectiveness of investments in PrEP in comparison to alternative resource allocation strategies. Predictive modeling can also identify individuals at elevated risk who may benefit most from PrEP. The studies contained in this dissertation address fundamental issues in estimating the cost and potential impact of PrEP implementation in sub-Saharan Africa. First, we estimated the cost of routine PrEP delivery through maternal and child health (MCH) and family planning (FP) clinics in western Kenya (Chapter 1). PrEP delivery through MCH and FP leverages existing service delivery platforms that reach a large fraction of women at elevated HIV risk. Using data from over 20,000 PrEP encounters through 16 clinics, we estimated that the cost per client-month of PrEP dispensed to be $26.52 (2017 USD), with personnel (43%), drugs (25%), and laboratory testing (14%) accounting for the majority of costs. Postponing creatinine testing from PrEP initiation to the first follow-up visit could save 8% of total program costs. Under Ministry of Health implementation, we projected costs would decrease by 38%, but estimates were sensitive to changes in PrEP uptake and retention. Second, we used an individual-based transmission model calibrated to Eswatini to evaluate the sensitivity of model projections of PrEP impact and efficiency to specification HIV exposure heterogeneity (Chapter 2). A common method for introducing HIV exposure heterogeneity into a model is to stratify the population into “risk group” categories with different average sexual behavior parameters, allowing PrEP coverage to vary by risk group without having to explicitly represent individual partnerships. We found that this specification leads to a sharp tradeoff between total impact and efficiency depending on PrEP coverage levels in each risk group. In comparison, PrEP use among the general population is projected to be two times more efficient if PrEP use is prioritized during partnerships and over six times more efficient if use is further prioritized among individuals with HIV-positive partners. In addition, large incidence reductions can be achieved at low levels of PrEP coverage if PrEP use in the general population is concentrated when HIV exposure is more likely, but high levels of PrEP coverage are needed if time-varying individual risk is ignored. Third, we developed and validated HIV risk prediction models incorporating individual-level and geospatial covariates using data from nearly 20,000 individuals in a population-based cohort in rural KwaZulu-Natal, South Africa (Chapter 3). Individual-level predictors included demographic, socioeconomic, and sexual behavior measures, while geospatial covariates included local estimates of community HIV prevalence and viral load. We compared full models to simpler models restricted to only individual-level covariates or only age and geospatial covariates. Models using only age group and geospatial covariates had similar performance (women: area under the receiver operating characteristic curve (AUROC) = 0.65, men: AUROC = 0.71) to the full models (women: AUROC = 0.68, men: AUROC = 0.72). In addition, geospatial models more accurately identified high incidence regions than individual-level models; the 20% of the study area with the highest predicted risk accounted for 60% of the high incidence areas when using geospatial models but only 13% using models with only individual-level covariates. These findings have implications for PrEP policies. Our primary costing study identified service delivery bottlenecks and cost drivers that can inform efforts to streamline PrEP delivery. By ignoring the alignment of PrEP use with time-varying individual HIV exposure, models using a risk group specification may overestimate the cost and underestimate the impact of widespread PrEP availability. Finally, local estimates of HIV prevalence can help identify individuals and areas to prioritize for PrEP services to maximize impact.
Download or read book Missing Voices written by Stephanie Brown and published by Oxford University Press, USA. This book was released on 1994 with total page 316 pages. Available in PDF, EPUB and Kindle. Book excerpt: Motherhood is often portrayed as one of the most fulfilling experiences in a woman's life. Books on pregnancy, birth and motherhood not only tell women what they should do, they also encourage them to have high expectations of what is inevitably a 'journey into the unknown'. Missing Voices isdifferent: its authors offer no prescriptions. Instead they tell the stories of 800 recent mothers. We hear about what happened to them during pregnancy and childbirth, what contributed to good and bad experiences of birth, and what women thought of the care they received. Ninety of the women went on to participate in interviews two years later. The result is a moving and powerful account of what it is like to be a mother in Australia in the 1990s. How do mothers' daily lives compare with accepted wisdom about 'good mothers'? How is the work of caring for children,running the household and providing financial support divided within the family? How do women feel about the care of children and work - both paid and unpaid? One in seven women was depressed in the year after birth. In Missing Voices they talk candidly about the origins of this depression and howthey coped with it. This is a book for all mothers (and fathers), for anyone contemplating having children, and for all those concerned about the health and well-being of mothers, children and families.
Download or read book Egocentric Network Analysis written by Brea L. Perry and published by Structural Analysis in the Soc. This book was released on 2018-03-22 with total page 371 pages. Available in PDF, EPUB and Kindle. Book excerpt: An in-depth, comprehensive and practical guide to egocentric network analysis, focusing on fundamental theoretical, research design, and analytic issues.
Download or read book The Network Relations Study written by Todd G. Pierce and published by . This book was released on 2011 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: African American women are amongst the fastest growing population of new HIV cases in the United States. Washington, D.C. represents the highest rates of HIV in the United States. There are many contributing factors as to why African American women are at such risk. Poverty, violence, illegal drug use and histories of childhood sexual abuse are some of these factors. This dissertation examines the interplay between violence, social networks, drug abuse, sexual behaviors and HIV risk among African American women in Washington, D.C. who have had lifelong histories as victims of violence and sexual abuse. Thirty-two months of ethnographic research was conducted with five selected women who have histories of drug abuse, sexual abuse and other forms of abuse and violence in their lives. Research was also conducted with harm reduction organizations, such as HIV risk reduction outreach and education organizations to assist in contextualizing the participating women's lives. Neighborhood community data collected on issues of violence and social beliefs provided further social contexts in which to frame the lives of the participating women. A multi-methodological approach using participant observation, life history interviews, social network plotting and event recall interviews was utilized to illustrate and examine the effects of psychological and physical trauma brought on by experiences of violence and abuse, and how said trauma impact individual social and sexual practices. This research also examined ways in which cyclical violence and abuse within the participating women's family and social network histories have influenced the women's decision-making abilities with regards to HIV risk behaviors. This research illustrates the interplay between the self and social networks in relation to drug addiction and violence, and demonstrates how violence affects the self and limits human agency, especially in regard to HIV risk behaviors, and identifies the need to include childhood sexual abuse as a key indicator for risk of HIV and other diseases and social ailments.
Download or read book Improving Pre exposure Prophylaxis Delivery for Young Women in Kenya written by Valentine Adhiambo Wanga and published by . This book was released on 2020 with total page 82 pages. Available in PDF, EPUB and Kindle. Book excerpt: The rollout of pre-exposure prophylaxis (PrEP) for HIV prevention to priority populations, including young women, is expanding in sub-Saharan Africa. However, existing barriers to PrEP rollout at the individual, community and policy levels could slow progress and impede the success of PrEP implementation programs. In order to achieve success in HIV prevention, it is crucial to address these barriers, particularly among young women, a population especially vulnerable to HIV. In this dissertation, we evaluated the links among risk perception, sexual behavior and PrEP adherence in serodiscordant couples, evaluated the impact of incorporating HIVST in PrEP delivery for young women and assessed the cost of delivering PrEP to young women. In Aim 1, we used data from HIV-negative adults enrolled in a study of PrEP and antiretroviral therapy for HIV-serodiscordant couples in Kenya and Uganda to examine associations between: 1) condom use and risk perception and 2) risk perception and PrEP adherence. In Aim 2, we offered HIV self-testing (HIVST) to young women enrolled in a PrEP implementation study in two family planning clinics and assessed satisfaction with HIV testing and clinic experience, and the impact of HIVST on PrEP delivery procedures. In Aim 3, using the same population as that in Aim 2, we used micro-costing methods to estimate the incremental cost of delivering PrEP to young women. We found that sexual behavior aligned with perceived HIV risk, which can facilitate an HIV-negative individual's decisions about PrEP use. Additionally, we found HIVST to be feasible and acceptable for young women using PrEP, highlighting the need to evaluate its utility to streamline PrEP delivery and provide more testing options for young women on PrEP. Lastly, using practical data from PrEP implementation, we estimated the cost of delivering PrEP to young women, providing valuable data to inform budget impact and cost-effectiveness analyses as well as local resource allocation for scale-up of PrEP delivery to young women. Collectively, these studies addressed some of the barriers to PrEP delivery, proposed solutions to these barriers and drew attention to priority research needs for PrEP delivery to young women.
Download or read book Knowledge Attitudes HIV Behavioral Self efficacy and Willingness to Use HIV Pre exposure Prophylaxis PrEP Among African American Women Using Social Media written by Sharita Jewell Ambrose and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Women at the Margins written by J Dianne Garner and published by Routledge. This book was released on 2013-01-11 with total page 442 pages. Available in PDF, EPUB and Kindle. Book excerpt: A compelling look at the crisis of disadvantaged women This powerful document takes a sobering look at the phenomenon of marginalized women pushed to the edges of society, holding on with the barest of hope and extraordinary bravery. Handicapped by the increasing societal inequality they face as an everyday fact of life, these women (and in many cases, their children) have been disconnected from the mainstream for reasons of age, race, gender, health, incarceration, domestic abuse, unwanted pregnancy, unemployment, and economic circumstance. They are poor in an affluent society, powerless in a powerful nation, and the suffering caused by their exclusion is poignant and troubling. Eloquently illustrated with poetry, art, and prose created by marginalized women, Women at the Margins: Neglect, Punishment, and Resistance makes a compelling argument for social change. The book offers a no-holds-barred look at how economic restructuring, welfare reform, neo-conservative ideology, and institutional exclusion have locked women into subservient, substandard roles, stripping them of their citizenship and rendering them expendable. Diverse authors track the life cycle of marginalized women, from teenage pregnancy to the lonliness of older women in poverty or prison. Women at the Margins: Neglect, Punishment, and Resistance addresses: the effects of welfare reform the forgotten group: women in prison and jail low-income women and housing women marginalized by substance abuse, poverty, and incarceration teenage pregnancy children and their incarcerated mothers recidivism and reintegration women, law, and the justice system and much more! Women at the Margins: Neglect, Punishment, and Resistance acknowledges the long history of the inequality faced by women living in exclusion but focuses on the present with a hopeful but realistic eye toward the future. It is an indispensible resource for sociology, social work, legal and penal system professionals, and academics, and an essential read for everyone.
Download or read book Perceptions of Pre exposure Prophylaxis PrEP and Acceptability of Peer Navigation Among HIV negative Latinx and Black Men who Have Sex with Men MSM in Western Washington written by Jahn Jaramillo and published by . This book was released on 2018 with total page 47 pages. Available in PDF, EPUB and Kindle. Book excerpt: HIV PrEP (pre-exposure prophylaxis) is an effective biomedical approach for HIV prevention. However, PrEP is an underutilized resource among Latinx and Black men who have sex with men (MSM) in the United States. Peer navigation approaches are being widely scaled up to support PrEP uptake and adherence, though it remains unclear what strategies work best to effectively address the diverse social and cultural needs of Latinx and Black MSM. This study is based on qualitative research conducted on a subset of 66 Latinx and Black MSM residing in Western Washington who participated in an online CAPI REDCap survey. We conducted semi-structured in-depth interviews with 21 men selected through purposive sampling methods to evaluate the intersectionality of race, ethnicity, sexual orientation, and other identities men possessed and how this related to their views on PrEP in general, and on peer navigation specifically. Thematic analysis was used to identify and analyze emergent themes. Four major themes emerged as relevant to PrEP interest and uptake: 1) disclosure concerns for bisexual/gay masculine identified men; 2) specific challenges for Latinx MSM, including migration status and need for advocacy; 3) specific challenges for Black MSM, including discrimination and need lack of trust; and 4) special considerations for younger men, including limited knowledge and experience discussing sexual health and an interest in more comprehensive peer intervention content. Interest in peer navigation was high among study participants, particularly for men with limited social support or English proficiency and for men who had moved from out of state or another country. Several potential approaches to improve peer navigation were identified, including developing culturally congruent programming to match peers with men based on various identity considerations and identified needs, employing social media such as chatrooms and informational phone lines as complementary combination strategies, and incorporating trauma-informed care into a peer navigation program for Latinx and Black MSM. Tailored peer navigation approaches may help MSM of color by increasing resilience to societal stigma at the individual level, enhancing social support at the interpersonal level and serving as a bridge to providers at the structural level. These strategies could ultimately reduce racial/ethnic HIV disparities, if implemented.
Download or read book Sexually Transmitted Infections written by National Academies of Sciences, Engineering, and Medicine and published by . This book was released on 2021-12-24 with total page 750 pages. Available in PDF, EPUB and Kindle. Book excerpt: One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
Download or read book Grounded Theory in Practice written by Anselm L. Strauss and published by SAGE. This book was released on 1997-03-11 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: Grounded Theory in Practice presents a series of readings that emphasises different aspects of grounded theory methodology and methods. The selections are written by former students of the late Anselm Strauss.
Download or read book A Dyadic Analysis of PrEP Related Interpersonal Communication Among Women who Inject Drugs in Philadelphia written by Marisa A. Felsher and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Women who inject drugs (WWID) remain a population at risk for HIV infection. Pre-exposure prophylaxis (PrEP) is a user-controlled biomedical HIV prevention tool that could decrease HIV risk among WWID. However, PrEP uptake among WWID is low, which can be attributed in part to low awareness. Interventions that incorporate interpersonal communication between WWID and their network members could play an important role in the diffusion of PrEP information. However, little is known about who WWID would be willing to diffuse PrEP information to in the context of a peer intervention, nor characteristics of relationships that motivate willingness to share information. The objective of this dissertation is to identify how characteristics of relationships impact interpersonal communication about PrEP between WWID and members of their social network. This dissertation used a sequential mixed-methods exploratory design. In Phase 1 (aim 1) in-depth interviews were conducted with 20 WWID to explore the context and content of previous communication about PrEP with network members. In phase 2 (aims 2 and 3), a quantitative social network survey was administered to 40 WWID and elicited information about 375 social network members in order to identify factors associated with willingness to share information about PrEP within dyads in the context of a peer intervention. Findings from each of these studies were compared and contrasted through triangulation to identify key themes and areas for future research and practice. Aim 1 findings demonstrate that WWID initiated PrEP-related conversations with over half of network members elicited. Reasons included to educate other WWID perceived to be at risk for HIV about PrEP, to receive social support from peers with whom they are emotionally close, and to disclose PrEP use to control the narrative of why they take PrEP. Findings from aim 2 show that WWID were willing to share PrEP information with 83% (m=312) of network members in the context of a peer intervention. In a multivariable model, participants had higher odds of willingness to share PrEP information within relationships where the network member was female, homeless, and perceived by respondent to be at risk for HIV. Aim 3 results show that constructs related to the Theory of Planned Behavior (attitudes, subjective norms, and perceived behavior control of sharing information about PrEP) vary between relationships and are significantly associated with willingness to share PrEP information. This dissertation highlights that WWID have previously shared PrEP information with network members and are also willing to share PrEP information with most network members in the context of an intervention. Characteristics of relationships, as well as constructs of TPB operating within dyads, impact WWID's willingness to share information with network members. Formatting TPB be used within ego-centric social network analysis expands the utility of TPB to encompass interpersonal processes and has application to predicting intention to engage in other dyadic behaviors. Peer interventions where WWID share PrEP information with network members may be a feasible approach to increasing PrEP awareness among highly vulnerable populations.
Download or read book HIV AIDS in South Africa 25 Years On written by Poul Rohleder and published by Springer Science & Business Media. This book was released on 2009-09-01 with total page 396 pages. Available in PDF, EPUB and Kindle. Book excerpt: Much has happened since the first appearance of AIDS in 1981: it has been identified, studied, and occasionally denied. The virus has shifted host populations and spread globally. Medicine, the social sciences, and world governments have joined forces to combat and prevent the disease. And South Africa has emerged as ground zero for the pandemic. The editors of HIV/AIDS in South Africa 25 Years On present the South African crisis as a template for addressing the myriad issues surrounding the epidemic worldwide, as the book brings together a widely scattered body of literature, analyzes psychosocial and sexual aspects contributing to HIV transmission and prevention, and delves into complex intersections of race, gender, class, and politics. Including largely overlooked populations and issues (e.g., prisoners, persons with disabilities, stigma), as well as challenges shaping future research and policy, the contributors approach their topics with rare depth, meticulous research, carefully drawn conclusions, and profound compassion. Among the topics covered: The relationship between HIV and poverty, starting from the question, "Which is the determinant and which is the consequence?" Epidemiology of HIV among women and men: concepts of femininity and masculinity, and gender inequities as they affect HIV risk; gender-specific prevention and intervention strategies. The impact of AIDS on infants and young children: risk and protective factors; care of children by HIV-positive mothers; HIV-infected children. Current prevention and treatment projects, including local-level responses, community-based work, and VCT (voluntary counseling and testing) programs. New directions: promoting circumcision, vaccine trials, "positive prevention." South Africa’s history of AIDS denialism. The urgent lessons in this book apply both globally and locally, making HIV/AIDS in South Africa 25 Years On uniquely instructive and useful for professionals working in HIV/AIDS and global public health.
