Cultural Approach to HIV/AIDS Harm Reduction in Muslim Countries

Muslim countries, previously considered protected from HIV/AIDS due to religious and cultural norms, are facing a rapidly rising threat. Despite the evidence of an advancing epidemic, the usual response from the policy makers in Muslim countries, for protection against HIV infection, is a major focus on propagating abstention from illicit drug and sexual practices. Sexuality, considered a private matter, is a taboo topic for discussion. Harm reduction, a pragmatic approach for HIV prevention, is underutilized. The social stigma attached to HIV/AIDS, that exists in all societies is much more pronounced in Muslim cultures. This stigma prevents those at risk from coming forward for appropriate counseling, testing, and treatment, as it involves disclosure of risky practices. The purpose of this paper is to define the extent of the HIV/AIDS problem in Muslim countries, outline the major challenges to HIV/AIDS prevention and treatment, and discuss the concept of harm reduction, with a cultural approach, as a strategy to prevent further spread of the disease. Recommendations include integrating HIV prevention and treatment strategies within existing social, cultural and religious frameworks, working with religious leaders as key collaborators, and provision of appropriate healthcare resources and infrastructure for successful HIV prevention and treatment programs in Muslim countries

Antenatal HIV Screening and Treatment in South Africa: Social Norms and Policy Options

South Africa has one of the highest prevalence of HIV and AIDS in the world, with mother-to-child transmission being an important route for spread of the infection. For years, AIDS scientists and activists locally and internationally have been working desperately for the people of South Africa to have access to treatment for HIV and AIDS. Policymakers in South Africa have consistently maintained that HIV infection is not responsible for AIDS, thus creating the biggest obstacle to implementation of appropriate prevention and therapeutic programmes, including antiretroviral therapy for HIV positive persons. Only recently, people within the government and ruling party, defying previous policy, have agreed that antiretroviral drugs should be given to pregnant women with HIV. The social fabric of South African society is markedly different from that of Western countries. In this paper, the author analyses the likely implications of antenatal testing and treatment of pregnant women in South Africa, in light of the socio-economic and cultural status of women in that society. (Afr J Reprod Health 2004; 8[2]: 77-85 ) KEY WORDS: HIV screening, South Africa, pregnant women Dépistage et traitement prénatals du VIH en Afrique du Sud: normes sociales et options des politiques. L\'Afrique du Sud a une des plus hautes prévalences du VIH et SIDA du monde, dont la transmission de la mère à l\'enfant est une voie importante pour la propagation de l\'infection. Depuis des années, les scientifiques et des activistes du SIDA sur le plan local et international, travaillent désespéremment pour que les gens d\'Afrique du Sud aient un accès au traitement pour le VIH et le SIDA. Les décisionnaires en Afrique du Sud ont systématiquement insisté sur le fait que l\'infection du VIH n\'est pas responsable du SIDA, créant ainsi le plus grand obstacle à la réalisation de la prévention appropriée et des programmes thérapeutiques, y compris la thérapie antirétrovirale pour les personnes séropositives. Très récemment, les fonctionnaires et les membres du parti politique au pouvoir, au mépris de l\'ancienne politique, ont accepté que les médicaments antirétroviraux soient donnés aux femmes enceintes séropositives. Le tissu social de la société sud africaine est remarquablement différent de celui des pays occidentaux. Dans cet article, l\'auteur fait une analyse des implications probables du dépistage et traitement prénatals des femmes enceintes en Afrique du Sud, à la lumière de la situation socio-économique et culturelle des femmes dans cette société-là. (Rev Afr Santé Reprod 2004; 8[2]: 77-85

Social capital, religiosity, and human capital: Impacts on HIV/AIDS risk behaviors.

Social capital, religiosity, and human capital: Impacts on HIV/AIDS risk behaviors

Risk perception and risk attitude in informed consent

The standard account of the (Kahneman and Tversky, 1979) is that attitude toward risk changes across gain or loss framings of outcomes. Weber and Bottom (1989) proposed an alternative account in which decision makers have stable risk attitudes, but changing risk perceptions. Undergraduates were randomly assigned to read one of three hypothetical informed consent documents from a trial of a cholesterol-lowering drug. Documents used gain, loss or both framings to describe expected benefits. Respondents rated riskiness of participation and non-participation in the trial and made a choice about whether they would participate in the trial.

Let\u27s Not Reinvent the Wheel: Using Communities of Learning and Practice to Address SDOH and Advance Health Equity.

BACKGROUND: Despite advances in knowledge and science, evidence indicates that health care disparities and inequities continue to exist across diverse populations. Educating and training the next generation of health professionals to focus on addressing social determinants of health (SDOH) and advancing health equity is a key priority. This aim requires educational institutions, communities, and educators to strive for change in health professions education, to attain the goal of creating transformative educational systems that better meet the public health needs of the 21st Century. PURPOSE AND OUTCOMES: Communities of practice (CoPs) are groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. The National Collaborative for Education to Address Social Determinants of Health (NCEAS) CoP is focused on integrating SDOH into the formal education of health professionals. The NCEAS CoP is one model to replicate how health professions educators can work together for transformative health workforce education and development. The NCEAS CoP will continue to advance health equity by sharing evidence-based models of education and practice that address SDOH and help build and sustain a culture of health and well-being through sharing models for transformative health professions education. CONCLUSIONS: Our work is an example that shows we can build partnerships across communities and professions, thereby freely sharing ideas and curricular innovations that address the systemic inequities that continue to fuel persistent health disparities and inequities, and contribute to moral distress and burnout of our health professionals

Instrument Refinement for Measuring Self-Efficacy for Competence in Interprofessional Collaborative Practice : Development and Psychometric Analysis of IPECC-SET 27 and IPECC-SET 9.

Assessing competence in interprofessional collaborative practice (ICP) among health professions students is a high priority. This cross-sectional study built on the authors' prior work that led to the development of the 38-item Interprofessional Education Collaborative Competency Self Efficacy Tool (IPECC-SET), an instrument to evaluate health professions students' self-efficacy in interprofessional collaborative competency, and addressed two primary questions. First, could a unidimensional scale based on the IPEC competencies and assessing perceived self-efficacy for competence in ICP and be constructed? Second, could a shorter version of that instrument still meet criteria for unidimensionality and retain the ability to separate students in distinct levels of perceived self-efficacy for competence in ICP? Study participants were two cohorts of students from 11 health professions programs participating in an institutional interprofessional immersion event in 2015 and 2016. Statistical stepwise analyses were conducted using a Rasch rating scale model. The original 38 IPECC-SET items did not meet the criteria to generate a valid unidimensional measure of self-efficacy for competence in ICP, but could be condensed into a 27-item scale that met all set criteria for unidimensionality, with an explained variance of 61.2% and a separation index of 3.02. A shorter, 9-item scale demonstrated a separation index of 2.21. The nine items included also demonstrated a relatively equivalent range (54.93-45.65) as compared to the 27-item scale (57.26-46.16). Findings confirm empirically the conceptual suggestion from our earlier work that the four dimensions in the original IPEC competencies contribute to a shared underlying construct: perceived competence in interprofessional collaboration. Given the emphasis on ICP, psychometrically sound instruments are needed to evaluate the effectiveness of educational efforts to promote competency for ICP. Based on the findings from this study, both the IPECC-SET 27 and IPECC-SET 9 can be used to measure perceived self-efficacy for competence in ICP

Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes