Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: A qualitative study

2016 ◽  
Vol 99 (5) ◽  
pp. 754-759 ◽  
Author(s):  
Ismael Ddumba-Nyanzi ◽  
David Kaawa-Mafigiri ◽  
Helle Johannessen
Keyword(s):  
Qualitative Study ◽  
Hiv Care ◽  
Care Providers ◽  
Women Living With Hiv ◽  
Child Bearing ◽  
Barriers To Communication ◽  
Living With Hiv

Gender-affirming healthcare experiences and medical transition among transgender women living with HIV: a mixed-methods study

Sexual Health ◽  
2019 ◽  
Vol 16 (4) ◽  
pp. 367 ◽  
Author(s):  
Ashley Lacombe-Duncan ◽  
Peter A. Newman ◽  
Greta R. Bauer ◽  
Carmen H. Logie ◽  
Yasmeen Persad ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Study ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Structural Barriers ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Trans Women ◽  
Living With Hiv

Background Transgender (trans) women are overrepresented among people living with HIV, yet trans women living with HIV (WLWH) experience lower access to HIV care. Access to medical transition may facilitate access to HIV care among trans WLWH. This study sought to describe barriers and facilitators to access to medical transition among trans WLWH. Methods: This convergent parallel mixed-methods study drew on cross-sectional quantitative data from 48 trans WLWH analysed using descriptive and bivariate analyses, as well as qualitative semistructured interview data from a subsample of 11 participants analysed using framework analysis. The primary outcome was self-reported transition experience (completed or in the process of medical transition vs planning to but have not begun medical transition). Quantitative and qualitative results were merged and analysed for convergence, divergence and/or expansion of understanding. Results: Just over half the participants reported being fully completed medical transition or in the process of medical transition (52.1% (25/48); 95% confidence interval (CI) 37.5–67.6%), with one-fifth reporting planning to but not having begun medical transition (18.8% (9/48); 95% CI 8.3–29.2%). Factors significantly associated with not having begun one’s medical transition included housing instability, transphobia, HIV-related stigma and barriers in access to care. Qualitative findings revealed varied transition experiences, influenced by community norms, passing and class privilege, HIV and structural barriers. Mixed-methods results showed positive relationships between trans WLWH and HIV care providers in terms of trans and HIV health care. Conclusions: HIV-related stigma and social determinants of health limit access to medical transition for trans WLWH. Stigma must be addressed in a broad range of healthcare settings, in addition to structural barriers, to increase access to gender-affirming HIV care and medical transition for trans WLWH.

scholarly journals HIV MADE ME STRONGER: CONCEPTIONS OF SUCCESSFUL AGING AMONG OLDER WOMEN LIVING WITH HIV

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S765-S765
Author(s):  
Anna A Rubtsova ◽  
Tonya Taylor ◽  
Gina Wingood ◽  
Igho Ofotokun ◽  
Deborah Gustafson ◽  
...  
Keyword(s):  
Data Collection ◽  
Qualitative Study ◽  
Older Women ◽  
Successful Aging ◽  
Life Course Perspective ◽  
Stable Phase ◽  
Structured Interviews ◽  
Women Living With Hiv ◽  
Living With Hiv

Abstract Little is known about successful aging (SA) among older (50+) women living with HIV (OWLH). Therefore, the purpose of this qualitative study was to examine subjective understandings of SA among OWLH. Participants were OWLH enrolled in the Women’s Interagency HIV Study (WIHS) and those not enrolled in WIHS: 8 in Atlanta, GA (3 WIHS and 5 non-WIHS) and 9 in Brooklyn, NY (6 WIHS and 3 non-WIHS). Semi-structured interviews ranged from 30 to 120 minutes. Several themes emerged in participants’ definitions of SA, e.g. self-care, taking HIV medications, and being resilient (“HIV made me stronger”). Both WIHS and non-WIHS participants emphasized life course perspective in their definitions of SA -- women viewed their aging successful as a more stable phase of life in contrast to hardships they experienced while being younger (e.g., drug use, incarceration). Data collection efforts are ongoing and will allow further characterization of SA among this population.

scholarly journals Health System Factors Constrain HIV Care Providers in Delivering High-Quality Care: Perceptions from a Qualitative Study of Providers in Western Kenya

2019 ◽  
Vol 18 ◽  
pp. 232595821882328 ◽  
Author(s):  
Becky Genberg ◽  
Juddy Wachira ◽  
Catherine Kafu ◽  
Ira Wilson ◽  
Beatrice Koech ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Working Environment ◽  
Health System Strengthening ◽  
Eastern Africa ◽  
Hiv Care ◽  
Care Providers ◽  
High Quality ◽  
Western Kenya ◽  
System Factors

The burden on health systems due to increased volume of patients with HIV continues to rapidly increase. The goal of this study was to examine the experiences of HIV care providers in a high patient volume HIV treatment and care program in eastern Africa. Sixty care providers within the Academic Model Providing Access to Healthcare program in western Kenya were recruited into this qualitative study. We conducted in-depth interviews focused on providers’ perspectives on health system factors that impact patient engagement in HIV care. Results from thematic analysis demonstrated that providers perceive a work environment that constrained their ability to deliver high-quality HIV care and encouraged negative patient–provider relationships. Providers described their roles as high strain, low control, and low support. Health system strengthening must include efforts to improve the working environment and easing burden of care providers tasked with delivering antiretroviral therapy to increasing numbers of patients in resource-constrained settings.

scholarly journals Health care providers and HIV

2021 ◽  
Author(s):  
Anne C. Wagner
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Care Providers ◽  
Related Stigma ◽  
Convergent And Divergent Validity ◽  
Living With Hiv

The current investigation seeks to examine the attitudes and beliefs of health care providers in Canada about people living with HIV. The line of research consists of three studies. Study 1 was a qualitative study conducted with a critical lens. The critical lens was used in a series of four focus groups when qualitatively soliciting opinions about the range of attitudes, behaviours and cognitions health care providers may have towards people living with HIV. Study 2 used the information gathered from Study 1 to develop a scale to assess HIV stigma in health care providers. Items were created from examples and themes found in the qualitative study, and were tested via exploratory factor analysis, confirmatory factor analysis, test-retest reliability analysis, and assessed for convergent and divergent validity. Study 3 examined the newly developed scale’s relationship to proposed overlapping stigmas and attitudes, and tested the adapted intersectional model of HIV-related stigma with health care trainees using the newly developed HIV stigma scale as an outcome measure. The line of research found that HIV stigma continues to be a significant problem in the health care system. The scale developed in Study 2 demonstrates that HIV stigma can be conceptualized and assessed as a tripartite model of discrimination, stereotyping and prejudice, and that this conceptualization of HIV stigma supports an intersectional model of overlapping stigmas with homophobia, racism, stigma against injection drug use and stigma against sex work.

Utility and acceptability of text messages for PMTCT: a qualitative assessment of user experiences (Preprint)

2021 ◽  
Author(s):  
Melinda Brown ◽  
May Maloba ◽  
Catherine Wexler ◽  
Natabhona Mabachi ◽  
Sharon Koech ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Pilot Study ◽  
Clinical Care ◽  
Text Messages ◽  
Hiv Care ◽  
Qualitative Assessment ◽  
Women Living With Hiv ◽  
Pregnancy And Postpartum ◽  
Living With Hiv ◽  
The Impact

BACKGROUND Evidence that text messages can support patient adherence to HIV care is growing. We conducted a pilot study of the HIV Infant Tracking System (HITSystem 2.0), an intervention that includes SMS to patients to support maternal medication adherence, appointment attendance, and hospital-based deliveries during the antenatal period. OBJECTIVE The objective of this study was to qualitatively assess women’s experiences receiving SMS to understand message utility and acceptability with the goal of refining and strengthening the intervention. METHODS As part of an intervention development pilot study, we conducted semi-structured interviews with 33 women living with HIV who received SMS through the HITSystem 2.0 throughout their pregnancy and postpartum period. Interview questions assessed women’s feedback of the SMS, the impact of the SMS on their PMTCT care, and suggestions for improvement. RESULTS Participants described how SMS reinforced existing strategies for medication adherence and served as cues to action for antenatal appointments and hospital-based deliveries. SMS also provided encouragement and enhanced their sense of engagement with their clinical care team. Given the neutral content of the messages, most women reported no concerns about message confidentiality. Recommendations to enhance utility included greater customizability (timing and frequency of messages) and a few women suggested more comprehensive counseling regarding the SMS content to anticipate at the time of enrollment. CONCLUSIONS SMS content was deemed useful and acceptable by pregnant and postpartum women living with HIV and engaged in PMTCT services. Participant recommendations to increase message customization options have been adopted to enhance the intervention. CLINICALTRIAL Trial registration: clinicaltrials.gov, NCT02726607. Registered 01 April 2016. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02726607

scholarly journals 3242 Stressful experiences and adherence to HIV care among Black Women Living with HIV: A qualitative analysis

2019 ◽  
Vol 3 (s1) ◽  
pp. 74-74
Author(s):  
Crystal Chapman Lambert ◽  
Chastity McDavid ◽  
Tammi F. Thomas ◽  
Kiko King ◽  
Andres Azuero ◽  
...  
Keyword(s):  
Social Support ◽  
Black Women ◽  
Physical Abuse ◽  
Traumatic Events ◽  
The United States ◽  
Stressful Events ◽  
Hiv Care ◽  
Care Clinic ◽  
Women Living With Hiv ◽  
Living With Hiv

OBJECTIVES/SPECIFIC AIMS: Our primary objective was to understand the relationship between incident or recent stressful events and adherence to HIV care in the context of other person, environment, and HIV-specific stressors in a sample of Black women living with HIV (WLWH). METHODS/STUDY POPULATION: Thirty in-depth interviews were conducted with Black women living with HIV who receive care at an academic HIV primary care clinic in the Southern region of the United States to elicit stressful events influencing adherence to HIV care. Semi-structured interview guides were used to facilitate discussion regarding stressful events and adherence to HIV care. Interviews were audiotaped and transcribed verbatim. Transcripts were independently coded using a theme-based approach by two experienced coders, findings were compared, and discrepancies were resolved by discussion. RESULTS/ANTICIPATED RESULTS: Participants described frequently experiencing incident stressful events including death or serious illness of a close friend or family member, and relationship, financial, and employment difficulties. Furthermore, participants reported experiencing traumatic events such as sexual and physical abuse during childhood and adolescents. While experiencing traumatic events such as sexual and physical abuse during childhood and adolescence may be distressing, these events did not influence adherence to HIV care. However, incident stressful events as defined above did influence adherence to HIV care for some participants, but not for others. For participants who reported that stressful events did not influence adherence to HIV care, factors such as personal motivation, access to social support, and adaptive coping strategies facilitated their engagement in care. DISCUSSION/SIGNIFICANCE OF IMPACT: Experiencing stressful events, incident or traumatic, is common among Black WLWH and have the potential to negatively influence adherence to HIV care. Thus, Interventions aimed at identifying and addressing stress, social support, and coping are essential to improve adherence to HIV care behaviors.

scholarly journals Evolving Toward Shared HIV Care Using the Champlain BASE eConsult Service

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831986821
Author(s):  
Claire E. Kendall ◽  
Janessa E. Porter ◽  
Esther S. Shoemaker ◽  
Rachel Seoyeon Kang ◽  
Michael Fitzgerald ◽  
...  
Keyword(s):  
At Risk ◽  
Primary Care Providers ◽  
Question Type ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Local Health ◽  
Care Providers ◽  
Patients At Risk ◽  
Survey Responses ◽  
Living With Hiv

Background. Electronic consultation (eConsultation) is a potential strategy to improve access to specialist expertise and facilitate collaborative care models. The Champlain BASE eConsult service allows for asynchronous communication between primary care providers (PCP) and specialists on a secure, web-based system. HIV experts accessible include HIV physician specialists, HIV pharmacists, and social workers with expertise in HIV. Objective. This study aims to describe the use, value, and utility of this eConsultation service in the care of people living with HIV and to characterize the common question types and clinical topics asked by PCPs. Methods. We analyzed the data from eConsults sent to the HIV specialty group in Ontario’s Champlain Local Health Integration Network between February 2015 and December 2017. Usage data and close-out survey responses were analyzed using descriptive statistics, eConsults were classified using a predefined list of validated taxonomy, and a thematic analysis was performed on the consultation logs to identify common clinical themes. Results. Among the 46 eConsults, the most common question type related to drug treatment (58.7%, n = 27) and management (19.6%, n = 9). The main clinical themes involved the care of significant complexities in people living with HIV, such as comorbidities and drug interactions, and suggestions of coordinated patient care. As well, eConsult was used for advice regarding pre-exposure prophylaxis for HIV-negative patients at risk of HIV infection. PCPs highly valued the eConsult service (average rating 4.8/5). Conclusion. Overall, this study demonstrates that eConsult provides an efficient and valuable service to PCPs caring for patients living with or at risk for HIV by improving access to HIV specialists and facilitating the delivery of team-based comprehensive care.

scholarly journals Training Exposure and Self-Rated Competence among HIV Care Providers Working with Adolescents in Kenya

2020 ◽  
Vol 19 ◽  
pp. 232595822093526
Author(s):  
Elizabeth Karman ◽  
Kate S. Wilson ◽  
Cyrus Mugo ◽  
Jennifer A. Slyker ◽  
Brandon L. Guthrie ◽  
...  
Keyword(s):  
Health Care ◽  
Work Experience ◽  
Hiv Care ◽  
Care Providers ◽  
Care Workers ◽  
Competence Training ◽  
Expert Input ◽  
Living With Hiv ◽  
Care Worker ◽  
Youth Friendly

Lack of health care worker (HCW) training is a barrier to implementing youth-friendly services. We examined training coverage and self-reported competence, defined as knowledge, abilities, and attitudes, of HCWs caring for adolescents living with HIV (ALWH) in Kenya. Surveys were conducted with 24 managers and 142 HCWs. Competence measures were guided by expert input and Kalamazoo II Consensus items. Health care workers had a median of 3 (interquartile range [IQR]: 1-6) years of experience working with ALWH, and 40.1% reported exposure to any ALWH training. Median overall competence was 78.1% (IQR: 68.8-84.4). In multivariable linear regression analyses, more years caring for ALWH and any prior training in adolescent HIV care were associated with significantly higher self-rated competence. Training coverage for adolescent HIV care remains suboptimal. Targeting HCWs with less work experience and training exposure may be a useful and efficient approach to improve quality of youth-friendly HIV services.

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