Factors that Impact Assigned Female Sexual Minority Individuals Health Care Experiences: A Qualitative Descriptive Study

This qualitative descriptive study identified factors that impact assigned female at birth (AFAB) cisgender and non-binary sexual minority individuals’ decision to engage, or not engage, in health-seeking behaviors and receive preventative health care services. AFAB sexual minority individuals were asked to describe their health care experiences to determine modifiable factors that could improve their intention to seek care and improve their health care experiences. Purposive sampling was used to recruit AFAB sexual minority individuals between 18 and 30 years of age in the Chicago metropolitan area. Three main themes emerged from data acquired through individual interviews: (1) “ask the right questions”; main themes (2) lack of trust in health professionals; (3) the need for better sexual health education. An important finding was participants wanted to be asked about their sexual orientation, sexual behavior, and gender identity. Participants wanted to be able to share their sexual orientation and gender identity with health care professionals so they could receive appropriate care, accurate information, and feel comfortable sharing aspects about their life. Additionally, the results suggested that general and health sciences curricula should include content about diverse sexual and gender minority populations. Findings have important implications for health education and clinical practice

Strategies to improve HIV treatment adherence in developed countries: clinical management at the individual level

Remarkable advances in the treatment of human immunodeficiency virus (HIV) disease have been blunted by widespread suboptimal adherence (ie, nonadherence), which has emerged as a major barrier to achieving the primary goal of antiretroviral (ARV) therapy: suppression of HIV viral load. Nonsuppressed HIV viral load is associated with drug resistance, increased morbidity and mortality, and a higher risk of person-to-person HIV transmission. For HIV-infected individuals who are failing HIV treatment due to nonadherence, becoming adherent is a life-saving behavior change. However, overcoming nonadherence is one of the most daunting challenges in the successful management of HIV disease. The purpose of this paper is to provide clinicians with a better understanding of nonadherence to ARV treatment and to review the various factors that have been associated with either adherence or nonadherence. Strategies are presented that may help the nonadherent individual become ready to take HIV medications as prescribed

Silence Is Not Golden: Invisible Latinas Living with HIV in the Midwest

This qualitative study was conducted to better understand the health needs and concerns of immigrant HIV-infected Latinas residing in the Midwest United States. Individual interviews (n = 18) were conducted in Spanish with Latinas in Kansas, Oklahoma and Missouri. Women were at different stages of acceptance about their HIV diagnosis and four common themes emerged from the data: pregnancy as a death sentence, HIV is taboo, God as their only resource, and living in isolation. Silence was an over-arching theme present throughout all the narratives and many women had never shared their stories about HIV with anyone. Depressive symptoms and suicidal ideation were common. These findings have implications for strategies to address the HIV prevention and HIV-related healthcare needs of this population of women. Results from this study further suggest that efforts are needed to break the silence surrounding HIV and to reduce HIV-related stigma in smaller Midwestern Hispanic communities

A Pilot Self-Care Group Intervention for Low-Income HIV-Positive Women

This article describes the development of a self-care intervention and examines its efficacy with low-income HIV-positive women (n=34) in the Midwestern United States. Adapted from an individual nurse-led intervention, this effort focused on increasing self-care behaviors through enhancing self-esteem and social support. The investigators used a community-based participatory approach and partnered with three HIV-positive women to adapt and pilot test the new group intervention. A within-group, repeated-measures, pre-/post-test design, together with participant interviews, was used to evaluate the intervention. Mean scores on measures of self-care behaviors, self-esteem, social support and depressive symptoms all changed in the clinically desirable direction. Group interventions, such as the one described here, could be useful if provided in community settings to enhance the mental and physical health of HIV-positive women. Further testing of this intervention with a larger sample is needed to determine its effectiveness