What makes an optimal delivery for PrEP against HIV: A qualitative study in MSM

2022 ◽  
pp. 095646242110608
Author(s):  
Janice Y. C. Lau ◽  
Ngai-Sze Wong ◽  
Krystal C. K. Lee ◽  
Tsz-Ho Kwan ◽  
Grace C. Y. Lui ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Service Providers ◽  
Effective Means ◽  
Qualitative Assessment ◽  
Theory Approach ◽  
Service Model ◽  
Structured Interviews ◽  
Sexually Transmitted ◽  
Ethnic Chinese ◽  
Sex With Men

Background Pre-exposure prophylaxis (PrEP) is an effective means of HIV prevention for men who have sex with men (MSM), a key population whose engagement is crucial for achieving effective public health outcomes. An optimal service model would be important in planning the implementation of PrEP in places where such service has not been established. Methods A qualitative study was conducted to delineate the attributes of an optimal PrEP service model for MSM in Hong Kong, a city where no formal PrEP programs existed. Twenty purposively sampled MSM who were enrollees of two pilot PrEP projects participated in the semi-structured interviews promoting story-telling. The coded data were thematically analyzed following Grounded Theory approach, focusing on uncovering a typology of the essential attributes of an optimal PrEP service model, and the reasons for such preferences. Results Participating MSM were all ethnic Chinese and aged 26 to 52 years. All had received PrEP from pilot projects in conjunction with periodic screening of sexually transmitted infections (STI), HIV antibody, and plasma creatinine. Four major themes emerged as regards the attributes of a preferred PrEP service: (i) comprehensiveness of HIV/STI and safety monitoring; (ii) convenient unitary service; (iii) stigma-free PrEP access and protecting confidentiality; and (iv) affordable price. Whereas regular provision of PrEP was acceptable to MSM, unaffordability and related stigma were the anticipated challenges for potential service providers. Conclusions The qualitative assessment of MSM’s preference for PrEP service delivery has yielded important information on the many facets of a desirable service model.

scholarly journals “You can smell the freedom”: a qualitative study on perceptions and experiences of sex among Swedish men who have sex with men in Berlin

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024459 ◽  
Author(s):  
Nicklas Dennermalm ◽  
Kristina Ingemarsdotter Persson ◽  
Sarah Thomsen ◽  
Birger C Forsberg
Keyword(s):  
Qualitative Study ◽  
High Mobility ◽  
Structured Interviews ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Cultural Aspects ◽  
Multiple Partners ◽  
Sti Testing ◽  
Sex With Men ◽  
Exposure Prophylaxis

PurposeThe purpose of this study was to explore the perceptions and experiences of sex among Swedish Men who have Sex with Men (MSM) in Berlin.BackgroundMSM are disproportionally affected by HIV.Berlin is also a key destination when looking into where Swedish MSM sero-convert, while travelling.MethodA qualitative study with semi-structured interviews using open-ended questions with participants recruited through network sampling. Data were analysed with content analysis.Participants15 Swedish cis-men (as in non-transgender) who have sex with men aged 25–44 years, who travelled to or were living in Berlin. To be included in the study, the participants had to be cis-MSM, Swedish citizens, spending time in Berlin and having sex in both settings.ResultsFor a majority of the participants, sex was the main reason for going to Berlin but cultural aspects like art and the techno scene were also important. Berlin was perceived as a sex-oriented city providing venues where respondents did not have to care about reputation and status and where social and sexual spaces co-existed side by side. This in sharp contrast to Sweden, which represented a limiting environment both in culture and what was available culturally and sexually.ConclusionThe men interviewed experienced multiple partners and had a broad sexual repertoire both abroad and at home. However, the behaviour was amplified in Berlin. The men did not alter their safer sex practice depending on if they had sex in Sweden or Berlin. The high mobility and vulnerability for HIV/sexually transmitted infection (STI) among these men highlights the need of increased access to antiretroviral treatment, pre-exposure prophylaxis for HIV and low-threshold HIV/STI testing services in Europe.

scholarly journals Processes and determinants of integration of eGFR in physicians’ drug prescriptions: a qualitative study of semi-structured interviews

2019 ◽  
Vol 20 ◽  
Author(s):  
Louis Lefèvre ◽  
Maud Jourdain ◽  
Jean-Pascal Fournier
Keyword(s):  
Qualitative Study ◽  
Adverse Drug Reactions ◽  
Healthcare Professionals ◽  
Drug Prescriptions ◽  
Theory Approach ◽  
Snowball Sampling ◽  
Drug Reactions ◽  
Structured Interviews ◽  
Training Professional ◽  
Grounded Theory Approach

Abstract Aim: Our objective was to explore the processes and determinants leading physicians to integrate estimated glomerular filtration rate (eGFR) in their drug prescriptions Background: Access to patients’ eGFR would allow primary care pharmacists to optimise their role in the procedure of safe prescribing. Some rare physicians actively integrate eGFR in their prescriptions, in a sporadically and uncoordinated manner. Methods: Qualitative study using semi-directed interviews conducted among 12 French physicians who integrated eGFR in their drug prescriptions, (February 2016–April 2017). These voluntary participants were recruited through different means: Twitter®, forums, direct contact and snowball sampling. Data analysis was based on the grounded theory approach, underpinned by a comprehensive perspective of interactionist orientation. Findings: Residency and training, professional experience – including experiences of adverse drug reactions – and the membership in various communities of professionals were key drivers for the integration of eGFR in prescriptions. The theoretical aim was above all safe prescribing in order to reduce adverse drug reactions, with the control by a dispensing pharmacist and/or other healthcare professionals. Nevertheless, none of the physicians had received any feedback from any healthcare professionals. Despite their disappointment, the physicians remained convinced of the interest of integrating eGFR in their prescriptions and would continue to do so. Characteristics associated with integration of eGFR in drug prescriptions belong partly to Roger’s theory of innovations. If a widespread diffusion of this habit takes place, it will be necessary to evaluate its adoption by both physicians and pharmacists.

Outcomes of a care coordinated service model for persons with severe and persistent mental illness: A qualitative study

2016 ◽  
Vol 63 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Anton N Isaacs ◽  
Keith Sutton ◽  
Kim Dalziel ◽  
Darryl Maybery
Keyword(s):  
Mental Illness ◽  
Qualitative Study ◽  
Service Providers ◽  
Unmet Need ◽  
Australian Government ◽  
Service Model ◽  
Delivery Of Care ◽  
Persistent Mental Illness ◽  
Multiple Services ◽  
Partners In Recovery

Background: Owing to difficulties faced by individuals with severe and persistent mental illness (SPMI) in accessing multiple services, the Australian Government trialed a care coordinated service model called the Partners in Recovery (PIR) initiative. Material: A total of 45 stakeholders in Gippsland were asked what difference the initiative had made. Discussion: The PIR initiative benefited not only clients and carers but also service providers. It addressed an unmet need in service delivery for individuals with SPMI. Conclusion: The PIR initiative has filled a gap in delivery of care for individuals with SPMI in Gippsland.

scholarly journals Sexual risk behaviour and sexually transmitted infections in men who have sex with men

2020 ◽  
Vol 6 (2) ◽  
pp. 178
Author(s):  
Murugan Swamiappan ◽  
Manjula Jagannathan ◽  
Aysha Abdulla
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexual Risk ◽  
Service Providers ◽  
Risk Behaviour ◽  
Unprotected Sex ◽  
Sexual Risk Behaviour ◽  
Sexually Transmitted ◽  
Condom Usage ◽  
Sex With Men ◽  
Clinical Records

<p class="abstract"><strong>Background:</strong> In India the estimated men who have sex with men (MSM) population is around 352, 000, among that 4.3% are living with HIV. The incidence of sexually transmitted infections (STIs) in MSM is greater than that reported in women and men who have sex with women only. The aim of the study is to determine the trends of sexual behaviour and the pattern of sexually transmitted infections in men who have sex with men.</p><p class="abstract"><strong>Methods:</strong> A retrospective study of the data collected from the clinical records of all MSM, who had attended the STI clinic of Kilpauk Medical College, Chennai, Tamil Nadu, during the three-year study period, from July 2016 to June 2019. Demographic data, sexual risk behaviour, condom usage and STIs, among the MSM, were computed and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the study period 489 MSM attended the STI clinic, 51.9% were bisexual and 48.1 % were homosexual. Among them, exclusive penetrative sex in 50.7%, exclusive receptive sex in 15.7% and both in 33.6% were reported. Condom usage was consistent in 18.8%, inconsistent in 28.8% and 52.9% never used condom. Unprotected sex is more common in oral sex than with anal sex. STIs were seen in 20.9% and HIV in 1.4% of MSM. Syphilis was the most common STI seen.</p><p class="abstract"><strong>Conclusions:</strong> Our study elucidated the high prevalence of STIs among MSM and increasing trends of sexual risk behaviour. Health service providers must take necessary steps to improve the provision of biological and medical measures to screen, treat and prevent infections.</p><p class="abstract"> </p>

scholarly journals Telemedicine in The Context of Covid-19- A Qualitative Study of Cancer Patients and Clinicians

2021 ◽  
Author(s):  
Dylan Chan Tai Kong ◽  
Ashfaq Chauhan ◽  
Anaïs Tiffany Ah Leung ◽  
Melvin Chin
Keyword(s):  
Qualitative Study ◽  
Theory Approach ◽  
Structured Interviews ◽  
Hospital Data ◽  
Metropolitan Regions ◽  
Theoretical Sampling ◽  
Proper Training ◽  
Grounded Theory Approach

Abstract Background:Prior to the Covid-19 pandemic, telemedicine was only used to deliver health care to patients living in remote areas of Australia. However, the spread of the Covid-19 virus pushed the widespread uptake of telemedicine across Australia, including in metropolitan regions. This qualitative study will explore the medical oncology (MO) patient and clinician experience of telemedicine in a metropolitan setting as a result of Covid-19.Method:Participants were selected and invited to participate by theoretical sampling from MO clinicians and patients attending MO clinics at Prince of Wales Hospital. Data was collected by in-depth semi-structured interviews. Thematic analysis was performed to analyse the interview data. Transcripts were coded using the grounded theory approach to identify overarching themes.Results:Twelve participants were recruited to the study. Most participants viewed the adoption of telemedicine positively because it was considered as convenient, efficient and could be used in order to reduce the spread of Covid-19. Nonetheless, participants complained about the poor implementation of telemedicine, technical difficulties and lack of proper training. Finally, providers expressed mixed views over the lack of personal interaction and the lack of physical examination from telemedicine. However, both clinicians and patients viewed telemedicine as acceptable to be used in the context of routine follow-ups.Conclusion:Although some operational improvements are necessary, the role of telemedicine in the follow up of MO patients seems likely to continue beyond Covid-19.

Challenges of the Relative Value Unit Experience in Iran: A Qualitative Study

2021 ◽  
Vol 15 (5) ◽  
pp. 1249-1255
Author(s):  
S. Forootan ◽  
S. Hajebrahimi ◽  
B. Najafi ◽  
A. Janati
Keyword(s):  
Qualitative Study ◽  
Service Providers ◽  
Health Sector ◽  
Active Role ◽  
Structured Interviews ◽  
Group Discussions ◽  
Provider Behavior ◽  
Income Disparities ◽  
Relative Value ◽  
Data Content

Background: The Relative Value Unit (RVU) is a value scale and plays a key role in the physician reimbursement system. The health sector has faced challenges such as providers’ dissatisfaction, income disparities, and reduced service quality which is said to be due to improper RVUs. Always there are debates about it. This study aims to identify the challenges of the RVU experience in Iran from the perspective of the service providers, payers and, policymakers. Methods: This qualitative study was conducted in 2020. Data were collected from November 2019 to February 2020. Thirty experts participated in the study and were categorized into four groups: insurance organizations’ managers, surgeons, health economists, and health policymakers. Focus Group Discussions and semi-structured interviews were held to collect data. Content analysis was conducted to analyze data. Results: According to the expert, the challenges of RVU in Iran are classified into five scopes. Financial, payment, macro-organization, regulation, and persuasion scope. Each scope’s result was categorized into main themes and relevant sub-themes. Conclusions: The RVU has an important impact on the health system, provider behavior, and even patients. Paying attention to required infrastructures, decision- makers’ conflict of interests, decrease the Ministry of Health and Medical Education’s authority, and expanding the active role of involved organizations to increase their commitment to the successful implantation of RVU is necessary. Keywords: Relative Value Unit, Challenge, Expert opinion, Qualitative study, Iran.

Reactions to Self-Sampling for Ano-Rectal Sexually Transmitted Infections Among Men Who Have Sex with Men: A Qualitative Study

2009 ◽  
Vol 40 (2) ◽  
pp. 281-288 ◽  
Author(s):  
Joshua G. Rosenberger ◽  
Brian Dodge ◽  
Barbara Van Der Pol ◽  
Michael Reece ◽  
Debby Herbenick ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted ◽  
Sex With Men

scholarly journals ‘Thinking you're old and frail’: a qualitative study of frailty in older adults

2015 ◽  
Vol 36 (7) ◽  
pp. 1483-1500 ◽  
Author(s):  
KRYSTAL WARMOTH ◽  
IAIN A. LANG ◽  
CASSANDRA PHOENIX ◽  
CHARLES ABRAHAM ◽  
MELISSA K. ANDREW ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Physical Activities ◽  
Future Research ◽  
Activity Levels ◽  
Theory Approach ◽  
Structured Interviews ◽  
Institutional Settings ◽  
Perceptions And Attitudes ◽  
Grounded Theory Approach

ABSTRACTMany older adults experience what is clinically recognised as frailty but little is known about the perceptions of, and attitudes regarding, being frail. This qualitative study explored adults' perceptions of frailty and their beliefs concerning its progression and consequences. Twenty-nine participants aged 66–98 with varying degrees of frailty, residing either in their homes or institutional settings, participated in semi-structured interviews. Verbatim transcripts were analysed using a Grounded Theory approach. Self-identifying as ‘frail’ was perceived by participants to be strongly related to their own levels of health and engagement in social and physical activity. Being labelled by others as ‘old and frail’ contributed to the development of a frailty identity by encouraging attitudinal and behavioural confirmation of it, including a loss of interest in participating in social and physical activities, poor physical health and increased stigmatisation. Using both individual and social context, different strategies were used to resist self-identification. The study provides insights into older adults' perceptions and attitudes regarding frailty, including the development of a frailty identity and its relationship with activity levels and health. The implications of these findings for future research and practice are discussed.

scholarly journals Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrés Cernadas ◽  
Ángela Fernández
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Healthcare Workers ◽  
Service Providers ◽  
Universal Access ◽  
Healthcare Services ◽  
Medical Professional ◽  
Homeless Population ◽  
Public Health Services ◽  
Structured Interviews

Abstract Background In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use public care enough to maintain their health. The objective of this study is to determine if homeless individuals can access public health services in conditions of equality with the rest of the population, as established in healthcare legislation, and to better understand the causes of observed inequalities or inequities of access. Methods A detailed qualitative study was carried out in the city of Barcelona (Spain) from October 2019 to February 2020. A total of nine open and in-depth interviews were done with homeless individuals along with seven semi-structured interviews with key informants and two focus groups. One group was composed of eight individuals who were living on the street at the time and the other consisted of eight individuals working in healthcare and social assistance. Results The participants indicated that homeless individuals tend to only access healthcare services when they are seriously ill or have suffered some kind of injury. Once there, they tend to encounter significant barriers that might be 1) administrative; 2) personal, based on belief that that will be poorly attended, discriminated against, or unable to afford treatment; or 3) medical-professional, when health professionals, who understand the lifestyle of this population and their low follow-through with treatments, tend towards minimalist interventions that lack the dedication they would apply to other groups of patients. Conclusions The conclusions derived from this study convey the infrequent use of health services by homeless individuals for reasons attributable to the population itself, to healthcare workers and to the entire healthcare system. Accordingly, to reduce inequities of access to these services, recommendations to healthcare service providers include adapting facilities to provide more adequate care for this population; increasing sensitivity/awareness among healthcare workers; developing in situ care systems in places where the homeless population is most concentrated; and establishing healthcare collaboration agreements with entities that work with this population.

scholarly journals Factors Predicting Uptake of Sexually Transmitted Infections Testing among Men Who Have Sex with Men Who Are “Pre-Exposure Prophylaxis Tourists”—An Observational Prospective Cohort Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3582
Author(s):  
Zixin Wang ◽  
Yuan Fang ◽  
Natthakhet Yaemim ◽  
Kai J. Jonas ◽  
Andrew Chidgey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Service Providers ◽  
Risky Behaviors ◽  
Service Planning ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Sex With Men ◽  
Exposure Prophylaxis

The term “Pre-exposure prophylaxis (PrEP) tourists” refers to individuals who obtain PrEP in other countries and use it in their home countries. A prospective observational cohort study was conducted among a group of men who have sex with men (MSM) who obtained PrEP in private clinics in Thailand and used it in Hong Kong. Participants completed two web-based self-administered surveys when obtaining PrEP in Thailand and three months afterwards. Out of 110 participants at baseline, 67 completed the follow-up. The prevalence of sexually transmitted infection (STI) testing was 47.8% during the follow-up period. Eleven participants received an STI diagnosis, and seven of them were incident infections in the past three months. Participants who perceived a higher chance for STI infection (adjusted odds ratios (AOR): 1.90, 95% CI: 1.00, 3.75) and reported higher intention to take up STI testing at baseline (AOR: 1.62, 95% CI: 1.05, 2.50) were more likely to receive STI testing during the follow-up period. Baseline perceptions that service providers would think they were having risky behaviors because of PrEP use was negatively associated with the dependent variable (AOR: 0.51, 95% CI: 0.31, 0.86). Service planning and health promotion related to STI testing is needed for MSM “PrEP tourists”.

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