scholarly journals Using an Intersectional Approach to Study the Impact of Social Determinants of Health for African American Mothers Living With HIV

2014 ◽  
Vol 37 (4) ◽  
pp. 287-298 ◽  
Author(s):  
Courtney Caiola ◽  
Sharron L. Docherty ◽  
Michael Relf ◽  
Julie Barroso
2020 ◽  
Author(s):  
Scott D. Rhodes ◽  
Lilli Mann-Jackson ◽  
Jorge Alonzo ◽  
Manuel Garcia ◽  
Amanda E. Tanner ◽  
...  

Abstract Persons living with HIV (PLWH) may be at increased risk for severe COVID-19-related illness. Our community-based participatory research partnership collected and analyzed semi-structured interview data to understand the early impact of the COVID-19 pandemic on a sample of racially/ethnically diverse gay, bisexual, and other men who have sex with men living with HIV. Fifteen cisgender men participated; their mean age was 28. Six participants were Black/African American, five were Spanish-speaking Latinx, and four were White. Seventeen themes emerged that were categorized into six domains: knowledge and perceptions of COVID-19; COVID-19 information sources and perceptions of trustworthiness; impact of COVID-19 on behaviors, health, and social determinants of health; and general COVID-19-related concerns. Interventions are needed to ensure that PLWH have updated information and adhere to medication regimens, and to reduce the impact of COVID-19 on social isolation, economic stability, healthcare access, and other social determinants of health within this vulnerable population.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Phyo Pyae Nyein ◽  
Eithandee Aung ◽  
Ne Myo Aung ◽  
Mar Mar Kyi ◽  
Mark Boyd ◽  
...  

Abstract Background There is a growing recognition of the impact of gender and the social determinants of health on the clinical course of people living with HIV (PLHIV). However, the relative contribution of these factors to clinical outcomes of PLHIV is incompletely defined in many countries. This study was performed to gain a greater understanding of the non-clinical determinants of prognosis of PLHIV in Myanmar. Methods Selected demographic, behavioural and socioeconomic characteristics of outpatients at two specialist HIV hospitals and one general hospital in Yangon, Myanmar were correlated with their subsequent clinical course; a poor outcome was defined as death, hospitalisation, loss to follow-up or a detectable viral load at 6 months of follow-up. Results 221 consecutive individuals with advanced HIV commencing anti-retroviral therapy (ART) were enrolled in the study; their median CD4 T-cell count was 92 (44–158) cells/mm3, 138 (62.4%) were male. Socioeconomic disadvantage was common: the median (interquartile range (IQR) monthly per-capita income in the cohort was US$48 (31–77); 153 (69.9%) had not completed high school. However, in a multivariate analysis that considered demographic, behavioural, clinical factors and social determinants of health, male gender was the only predictor of a poor outcome: odds ratio (95% confidence interval): 2.33 (1.26–4.32, p = 0.007). All eight of the deaths and hospitalisations in the cohort occurred in males (p = 0.03). Conclusions Men starting ART in Myanmar have a poorer prognosis than women. Expanded implementation of gender-specific management strategies is likely to be necessary to improve outcomes.


2019 ◽  
Vol 24 (2) ◽  
pp. 159-165
Author(s):  
Jillian M. Berkman ◽  
Jonathan Dallas ◽  
Jaims Lim ◽  
Ritwik Bhatia ◽  
Amber Gaulden ◽  
...  

OBJECTIVELittle is understood about the role that health disparities play in the treatment and management of brain tumors in children. The purpose of this study was to determine if health disparities impact the timing of initial and follow-up care of patients, as well as overall survival.METHODSThe authors conducted a retrospective study of pediatric patients (< 18 years of age) previously diagnosed with, and initially treated for, a primary CNS tumor between 2005 and 2012 at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Primary outcomes included time from symptom presentation to initial neurosurgery consultation and percentage of missed follow-up visits for ancillary or core services (defined as no-show visits). Core services were defined as healthcare interactions directly involved with CNS tumor management, whereas ancillary services were appointments that might be related to overall care of the patient but not directly focused on treatment of the tumor. Statistical analysis included Pearson’s chi-square test, nonparametric univariable tests, and multivariable linear regression. Statistical significance was set a priori at p < 0.05.RESULTSThe analysis included 198 patients. The median time from symptom onset to initial presentation was 30.0 days. A mean of 7.45% of all core visits were missed. When comparing African American and Caucasian patients, there was no significant difference in age at diagnosis, timing of initial symptoms, or tumor grade. African American patients missed significantly more core visits than Caucasian patients (p = 0.007); this became even more significant when controlling for other factors in the multivariable analysis (p < 0.001). African American patients were more likely to have public insurance, while Caucasian patients were more likely to have private insurance (p = 0.025). When evaluating survival, no health disparities were identified.CONCLUSIONSNo significant health disparities were identified when evaluating the timing of presentation and survival. A racial disparity was noted when evaluating missed follow-up visits. Future work should focus on identifying reasons for differences and whether social determinants of health affect other aspects of treatment.


Author(s):  
Quyen Phan ◽  
Naomi Johnson ◽  
JoAnna Hillman ◽  
Daniel Geller ◽  
Laura P. Kimble ◽  
...  

AbstractObjectiveFor nursing students, competency in population health management involves acquiring knowledge and forming attitudes about the impact of the social determinants of health (SDoH) on health equity. The purpose of this pilot study was to assess nursing students’ knowledge and attitudes about the SDoH and health equity following a focused simulation activity.MethodBaccalaureate nursing students (N=182) participated in a ninety-minute health equity simulation and a post-simulation debrief. Forty-four students (23%) completed a 19-item post-simulation survey.ResultsSixty-four percent of participants reported positive attitude change in working with marginalized populations caused by the SDoH, and 89% reported being knowledgeable about the role of the registered nurse in addressing health equity. Seventy-five percent reported enhanced knowledge of the SDoH through the health equity simulation.ConclusionUsing health equity simulation may be effective in enhancing students’ knowledge, as well as their attitudes in caring for the health of marginalized populations by addressing the SDoH.


Sign in / Sign up

Export Citation Format

Share Document