scholarly journals A realist evaluation of the continuum of HIV services for men who have sex with men

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Willy Dunbar ◽  
Marie Colette Alcide Jean-Pierre ◽  
Jacky S. Pétion ◽  
Aline Labat ◽  
Nathalie Maulet ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Community Support ◽  
Retention In Care ◽  
Realist Evaluation ◽  
Cross Sectional ◽  
Loss To Follow Up ◽  
Hiv Services ◽  
Services Delivery ◽  
Sex With Men ◽  
The Continuum

Abstract Background Men who have Sex with Men (MSM) represent the risk group that are disproportionately most affected by the human immunodeficiency virus (HIV) and continue to drop-off from the steps of the continuum of HIV services that have been adopted to overcome poor engagement and retention in care. This realist evaluation aimed at: (1) describing the evaluation carried out in Haiti aiming to ascertain why, how and under which circumstances MSM are linked and retained along the continuum, (2) assessing the outcomes of this approach and (3) exploring the motivators and facilitators for the HIV continuum of services through mechanisms and pathways. Methods Guided by a realist approach, first, an initial program theory (IPT) was developed based on literature and frameworks review, participant observations and discussions with stakeholders. Then, the IPT was tested using a mixed method explanatory study: a quantitative phase to build the continuum from a cross-sectional analysis, and a qualitative phase to explore the motivators and facilitators related to proper linkages along the continuum. Finally, the IPT was refined by eliciting the mechanisms and pathways for outcomes improvement. Results The results showed that the current service delivery model is suboptimal in identifying, engaging, linking and retaining MSM, resulting in loss to follow-up at every step of the continuum and failure to fully realize the health and prevention benefits of antiretroviral. However, the mechanisms through which linkages across the continuum can be improved are: self-acceptance, sense of community support and sense of comprehensive and tailored HIV services. These mechanisms are based on 10 different pathways: self-esteem, awareness and pride, perception of HIV risk, pcceptance and HIV status, addressing community stigma, strengthening of MSM organizations and community networks, societal acceptation and tolerance, stigma reduction training for healthcare providers, engagement of peers as educators and navigators and, adapted services delivery through drug dispensing points and mobile technology and financial assistance. Conclusions The study findings show that engagement, adherence and retention to the continuum of HIV service for MSM are affected by a multi-layer of factors, thus highlighting the importance of taking a comprehensive approach to improve the program.

scholarly journals A realist evaluation of the continuum of HIV services for men who have sex with men

2021 ◽  
Author(s):  
Willy Dunbar ◽  
Marie Colette Alcide Jean Pierre ◽  
Jacky S Pétion ◽  
Aline Labat ◽  
Nathalie Maulet ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Community Support ◽  
Retention In Care ◽  
Realist Evaluation ◽  
Cross Sectional ◽  
Loss To Follow Up ◽  
Hiv Services ◽  
Services Delivery ◽  
Sex With Men ◽  
The Continuum

Abstract BackgroundMen who have Sex with Men (MSM) represent the risk group that are disproportionately most affected by the human immunodeficiency virus (HIV) and continue to drop-off from the steps of the continuum of HIV services that have been adopted to overcome poor engagement and retention in care. This realist evaluation aimed at: 1) describing the evaluation carried out in Haiti aiming to ascertain why, how and under which circumstances MSM are linked and retained along the continuum, 2) assessing the outcomes of this approach and 3) exploring the motivators and facilitators for the HIV continuum of services through mechanisms and pathways. MethodsGuided by a realist approach, first, an initial program theory (IPT) was developed based on literature and frameworks review, participant observations and discussions with stakeholders. Then, the IPT was tested using a mixed method explanatory study: a quantitative phase to build the continuum from a cross-sectional analysis, and a qualitative phase to explore the motivators and facilitators related to proper linkages along the continuum. Finally, the IPT was refined by eliciting the mechanisms and pathways for outcomes improvement.ResultsThe results showed that the current service delivery model is suboptimal in identifying, engaging, linking and retaining MSM, resulting in loss to follow-up at every step of the continuum and failure to fully realize the health and prevention benefits of antiretroviral. However, the mechanisms through which linkages across the continuum can be improved are: self-acceptance, sense of community support and sense of comprehensive and tailored HIV services. These mechanisms are based on 10 different pathways: self-esteem, awareness and pride, perception of HIV risk, pcceptance and HIV status, addressing community stigma, strengthening of MSM organizations and community networks, societal acceptation and tolerance, stigma reduction training for healthcare providers, engagement of peers as educators and navigators and, adapted services delivery through drug dispensing points and mobile technology and financial assistance.ConclusionsThe study findings show that engagement, adherence and retention to the continuum of HIV service for MSM are affected by a multi-layer of factors, thus highlighting the importance of taking a comprehensive approach to improve the program.

scholarly journals A realist evaluation of the continuum of HIV services for men who have sex with men

2021 ◽  
Author(s):  
Willy Dunbar ◽  
Aline Labat ◽  
Nathalie Maulet ◽  
Yves Coppieters
Keyword(s):  
Community Support ◽  
Realist Evaluation ◽  
Service Delivery Model ◽  
Loss To Follow Up ◽  
Hiv Services ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Underlying Mechanisms ◽  
The Continuum

Abstract Men who have Sex with Men (MSM) represent the risk group that are disproportionately most affected by human immunodeficiency virus (HIV), yet are understudied in intervention research. This realist evaluation assessed the continuum of HIV services for MSM in Haiti. Guided by the Context-Mechanisms-Outcomes configuration, first, aninitial program theory (IPT) was developed based on reviews, observations and discussions. Second, the IPT was tested using a mixed-method explanatory study. Third, we refined the IPT by eliciting the underlying mechanisms. The results showed that the current service delivery model is suboptimal in engaging and retaining MSM, resulting in loss to follow-up and failure to fully realize the health benefits of antiretroviral. However, the mechanisms through which linkages across the continuum can be improved are: self-acceptance, sense of community support and sense of comprehensive and tailored HIV services. Our evaluation highlighted the importance of taking a comprehensive approach to improve the continuum.

scholarly journals Knowledge, attitude, practice and stigma of tuberculosis among healthcare providers in hospital Sultan Haji Ahmad Shah, Temerloh, Pahang

2019 ◽  
Vol 10 (SPL1) ◽  
Author(s):  
Nuralia Akma ◽  
Mohamad Mustafa ◽  
Siti Aishah Suran ◽  
Abdul Aziz Marwan ◽  
Mohd Rahman Omar
Keyword(s):  
Disease Transmission ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
World Health ◽  
Occupational Hazard ◽  
Perceived Stigma ◽  
Cross Sectional ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Knowledge And Practice

Malaysia is categorized as an intermediate tuberculosis (TB) burden country by World Health Organisation. This cause great challenge as an occupational hazard for healthcare providers (HCPs) in Malaysia, as they received two- to three-fold greater risk of contracting TB than the general population. This cross-sectional questionnaire study aimed to assess HCPs' knowledge, attitude, practice, and stigma (KAPS) towards TB in Hospital Sultan Haji Ahmad Shah, Temerloh. A pilot-tested questionnaire was designed based on the WHO recommendation for KAPS study in TB. A survey was carried out between September 2018 and February 2019. Data were analyzed using SPSS version 25.The majority of respondents have moderate knowledge (75%) and practice (93%) on tuberculosis whilst scored lower on attitude (49%). Average self-perceived stigma was observed (67%) with higher sympathy (73%). Overall knowledge and practice on tuberculosis among HCPs in HOSHAS was good with some misconceptions about disease transmission. However, more works needed to improve the attitude and stigma towards TB, as it may affect health services delivery towards TB patients.

scholarly journals Factors Associated with Men Engagement in HIV Continuum of Care in Rwanda: A Cross Sectional Study to Identify Gaps to be Closed Towards HIV Epidemic Control in Rwanda

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Rwibasira GN ◽  
◽  
Rutayisire E ◽  
Keyword(s):  
Viral Load ◽  
Population Based ◽  
Cross Sectional Study ◽  
Viral Load Suppression ◽  
Cross Sectional ◽  
Hiv Services ◽  
Services Delivery ◽  
Hiv Epidemic ◽  
Hiv Continuum Of Care ◽  
The Impact

Despite the global achievements to control HIV epidemic and end AIDS by 2030, there is still a discrepancy in accessing HIV services. Men are among the population that are lagging behind when it comes to consuming available services to mitigate the impact of HIV/AIDS. We conducted this study to determine the level of Rwandan men engagement in HIV services delivery. We used cross- sectional design to analyze data from a Population- based HIV impact assessment, a household-based survey conducted in Rwanda from October 2018 to March 2019. Cascade from awareness of the HIV status, linkage to ART and Viral load suppression were analyzed. Logistic regression analysis was conducted to establish relationship between independent variables and outcomes. Data cleaning and analysis was conducted using SAS 9.4. 13. A total of 821 males aged 15 to 64 years participated in the survey, 302 (2.1%) of them tested positive, 92.2% (95% CI: 89.2-95.2) reported tested once for HIV. Overall, 78.2% (95% CI: 72.4-84) reported to be aware of their status and on ART. 70.5% (95% CI: 63.8-77.2) reported to have suppressed viral load. Married or living together with a partner showed to be 7 times more likely to be on ART vs single or never married (OR: 7.42, 95% CI: (1.75;31.38), P <0.01). Odds of viral load suppression increases with age, and those aged above 55 years showed to be more suppressing their virus (OR: 3.94, (95% CI: 0.92-16.9), P=0.07). Findings from this study revealed the gaps to be closed to include all population in maximizing HIV service delivery.

scholarly journals Facilitators and barriers of 2-1-1 HIV pre-exposure prophylaxis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251917
Author(s):  
Christina Camp ◽  
Parya Saberi
Keyword(s):  
Hiv Prevention ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Facilitators And Barriers ◽  
Sexual Encounters ◽  
Prevention Method ◽  
Sex With Men ◽  
Dosing Strategy ◽  
Exposure Prophylaxis

An alternative strategy for men who have sex with men (MSM) experiencing challenges with daily HIV pre-exposure prophylaxis (PrEP) includes 2-1-1 dosing. Understanding 2-1-1 PrEP facilitators and barriers, especially during the SARS-CoV-2 pandemic, may guide researchers and healthcare providers in future studies and clinical preparedness. We conducted a national cross-sectional study of MSM in the US who had taken 2-1-1 PrEP to examine facilitators and barriers of this on-demand PrEP dosing option. With the shelter-in-place orders in March 2020, this study was adapted to include questions on how the SARS-CoV-2 pandemic affected participants’ PrEP use. A total of 140 individuals participated in the survey, 106 of which completed questions pertaining to the SARS-CoV-2 pandemic. The most common reasons for switching from once-daily to 2-1-1 PrEP included having sex less frequently (63.6%) and wanting to take fewer pills (46.4%). Participants reported high medication adherence based on each component of 2-1-1 PrEP dosing (>84%). The most common barriers with 2-1-1 PrEP dosing included unplanned sexual encounters resulting in missing the double-dose pre-sex (43.6%) and trouble remembering doses post-sex (29.3%). Facilitators of the 2-1-1 PrEP dosing strategy included reductions in sexual encounters (63.6%), preference to take fewer pills (46.4%), need to reduce cost (22.1%), and desire to reduce side effects (19.3%). Challenges to receiving PrEP services during the pandemic included obtaining laboratory testing (25.5%) and PrEP refills (either receipt of a refill authorization from a healthcare provider or processing of a refill from the pharmacy) (18.9%). 2-1-1 PrEP is an effective HIV prevention method; therefore, understanding facilitators and barriers of this dosing strategy can result in continuous provision of HIV prevention efforts, particularly during a pandemic.

Knowledge and Communication of the National Core Standards Tool

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Winnie Thembisile Maphumulo ◽  
Busisiwe Bhengu
Keyword(s):  
Pearson Correlation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Quality Of Healthcare ◽  
Survey Study ◽  
Public Healthcare ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Nurses

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.

Impacto de la comunicación de la responsabilidad social universitaria en la selección de universidad y efecto mediador de la reputación

2020 ◽  
Author(s):  
Lucy Erazo-Coronado ◽  
Sergio Llano-Arristizábal ◽  
Miguel Garcés-Prettel ◽  
Ana-María Erazo-Coronado
Keyword(s):  
Social Responsibility ◽  
Professional Training ◽  
Research Work ◽  
Community Support ◽  
Human Beings ◽  
Cross Sectional ◽  
Public And Private ◽  
University Selection ◽  
Cross Sectional Design ◽  
Institutional Websites

The emerging concept of university social responsibility (USR) consists in the fulfillment of the mission of the university in terms of ethical standards, community support, respect for human beings, and respect for the environment. Thus, universities must not only provide professional training but also instill ethical principles in students to allow them to behave as good citizens and help solve community problems. On the other hand, competition for students requires efficient management of university reputation and communication with their stakeholders, to demonstrate the accomplishment of the university’s mission and attract potential students. The objective of this paper is thus to explain the causal relationship between communication about university social responsibility (USR) activities through institutional websites and university selection, as well as the role of reputation. Research work was carried out based on an explanatory cross-sectional design, with a sample of 356 subjects from a population of 11th-grade students from public and private schools in the City of Barranquilla (Colombia). The results revealed that USR communication through institutional websites has a significant influence on university selection, not only directly but also indirectly, through reputation as a mediating variable. These findings contribute at a theoretical level by providing empirical evidence to understand and explain the analyzed topic. Furthermore, the results provide useful information to evaluate USR disclosure and implement strategies to make progress on USR issues. Resumen El naciente concepto de responsabilidad social universitaria (RSU) consiste en el cumplimiento de la misión de la universidad dentro de unos estándares éticos, de apoyo a la comunidad, respeto al ser humano y al medio ambiente. Así, pues, la universidad no sólo debe impartir formación profesional, sino inculcar a sus estudiantes principios éticos que les permitan comportarse como buenos ciudadanos y contribuir a la solución de los problemas de la comunidad. Por otra parte, la competencia entre universidades exige una gestión eficiente de su reputación y de la comunicación con sus distintos stakeholders, para demostrar a la sociedad el cumplimiento de su misión social, y para atraer estudiantes potenciales hacia la institución. Por lo tanto, este artículo tiene como objetivo explicar la relación de causalidad entre la comunicación de las prácticas de RSU en los sitios web institucionales y la selección de universidad, y el papel mediador de la reputación en esta relación. Para lograrlo, se llevó a cabo una investigación cuantitativa de nivel explicativo experimental y diseño transversal, con una muestra conformada por 356 sujetos, de una población de estudiantes de grado 11º de colegios públicos y privados de la ciudad de Barranquilla (Colombia). Los resultados revelan que la comunicación de las prácticas de RSU en los sitios web institucionales ejerce una influencia significativa directa en la intención de selección de universidad, e indirecta, a través de la reputación como variable mediadora. La evidencia empírica aportada representa un avance teórico en la comprensión y explicación del fenómeno estudiado, e igualmente servirá para que las universidades evalúen si están comunicando adecuadamente su responsabilidad social y adopten estrategias para avanzar en este aspecto.

Fraud Detection Protocol for Web-Based Research Among Men Who Have Sex With Men: Development and Descriptive Evaluation (Preprint)

2018 ◽  
Author(s):  
April M Ballard ◽  
Trey Cardwell ◽  
April M Young
Keyword(s):  
Survey Research ◽  
Hiv Transmission ◽  
Personal Information ◽  
Fraud Detection ◽  
Detection Algorithm ◽  
Cross Sectional ◽  
Web Based ◽  
Young Msm ◽  
Data Survey ◽  
Sex With Men

BACKGROUND Internet is becoming an increasingly common tool for survey research, particularly among “hidden” or vulnerable populations, such as men who have sex with men (MSM). Web-based research has many advantages for participants and researchers, but fraud can present a significant threat to data integrity. OBJECTIVE The purpose of this analysis was to evaluate fraud detection strategies in a Web-based survey of young MSM and describe new protocols to improve fraud detection in Web-based survey research. METHODS This study involved a cross-sectional Web-based survey that examined individual- and network-level risk factors for HIV transmission and substance use among young MSM residing in 15 counties in Central Kentucky. Each survey entry, which was at least 50% complete, was evaluated by the study staff for fraud using an algorithm involving 8 criteria based on a combination of geolocation data, survey data, and personal information. Entries were classified as fraudulent, potentially fraudulent, or valid. Descriptive analyses were performed to describe each fraud detection criterion among entries. RESULTS Of the 414 survey entries, the final categorization resulted in 119 (28.7%) entries identified as fraud, 42 (10.1%) as potential fraud, and 253 (61.1%) as valid. Geolocation outside of the study area (164/414, 39.6%) was the most frequently violated criterion. However, 33.3% (82/246) of the entries that had ineligible geolocations belonged to participants who were in eligible locations (as verified by their request to mail payment to an address within the study area or participation at a local event). The second most frequently violated criterion was an invalid phone number (94/414, 22.7%), followed by mismatching names within an entry (43/414, 10.4%) and unusual email addresses (37/414, 8.9%). Less than 5% (18/414) of the entries had some combination of personal information items matching that of a previous entry. CONCLUSIONS This study suggests that researchers conducting Web-based surveys of MSM should be vigilant about the potential for fraud. Researchers should have a fraud detection algorithm in place prior to data collection and should not rely on the Internet Protocol (IP) address or geolocation alone, but should rather use a combination of indicators.

COVID-19: knowledge, awareness and perceived stress among Jordanian healthcare providers (Preprint)

2020 ◽  
Author(s):  
Emad Aborajooh ◽  
Mohammed Qussay Al-Sabbagh ◽  
Baraa Mafrachi ◽  
Muhammad Yassin ◽  
Rami Dwairi ◽  
...  
Keyword(s):  
Social Media ◽  
Psychological Stress ◽  
Health Care Providers ◽  
Best Practice ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis ◽  
Source Of Information

UNSTRUCTURED We aimed to measure levels of knowledge, awareness, and stress about COVID-19 among health care providers (HCP) in Jordan. This was a cross-sectional study on 397 HCPs that utilized an internet-based questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perception, and psychological distress. Ordinal logistic regression analysis was used to evaluate factors associated with knowledge and psychological stress. Overall, 24.4% and 21.2% of the participants showed excellent knowledge and poor knowledge, respectively. Social media (61.7%) was the most commonly used source of information. Being female (β= 0.521, 95% CI 0.049 to 0.992), physician (β=1.421, 95% CI 0.849 to 1.992), or using literature to gain knowledge (β= 1.161, 95% CI 0.657 to 1.664) were positive predictors of higher knowledge. While having higher stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) or conventional media (β= -0.884, 95% CI -1.358 to -0.409) for information were negative predictors of knowledge levels. HCPs are advised to use the literature as a source of information about the virus, its transmission, and the best practice. PPEs should be secured for HCPs to the psychological stress associated with treating COVID-19 patients.

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