Use of dietary supplements among people living with HIV/AIDS is associated with vulnerability to medical misinformation on the internet

<p>Abstract</p> <p>Background</p> <p>Use of dietary supplements is common among people living with HIV/AIDS. Because dietary supplements are used in the context of other health behaviors, they may have direct and indirect health benefits. However, supplements may also be associated with vulnerability to medical misinformation and unfounded health claims. We examined use of dietary supplements among people living with HIV/AIDS (PLWH) and the association between use of dietary supplements and believing medical misinformation.</p> <p>Methods</p> <p>A convenience sample of 268 men and 76 women living with HIV was recruited from AIDS services and clinics in Atlanta, GA. Participants completed measures of demographic and health characteristics, dietary supplement use, beliefs about dietary supplements, internet use, and an internet evaluation task designed to assess vulnerability to medical misinformation.</p> <p>Results</p> <p>One out of four PLWH currently used at least one dietary supplement product excluding vitamins. Dietary supplement use was associated with higher education and greater use of the internet for health-related information. Dietary supplement users also endorsed greater believability and trust in unfounded claims for HIV cures.</p> <p>Conclusions</p> <p>Dietary supplement use is common among PLWH and is associated with a broad array of health information seeking behaviors. Interventions are needed to reduce the vulnerability of PLWH, particularly dietary supplement users, to medical misinformation propagated on the internet.</p

Exploring motivation to notify and barriers to partner notification of sexually transmitted infections in South Africa: a qualitative study

Background This article will review qualitative data from intervention-based counselling sessions to explore barriers to partner notification (PN) for South African men and women who have contracted sexually transmitted infections (STIs). This qualitative study took place in a township where there is high STI and HIV prevalence. In addition to reviewing barriers to PN, the study will also identify participants’ perceptions about effective PN strategies that are presented during the intervention. Ultimately, the study will assess the intervention’s impact on participants’ motivation and skills to notify their partners about their STI status. Methods Relying on recorded counselling sessions from an intervention run by a parent study, this sub- study reviewed 30 transcripts from counselling sessions with 15 men and 15 women. The intervention was a 60 min interactive session where STI and HIV education, risk mitigation, and effective PN strategies were discussed. Participants were between 19 and 41 years old (mean age = 28.4) and lived within the catchment area of a South African township. Recordings were chosen based on verbal responsiveness of the participant and were manually coded for analysis. In addition, two programme counsellors were interviewed about their perceptions of the intervention and their experiences with participants to enhance rigour and reduce potential bias. Results By the conclusion of the intervention session, both male and female participants were motivated to notify their partners face-to-face about their positive STI status. Despite this, misperceptions about the etiology and transmission of STIs, as well as inadequate support from the clinical level and power imbalances amongst men and women emerged as major barriers for the prevention of future STIs. Conclusions While the intervention appears to be successful in facilitating partners’ intentions to notify, the data shows significant social and structural barriers that will create difficulties for the prevention of future STIs. Participants’ persistent concerns about acquiring HIV or their current positive status affect decision-making and therefore, could be a window of opportunity for health-care providers or lay counsellors to discuss STIs in high prevalence areas

How common and frequent is heterosexual anal intercourse among South Africans? A systematic review and meta-analysis.

BACKGROUND: HIV is transmitted more effectively during anal intercourse (AI) than vaginal intercourse (VI). However, patterns of heterosexual AI practice and its contribution to South Africa's generalized epidemic remain unclear. We aimed to determine how common and frequent heterosexual AI is in South Africa. METHODS: We searched for studies reporting the proportion practising heterosexual AI (prevalence) and/or the number of AI and unprotected AI (UAI) acts (frequency) in South Africa from 1990 to 2015. Stratified random-effects meta-analysis by sub-groups was used to produce pooled estimates and assess the influence of participant and study characteristics on AI prevalence. We also estimated the fraction of all sex acts which were AI or UAI and compared condom use during VI and AI. RESULTS: Of 41 included studies, 31 reported on AI prevalence and 14 on frequency, over various recall periods. AI prevalence was high across different recall periods for sexually active general-risk populations (e.g. lifetime = 18.4% [95%CI:9.4-27.5%], three-month = 20.3% [6.1-34.7%]), but tended to be even higher in higher-risk populations such as STI patients and female sex workers (e.g. lifetime = 23.2% [0.0-47.4%], recall period not stated = 40.1% [36.2-44.0%]). Prevalence was higher in studies using more confidential interview methods. Among general and higher-risk populations, 1.2-40.0% and 0.7-21.0% of all unprotected sex acts were UAI, respectively. AI acts were as likely to be condom protected as vaginal acts. CONCLUSION: Reported heterosexual AI is common but variable among South Africans. Nationally and regionally representative sexual behaviour studies that use standardized recall periods and confidential interview methods, to aid comparison across studies and minimize reporting bias, are needed. Such data could be used to estimate the extent to which AI contributes to South Africa's HIV epidemic

SPECT/CT imaging of the lumbar spine in chronic low back pain: a case report

Mechanical low back pain is a common indication for Nuclear Medicine imaging. Whole-body bone scan is a very sensitive but poorly specific study for the detection of metabolic bone abnormalities. The accurate localisation of metabolically active bone disease is often difficult in 2D imaging but single photon emission computed tomography/computed tomography (SPECT/CT) allows accurate diagnosis and anatomic localisation of osteoblastic and osteolytic lesions in 3D imaging. We present a clinical case of a patient referred for evaluation of chronic lower back pain with no history of trauma, spinal surgery, or cancer. Planar whole-body scan showed heterogeneous tracer uptake in the lumbar spine with intense localisation to the right lateral aspect of L3. Integrated SPECT/CT of the lumbar spine detected active bone metabolism in the right L3/L4 facet joint in the presence of minimal signs of degenerative osteoarthrosis on CT images, while a segment demonstrating more gross degenerative changes was more quiescent with only mild tracer uptake. The usefulness of integrated SPECT/CT for anatomical and functional assessment of back pain opens promising opportunities both for multi-disciplinary clinical assessment and treatment for manual therapists and for research into the effectiveness of manual therapies

Randomized community-level HIV prevention intervention trial for men who drink in South African alcohol-serving venues

South African alcohol-serving establishments (i.e., shebeens) offer unique opportunities to reduce HIV risks among men who drink. Purpose: To test an individual- and a social structural-level HIV prevention intervention for men who drink in shebeens. Methods: Twelve matched pairs of township neighbourhoods were randomized to receive either (i) an HIV prevention intervention (guided by Social Action Theory) to reduce sexual risk and increase risk reduction communication in social networks, or (ii) an attention-matched control intervention that focused on the prevention of relationship violence. At the individual level, the interventions delivered skills building workshops focused on sexual risk reduction. At the social structural level, the intervention aimed to increase conversations about safer sex among men in the shebeens, distributed small media and implemented community educational events. Individual-level outcomes were assessed by following the workshop cohorts for 1 year (N = 984), and community-level outcomes were examined through cross-sectional community surveys conducted for 1 year in the shebeens (N = 9,678). Results: Men in the HIV prevention workshops demonstrated greater condom use, more HIV prevention-oriented conversations and greater perceptions of safer sex norms than men in the comparison workshops. Changes at the community level demonstrated significant differences in condom use, although the pattern was not consistent over time. Conclusions: Multi-level interventions that target men who drink in South African shebeens may help reduce risks for HIV and other sexually transmitted infections.Web of Scienc

Social constructions of gender roles, gender-based violence and HIV/AIDS in two communities of the Western Cape, South Africa

The links between gender roles, gender-based violence and HIV/AIDS risk are complex and culturally specific. In this qualitative study we investigated how women and men in two black communities in the Western Cape, South Africa, constructed their gender identities and roles, how they understood gender-based violence, and what they believed about the links between gender relations and HIV risk. First we conducted 16 key informant interviews with members of relevant stakeholder organisations. Then we held eight focus group discussions with community members in single-sex groups. Key findings included the perception that although traditional gender roles were still very much in evidence, shifts in power between men and women were occurring. Also, gender-based violence was regarded as a major problem throughout communities, and was seen to be fuelled by unemployment, poverty and alcohol abuse. HIV/AIDS was regarded as particularly a problem of African communities, with strong themes of stigma, discrimination, and especially ‘othering' evident. Developing effective HIV/AIDS interventions in these communities will require tackling the overlapping as well as divergent constructions of gender, gender violence and HIV which emerged in the study. Keywords: gender roles, gender-based violence, HIV/AIDS, South Africa. RÉSUMÉ Les liens entre les rôles de genre, la violence contre les femmes et le risque du VIH/SIDA sont complexes et culturellement particuliers. Dans cette étude qualitative, nous avons examiné: comment des hommes et des femmes ont construit des identités et les rôles de genre dans deux communautés noires du Cap de l'Ouest, en Afrique du Sud, comment ont-ils compris la violence contre les femmes et ce qu'ils croyaient des liens entre les relations de sexes et le risque du VIH. Dans un premier temps, nous avons mené 16 entretiens principaux d'informateurs auprès des membres des organismes dépositaires. Ensuite, nous avons eu huit discussions des groupes de foyer avec des membres de la communauté en deux groupes différents, un pour les femmes un autre pour les hommes. Les résultats de recherche ont inclus la perception que: même si les rôles de genre traditionnels restent toujours évidents, il y a aussi le déplacement de pouvoir entre les hommes et les femmes. De plus, la violence contre les femmes était vue comme un problème majeur à travers les communautés et d'être aggravée par le chômage, la pauvreté et l'abus d'alcool. Le VIH/SIDA était considéré particulièrement comme un problème des communautés africaines avec des thèmes fortes de stigmatisation, de discrimination et surtout le ‘othering' évidents. Le développement des interventions efficaces du VIH/SIDA dans ces communautés va exiger une maîtrise des constructions de genre qui se recouvrent partiellement et qui sont divergentes également, la violence contre les femmes et le VIH qui ont apparu dans cette étude. Mot clés: les rôles de genre, la violence contre les femmes, le VIH/SIDA, l'Afrique du Sud

Heritability of a skeletal biomarker of biological aging

Changes in the skeletal system, which include age-related bone and joint remodeling, can potentially be used as a biomarker of biological aging. The aim of the present study was to investigate the extent and mode of inheritance of skeletal biomarker of biological aging—osseographic score (OSS), in a large sample of ethnically homogeneous pedigrees. The investigated cohort comprised 359 Chuvashian families and included 787 men aged 18–89 years (mean 46.9) and 723 women aged 18–90 years (mean 48.5). The TOSS - transformed OSS standardized in 5-year age groups for each sex, was analyzed as a BA index. We evaluated familial correlations and performed segregation analysis. Results of our study suggest the familial aggregations of TOSS variation in the Chuvashian pedigrees. In a segregation analysis we found a significant major gene (MG) effect in the individual’s TOSS with a dominant most parsimonious model (H2 = 0.32). Genetic factors (MG genotypes) explained 47% of the residual OSS variance after age adjustment and after including sex-genotype interaction, they explained 52% of the residual variance. Results of our study also indicated that the inherited difference in the skeletal aging pattern in men lies mostly in the rate of aging, but in women in the age of the onset of the period of visible skeletal changes

Taste Sensitivity to Phenylthiocarbamide Found in South Sinai Bedouin Tribes

The aim of this work was to study taste sensitivity to phenylthiocarbamide (PTC) amongst Bedouin tribes and compare the Bedouins with Arab and Jewish populations. Data obtained by the classic method of serial dilutions in 317 healthy male Bedouins, aged 16–70 belonging to different tribes, were examined. We discovered significant differ­ences in chemosensitivity to PTC in the Bedouin communities. A high frequency of the t allele was documented in the Bedouin tribes of Hamada, Muzeina, and “other Bedouins” and a relatively low level of the t allele frequency in the Gebelia tribe. The frequencies of non-tasters amongst Arab groups were similar in values to those of the Gebelia tribe. Three other Bedouin tribes showed very high values for the non-tasters’ frequencies. The revealed intertribal differ­ences can be explained by the genetic drift in isolated populations, on the other hand, this may be the result of endog­amy

Designing theoretically-informed implementation interventions

Clinical and health services research is continually producing new findings that may contribute to effective and efficient patient care. However, the transfer of research findings into practice is unpredictable and can be a slow and haphazard process. Ideally, the choice of implementation strategies would be based upon evidence from randomised controlled trials or systematic reviews of a given implementation strategy. Unfortunately, reviews of implementation strategies consistently report effectiveness some, but not all of the time; possible causes of this variation are seldom reported or measured by the investigators in the original studies. Thus, any attempts to extrapolate from study settings to the real world are hampered by a lack of understanding of the effects of key elements of individuals, interventions, and the settings in which they were trialled. The explicit use of theory offers a way of addressing these issues and has a number of advantages, such as providing: a generalisable framework within which to represent the dimensions that implementation studies address, a process by which to inform the development and delivery of interventions, a guide when evaluating, and a way to allow for an exploration of potential causal mechanisms. However, the use of theory in designing implementation interventions is methodologically challenging for a number of reasons, including choosing between theories and faithfully translating theoretical constructs into interventions. The explicit use of theory offers potential advantages in terms of facilitating a better understanding of the generalisability and replicability of implementation interventions. However, this is a relatively unexplored methodological area