scholarly journals Validation of an HIV/AIDS Stigma Measure for Children Living with HIV and Their Families

2019 ◽  
Vol 18 ◽  
pp. 232595821988057
Author(s):  
Rachel Christine Vreeman ◽  
Michael Lawrence Scanlon ◽  
Wanzhu Tu ◽  
James Slaven ◽  
Carole McAteer ◽  
...  
Keyword(s):  
Construct Validity ◽  
Behavioral Outcomes ◽  
Estimating Equation ◽  
Hiv Stigma ◽  
Generalized Estimating Equation ◽  
Western Kenya ◽  
Aids Stigma ◽  
Depressed Child ◽  
Living With Hiv ◽  
Child Caregiver

Background: There are few validated tools to measure stigma, particularly among children living with HIV and their families. Methods: This study was nested within a larger study that followed 240 child–caregiver dyads (children aged 10-15 years) at 8 clinics in western Kenya. The stigma instrument was administered to all child–caregiver dyads at 2 time points 6 months apart. The primary end point was to construct validity assessed by comparison to criterion constructs using generalized estimating equation models. Results: Mean age of child participants was 12.3 years and 52% were female. Generally, caregivers reported experiencing higher levels of HIV stigma compared to their children. Children (9%) and caregivers (14%) reported that HIV stigma made them feel stressed, anxious, and depressed. Child and caregiver stigma items showed high construct validity by emotional and behavioral outcomes. Conclusions: The stigma instrument showed high validity when compared to emotional and behavioral outcomes.

scholarly journals HIV–AIDS Stigma in Burundi: A Qualitative Descriptive Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9300
Author(s):  
Néstor Njejimana ◽  
Lucía Gómez-Tatay ◽  
José Miguel Hernández-Andreu
Keyword(s):  
Physical Violence ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
African Countries ◽  
Aids Stigma ◽  
Global Issue ◽  
Qualitative Descriptive ◽  
Verbal Violence ◽  
Living With Hiv ◽  
Hiv Aids

HIV/AIDS stigma is a global issue and a serious problem in African countries. Although prevalence remains high in this region, no detailed study has yet been carried out to determine and characterize this problem in Burundi. Using a qualitative analysis based on an extensive series of 114 interviews, we describe the main characteristics of HIV stigma in the country. The results of our study indicate that the problem of HIV/AIDS stigma is widespread in Burundian society, as all participants in the research reported having experienced some kind of HIV stigma. The seven dimensions of stigma identified in people living with HIV/AIDS (PLWHA) in Burundi are physical violence, verbal violence, marginalization, discrimination, self-stigma, fear and insecurity, and healthcare provider stigma. These dimensions of stigma can be experienced through different manifestations, which have been characterized in this study, revealing that the problem of stigma in PLWHA is still an important issue in Burundi.

scholarly journals A preliminary analysis of the association between perceived stigma and HIV-related pain in South Africans living with HIV

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Antonia L. Wadley ◽  
Tamar Pincus ◽  
Michael Evangeli
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Mediation Analysis ◽  
Rating Scale ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Aids Stigma ◽  
Living With Hiv ◽  
The Relationship

Background: Stigma related to the human immunodeficiency virus (HIV) remains common and has been associated with severity of HIV-related symptoms. Associations between HIV stigma and HIV-related pain, one of the most common symptoms in HIV, have however not been investigated. Data from low back pain populations suggest that stigma is associated with worse pain intensity and so we hypothesised that the same would be the case in HIV.Aim: The goal of this study was to assess the association between HIV stigma and pain intensity in people living with HIV (PLWH) with chronic pain whilst controlling for depression, a well-established correlate of pain.Setting: The study took place at an HIV clinic in Johannesburg, South Africa.Methods: Mediation analysis was used to assess the effect of depression on the relationship between stigma and pain intensity in a cross-sectional cohort of 50 PLWH and chronic pain (pain most days of the week for > 3 months). All participants were assessed using the HIV/AIDS Stigma Instrument – PLWA, an 11-point numerical pain rating scale and the Beck Depression Inventory II.Results: In all, 88% (44/50) of participants reported experiencing some form of HIV stigma (HIV stigma scale score ≥ 1). Worst pain intensity and depressive symptoms individually correlated with total stigma score (Spearman’s r = 0.33, p = 0.02 for both). The mediation analysis highlighted that mediation of the relationship by depression was equivocal (b = -0.002, bootstrapped confidence interval -0.02 to 0.00).Conclusion: Whilst these preliminary data are marginal, they do suggest that associations between HIV stigma and HIV-related pain warrant further investigation. Future study should also include potential mechanisms, which may include mediation through depression.

scholarly journals A Qualitative Examination of Perceived Stigma and its Sources Among Adolescents Living With HIV in Western Kenya

2022 ◽  
Vol 9 ◽  
pp. 2333794X2110653
Author(s):  
Grant Callen ◽  
Ashley Chory ◽  
Festus Sang ◽  
Dennis Munyoro ◽  
Josephine Aluoch ◽  
...  
Keyword(s):  
Hiv Stigma ◽  
Qualitative Investigation ◽  
Perceived Stigma ◽  
Western Kenya ◽  
Common Cause ◽  
School Settings ◽  
Related Stigma ◽  
Living With Hiv ◽  
Anti Hiv

Introduction. Adolescents (10-19 years) living with HIV (ALWH) face unique challenges in controlling HIV long-term, including stigma and perception of stigma within their communities. Methods. We conducted a qualitative investigation of the sources of perceived HIV-related stigma with ALWH in western Kenya. Forty-six ALWH on ART, aware of their status, and engaged in care were enrolled. Interviews explored perceived stigma by probing the individuals and experiences that adolescents identify as causing or perpetuating their ongoing fears. Results. Participants (54% male, mean age 17.4) reported ongoing fears of stigmatization related to friends and peers not living with HIV. They described previous enacted and first-hand observations of stigma, most often occurring in pre-adolescence, by age mates or peers at school as the most common cause for their ongoing fears. Conclusions. Perceived stigma is prevalent among ALWH and develops from experiences in pre-adolescence. Anti-HIV stigma interventions addressing educators and children in school settings to combat perceived stigma at its source should be investigated.

scholarly journals Perspectives of education sector stakeholders on a teacher training module to reduce HIV/AIDS stigma in Western Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ashley Chory ◽  
Winstone Nyandiko ◽  
Whitney Beigon ◽  
Josephine Aluoch ◽  
Celestine Ashimosi ◽  
...  
Keyword(s):  
Teacher Training ◽  
Role Models ◽  
Education Sector ◽  
Hiv Stigma ◽  
Community Advisory Board ◽  
People Living With Hiv ◽  
Training Module ◽  
Head Teachers ◽  
Aids Stigma ◽  
Living With Hiv

Abstract Background For adolescents living with HIV (ALWH), school may be the most important but understudied social sphere related to HIV stigma. Teachers are role models in the classroom and within the community, and their attitudes and behavior towards people living with HIV may have critical psychosocial and treatment ramifications. Altering teachers’ knowledge, attitudes and beliefs (K/A/B) about HIV could reduce the stigmatizing content within their teaching, classrooms and school, improving the environment for ALWH. Methods We developed a one-day teacher training module to enrich teacher K/A/B that included lecture presentations, HIV films and educational animation, structured instructions for teacher role play scenarios, and a question-and-answer session facilitated by a trained ALWH peer educator. We also conducted key informant interviews with education sector subject matter experts (SMEs), including education officers, county commissioners and head teachers to review and provide feedback on the teacher training module. Results We assembled an adolescent community advisory board and recruited 50 SMEs to review the training module and provide feedback. All SME participants stressed the importance and need for interventions to reduce stigma in the classroom, highlighting their own experiences observing stigmatizing behaviors in the community. The participants perceived the training as culturally relevant and easy to understand and had minor suggestions for improvement, including using image-based resources and brighter colors for ease of reading. All participants thought that the training should be expanded outside of the schools, as all people in a community have a role in the reduction of HIV stigma, and offered suggestions for other settings for implementation. Conclusion Data from interviews with education sector stakeholders demonstrate that our process for developing a culturally appropriate multi-media intervention to reduce HIV stigma in the schools was feasible.

scholarly journals A Pilot Study of a Mobile Intervention to Support Mental Health and Adherence Among Adolescents Living with HIV in Western Kenya

2021 ◽  
Author(s):  
Ashley Chory ◽  
Grant Callen ◽  
Winstone Nyandiko ◽  
Tabitha Njoroge ◽  
Celestine Ashimosi ◽  
...  
Keyword(s):  
Pilot Study ◽  
Behavioral Health ◽  
Treatment Adherence ◽  
Peer Support ◽  
Mobile Technologies ◽  
Hiv Care ◽  
Individual Counseling ◽  
Middle Income ◽  
Western Kenya ◽  
Living With Hiv

AbstractMobile technologies represent potentially novel and scalable intervention delivery platforms for adolescents living with HIV (ALWH) in low- and middle-income countries. We conducted a prospective, mixed methods pilot study to evaluate the acceptability and feasibility of the WhatsApp® platform to deliver individual counseling services and facilitate peer support for ALWH in western Kenya. Thirty ALWH (17 female, mean age 15.4) on ART, engaged in HIV care and aware of their status, were enrolled. After 6 months, participants described their experiences with the intervention. Treatment adherence, stigma, and mental and behavioral health were assessed prospectively. Participants reported overall positive experiences and indicated that the platform encouraged peer network development. They endorsed potential benefits for treatment adherence, stigma reduction, and mental and behavioral health. All participants supported intervention expansion. In western Kenya, WhatsApp® was an acceptable and feasible platform for mobile counseling and peer support for ALWH.

Models for Longitudinal Data: A Generalized Estimating Equation Approach

Biometrics ◽  
1988 ◽  
Vol 44 (4) ◽  
pp. 1049 ◽  
Author(s):  
Scott L. Zeger ◽  
Kung-Yee Liang ◽  
Paul S. Albert
Keyword(s):  
Longitudinal Data ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Equation Approach ◽  
Generalized Estimating

Remittances and the Financing of Terrorism In Sub-Saharan Africa: 1974 - 2006

2012 ◽  
Vol 18 (1) ◽  
Author(s):  
Juliet U. Elu ◽  
Gregory N. Price
Keyword(s):  
Economic Growth ◽  
Count Data ◽  
Important Determinant ◽  
Estimating Equation ◽  
Sub Saharan Africa ◽  
Generalized Estimating Equation ◽  
Parameter Estimates ◽  
Consumption Expenditures ◽  
Sub Saharan ◽  
Financing Of Terrorism

AbstractRemittances have been recognized as an important determinant of economic growth for Sub-Saharan African economies as they can finance other determinants that constitute drivers of growth. To the extent that remittances finance terrorism, they can also inhibit economic growth as terrorism can constrain important drivers of growth such as investment and consumption expenditures. In this paper, we appeal to a theory of rational terrorism and consider whether remittances to Sub-Saharan Africa finance terrorism. We estimate the parameters of a static and dynamic terrorism incident supply function with maximum likelihood and Generalized Estimating Equation count data estimators for Sub-Saharan Africa between 1974 and 2006. Our parameter estimates suggest that for Sub-Saharan Africa, remittances are a source of finance for terrorism. We find that approximately one terrorism incident is financed in Sub-Saharan Africa for remittance inflows that range between approximately one quarter of a million dollars and one million dollars.

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.

Hip and Trunk Muscle Activity and Mechanics During Walking With and Without Unilateral Weight

2021 ◽  
pp. 1-8
Author(s):  
Kerri A. Graber ◽  
Kari L. Loverro ◽  
Mark Baldwin ◽  
Erika Nelson-Wong ◽  
Joshua Tanor ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Therapeutic Option ◽  
Frontal Plane ◽  
Estimating Equation ◽  
Trunk Muscle ◽  
Lower Extremity Injury ◽  
Generalized Estimating Equation ◽  
Functional Activities ◽  
Strengthening Exercises ◽  
Hip Abductor

Pelvic drop is caused by decreased hip abductor muscle activity and is associated with lower-extremity injury. Hip abductor strengthening exercises are well established; however, no standard method exists to increase hip abductor activity during functional activities. The purpose of this research was to study the effects of walking with a unilateral weight. A total of 26 healthy adults walked on an instrumented treadmill with and without handheld weight (15%–20% body weight). Muscle activity, kinematic, and kinetic data were collected using surface electromyography, motion capture, and force plates, respectively. Average hip and trunk muscle activity, hip, pelvic, and trunk angles, and peak internal hip moments during stance were compared for each side (contralateral/ipsilateral to the weight) between conditions (unweighted/weighted) using a generalized linear model with generalized estimating equation correction. Interactions between condition and side were observed for muscle activity, frontal plane pelvic and trunk angles, and frontal plane hip moments (P ≤ .003). Compared with the unweighted condition, the weighted condition had higher hip abductor activity contralateral to the weight (P < .001), while no change was found ipsilateral to the weight (P ≥ .790). Similar changes were found for kinematic and kinetic variables. Walking with a unilateral weight may be a therapeutic option to increase functional hip abductor activity.

The relationship between remission and health-related quality of life in a cohort of SLE patients

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 628-635 ◽  
Author(s):  
Michel W P Tsang-A-Sjoe ◽  
Irene E M Bultink ◽  
Maaike Heslinga ◽  
Lilian H van Tuyl ◽  
Ronald F van Vollenhoven ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Global Assessment ◽  
Short Form ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Relationship

Abstract Objective To investigate the relationship between remission and health-related quality of life (HRQoL) in patients with SLE in a longitudinal observational cohort. Methods HRQoL was measured at cohort visits using the physical and mental component score (PCS and MCS, respectively) of the Short Form 36 questionnaire. Definitions of Remission in SLE remission categories (no remission/remission on therapy/remission off therapy) were applied. Determinants of PCS and MCS were identified with simple linear regression analyses. Association between remission and HRQoL was assessed using generalized estimating equation models. Results Data from 154 patients with 2 years of follow-up were analysed. At baseline 60/154 (39.0%) patients were in either form of remission. Patients in remission had higher Short Form 36 scores in all subdomains compared with patients not in remission. PCS was positively associated with remission and employment, and negatively associated with SLICC damage index, ESR, medication, patient global assessment and BMI. MCS was positively associated with Caucasian ethnicity and negatively associated with patient global assessment. In generalized estimating equation analysis, a gradual and significant increase of PCS was observed from patients not in remission (mean PCS 36.0) to remission on therapy (41.8) to remission off therapy (44.8). No significant difference in MCS was found between remission states. Conclusion we show a strong and persistent association between remission and PCS, but not MCS. These results support the relevance (construct validity) of the Definition of Remission in SLE remission definitions and the further development of a treat-to-target approach in SLE.

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