DOES MENOPAUSAL STATUS INFLUENCE SEXUAL RISK? A CROSS-SECTIONAL ANALYSIS OF THE U.S. NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY

Middle-aged and older adults remain sexually active, but the combination of sexual longevity, inconsistent safe sex practices, and poor condom knowledge, increases their likelihood to risk their sexual health. Menopause may influence sexual risk, as postmenopausal women may engage in risky sexual behaviours, while hormonal changes increase physiological vulnerability to sexually transmitted infections. This project explored whether menopause and type of post-menopause (natural versus surgically- induced) influenced sexual behaviour and herpes simplex virus type 2 (HSV-2) seroprevalence, using logistic regression modeling of the U.S. National Health and Nutrition Examination Survey data. Controlling for confounding, menopause was negatively associated with number of sexual partners, negatively associated with condom use in non-partnered low education women, and positively associated with HSV-2. Type of menopause was not associated with any outcomes. This project highlights a need for improved data on sexual behaviour in older adults

The Problematization of Sexuality among Women Living with HIV and a New Feminist Approach for Understanding and Enhancing Women’s Sexual Lives

In the context of HIV, women’s sexual rights and sexual autonomy are important but frequently overlooked and violated. Guided by community voices, feminist theories, and qualitative empirical research, we reviewed two decades of global quantitative research on sexuality among women living with HIV. In the 32 studies we found, conducted in 25 countries and composed mostly of cis-gender heterosexual women, sexuality was narrowly constructed as sexual behaviours involving risk (namely, penetration) and physiological dysfunctions relating to HIV illness, with far less attention given to the fullness of sexual lives in context, including more positive and rewarding experiences such as satisfaction and pleasure. Findings suggest that women experience declines in sexual activity, function, satisfaction, and pleasure following HIV diagnosis, at least for some period. The extent of such declines, however, is varied, with numerous contextual forces shaping women’s sexual well-being. Clinical markers of HIV (e.g., viral load, CD4 cell count) poorly predicted sexual outcomes, interrupting widely held assumptions about sexuality for women with HIV. Instead, the effects of HIV-related stigma intersecting with inequities related to trauma, violence, intimate relations, substance use, poverty, aging, and other social and cultural conditions primarily influenced the ways in which women experienced and enacted their sexuality. However, studies framed through a medical lens tended to pathologize outcomes as individual “problems,” whereas others driven by a public health agenda remained primarily preoccupied with protecting the public from HIV. In light of these findings, we present a new feminist approach for research, policy, and practice toward understanding and enhancing women’s sexual lives—one that affirms sexual diversity; engages deeply with society, politics, and history; and is grounded in women’s sexual rights

Use of Drawings to Explore US Women's Perspectives on Why People Might Decline HIV Testing

The purpose of this research is to explore through drawings and verbal descriptions women's perspectives about reasons why persons might decline human immunodeficiency virus (HIV) testing. We asked 30 participants to draw a person that would NOT get tested for HIV and then explain drawings. Using qualitative content analysis, we extracted seven themes. We found apprehension about knowing the result of an HIV test to be the most commonly identified theme in women's explanations of those who would not get tested. This technique was well received and its use is extended to HIV issues

Women’s HIV Prevention Study (Whips): A Proposal to Pilot Test an HIV Intervention for Older African American Women Living with HIV

Despite improvements in treatments over the past 30 years, HIV /AIDS continues to be a major public health threat, particularly among sub-populations such as African American women. Midlife and older adults (those aged 40 years and over) are fast becoming a growing concern for HIV/AIDS infections, particularly older African American women. There has been limited research targeting midlife and older African American women living with HIV that aimed to reduce their transmission of HIV and promote them becoming prevention advocates. In response to this gap in the literature, a culturally tailored intervention guided by the IMB Model of behavior change that aimed to reduce sexual risk transmission, increase perceived social support and promote women becoming prevention advocates, was developed and pilot tested. A total of 58 African American women age 40 years and over were screened, enrolled, completed informed consent and randomly assigned to receive an 8-hour group intervention session or a time-matched control session. Study participants completed assessments at baseline, 1-month and 3-months later. Measures included demographic variables, self-reported sex behaviors by partner HIV status, HIV knowledge, HIV risk reduction intentions, HIV risk reduction self-efficacy, HIV risk reduction acts, perceived social support, and intentions to prevent HIV in others. Analysis included a repeated measures factorial ANOVA to detect differences between groups and over time. We found no significant difference between the groups and no intervention effect on the variables of HIV risk reduction intentions, HIV risk reduction self-efficacy, HIV risk reduction acts perceived social support or intentions to prevent HIV in others. HIV knowledge scores changed over time, however no intervention effect was detected. Results also indicated that 83% (n=48) of the women reported having a male sex partner in the previous three months. Women in our study reported having unprotected vaginal sex with partners who were HIV +, HIV-, and whose HIV status was unknown at the time of sexual activity. At three month follow-up there were no significant differences found between the groups on the mean number of unprotected or protected sex acts and no intervention effect was found. Although there were no significant findings from this pilot, there is still much to be learned about the sexual health behaviors of midlife and older African American HIV+ women. Future research with this population might benefit from exploring the use of more gender focused theoretical models to understand the health behaviors of women. Future research with this population should also examine other psychosocial variables related to sex behaviors such as social and sexual networks

Proceeding: 3rd Java International Nursing Conference 2015 “Harmony of Caring and Healing Inquiry for Holistic Nursing Practice; Enhancing Quality of Care”, Semarang, 20-21 August 2015

This is the proceeding of the 3rd Java International Nursing Conference 2015 organized by School of Nursing, Faculty of Medicine, Diponegoro University, in collaboration with STIKES Kendal. The conference was held on 20-21 August 2015 in Semarang, Indonesia. The conference aims to enable educators, students, practitioners and researchers from nursing, medicine, midwifery and other health sciences to disseminate and discuss evidence of nursing education, research, and practices to improve the quality of care. This conference also provides participants opportunities to develop their professional networks, learn from other colleagues and meet leading personalities in nursing and health sciences. The 3rd JINC 2015 was comprised of keynote lectures and concurrent submitted oral presentations and poster sessions. The following themes have been chosen to be the focus of the conference: (a) Multicenter Science: Physiology, Biology, Chemistry, etc. in Holistic Nursing Practice, (b) Complementary Therapy in Nursing and Complementary, Alternative Medicine: Alternative Medicine (Herbal Medicine), Complementary Therapy (Cupping, Acupuncture, Yoga, Aromatherapy, Music Therapy, etc.), (c) Application of Inter-professional Collaboration and Education: Education Development in Holistic Nursing, Competencies of Holistic Nursing, Learning Methods and Assessments, and (d) Application of Holistic Nursing: Leadership & Management, Entrepreneurship in Holistic Nursing, Application of Holistic Nursing in Clinical and Community Settings

Greentree II: Violence against Women and Girls, and HIV

Compiled and edited by Lori Heise and Elizabeth McGrory, this publication synthesizes the discussions and conclusions of a three-day expert consultation on the links between HIV and violence against women and girls (VAWG). STRIVE convened the consultation with support from WHO, UNICEF, UNAIDS and the Greentree Foundation in order to: - examine the existing evidence base on the links between VAWG and HIV and identify critical knowledge gaps - develop a conceptual model that captures the potential pathways through which violence influences HIV-related outcomes - propose a research agenda to resolve outstanding questions -suggest priority actions for policy, programmes and researc