Yoga for the Pelvic Floor

A detailed, instructional guide to yoga that helps strengthen the pelvic floor

Not Immune: A Research Plan for Better Understanding the Lived Experiences of HIV-Positive Women Age 50 and Older

Background: This paper describes a literature review of peer-reviewed articles researching specific stressors, coping strategies and self perceived quality of life among HIV positive women age 50 and older. Following the literature review, a research plan for a qualitative study aiming to investigate these issues is explained, including preliminary data. Methods of Research Project: Qualitative in-depth interviews are being conducted among HIV-positive women age 50 and older who are current patients in the UNC Infectious Diseases Clinic. Interviews are tape-recorded, transcribed and coded by the primary investigator. Analysis for emergent themes is conducted following a grounded theory research approach. Results: Analyses on the first five interviews highlight important considerations for the remainder of the study. Issues regarding HIV status disclosure, the perceived lack of public acknowledgement regarding risks among older women, and the importance of individual faith as a coping strategy are common themes in the interviews. Conclusion: Completion of the study will continue to explain and characterize the preliminary results, and may point to previously unestablished means by which to approach and provide for this particular population.Master of Public Healt

“I Should Know Better”: The Roles of Relationships, Spirituality, Disclosure, Stigma, and Shame for Older Women Living With HIV Seeking Support in the South

The population of older people living with HIV in the United States is growing. Little is known about specific challenges older HIV-infected women face in coping with the disease and its attendant stressors. To understand these issues for older women, we conducted semi-structured in-depth interviews with 15 women (13 African American, 2 Caucasian) 50 years of age and older (range 50–79) in HIV care in the Southeastern United States, and coded transcripts for salient themes. Many women felt isolated and inhibited from seeking social connection due to reluctance to disclose their HIV status, which they viewed as more shameful at their older ages. Those receiving social support did so mainly through relationships with family and friends, rather than romantic relationships. Spirituality provided great support for all participants, although fear of disclosure led several to restrict connections with a church community. Community-level stigma-reduction programs may help older HIV-infected women receive support

Risk factors for lower urinary tract injury at the time of hysterectomy for benign reasons

None of the authors has any conflicts of interest to report except for Dr. Rebecca G. Rogers, who is DSMB chair for American Medical Systems Transform Trial, UptoDate royalties, ACOG royalties, and is on the executive board of the ACOG. Dr. Gena Dunivan is a member of the AUGS Education Committee

Risk factors for lower urinary tract injury at the time of hysterectomy for benign reasons

DISCLOSURES: None of the authors has any conflicts of interest to report except for Dr. Rebecca G. Rogers, who is DSMB chair for American Medical Systems Transform Trial, UptoDate royalties, ACOG royalties, and is on the executive board of the ACOG. Dr. Gena Dunivan is a member of the AUGS Education Committee. OBJECTIVE: To identify risk factors associated with lower urinary tract injury at the time of performing hysterectomy for benign indications. METHODS: We conducted a multi-center case–control study of women undergoing hysterectomy for benign disease. Cases were identified via ICD-9 codes for lower urinary tract injury at the time of hysterectomy from 2007 to 2011: controls were two subsequent hysterectomies following the index case in the same institution that did not have lower urinary tract injury. Logistic regression was used to perform univariate and multivariate comparisons between groups. RESULTS: At 7 centers, 135 cases and 270 controls were identified. Cases comprised 118 bladder injures and 25 ureteral injuries: 8 women had both bladder and ureteral injury. Bladder injury was associated with a history of prior cesarean section OR 2.9 (95% CI 1.7–5), surgery by a general obstetrician and gynecologist OR 2.4 (95% CI 1.2–5.2), and total abdominal hysterectomy OR 1.9 (95% CI 1.06–3.4). Ureteral injury was more likely among women who underwent laparoscopic-assisted vaginal hysterectomy (LAVH) OR 10.4 (95% CI 2.3–46.6) and total abdominal hysterectomy (TAH) OR 4.7 (95% CI 1.4–15.6). CONCLUSION: Bladder injury at the time of benign hysterectomy is associated with a prior history of Cesarean section and TAH as well as surgery by generalist OB-GYN; ureteral injury is associated with LAVH and TAH