Capital assets: a community research intervention by the African Forum in Redbridge and Watham Forest

Duration: September 1999 - November 2000 This was a community-led initiative in which over 1000 Africans resident in Redbridge and Waltham Forest were asked about their assets and health needs. The survey was instigated by Redbridge & Waltham Forest African Forum, and undertaken by community groups themselves in collaboration with Sigma Research. The survey was designed both to gather information from the communities and to provide information to them. The information sought was not simply about the participants needs but also about the assets within those communities to address those needs. The project sought information about the relationship between Africans living in Redbridge or Waltham Forest, their assets, health needs and the potential for interventions. It did so by: providing all stakeholders with clear and accessible information about the demography of the local African communities. mapping the priorities and needs of the groups. assessing knowledge about HIV and its prevention. mapping linguistic assets and social structures of participating community groups that may contribute to meeting these needs. identifying acceptable, culturally appropriate methods of intervention. Questionnaire content was led by the members of the African Forum as was the structure and content of the report. Members of community groups did all the interviewing. Between them, 41 interviewers talked to 1008 residents. The majority of African women and men living locally were at an age when people can be at their most active physically, mentally and economically. Mental health and HIV and AIDS were the major health concerns although health concerns were associated with country of birth. Many respondents lacked basic knowledge of HIV transmission. There is a need for more awareness of clinical sexual health services. Language ability and social networks are common assets for health. English is spoken by 78% of participants and 88% of the entire sample mentioned at least one person they were close to. The survey provides information that helps to identify key areas where community organisations and statutory services working in partnership can improve quality of life and access to services. The final report was called Capital assets: a community research intervention by The African Forum in Redbridge and Waltham Forest

Protocol of a two arm randomised, multi-centre, 12-month controlled trial: Evaluating the impact of a Cognitive Behavioural Therapy (CBT)-based intervention Supporting UPtake and Adherence to antiretrovirals (SUPA) in adults with HIV

BACKGROUND: Delay to start antiretroviral therapy (ART) and nonadherence compromise the health and wellbeing of people living with HIV (PLWH), raise the cost of care and increase risk of transmission to sexual partners. To date, interventions to improve adherence to ART have had limited success, perhaps because they have failed to systematically elicit and address both perceptual and practical barriers to adherence. The primary aim of this study is to determine the efficacy of the Supporting UPtake and Adherence (SUPA) intervention. METHODS: This study comprises 2 phases. Phase 1 is an observational cohort study, in which PLWH who are ART naïve and recommended to take ART by their clinician complete a questionnaire assessing their beliefs about ART over 12 months. Phase 2 is a randomised controlled trial (RCT) nested within the observational cohort study to investigate the effectiveness of the SUPA intervention on adherence to ART. PLWH at risk of nonadherence (based on their beliefs about ART) will be recruited and randomised 1:1 to the intervention (SUPA intervention + usual care) and control (usual care) arms. The SUPA intervention involves 4 tailored treatment support sessions delivered by a Research Nurse utilising a collaborative Cognitive Behavioural Therapy (CBT) and Motivational Interviewing (MI) approach. Sessions are tailored to individual needs and preferences based on the individual patient’s perceptions and practical barriers to ART. An animation series and intervention manual have been developed to communicate a rationale for the personal necessity for ART and illustrate concerns and potential solutions. The primary outcome is adherence to ART measured using Medication Event Monitoring System (MEMS). 372 patients will be sufficient to detect a 15% difference in adherence with 80% power and an alpha of 0.05. Costs will be compared between intervention and control groups. Costs will be combined with the primary outcome in cost-effectiveness analyses. Quality adjusted life-years (QALYs) will also be estimated over the follow-up period and used in the analyses. DISCUSSION: The findings will enable patients, healthcare providers and policy makers to make informed decisions about the value of the SUPA intervention

The people living with HIV stigma survey UK 2015: HIV-related sexual rejection and other experiences of stigma and discrimination among gay and heterosexual men

We aim to understand the difference in stigma and discrimination, in particular sexual rejection, experienced between gay and heterosexual men living with HIV in the UK. The People Living with HIV StigmaSurvey UK 2015 recruited a convenience sample of persons with HIV through over 120 cross sector community organisations and 46 HIV clinics to complete an online survey. 1162 men completed the survey, 969 (83%) gay men and 193 (17%) heterosexual men, 92% were on antiretroviral therapy. Compared to heterosexual men, gay men were significantly more likely to report worrying about workplace treatment in relation to their HIV (21% vs. 11%), worrying about HIV-related sexual rejection (42% vs 21%), avoiding sex because of their HIV status (37% vs. 23%), and experiencing HIV-related sexual rejection (27% vs. 9%) in the past 12 months. In a multivariate logistic regression controlling for other sociodemographic factors, being gay was a predictor of reporting HIV-related sexual rejection in the past 12 months (aOR 2.17, CI 1.16, 4.02). Both gay and heterosexual men living with HIV experienced stigma and discrimination in the past 12 months, and this was higher for gay men in terms of HIV-related sexual rejection. Due to the high proportion of men reporting sexual rejection, greater awareness and education of the low risk of transmission of HIV among people on effective treatment is needed to reduce stigma and sexual prejudice towards people living with HIV

Retail payment systems in the OIC Member Countries

Retail payment systems have been applied to one of the oldest problems of civilisations: how payment can be made for goods. In this report we address these systems primarily from the perspective of those relatively new technologies, businesses and processes that challenge cash-based systems. Our purpose is to explain these new technologies and their significance for OIC Member States and to offer recommendations on how to learn from best practices that can enhance the economies of these countries

En återuppstånden skämtare : camera-obscura-bilder från 1840-talets Stockholm /

In recent years there has been an increasing amount of international-level policy and research about the negative impact that HIV-related stigma and discrimination have on the well-being of people with HIV and on prevention (Aggleton & Parker 2002, DeBruyn 2002, Nyblade 2003, UNAIDS/WHO 2003, United Nations 2001). It is clear that stigma and discrimination relating to HIV infection are persistent problems for those who have been diagnosed. Evidence gathered in the UK demonstrates that the majority of people living with HIV report the effects of stigma and discrimination in a range of settings (see Scott 2001 for a detailed review). Sigma’s own work investigating the experiences of people living with HIV in the UK has found that just under a quarter experienced discrimination within the previous year while accessing services, social settings, and in public (Weatherburn et al. 2002). Moreover, a study focussing on African people living with HIV in the UK (Weatherburn et al. 2003) revealed that over one third had experienced problems with discrimination in the previous year. This same study revealed that just under half of African people with HIV had not revealed their diagnosis to anyone they lived with, two thirds had not told their employers and a quarter had not told their GP. There is little question that people’s concern about disclosure of their diagnosis bears a direct relationship to their concern that doing so will bring about damaging consequences. Although the prevalence and impact of stigma and discrimination relating to HIV in the UK is clear, there is little qualitative research that explores the operation of stigma and discrimination as processes and seeks to describe the nature of the relationship between stigma, discrimination and reduced health outcomes (although see Elam, 2004). Case studies and policy reports point to the role of government policy, political leadership and social environments in either worsening or ameliorating the negative effects of stigma and discrimination (Atrill et al. 2001, Kinniburgh et al. 2001, Fortier 2003). This report presents the findings of a study which explores how stigma and discrimination contribute to reduced health and well-being for the two largest groups of people living with HIV in the UK: African migrants and Gay and Bisexual men. In order to do so, it is necessary to critically consider the ways in which stigma and discrimination are theorised and described

Better mind the gap : addressing the shortage of HIV-positive women in clinical trials

no abstract availabl