The demographic features and outcome indicators of the Barbados HIV Pre-exposure Prophylaxis Program, 2018-2019

Objectives. To assess the demographics, risk profiles and outcome indicators of one of the few government-supported programs on pre-exposure prophylaxis (PrEP) in the English-speaking Caribbean. Methods. Chart review of all persons enrolled into the national PrEP Program from its inception on March 1st 2018 to November 30th 2019, with a descriptive summary analysis of the data extracted. Results. Of the 134 persons enrolled into the program most identified as men who have sex with men (67.9%), followed by men who have sex with men and women (14.9%); there were 20 persons, mostly men (85%), in sero-discordant relationships. PrEP uptake was 96%; however, the continuation rate (continuing for three consecutive months after initiation) was 61.5%. Continuation status for many could not be ascertained due to loss-to-follow-up. PrEP-associated toxicity prevalence was 2.3%, although side-effects occurred in 52% (mostly gastrointestinal). HIV positivity during the study period was 1.5%. Conclusion. Uptake of Barbados’ national PrEP Program is excellent but fairly low continuation rates and the HIV positivity rate indicate the need for improved pre-ART initiation education and follow-up processes. Service utilisation is mainly by men who have sex with men, and provision expansion to other civil society partners and private practitioners, as well as increased public awareness could increase access by other high-risk groups

Providing care to LGBT patients in Guyana: an assessment of medical providers’ knowledge, attitudes and readiness to learn

This study investigated the knowledge, attitudes and desire for continued education among Guyanese doctors with regards to LGBT health. It utilized a mixed methodology of quantitative, self-administered online surveys among 90 doctors, and qualitative semi-structured individual interviews with 8 other doctors. Descriptive and analytic calculations were performed on the quantitative data while thematic analysis was used for the qualitative data. The results show moderate knowledge levels regarding LGBT health, with deficits in awareness of LGBT health disparities; generally nondiscriminatory attitudes; and suboptimal education on LGBT health. Further training and pre-service curricular changes are necessary to address gaps and improve competency

Medical students’ attitudes towards, and knowledge of LGBT persons in Guyana

Evidence from industrialized countries show that discrimination and experienced and/or perceived negative encounters with healthcare workers affect frequency and type of healthcare sought by lesbian, gay, bisexual and transgender (LGBT) persons. In Guyana, and the wider English-speaking Caribbean region, there is a dearth of research on how healthcare workers and students perceive and interact with LGBT patients. This study investigated the attitudes and knowledge with regards to LGBT health among students at a medical school in Guyana by using quantitative, self-administered online surveys. We analyzed data using SPSS for descriptive and analytic calculations, and results showed that students held moderately prejudiced attitudes toward LGBT persons. Religiosity and heterosexual orientation were the main factors found to be associated with negative attitudes. Knowledge levels were also moderate with pronounced deficiencies in certain areas, and almost all students had not received LGBT-specific medical education, but most indicated a desire for such education

My body. My politics. An exploration of body image and health in Barbadian sexual minority women

There is a dearth of research on how pervasive Western stereotypes of the ideal body affect non-heterosexual women, and this body of research shrinks even further when considering sexual minority women in the Caribbean. This study aimed to uncover how negotiations between identity, desire, and body politics are being navigated and experienced by sexual minority women in Barbados, along with examining concerns about body image, the impact of societal expectations, and the consequences of these expectations on physical and mental health. Using a qualitative methodology that employed a semi-structured guide, thirteen women were interviewed over the course of a year. Thematic analysis revealed three major themes that centered around the interconnectivity of desire and presentation as it related to body image; distancing from Western influences and grappling with local body ideals; and the ways in which layered events and identities have resulted in complicated relationships with food. A selection of identified community needs is also offered in conclusion

A Clinicopathological Profile of Prostate Cancer in Trinidad and Tobago

Aim. To conduct a clinicopathological review of all prostate biopsies performed in a tertiary referral centre in Trinidad and Tobago over a period of 30 months. Methods. The records of all patients who had prostate biopsies from January 2012 to July 2014 were reviewed. Clinical and pathologic data were compiled and subsequently analysed using SPSS version 20. Results. From January 2012 to July 2014, 617 transrectal ultrasound guided prostate biopsies were performed. Pathological data were found for 546 patients of whom 283 (51.8%) were confirmed carcinoma of the prostate. Moderately differentiated tumors (Gleason 7) were the most common group. Using the D' Amico risk classification, most cases were found to be high risk (63.1%). Afro-Trinidadians comprised 72.1% of the patients with prostate cancer. Afro-Trinidadians were also more likely to have high risk and high grade disease as well as high PSA values. Conclusion. This study demonstrates that over half of our biopsies are eventually positive for cancer and most cases were high risk. Afro-Trinidadians comprised a disproportionate number of those diagnosed with prostate cancer and had a greater risk of high risk disease