HIV testing experiences of Aboriginal youth in Canada: service implications

The objective of this study was to explore HIV testing experiences and service views of Canadian Aboriginal youth in order to provide information for HIV testing services. An exploratory, mixed-method, community-based research design was used for this study. Findings reported here are from 210 survey participants who had experienced an HIV test. Youth were recruited through 11 Aboriginal organizations across Canada, including AIDS service organizations, health centers, community organizations, and friendship centers. Youth who had tested for HIV ranged in age from 15 to 30 years of age (20% were B20), and came from First Nations (75%), Me ́ tis (14%), and Inuit (9%) backgrounds. Participants lived in all provinces and one territory. Over half (62%) were female. While the majority of survey respondents indicated at their last HIV test they had been treated with care (80%), respect (77%), or kindness (76%), some reported being treated with hostility (19%), fear (12%), discrimination (11%), avoidance (10%), or being treated in a bored way (15%). When asked about information they had received, 28% of survey respondents could not remember; 23% said they were not given any information, and 24% said their questions were not answered. Emotional reactions to testing ranged from anxiety/apprehension (64% of survey respondents) to being ‘‘calm’’ (19%). When asked for suggestions to improve testing services, participants indicated emotional support, compassion, professional yet personable services, and personalized HIV information were important. Study results suggest that to facilitate HIV testing for Aboriginal youth, testing services and counseling must be respectful, compassionate, non-judgmental, and culturally responsive in order to provide emotional support and HIV information that is meaningful and memorable

HIV Testing and Care in Canadian Aboriginal Youth: A community based mixed methods study

<p>Abstract</p> <p>Background</p> <p>HIV infection is a serious concern in the Canadian Aboriginal population, particularly among youth; however, there is limited attention to this issue in research literature. The purpose of this national study was to explore HIV testing and care decisions of Canadian Aboriginal youth.</p> <p>Methods</p> <p>A community-based mixed-method design incorporating the Aboriginal research principles of Ownership, Control, Access and Possession (OCAP) was used. Data were collected through surveys (n = 413) and qualitative interviews (n = 28). Eleven community-based organizations including urban Aboriginal AIDS service organizations and health and friendship centres in seven provinces and one territory assisted with the recruitment of youth (15 to 30 years).</p> <p>Results</p> <p>Average age of survey participants was 21.5 years (median = 21.0 years) and qualitative interview participants was 24.4 years (median = 24.0). Fifty-one percent of the survey respondents (210 of 413 youth) and 25 of 28 interview participants had been tested for HIV. The most common reason to seek testing was having sex without a condom (43.6%) or pregnancy (35.4%) while common reasons for not testing were the perception of being low HIV risk (45.3%) or not having had sex with an infected person (34.5%). Among interviewees, a contributing reason for not testing was feeling invulnerable. Most surveyed youth tested in the community in which they lived (86.5%) and 34.1% visited a physician for the test. The majority of surveyed youth (60.0%) had tested once or twice in the previous 2 years, however, about one-quarter had tested more than twice. Among the 26 surveyed youth who reported that they were HIV-positive, 6 (23.1%) had AIDS at the time of diagnosis. Delays in care-seeking after diagnosis varied from a few months to seven years from time of test.</p> <p>Conclusion</p> <p>It is encouraging that many youth who had tested for HIV did so based on a realistic self-assessment of HIV risk behaviours; however, for others, a feeling of invulnerability was a barrier to testing. For those who tested positive, there was often a delay in accessing health services.</p

The Mangle of Interprofessional Health Care Teams

The aim of this study was to explore dimensions of relational work in interprofessional health care teams. Practitioners from a variety of disciplines came together to examine teamwork and cocreate knowledge about interprofessionalism using forum theater. Interviews held prior to the workshop to explore teamwork were foundational to structuring the workshop. The forum theater processes offered participants the opportunity to enact and challenge behaviors and attitudes they experienced in health care teams. Throughout the workshop, aspects of professional identity, power, trust, communication, system structures, and motivation were explored. The activities of the workshop were analyzed using Pickering’s theory, identifying three mangle strands found in being a team: organizational influences, accomplishing tasks, and an orientation to care. Performativity was identified as having a bearing on how teams perform and how teamwork is enacted. Practice components were seen as strands within a mangling of human and nonhuman forces that shape team performativity

Performativität als Methodologie und Phänomen

Performativity is both a methodology and in its complexity, phenomena. Understanding the concept, the evolution of the term and how performativity can open spaces for inquiry adds to knowledge about interprofessional healthcare teams. Distinguishing between performance and performativity is essential. In this article, we examine methodological aspects of performativity through the use of forum theater. Dialogue from a performance-based inquiry workshop with healthcare team members provides a way to discuss performative methodology. The workshop was built upon recurrent characteristics of interprofessionalism in healthcare teams seen in conversational interviews with healthcare practitioner participants. Performativity provides a way to explore the relational work in interprofessional team practices. The methodological messiness of performative inquiry is discussed.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1402112La performatividad es una metodología y un fenómeno. Comprender el concepto, la evolución del término y cómo la performatividad puede abrir espacios para la investigación, enriquece el conocimiento acerca de los equipos sanitarios interprofesionales. Es esencial distinguir entre performance y performatividad. En este artículo, examinamos los aspectos metodológicos de la performatividad mediante el uso del teatro foro. El diálogo en un taller de investigación- basada-en performance con miembros de un equipo de profesionales del cuidado de la salud permite una vía para discutir la metodología performativa. El taller fue construido sobre las características recurrentes del inter-profesionalismo en los equipos de cuidado de la salud visualizadas en entrevistas conversacionales con los participantes. La performatividad proporciona una manera de explorar el trabajo relacional en las prácticas del equipo interprofesional. Se discute el desorden metodológico de la investigación performativa.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1402112Performativität ist beides, Methodologie und Phänomen: Das Konzept und dessen Genese zu verstehen und auch zu sehen, in welcher Weise Performativität Untersuchungsräume öffnet, verhilft zu Wissen über interprofessionelle Pflegeteams. Dabei ist es essenziell, zwischen Performanz und Performativität zu unterscheiden.In diesem Beitrag beschäftigen wir uns mit methodologischen Aspekten von Performativität bei der Nutzung des Forumtheater, wobei Dialoge aus einem Workshop mit Mitgliedern von Pflegeteams zur Veranschaulichung herangezogen werden. Ausgangsmaterial für den Workshop waren wiederkehrende Charakteristika von Interprofessionalismus in solchen Teams, die in Interviews mit den Teilnehmenden erhoben worden waren. Performativität erlaubt dann, die relationale Arbeit innerhalb der Teampraktiken zu untersuchen. Die methodologische "Unordnung" performativer Forschung wird diskutiert.URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs140211

Considering performativity as methodology and phenomena

"Performativität ist beides, Methodologie und Phänomen: Das Konzept und dessen Genese zu verstehen und auch zu sehen, in welcher Weise Performativität Untersuchungsräume öffnet, verhilft zu Wissen über interprofessionelle Pflegeteams. Dabei ist es essenziell, zwischen Performanz und Performativität zu unterscheiden. In diesem Beitrag beschäftigen wir uns mit methodologischen Aspekten von Performativität bei der Nutzung des Forumtheater, wobei Dialoge aus einem Workshop mit Mitgliedern von Pflegeteams zur Veranschaulichung herangezogen werden. Ausgangsmaterial für den Workshop waren wiederkehrende Charakteristika von Interprofessionalismus in solchen Teams, die in Interviews mit den Teilnehmenden erhoben worden waren. Performativität erlaubt dann, die relationale Arbeit innerhalb der Teampraktiken zu untersuchen. Die methodologische 'Unordnung' performativer Forschung wird diskutiert." (Autorenreferat)"Performativity is both a methodology and in its complexity, phenomena. Understanding the concept, the evolution of the term and how performativity can open spaces for inquiry adds to knowledge about interprofessional healthcare teams. Distinguishing between performance and performativity is essential. In this article, we examine methodological aspects of performativity through the use of forum theater. Dialogue from a performance-based inquiry workshop with healthcare team members provides a way to discuss performative methodology. The workshop was built upon recurrent characteristics of interprofessionalism in healthcare teams seen in conversational interviews with healthcare practitioner participants. Performativity provides a way to explore the relational work in interprofessional team practices. The methodological messiness of performative inquiry is discussed." (author's abstract

Reducing HIV-related stigma among young people attending school in Northern Uganda: study protocol for a participatory arts-based population health intervention and stepped-wedge cluster-randomized trial

BACKGROUND: HIV-related stigma negatively impacts HIV prevention, treatment, and care, particularly among children and adolescents in sub-Saharan Africa. Interventions that are culturally grounded and relevant for addressing root causes may reduce the stigma experienced by HIV-positive and HIV-affected young people. This study, to be conducted in a post-conflict, rural setting in Omoro District, Uganda, will develop and evaluate a transformative  arts-based HIV-related stigma intervention rooted in local cultural knowledge to reduce stigma and improve HIV prevention and care for young people living with HIV. The intervention will be delivered to young people attending school by community Elders, with the support of teachers, through the transfer of local cultural knowledge and practices with the aim of re-establishing the important cultural and social role of Elders within a community that has suffered the loss of intergenerational transfer of cultural knowledge throughout a 25-year civil war. METHODS: A formative research phase consisting of interviews with students, teachers, and Elders will inform the intervention and provide data for study objectives. Workshops will be delivered to Elders and teachers in participating schools to build capacity for arts-based, educational workshops to be conducted with students in the classroom. The intervention will be evaluated using a stepped-wedge cluster-randomized trial. Government-funded schools in Omoro District will be randomized into three blocks, each comprised of two primary and two secondary schools (n=1800 students). Schools will be randomly assigned to a crossover sequence from control to intervention condition in 8-week intervals. A process evaluation will be implemented throughout the study to evaluate pathways between intervention development, implementation, and effects. DISCUSSION: This study will generate comprehensive, in-depth participatory research and evaluation data to inform an effective and sustainable protocol for implementing arts-based HIV stigma interventions for young people in school settings. Findings will have widespread implications in post-conflict settings for HIV prevention, treatment, and care. TRIAL REGISTRATION: ClinicalTrials.gov NCT04946071 . Registered on 30 June 2021