Social Determinants of Depression Among Older Black Women Living With HIV

2019 ◽  
Vol 26 (6) ◽  
pp. 576-585 ◽  
Author(s):  
Giovanna C. De Oliveira ◽  
Rosina Cianelli ◽  
Natalia Villegas ◽  
Angel Solorzano Martinez ◽  
Kimberly Hires ◽  
...  
Keyword(s):  
Black Women ◽  
Social Determinants ◽  
Age Groups ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Prevalence Of Depression ◽  
Severity Of Depression ◽  
The Individual ◽  
Living With Hiv ◽  
The Impact

BACKGROUND: The prevalence of depression spans age-groups, but it can be particularly destructive for older people with chronic illness. Among older Black women living with HIV (OBWLH), multiple social determinants have been associated with the prevalence and severity of depression. A greater understanding of the impact of the social determinants at the individual, interpersonal, and community levels is needed. AIMS: To explore social determinants of depression among OBWLH at the intrapersonal, interpersonal, and community levels. METHOD: Cross-sectional descriptive design. RESULTS: A total of 118 OBWLH were analyzed in the study. Depression was prevalent among the participants. Approximately 89.8% of the participants had moderate to severe depressive symptoms. Health status, exercise, and social support were significant predictors of depression in the sample. CONCLUSION: Social determinants at multiple levels play a significant role in the occurrence and management of depression among OBWLH. Implications for practice, education, and research can be drawn from these findings.

scholarly journals Support for Lowering Cervical Cancer Screening Age To 25 for Women Living With HIV: Retrospective Cross-Sectional Programmatic Data From Botswana

2021 ◽  
Author(s):  
Doreen Ramogola-Masire ◽  
Surbhi Grover ◽  
Anikie Mathoma ◽  
Barati Monare ◽  
Lesego Gabaitiri ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Age Groups ◽  
Cervical Cancer Prevention ◽  
World Health ◽  
Hiv Status ◽  
Cross Sectional ◽  
Cancer Risk Factors ◽  
Women Living With Hiv ◽  
Younger Age ◽  
Living With Hiv

Abstract Background: Women living with human immunodeficiency virus (HIV) tend to develop cervical cancer at a younger age than HIV-negative women. The World Health Organization’s (WHO) new guidelines for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention include a conditional recommendation for initiating screening at age 25 for women living with HIV (WLWH). This recommendation is based on low-certainty evidence, and WHO calls for additional data. We describe the association of age and HIV status with visual inspection with acetic acid (VIA) positivity and cervical intra-epithelial neoplasia grade two or higher (CIN2+) in Botswana. Methods: A retrospective cross-sectional study of 5,714 participants aged 25 through 49 years who underwent VIA screening. VIA-positive women received cryotherapy if indicated or were referred for colposcopy. Known cervical cancer risk factors, screening, and histological results were extracted from the program database. We compared the proportions and association of VIA positivity and CIN2+ by age and HIV status.Results: Median age was 35 years [IQR 31-39], and 18% of the women were aged 25-29. Ninety percent were WLWH; median CD4 count was 250 cells/µL [IQR 150-428], and 34.2% were on anti-retroviral treatment (ART). VIA-positivity was associated with younger age (OR 1.48, CI 1.28, 1.72 for 25-29 years versus age 30-49 years ), and HIV-positivity (OR 1.85, CI 1.51, 2.28). CIN2+ was associated with HIV positivity (OR 6.12, CI 3.39, 11.10), and proportions of CIN2+ were similar for both age groups in WLWH (12.1% versus 10.8%).Conclusions: Younger WLWH in Botswana had a significant burden of CIN2+. This finding further supports lowering the screening age for WLWH from 30 to 25.

scholarly journals Factors associated with contraceptive use among women living with HIV in Canada: a controlled, cross-sectional study

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Chadni C. Khondoker ◽  
Angela Kaida ◽  
Anna Marquez ◽  
Amber R. Campbell ◽  
Hélène C. F. Côté ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Contraceptive Use ◽  
Full Range ◽  
Hormonal Contraceptives ◽  
Healthcare Team ◽  
Care Providers ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Abstract Background Multiple contraindications to combined hormonal contraceptives (CHC) use exist. The impact of these factors on contraceptive choice, particularly among women living with HIV (WLWH), is not well understood. We measured and compared the prevalence of contraceptive use and contraindications among WLWH and women not living with HIV (controls). Methods We examined cross-sectional survey and medical chart data from 83 WLWH and 62 controls, aged 16–49 and sexually active, from 2013–2017. We compared the age-adjusted prevalence and types of contraceptives used in the last month and the proportion of women with CHC contraindications, including drug interactions, medical comorbidities, and smoking at ≥ 35 years old. All WLWH received care at an interdisciplinary, women-centred HIV clinic. Results Compared to controls, WLWH were older (median [IQR)] 39 [34–43] vs 31 [23–41] years; p = 0.003), had less post-secondary education (37% vs 73%; p < 0.001), and more often had household income < $15,000/year (49% vs 30%; p = 0.006). WLWH trended to higher contraceptive prevalence than controls (80% vs 63%; p = 0.06 adjusted for age). Overall hormonal contraceptive use was similar. However, despite controlling for age, WLWH used CHC less (4% vs 18%; p = 0.006) than controls, and had more frequently undergone tubal ligation (12% vs 2%; p = 0.03). WLWH also experienced more CHC contraindications (54% vs 13%; p = 0.0001), including smoking at ≥ 35 years old (30% vs 6%; p = 0.0003) or a CHC-related drug interaction (all antiretroviral related) (25% vs 0%; p = 0.0001). Conclusions WLWH attending our interdisciplinary clinic used hormonal contraception at similar rates as controls, though with different types. Differences may reflect different distributions of CHC contraindications. CHC contraindications present barriers to accessing the full range of contraceptive choices for WLWH. Guidelines and education for care providers and WLWH regarding contraceptive choices and drug interactions are needed, especially when care is provided without the benefit of an interdisciplinary women-centered healthcare team.

Predictors of End of Life Discussions Among Minority Older Women Living With HIV Infection

2020 ◽  
pp. 104990912097182
Author(s):  
Rosina Cianelli ◽  
Natalia Villegas ◽  
LaToya Lewis-Pierre ◽  
Beatriz Valdes ◽  
Evelyn Iriarte
Keyword(s):  
End Of Life ◽  
Ecological Model ◽  
Bright Light ◽  
Premature Aging ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Cross Sectional Design ◽  
The Individual ◽  
Living With Hiv

Background: Among the 39,782 newly HIV diagnosed individuals in the U.S., 17% were aged 50+. Although premature aging, morbidity, and mortality are issues for older people living with HIV that threaten their quality of life, less attention has been focused on end of life (EOL) discussions. Objectives: To examine predictors of EOL discussions with significant others, family members, and friends. Methods: Cross-sectional design was used for this study guided by the The Socio Ecological Model (SEM). Sample: 119 Black and 19 Hispanic women aged 50+ living with HIV. Results: Predictors of EOL discussions were education, living with a partner, religiosity, and pain, which were at the individual-intrapersonal level of the SEM. Discussion: Findings from this study have important implications for health policy makers and clinicians because they cast a bright light on the substantial continued effort that is needed to improve EOL discussions. 

An Active Learning Approach to Teaching Social Determinants of Health

2020 ◽  
Vol 6 (4) ◽  
pp. 266-273
Author(s):  
Jeanita W. Richardson
Keyword(s):  
Active Learning ◽  
Learning Style ◽  
Social Determinants ◽  
Learning Approach ◽  
Learning Style Preferences ◽  
Open Discussion ◽  
Approach To Teaching ◽  
The Individual ◽  
Style Preferences ◽  
The Impact

This active learning exercise is designed to deconstruct the impact of social determinants through the assumption of randomly selected personas. As an active learning exercise, it provides opportunities for discussion, problem solving, writing, and synthesis, while incorporating multiple learning style preferences. Part 1 involves assessing the individual social determinants at work. Part 2 involves exploring ways said determinants can enhance community health through collaboration. Assumption of personas unlike one’s own facilitates an open discussion of social position and ranges of factors influential to health without potentially evoking a sense of defensiveness associated with personal privilege (or the lack thereof).

Impact of the Depth-to-Width Ratio of Periodically Stratified Tidal Channels on the Estuarine Circulation

2015 ◽  
Vol 45 (8) ◽  
pp. 2048-2069 ◽  
Author(s):  
Elisabeth Schulz ◽  
Henk M. Schuttelaars ◽  
Ulf Gräwe ◽  
Hans Burchard
Keyword(s):  
Eddy Viscosity ◽  
Transport Model ◽  
Stable Stratification ◽  
Estuarine Circulation ◽  
Width Ratio ◽  
Cross Sectional ◽  
Tidal Straining ◽  
The Individual ◽  
Periodic Stratification ◽  
The Impact

AbstractThe dependency of the estuarine circulation on the depth-to-width ratio of a periodically, weakly stratified tidal estuary is systematically investigated here for the first time. Currents, salinity, and other properties are simulated by means of the General Estuarine Transport Model (GETM) in cross-sectional slice mode, applying a symmetric Gaussian-shaped depth profile. The width is varied over four orders of magnitude. The individual along-channel circulation contributions from tidal straining, gravitation, advection, etc., are calculated and the impact of the depth-to-width ratio on their intensity is presented and elucidated. It is found that the estuarine circulation exhibits a distinct maximum in medium-wide channels (intermediate depth-to-width ratio depending on various parameters), which is caused by a maximum of the tidal straining contribution. This maximum is related to a strong tidal asymmetry of eddy viscosity and shear created by secondary strain-induced periodic stratification (2SIPS): in medium channels, transverse circulation generated by lateral density gradients due to laterally differential longitudinal advection induces stable stratification at the end of the flood phase, which is further increased during ebb by longitudinal straining (SIPS). Thus, eddy viscosity is low and shear is strong in the entire ebb phase. During flood, SIPS decreases the stratification so that eddy viscosity is high and shear is weak. The circulation resulting from this viscosity–shear correlation, the tidal straining circulation, is oriented like the classical, gravitational circulation, with riverine outflow at the surface and oceanic inflow close to the bottom. In medium channels, it is about 5 times as strong as in wide (quasi one-dimensional) channels, in which 2SIPS is negligible.

scholarly journals Psychosocial Determinants of HIV Stigma among Men Who Have Sex with Men in San Francisco, California

2021 ◽  
Vol 18 (15) ◽  
pp. 8031
Author(s):  
Dharma N. Bhatta ◽  
Jennifer Hecht ◽  
Shelley N. Facente
Keyword(s):  
Mental Health ◽  
San Francisco ◽  
Age Groups ◽  
Hiv Stigma ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Adjusted Risk ◽  
Sex With Men ◽  
Living With Hiv

Background: Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma’s impacts. Methods: This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF’s electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV. Results: HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13–29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30–49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load. Conclusions: These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.

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