Serostatus disclosure among adults with HIV in the era of HIV therapy

Serostatus disclosure is an important component of secondary HIV prevention with potential benefits for both the individual by experiencing increased social support and society by reducing HIV transmission risk behaviors. This cross-sectional study assessed disclosure patterns to sex partners, family members, and friends by sociodemographic and HIV-related factors among an urban, Midwestern U.S. HIV clinic population (n=809); a majority of whom were African American and male with a mean age of 41 years. Almost three quarters (n=596) of the sample was currently receiving HIV therapy, with 68% (n=404) successfully suppressing their HIV viral loads. Among sexually activity individuals, 97% reported disclosing their serostatus to sex partners. This high rate of disclosure to sex partners suggests that social desirability may play a role in this self-reported measure. Approximately half of the sample (n=359) disclosed to at least one family member and 60% (n=474) disclosed to at least one friend. Disclosing to family members occurred more often among participants who were unemployed and endorsed depressive disorder symptoms (p<0.05 for all). Disclosing to friends occurred more frequently among women, Caucasians and those who completed higher levels of education (p<0.001 for all). HIV disclosure and disease severity were unassociated. Given the chronic nature of HIV care, additional research is needed to develop interventions to facilitate timely disclosure of HIV serostatus

Moral Hopelessness and HIV/AIDS Global Paralysis

No disease ever in history, other than the plague of the 14th century, has caused such serious psychological and emotional distress, affecting families and communities as the AIDS pandemic. The United Nations AIDS Program (UNAIDS) and the World Health Organization (WHO) now estimate the number of people living with HIV/AIDS today is 40 million. More than 25 million people have died of AIDS since 1981. At the end of 2007, women accounted for 48% of all adults living with HIV worldwide, and for 59% of those in sub-Saharan Africa. Young people (under 25 years old) account for half of all new HIV infections worldwide and about 6,000 become infected with HIV everyday (UNAIDS/WHO, 2007). Most of the infected (22.5 million) live in Africa, a continent home to only 10% of the world’s population, but shouldering over 70% of all cases and 95% of all orphans according to the UNAIDS/WHO report

EDITORIAL FROM PERSPECTIVES ON SOCIAL WORK VOLUME 6 (FALL 2007)

Editorial from Perspectives on Social Work Volume 5 (Fall 2007

Review of the evidence of gender-focused interventions including men to reduce HIV risk and violence against women in sub-Saharan Africa

<p>This review investigates gender-informed intervention studies conducted in sub-Saharan Africa that measure an outcome related to HIV. The review included 20,340 abstracts published between January 1990 and July 2015, 84 of which met our inclusion criteria for full review, resulting in 17 articles that are the current analysis. The findings demonstrate a wide variation in the types of interventions, from low-intensity educational content to multicomponent interventions. The review groups study outcomes into biological, HIV risk interventions, behavioral, violence, and risk reduction. Most interventions showed positive effects, and although research methodologies varied considerably, longer interventions appeared to be more effective. Cultural and behavioral practices require a multidimensional interventional approach to prevent the spread of HIV in sub-Saharan Africa. Studies of sexual violence, oppressive cultural norms, and cultural acceptance of men having multiple partners may contribute to disproportionate HIV rates in the region.</p

School-based HIV/AIDS education, risky sexual behaviors, and HIV testing among high school students in the United States

This study assessed the practical value of HIV/AIDS education among at-risk adolescents in the United States. Data were drawn from the 2013 Youth Risk Behavior Surveillance System spanning students in grades 9-12 who have engaged in sexual intercourse. A multivariate hierarchical logistic regression analysis was employed to test: (1) the individual effects of school-based HIV/AIDS education and risky sexual behaviors on the probability of HIV testing and (2) the interaction effects to estimate the degree to which the education effect varied by specific risky sexual behavior. The results indicated that students who engaged in risky sexual activities and received HIV/AIDS education were more likely to test for HIV compared to those who did not receive HIV/AIDS education. The relationship between education and HIV testing also varied according to the number of recent sexual partners. The findings have policy and practice implications. Specifically, HIV/AIDS education that promotes HIV testing should be encouraged particularly with the high-risk student population

Sexually Transmitted Diseases Among College Students in Sierra Leone: A Life Course Ecological Analysis

Applying life course theory, this study examined the direct and indirect effects of adverse childhood experiences (ACEs) on the risk of contracting sexually transmitted diseases (STDs), mediated by early sexual activity (first sexual experience before age 15), number of lifetime sex partners, and mental health problems. The link between ACEs and mental health on college students\u27 sexual risk is still understudied. Using cross-sectional data from a sample of 327 college students in Sierra Leone, this study tested the hypothesized mediation model using structural equation modeling analysis. The results showed that ACEs significantly increased sexual risks. Specifically, ACEs increased the risk of early initiation of sexual activity and the number of lifetime sex partners, which in turn increased the risk of STDs. Furthermore, ACEs significantly predicted negative mental health and were significantly associated with an increased risk of STDs. Effective future intervention strategies should include health education programs to address the lifelong effects of ACEs and mental health treatment

Exploring factors associated with HIV secondary stigma among adolescents and young adults in Uganda: A cross-sectional study

HIV stigma is a public health problem. It refers to irrational judgments and attitudes towards people living with or at risk of HIV. Among adolescents and young adults living with HIV, stigma can negatively influence help-seeking decisions and impede HIV prevention efforts. The present study aimed to explore social-ecological factors associated with HIV-related stigma using a cross-sectional study design. Data used were from the 2016 Uganda Demographic and Health Survey [UDHS] of young men (n = 2214) and young women (n = 8058) aged 15–24 years. We conducted a gender disaggregated multivariable logistic regression to understand social-ecological factors associated with HIV secondary stigma. An overwhelming majority of participants (85%) indicated that secondary HIV stigma was associated with factors such as gender, ethnicity, education, wealth, cultural attitudes, and testing experiences. The study concludes that many young people living with HIV experience stigma in Uganda. Therefore, the government of Uganda, health professionals, and researchers should consider developing interventions that address HIV stigma and discrimination. Supportive programmes, such as peer support services and community-based interventions, are needed to help young people living with HIV learn to cope with the illness