Journal of the Association of Nurses in AIDS Care - Articles in Press

Research Capacity–Building Program for Clinicians and Staff at a Community-Based HIV Clinic in Uganda: A Pre/Post Evaluation - Corrected Proof

2012-01-24

Developing capacity for HIV research and clinical practice is critically needed in resource-limited countries. The purpose of this study was to evaluate a research capacity–building program for community-based participants in the preparation and conduct of mobile phone–based technology interventions. A descriptive, cross-sectional design was used. Participants completed self-report surveys at three time points. Thirty-three participated in the situational analysis, and all (100%) felt that the research training was needed. For the interim evaluation, more than 96.8% (n = 30) reported increased knowledge and confidence and attributed this to the training. Fourteen participants completed the final evaluation. Dedicated time away from work was an important factor to facilitate recruitment and data collection, followed by financial incentives to commute to data collection sites. Expertise through supervision and mentorship for participants and sustained funding for research projects are critical to the innovation needed to improve HIV prevention and care outcomes.

“Doing It Blindfolded”—Successful Administration of Enfuvirtide by a Person Living With HIV and Blindness: A Case Study of Treatment Access and Disability - Corrected Proof

Elizabeth Crock, Judith Frecker — 2012-01-13

Derek, a 61-year-old man, was diagnosed with HIV infection in 1985. He became blind in both eyes in 1995 after an episode of herpes zoster ophthalmicus, and in 1999, he underwent a splenectomy for thrombocytopenia. Derek lives alone with his guide dog. Assistance from community services allows him to maintain his independence, which he values highly. He travels frequently and enjoys attending opera, theater, and films, and spending time with friends. He had a career as a nurse but stopped work in the mid-1980s when he first became unwell with HIV disease.

Factors Contributing to the Development of an HIV Ministry Within an African American Church - Corrected Proof

Jennifer M. Stewart, Barbara L. Dancy — 2012-01-04

Having an HIV ministry within a church depends on the religious culture of that church. However, little is known about how a church’s religious culture influences an HIV ministry. This study’s purpose was to examine how an African American church’s religious culture supported the development, implementation, and maintenance of an HIV ministry within the church. An ethnographic case study research design was used. Data were collected through interviews, nonparticipant and participant observations, review of pertinent documents, and survey of congregants. Results revealed the following as important for an HIV ministry: (a) a belief in helping others and treating everyone with respect and dignity, (b) feelings of compassion toward individuals infected with HIV, and (c) HIV education. This information can assist in developing interventions to enhance the African American church movement toward HIV ministries.

The Role of Social Support and Negative Affect in Medication Adherence for HIV-Infected Men Who Have Sex With Men - Corrected Proof

Eva N. Woodward, David W. Pantalone — 2012-01-03

Combinations of medications that control HIV viral replication are called antiretroviral therapy (ART). Regimens can be complex, so medication adherence is often suboptimal, although high rates of adherence are necessary for ART to be effective. Social support, which has been directly and indirectly associated with better treatment adherence in HIV-infected individuals, influences negative affect, including depression and anxiety. Our study assessed whether current anxious and depressive symptoms mediated the relationship between general social support and recent self-reported medication adherence in HIV-infected men who have sex with men (N = 136; 65% White, 15% Black/African American). Results revealed no direct effect, but an indirect effect of depressive (95% CI [−.011, −.0011]) and anxious symptoms (95% CI [−.0097, −.0009]), between social support and medication adherence. Greater levels of social support were associated with lower levels of depression and anxiety, which in turn were associated with lower ART adherence.

Pilot Study to Assess Subjective and Objective Reporting of Potential Adverse Drug Reactions in Older Versus Younger HIV-Infected Patients Using Antiretroviral Therapy - Corrected Proof

2011-12-02

Limited data exist on tolerability of antiretroviral therapy (ART) in older HIV-infected patients compared to their younger counterparts. There is also concern for overlap of ART toxicities with concomitant conditions potentially leading to an increased burden of ART-related adverse drug reactions (ADRs). A prospective, descriptive–comparative study was conducted to compare incidence and severity of ADRs secondary to ART in older (≥50 years) versus younger (<50 years) HIV-infected patients. No differences were found in the presence or severity of subjective or objective ADRs between groups. The burden of intolerance appeared to be high for certain ADRs in both age groups. Regardless of age, subjects with certain concomitant illnesses had higher rates of potential ADRs. Providers need to be aware of patient characteristics that lead to increased rates of ART intolerance; for patients with an increased comorbidity burden, providers need to be attentive to the potential impact on ART tolerability.

Grappling With HIV Transmission Risks: Narratives of Rural Women in Eastern Kenya Living With HIV - Corrected Proof

2011-12-02

As people live longer and more productively with HIV infection, issues of agency in reducing HIV risk are particularly important for HIV-infected women living in high prevalence, underresourced countries such as Kenya. Because of their gendered lives, in that being masculine is associated with dominance and being feminine is associated with passiveness, women in rural Kenya must cope with continued HIV transmission risk even after knowing they are infected with HIV. In this narrative interview study, informed by theories of gender and postcolonial feminism, we examined personal accounts of HIV risk and risk reduction of 20 rural women in eastern Kenya who were living with HIV. From our analysis of the women’s narratives, two major themes emerged: gender-based obstacles even in the context of a known HIV diagnosis, and struggles with economic pressures amid HIV risks. Implications for policy, programs, and research are discussed.

Variations in Young Men’s and Women’s Attitudes and Intentions to Use Condoms With Different Types of Sexual Partners - Corrected Proof

Brandon J. Hill, Erick E. Amick, Stephanie A. Sanders — 2011-12-02

Currently, the most highly effective method for the prevention of unwanted pregnancy and sexually transmitted infections (STIs), including HIV, is the consistent and correct use of condoms (). Research examining the sexual behaviors and risks of adolescents and young adults is particularly important given that this is a time in psychosocial development when young people are becoming sexually active (). During this critical period, adolescents and young adults may be increasing the risks of STI and HIV infection by not using condoms (). It is estimated that roughly half of the new HIV infections in the United States are among young people under the age of 25 years ().

The Forms and Functions of Peer Social Support for People Living With HIV - Corrected Proof

2011-11-15

Peers may be important sources of coping assistance, but their impact can be better understood if we examine their influence across various contexts. Although social support studies focused on people living with HIV have examined peer support in various contexts, they do not comprehensively account for situations in which peer support might be provided. The specific aims of this study were to (a) describe the various forms and functions of peer support for people living with HIV and (b) validate the concept analysis of peer support within health contexts. Results indicate that peer support is a potentially important adjunct to clinical care for enhancing coping skills, thereby improving the psychosocial functioning of people living with HIV. It is important to (a) assess patient access to peer support, (b) provide opportunities for peer support in the clinical setting, and (c) enhance disclosure and support-seeking skills to facilitate this benefit.

Parental Support and Condom Use Among Transgender Female Youth - Corrected Proof

Erin C. Wilson, Ellen Iverson, Robert Garofalo, Marvin Belzer — 2011-11-15

Evidence suggests that transgender female youth (TFY), much like their adult transgender female peers, are at high risk for HIV. Yet little attention has been given to important developmental experiences of TFY that may impact HIV risk for this youth population. The overall purpose of this study was to explore HIV risk in TFY. A reoccurring theme from the qualitative data was the importance of parents. To better understand the impact of parents on HIV risk among TFY, in-depth individual interview data from 21 TFY in Los Angeles and Chicago were analyzed, suggesting a potential link between HIV-related risk behavior and parental support. Youth with parental support in this sample reported regular condom use, while those without such support reported inconsistent condom use. Implications for the unique research and interventions needs of TFY related to parental support and sexual risk behaviors are discussed.

A Qualitative Description of Women’s HIV Self-Management Techniques: Context, Strategies, and Considerations - Corrected Proof

Allison R. Webel, Mary A. Dolansky, Anna G. Henry, Robert A. Salata — 2011-11-15

Women living with HIV face unique challenges managing their disease. The purpose of this descriptive qualitative study was to describe self-management techniques reported by 48 women living with HIV in the United States. Participants were involved in one 90-minute, digitally recorded focus group exploring aspects of HIV self-management strategies. Descriptive statistics, qualitative description, and content analysis were used to analyze the data. Participants had been living with HIV for an average of 12 years, and most (69%) were engaged in routine HIV care (85%) and were currently receiving antiretroviral therapy. Participants reported using self-management techniques: taking personal time (n = 23; 48%), advocacy (n = 12; 25%), sleeping (n = 17, 35%), attending support groups (n = 10; 21%), and attending medical appointments (n = 8; 17%). Nurses can add strategies to enhance HIV self-management to routine clinical care, which may have a positive impact on the health of women living with HIV.

HIV-Related Stigma Among Nursing Students in Cameroon - Corrected Proof

Neal Rosenburg, Donna Taliaferro, Patrick Ercole — 2011-11-07

Forms of health-related stigma are present in all societies. A lack of education, a growing apathy, and cultural skepticism surrounding HIV fuel the spread of misinformation and uninformed fears tied to HIV-related stigma. The degree, circumstances, and context of stigma vary among societies, cultural groups, and perception of illness (); nonetheless, stigma produces destructive effects. Most notably, blame, shame, fear, personal injury, violence, and death account for the majority of the effects of stigma () among HIV-infected persons. The potential for physical and emotional damage to the individual underscores the problems related to this avoidable behavior. In addition, the efforts of changing the defining attitudes of stigma pose unique challenges. Many attitudes attached to contemporary stigma are deeply ingrained in an individual’s social norms, familial values, and cultural mores ().

Personal Narratives, Coping, and Quality of Life in Persons Living With HIV - Corrected Proof

Kathryn R. Macapagal, Jamie M. Ringer, Shannon E. Woller, Paul H. Lysaker — 2011-10-28

Receiving a diagnosis of HIV can be a life-altering experience that results in significant psychosocial consequences, such as disruptions of one’s life trajectory and goals, sense of self, relationships with others, and participation in social and occupational activities. For many, adapting to these changes can be extremely challenging, yet little is known about the processes that influence how well or poorly individuals are able to recapture the ability to function in these areas.

Primary, Secondary, and Tertiary Prevention of Cardiovascular Disease in Patients With HIV Disease: A Guide for Nurse Practitioners - Corrected Proof

Hazel Jones-Parker — 2011-10-17

HIV infection elevates a patient’s risk for developing cardiovascular disease (CVD), due in part to direct effects of increased infection-producing inflammation and to drugs used to treat the infection, which can have untoward effects on serum lipid profiles. HIV-infected older adults often present with multiple comorbidities, including CVD, making disease management more challenging. Treatment paradigms are evolving, and nurse practitioners (NPs) are expected to play an ever-larger role in the management of HIV infection. Due to their accessibility and close patient contact, NPs are especially well suited to work with and educate patients to manage multiple risk factors. Appropriate use of primary, secondary, and tertiary CVD prevention strategies, including education to modify lifestyle risks, individualized antiretroviral treatment regimens to achieve serum lipid targets, and use of additional lipid-modifying strategies to minimize a patient’s overall CVD risk profile will be important throughout the treatment lifecycle.

HIV/STD Risk Behaviors Among In-School Adolescents in Post-conflict Liberia - Corrected Proof

2011-09-19

We conducted a randomized trial to address the health needs of in-school adolescents in Liberia, where we analyzed data from a behavioral survey administered to 820 students from eight urban schools. Our findings suggest that adolescents are at significant risk for HIV and other sexually transmitted diseases (STDs): 36% of respondents were sexually experienced, 34% of those had first sex at ages 14 or younger, 66% of first sexual encounters were unprotected, and 16% were described as “forced.” Also, females were more likely to have older boyfriends (Pearson’s chi square = 19.2, p = .0001) and sex resulting in pregnancies (Pearson’s chi square = 11.5, p = .01), while males were more likely to have a greater number of sexual partners (Pearson’s chi square = 5.6, p = .05) in the previous 3 months. We recommend further research to explore challenges associated with implementing behavioral-driven studies in post-conflict environments.

The Feasibility and Acceptability of a Motivational Interviewing Intervention for HIV-Infected Youth in an Urban Outpatient Clinic: A Pilot Study - Corrected Proof

2011-09-19

Youth living with HIV (YLH) are at an increased risk for nonadherence to medications and nondisclosure of an HIV diagnosis to their sexual contacts. Many factors unique to youth contribute to this risk including developmental stage, physical development, and social and cultural issues that surround the disease (). There are limited data for HIV-infected youth regarding how to improve medication adherence and disclosure of diagnosis, how to maintain healthy lives, and how to prevent the spread of the disease in their communities.

Pursuing Treatment and Moral Worth: HIV-Infected Women in a Northern Province of Vietnam Living With Antiretroviral Therapy - Corrected Proof

2011-09-19

There is a need to understand how social and cultural expectations of being a woman shape the challenges women face when trying to access antiretroviral therapy (ART) and to continue the treatment over time. Based on a 7-month prospective study of 15 HIV-infected women, the particular challenges met by these women in northern Vietnam are discussed in this article. We argued that, by taking ART to maintain their health and to fulfill their responsibilities to family and community, the women managed to reclaim the “moral worth” they had lost as a result of having HIV infection. At the same time, certain social and economic contingencies related to ART made it difficult for the women to uphold this moral position. The study demonstrated the importance of understanding the meanings and implications of ART in specific social contexts to understand how social support structures could be established to ensure treatment continuation.

Menopause-Associated Metabolic Manifestations and Symptomatology in HIV Infection: A Brief Review With Research Implications - Corrected Proof

Sara E. Dolan Looby — 2011-09-19

Many women living with HIV in the United States have entered or will soon enter menopause. Clinical changes including increased visceral fat, reduced muscle mass, and changes in lipids and bone density are seen across the menopause transition among non-infected women. HIV and antiretroviral therapy use have been associated with similar manifestations, including reduced bone density, and changes in lipid metabolism and body composition. Menopause is also associated with changes in mood, quality of life, and vasomotor symptoms. Similar psychological indices are common among women with HIV, and may worsen during menopause transition. Research investigating the presence and acuity of metabolic, psychological, and vasomotor symptoms among perimenopausal women with HIV is limited. An important, yet unknown consideration for researchers and clinicians is how metabolic and psychological co-morbidities associated with HIV will influence changes associated with menopause in this population. Further research is needed to provide answers to these important questions.

The Experiences, Needs, and Internet Use of Women Recently Diagnosed With HIV - Corrected Proof

Elizabeth C. Walsh, Keith J. Horvath, Holly Fisher, Cari Courtenay-Quirk — 2011-09-19

Women constitute an increasing proportion of persons diagnosed with HIV in the United States. From September 2007 through June 2008, in-depth interviews were conducted with 20 women diagnosed with HIV in the previous 12 months to explore their experiences immediately following their diagnoses. Most women had at least a high school education (90%) and were African American (45%) or Hispanic (15%). Analysis of transcripts showed that: (a) many women were surprised by the diagnosis because they did not fit the profile of people at high risk for HIV, (b) obtaining social support immediately after an HIV diagnosis was a primary need, and (c) HIV had an impact on a woman’s role in her family. We concluded that strategies are urgently needed to identify women at risk for HIV in a timely manner, and addressing the unique experiences and needs of women recently diagnosed with HIV is critical to their well-being.

Health Care Reform: What Does It Mean for People Living With HIV Infection? - Corrected Proof

Nancy C. Sharts-Hopko — 2011-09-07

President Obama signed the Patient Protection and Affordable Care Act (PPACA) and its companion legislation, the Health Care Education and Reconciliation Act (HCERA) of 2010, into law in March 2010. The HCERA was the legislation that reconciled differences in the PPACA as approved by the U.S. House of Representatives and the U.S. Senate. Readers who followed the evolution of this legislation know that the PPACA contains many compromises and is far from perfect. The inevitable modifications of the legislation over time could go in the direction of improving it and expanding access to care while reigning in costs, or they could go in the direction of weakening the impact of the law.

Self-Care Behaviors and Activities for Managing HIV-Related Anxiety - Corrected Proof

2011-08-12

The goal of this study was to identify the baseline prevalence and effectiveness of anxiety self-management strategies in a convenience sample of persons living with HIV (PLWH; n = 343) in the United States, Puerto Rico, Kenya, and South Africa who reported HIV-related anxiety symptoms. Relationships between demographics and anxiety characteristics were determined, as was the effectiveness of self-care activities/behaviors to reduce anxiety. We found that the use of anxiety self-management strategies varied by gender and that ratings of effectiveness varied by country. Highest anxiety intensity scores were found in participants who were taking antiretroviral medications and who had undetectable viral loads. Forty-five percent of the persons with a diagnosis of AIDS reported anxiety symptoms. As HIV increases in areas of the world where self-care is the primary approach to managing HIV, additional research will be needed to address the effectiveness of cross-cultural differences in strategies for self-managing HIV-related anxiety.

Providing Effective Medical and Case Management Services to HIV-Infected Youth Preparing to Transition to Adult Care - Corrected Proof

Mary E. Boudreau, Colleen M. Fisher — 2011-08-05

A key aspect of maintaining health for HIV-infected adolescents is the transition from pediatric care to adult medical care. Because young people who were infected with HIV as children were initially not expected to survive until adulthood, relatively little attention has been given to issues associated with this transition to adult care. With improved life expectancies, health professionals are increasingly faced with the new challenge of working with these young people as they grapple with the unique experience of being an HIV-infected adolescent transitioning into adulthood. This article discusses the unique developmental trajectories of young people infected with HIV as children, challenges for health care professionals who work with them, and strategies for practitioners to increase the competencies needed to develop effective partnerships with these youth as they transition into adult care.

An Integrated Approach for Antiretroviral Adherence and Secondary HIV Transmission Risk-Reduction Support by Nurses in Kenya - Corrected Proof

2011-08-01

Ongoing antiretroviral therapy (ART) adherence and secondary HIV transmission-risk reduction (positive prevention) support are needed in resource-limited settings. We evaluated a nurse-delivered counseling intervention in Kenya. We trained 90 nurses on a brief counseling algorithm that comprised ART and sexual-risk assessment, risk-reduction messages, and health-promotion planning. Self-reported measures were assessed before, immediately after, and 2 months post-training. Consistent ART adherence assessment was reported by 29% of nurses at baseline and 66% at 2 months post-training (p < .001). Assessment of patient sexual behaviors was 25% at baseline and 60% at 2 months post-training (p < .001). Nurse practice behaviors recommended in the counseling algorithm improved significantly at 2 months post-training compared with baseline, odds ratios 4.30–10.50. We found that training nurses in clinical counseling for ART adherence and positive prevention is feasible. Future studies should test impact of nurse counseling on patient outcomes in resource-limited settings.

Development of Evidence-Based Exercise Recommendations for Older HIV-Infected Patients - Corrected Proof

Anella Yahiaoui, Ellen L. McGough, Joachim G. Voss — 2011-08-01

Advances in antiretroviral therapy (ART) have decreased HIV-related morbidity and mortality and contributed to rapidly increasing numbers of older people living with HIV. Successful management of ART-related side effects (metabolic syndrome) and age-related comorbidities (frailty) are major challenges for patients and providers. Exercise has proven beneficial for younger HIV-infected patients, but we know little about which exercise regimens to recommend to the elderly. Our goal was to develop age-appropriate, evidence-based exercise recommendations for older HIV-infected adults (age > 50). We reviewed randomized controlled trials on the effects of physical exercise for: (a) HIV-infected young adults, (b) frail older adults, and (c) elderly individuals with metabolic syndrome. We recommend a combination of endurance and resistance exercises 3 times per week for at least 6 weeks to improve cardiovascular, metabolic, and muscle function. Further research is warranted to study the benefits and risks of physical exercise in older HIV-infected patients.

Cardiovascular Risk Assessment for Persons Living With HIV - Corrected Proof

Emily G. Burke, Joan Nelson, Jeffrey Kwong, Paul F. Cook — 2011-07-21

Systematic assessment of cardiovascular risk among persons living with HIV (PLWH) has become more important as HIV survival has increased. Since the advent of effective antiretroviral therapy (ART), PLWH often enjoy life expectancies equal to those of the general population. PLWH then share the same comorbidities as the general population, with some increased risks due to HIV and ART. One comorbidity, cardiovascular disease, is the leading cause of death in the United States. As the current population of PLWH ages, reducing cardiovascular risk will become even more important. Before cardiovascular risk reduction can take place, providers must first know the patient’s risks. This paper describes the importance of cardiovascular risk assessment for PLWH based on current literature and presents findings from a quality-improvement (QI) initiative designed to implement systematic cardiovascular assessment using the Framingham Risk (FR) for PLWH in an infectious-disease practice.

The Role of the Nurse in Implementation of an HIV Treatment Program in Rural Lesotho - Corrected Proof

Jennifer Furin, Mona Haidar, Nicolas Lesia, Limpho Ramangoela, Jonas Rigodon — 2011-07-18

Nurses have had a central role in the management of HIV since the disease was first reported (). They have been involved in all aspects of care from diagnosis and treatment support to home-based care and palliation (). In resource-poor settings around the world, nurses have taken on major responsibilities in the care of persons with HIV (). For example, recent studies from sub-Saharan Africa have shown that nurses can successfully diagnose and stage patients with HIV, initiate antiretroviral therapy (ART), diagnose and manage opportunistic infections, and participate in outreach projects such as male circumcision ().

Clinical Depression and Condom Use Attitudes and Beliefs Among African American Adolescent Females - Corrected Proof

Bridgette M. Brawner, Zupenda M. Davis, Ehriel F. Fannin, Kamila A. Alexander — 2011-07-07

Depression, HIV, and other sexually transmitted diseases (STDs) are growing concerns among African American adolescent females. Theoretical models contribute to identification of mediators of condom use; however, minimal research has addressed the explicit relationship between clinical depression and condom use in African American adolescent females. The authors report results from quantitative surveys with clinically depressed (n = 64) and nondepressed (n = 64) African American adolescent females in two large metropolitan cities in the eastern United States. Theoretical mediators of condom use in the study sample—attitudes, subjective norms, perceived behavioral control, and intentions— were investigated. Significant differences existed between the groups in condom use frequency (U = 356.5, p = .037); however, there were no statistically significant differences in condom use attitudes and beliefs. Although clinically depressed and nondepressed African American adolescent females may hold similar attitudes and beliefs about condom use, differences in condom use frequency may be a psychopathologic occurrence.

An Individualized Intervention to Foster Optimal Antiretroviral Treatment-Taking Behavior Among Persons Living With HIV: A Pilot Randomized Controlled Trial - Corrected Proof

Pilar Ramirez-Garcia, José Côté — 2011-07-07

The key to the success of antiretroviral (ARV) treatment is optimal treatment taking. However, people living with HIV (PLWH) have problems sustaining this behavior. An intervention to facilitate optimal ARV treatment taking was developed using the intervention mapping approach. A pilot randomized controlled trial was conducted to evaluate the feasibility, acceptability, and effects of this intervention on optimal ARV treatment taking and on viral and immunologic outcomes. Over the 9 months of recruitment, 76 PLWH were referred. A total of 51 participants were enrolled in the study. All but three experimental participants attended at least one of the four intervention sessions. At 12 and 24 weeks respectively, the HIV RNA level was undetectable for 34.8% and 56.5% of controls and 78.6% and 89.3% of experimental participants (p = .056). The results are compelling and suggest that this intervention is acceptable to PLWH and that further formal testing is worth considering.

Dealing With HIV-Related Stigma: A Qualitative Study of Women Outpatients from the Chris Hani Baragwanath Hospital - Corrected Proof

Robert Lekganyane, Gretchen du Plessis — 2011-06-29

HIV-related stigma is widely regarded as a key impediment to effective prevention and care. The purpose of this study was to explore HIV-infected women outpatients’ experiences of stigma and the coping strategies that they devised to deal with it. Six HIV-infected women receiving antiretroviral treatment from the Nthabiseng Clinic of the Chris Hani Baragwanath Hospital participated in this qualitative study. HIV-related stigma was experienced by all the participants and was narrated as a sense of loss that gave rise to feelings of fear and shame. To cope with this, the women isolated themselves, became secretive about their health, disclosed strategically, and enlisted support. The elements of stigma and the coping strategies employed as uncovered in this study suggest a basis from which interventions aimed at assisting HIV-infected people to deal with stigma can be planned.

Handheld Computers to Run ACASI to Assess HIV Risk and Deliver Tailored Soap Opera Video Feedback: Acceptability Among Young Adult Urban Women - Corrected Proof

Rachel Jones — 2011-06-13

The majority of all adolescent and young adult women (90%) with HIV were infected by unprotected sex with an infected male partner (). As of 2008, the epidemic had disproportionately affected Black women, who were 14% of the population of women in the United States but comprised 67% of women with HIV infection. It is estimated that in a lifetime, 1 in 30 Black women will be infected with HIV (). Innovative approaches to reduce sexual transmission of HIV to this population are needed.

Following the Trail of an HIV-Prevention Web Site Enhanced for Mobile Cell Phone Text Messaging Delivery - Corrected Proof

2011-05-10

Since the emergence of HIV, a plethora of Web sites have been developed to disseminate information about the disease. HIV-related Web sites provide facts about prevention, treatment, clinical trials, funding, support, and resources (). However, while the number of HIV-related Web sites has increased, rates of infection among African-American adolescents has also increased. In 2005, African Americans were 15% of the U.S. population ages 13–19 but represented 66% of adolescent AIDS cases (). These infection rates indicate that HIV-prevention efforts have not been fully effective in reaching at-risk adolescents. One evidence-based intervention, Becoming a Responsible Teen (BART), has been effective in reaching African-American adolescents with HIV information (), but the face-to-face approach of BART limits dissemination to only small groups of teens. Clearly an alternative approach to the delivery of this information is needed. One such alternative is the use of mobile cell phones (MCPs).

Falling Through the Cracks: Unmet Health Service Needs Among People Living with HIV in Atlanta, Georgia - Corrected Proof

2011-04-18

Despite growing numbers of people living with HIV (PLWH), the landscape of related services is shrinking. This study investigated health and social service needs of men (N = 489) and women (N = 165) living with HIV in Atlanta, GA. Participants completed confidential measures asking about the health and social services they needed and accessed. Results showed an array of health and social service needs among PLWH; failure to access services was prevalent. Hunger was among the most common basic needs, reported by greater than 60% of men and women. For men, unmet service needs were associated with fewer years since testing positive for HIV, higher CD4+ T cell values, experiencing more stressors and depression, and greater quantity of alcohol use. For women, failure to access services was associated with experiencing depression and not receiving HIV medications. Providing basic services to PLWH remains a public health priority and a moral imperative.

The Effects of Peer Education on Reduction of the HIV/Sexually Transmitted Infection Risk Behaviors Among Turkish University Students - Corrected Proof

Serap Bulduk, Semra Erdogan — 2011-04-18

This study investigated how HIV/sexually transmitted infection peer education (PE) affected HIV knowledge, perceived prevention self-efficacy, and risky sexual behaviors among Turkish university students (N = 118) who were sexually active but did not use condoms. A methodological and pre-/posttest controlled study design was used, with data collected before PE, just after PE, 3 months after PE, and 6 months after PE. We found significant differences according to group∗time interaction in the variables of HIV knowledge, self-efficacy for condom use and refusing sexual intercourse, and vaginal-oral-anal intercourse with condom, talking with the partner about condom use, refusing sexual intercourse with someone not using a condom, and taking alcohol before sexual intercourse. No differences were found according to group∗time interaction in self-efficacy for asking potential partners questions, using drugs before and after sexual intercourse, and sexual partner. Peer education was found to reduce risky sexual behaviors among university students. Peer education should focus on safer sexual behaviors to develop strategies to increase self-efficacy.