scholarly journals Health Care–Seeking Behaviors and Perceptions of Provider-Initiated Discussion of Pre-exposure Prophylaxis Among PrEP-Naïve HIV-Negative Men Who Have Sex With Men in Atlanta, Georgia

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Susanna L Trost ◽  
Udodirim N Onwubiko ◽  
Derick B Wilson ◽  
David P Holland ◽  
Allison T Chamberlain
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Care System ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Health Care Seeking Behaviors ◽  
Hiv Negative ◽  
Care System

Abstract Background Given high rates of HIV among men who have sex with men (MSM) in the United States, there is a need to more effectively leverage the health care system to bolster promotion of pre-exposure prophylaxis (PrEP) to at-risk MSM. Methods Using data collected from a 2018 venue-based cross-sectional survey, we examined factors associated with health care–seeking behaviors, discussing PrEP with a provider, and barriers to PrEP uptake among MSM. Associations between outcomes and respondents’ sociodemographic characteristics and sexual behaviors were assessed using log binomial regression. Results Of 478 MSM, 247 (51%) were PrEP-naïve and HIV-negative. Although 85% of PrEP-naïve MSM reported visiting a health care provider in the past year, only 31% recalled having any provider discuss PrEP. The most frequently cited reasons for not taking PrEP were low perception of personal risk of acquiring HIV (37%) and not knowing enough about PrEP (35%). Those who saw a provider in the last year were less likely than those who did not to cite lack of knowledge as a barrier to use (prevalence rate, 0.66, 95% confidence interval, 0.45–0.96). Conclusions Despite the majority of PrEP-naïve MSM interfacing with the health care system, recollection of discussing PrEP with providers was limited. Increased efforts to equip providers with the tools to discuss PrEP and address pressing concerns with at-risk individuals may help improve PrEP uptake among priority populations.

scholarly journals Health Care Seeking Behavior of Persons with Acute Chagas Disease in Rural Argentina: A Qualitative View

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ignacio Llovet ◽  
Graciela Dinardi ◽  
Cecilia Canevari ◽  
Nahal Torabi
Keyword(s):  
Health Care ◽  
Chagas Disease ◽  
Health Care System ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Acute Case ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
Health Care Seeking Behavior ◽  
Care System

Chagas disease (CD) is a tropical parasitic disease largely underdiagnosed and mostly asymptomatic affecting marginalized rural populations. Argentina regularly reports acute cases of CD, mostly young individuals under 14 years old. There is a void of knowledge of health care seeking behavior in subjects experiencing a CD acute condition. Early treatment of the acute case is crucial to limit subsequent development of disease. The article explores how the health outcome of persons with acute CD may be conditioned by their health care seeking behavior. The study, with a qualitative approach, was carried out in rural areas of Santiago del Estero Province, a high risk endemic region for vector transmission of CD. Narratives of 25 in-depth interviews carried out in 2005 and 2006 are analyzed identifying patterns of health care seeking behavior followed by acute cases. Through the retrospective recall of paths for diagnoses, weaknesses of disease information, knowledge at the household level, and underperformance at the provincial health care system level are detected. The misdiagnoses were a major factor in delaying a health care response. The study results expose lost opportunities for the health care system to effectively record CD acute cases.

Health care seeking behaviors for sick children: time span for seeking health care

2015 ◽  
Vol 19 (2) ◽  
pp. 67-74
Author(s):  
Fulya Akpak ◽  
Nuri Seha Yüksel ◽  
Ayşegül Kabanlı ◽  
Tolga Günvar
Keyword(s):  
Health Care ◽  
Time Span ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Sick Children ◽  
Health Care Seeking Behaviors

scholarly journals Southern African guidelines for the safe use of pre-exposure prophylaxis in men who have sex with men who are at risk for HIV infection

2012 ◽  
Vol 13 (2) ◽  
Author(s):  
Southern African HIV Clinicians Society Consensus Committee
Keyword(s):  
At Risk ◽  
Renal Function ◽  
Hiv Prevention ◽  
Hepatitis B ◽  
Hiv Infection ◽  
Creatinine Clearance ◽  
Fixed Dose ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Background. The use of oral antiretrovirals to prevent HIV infection among HIV-negative men who have sex with men (MSM) has been shown to be safe and efficacious. A large, randomised, placebo-controlled trial showed a 44% reduction in the incidence of HIV infection among MSM receiving a daily oral fixed-dose combination of tenofovir disoproxil fumarate and emtricitabine (Truvada) in combination with an HIV prevention package. Improved protection was seen with higher levels of adherence. Aim. The purpose of this guideline is to: (i) explain what pre-exposure prophylaxis (PrEP) is; (ii) outline current indications for its use; (iii) outline steps for appropriate client selection; and (iv) provide guidance for monitoring and maintaining clients on PrEP. Method. PrEP is indicated for HIV-negative MSM who are assessed to be at high risk for HIV acquisition and who are willing and motivated to use PrEP as part of a package of HIV prevention services (including condoms, lubrication, sexually transmitted infection (STI) management and risk reduction counselling). Recommendations. HIV testing, estimation of creatinine clearance and STI and hepatitis B screening are recommended as baseline investigations. Daily oral Truvada, along with adherence support, can then be prescribed for eligible MSM. PrEP should not be given to MSM with abnormal renal function, nor to clients who are unmotivated to use PrEP as part of an HIV prevention package; nor should it be commenced during an acute viral illness. Three-monthly follow-up visits to assess tolerance, renal function, adherence and ongoing eligibility is recommended. Six-monthly STI screens and annual creatinine levels to estimate creatinine clearance are recommended. Hepatitis B vaccination should be provided to susceptible clients. Gastro-intestinal symptoms and weight loss are common side-effects, mostly experienced for the first 4 - 8 weeks after initiating PrEP. There is a risk of the development of antiretroviral resistance among those with undiagnosed acute HIV infection during PrEP initiation and among those with sub-optimal adherence who become HIV infected while on PrEP. Risk compensation (increasing sexual behaviours that can result in exposure to HIV) while on PrEP may become a concern, and clinicians should continue to support MSM clients to continue to use condoms, condom-compatible lubrication and practice safer sex. Research is ongoing to assess optimum dosing regimens, potential long-term effects and alternative PrEP medications. Recommendations for the use of PrEP among other at-risk individuals, and the components of these recommendations, will be informed by future evidence. S Afr J HIV Med 2012;13(2):40-55.

Mental health services for individuals at risk of suicide in Peru: Attitudes and perspectives of mental health professionals

2020 ◽  
pp. 002076402094678
Author(s):  
Dana Alonzo ◽  
Dafne Aida Zapata Pratto
Keyword(s):  
Mental Health ◽  
Health Care ◽  
At Risk ◽  
Mental Health Care ◽  
Health Care System ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Specialized Training ◽  
Mental Health Care System ◽  
Care System

Background: Mental Health professionals often have to deal with at-risk individuals in crises and lack specialized training on suicide risk assessment and intervention. This study examined mental health professionals’ attitudes toward at-risk individuals and their perceptions of the quality of training and treatment available for assessing and intervening with this population. Methods: A total of 32 mental health professionals (13 psychiatrists, 16 psychologists, 2 psychiatric nurses; 1 social assistant) from highly vulnerable communities in Lima, Peru discussed their perceptions in four focus groups conducted by the authors. Results: Participants reported glaring deficiencies in all areas explored including training, knowledge and skills regarding suicide assessment and management. In addition, using ground theory analysis, three domains of findings emerged representing barriers and facilitators of treatment engagement, risk and protective factors of suicide and pros and cons of the current mental health care system including micro-, mezzo- and macro-level factors. The most frequently identified barrier was the perception that suicide is illegal; facilitator was family involvement; risk factor was poor parenting; protective factor was religious beliefs; pro of mental health care system was establishment of community-based services and con of mental health care system was lack of access to psychiatrists. Conclusion: The lack of specialized training available in the institutions that are designed to prepare mental health professionals for working with at-risk individuals is notable and has a direct and known impact self-identified by helping professionals. The need and desire for targeted training is palpable and essential to address growing rates of suicide, particularly among youth, in Peru.

Longitudinal Correlates of Health Care-Seeking Behaviors Among HIV-Seropositive Injection Drug Users

2007 ◽  
Vol 46 (Supplement 2) ◽  
pp. S120-S126 ◽  
Author(s):  
James D Wilkinson ◽  
Wei Zhao ◽  
Julia H Arnsten ◽  
Amy R Knowlton ◽  
Yuko Mizuno ◽  
...  
Keyword(s):  
Health Care ◽  
Injection Drug Users ◽  
Drug Users ◽  
Injection Drug ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Health Care Seeking Behaviors ◽  
Hiv Seropositive
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