“Money Helps”: People who inject drugs and their perceptions of financial compensation and its ethical implications

This study documents how people who inject drugs (PWID) in rural Puerto Rico perceive payments for participating in HIV epidemiological studies. In-depth interviews were conducted among a subset (n = 40) of active PWID older than 18 years of age who had been previously enrolled in a much larger study (N = 360). Findings suggest that financial compensation was the main motivation for initially enrolling in the parent study. Then, as trust in the researchers developed, participants came to perceive compensation as part of a reciprocal exchange in which they assisted researchers by providing a trustful account of their experiences and researchers reciprocated with financial support

“Money Helps”: People who inject drugs and their perceptions of financial compensation and its ethical implications

This study documents how people who inject drugs (PWID) in rural Puerto Rico perceive payments for participating in HIV epidemiological studies. In-depth interviews were conducted among a subset (n = 40) of active PWID older than 18 years of age who had been previously enrolled in a much larger study (N = 360). Findings suggest that financial compensation was the main motivation for initially enrolling in the parent study. Then, as trust in the researchers developed, participants came to perceive compensation as part of a reciprocal exchange in which they assisted researchers by providing a trustful account of their experiences and researchers reciprocated with financial support

Factors associated with HPV vaccine acceptability and hesitancy among Black mothers with young daughters in the United States

IntroductionCompared to other-race peers, Black women are disproportionately impacted by human papillomavirus [HPV] infection, related health outcomes, and cervical cancer mortality as a result of suboptimal HPV vaccine uptake during adolescence. Few studies in the United States have examined psychosocial determinants of HPV vaccine acceptability and hesitancy among Black parents. The current study integrated the health belief model and the theory of planned behavior to evaluate the extent to which psychosocial factors are associated with pediatric HPV vaccination intentions among this population.MethodsBlack mothers (N = 402; age range = 25 to 69 years, M = 37.45, SD = 7.88) of daughters ages 9 to 15 years completed an online survey assessing HPV infection and vaccine beliefs and attitudes across four domains: Mother’s HPV Perceptions, Mother’s Vaccine Attitudes, Cues to Action, and Perceived Barriers to HPV Vaccination. Participants indicated their willingness to vaccinate their daughter on a 5-level ordinal scale (“I will definitely not have my daughter get the vaccine” to “I will definitely have my daughter get the vaccine”) which was dichotomously recoded for binomial logistic regressions.ResultsHalf of the sample (48%) intended to vaccinate their daughter. Number of daughters, mother’s HPV vaccine status, perceived HPV vaccine benefits, HPV vaccine safety concerns, pediatric HPV vaccine peer norms, and doctor recommendations emerged as independent factors of Black mothers’ intentions to vaccinate their daughters against HPV when controlling for all other factors.DiscussionIn addition to medical training to increase doctor recommendation of the HPV vaccine for Black girls, population-tailored public health messaging aimed at promoting HPV vaccine acceptance among Black mothers is urgently needed. This messaging should engage community support and emphasize the benefits of vaccination for adolescent Black girls while also addressing parental concerns regarding the safety of pediatric HPV vaccination

Establishing trust in HIV/HCV research among people who inject drugs (PWID): Insights from empirical research

Background — The establishment of trust between researchers and participants is critical to advance HIV and HCV prevention particularly among people who inject drugs (PWID) and other marginalized populations, yet empirical research on how to establish and maintain trust in the course of community health research is lacking. This paper documents ideas about trust between research participants and researchers amongst a sub-sample of PWID who were enrolled in a large, multi-year community health study of social networks and HIV/HCV risk that was recently conducted in rural Puerto Rico. Methods — Qualitative research was nested within a multi-year Social Network and HIV/HCV Risk study involving N = 360 PWID \u3e 18 years of age living in four small, rural Puerto Rican communities. Semi-structured interviews were conducted between March 2017 and April 2017 with a subset of 40 active PWID who had been enrolled in the parent study. Interview questions invited participants to draw upon their recent experience as research participants to better understand how PWID perceive and understand participant-researcher trust within the context of HIV/HCV-related epidemiological research. Results — Fear of police, stigma and concerns regarding confidentiality and anonymity were identified as structural factors that could compromise participation in HIV/HCV-related research for PWID. While monetary compensation was an important motivation, participants also valued the opportunity to learn about their HIV/HCV status. During their participation in the study, gaining knowledge of safe injection practices was perceived as a valuable benefit. Participant narratives suggested that PWID may adopt an incremental and ongoing approach in their assessment of the trustworthiness of researchers, continuously assessing the extent to which they trust the research staff throughout the course of the research. Trust was initially generated through peer Respondent Driven Sampling recruitment. Research staff who maintained a presence in the community for the entire duration of the prospective study reinforced trust between participants and the research team. Conclusion — Although PWID face numerous structural barriers to research-related trust in HIV/HCV research, we found that using a peer-based recruitment method like RDS, and employing a research staff who are knowledgeable about the targeted population, culturally sensitive to their needs, and who maintain a long-term presence in the community may help mitigate many of these barriers. The reputation of the research is built incrementally as participants join the study. This contributes to a “street reputation” that grows as current or former participants vouch for the study. Establishing trust was identified as only the first step towards building a collaborative relationship with participants, and our findings suggest that steps to address criminalization and stigmatization also are necessary to support research trust

HIV testing among pregnant women living with HIV in India: are private healthcare providers routinely violating women’s human rights?

Background In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Methods Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India’s National AIDS Control Organization. Results While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings. Conclusions There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV

Methylmercury in marine ecosystems : spatial patterns and processes of production, bioaccumulation, and biomagnification

Author Posting. © International Association for Ecology and Health, 2008. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in EcoHealth 5 (2008): 399-408, doi:10.1007/s10393-008-0201-1.The spatial variation of MeHg production, bioaccumulation and biomagnification in marine food webs is poorly characterized but critical to understanding the links between sources and higher trophic levels such as fish that are ultimately vectors of human and wildlife exposure. This paper discusses both large and local scale processes controlling Hg supply, methylation, bioaccumulation and transfer in marine ecosystems. While global estimates of Hg supply suggest important open ocean reservoirs of MeHg, only coastal processes and food webs are known sources of MeHg production, bioaccumulation, and bioadvection. The patterns observed to date suggest that not all sources and biotic receptors are spatially linked and that physical and ecological processes are important in transferring MeHg from source regions to bioaccumulation in marine food webs and from lower to higher trophic levels.Supported by NIH Grant Number P42 ESO7373 from the NIEHS, SERDP funds from the Department of Defense, the ESSRF (Environmental Science Strategic Research Fund) DFO, Canada, Woods Hole Sea Grant, Woods Hole Coastal Ocean Institute, National Science Foundation, and RI-INBRE Grant #P20RR016457 from NCRR, NIH

A tale of two universities: graduates perceived value of entrepreneurship education

The purpose of this paper is to evaluate career impact of entrepreneurship education (EE) considering evidence drawn from a quantitative study of alumni within two UK higher education institutions (HEIs) from a retrospective perspective. The findings inform the value of the EE experience and its impact on both self-employability and wider employability career choices. This study will be of relevance to both enterprise support agencies and government policy makers. This research study considers evidence drawn from an online quantitative survey of EE within two UK HEIs. The survey evaluated a range of issues including course design, programme satisfaction, impact, career outcomes and respondents demographics. Over 80 respondents completed the survey in full which was analysed using a range of bivariate techniques. The evidence suggested here indicates that EE programmes provide value both in terms of helping to enable business start-ups and also in supporting other career paths, through the enterprising knowledge and skill sets graduates acquire during their specialised studies. This study contributes to the literature by recognising and measuring these contributions. For example, this study enables discernment between different EE course components and their value for different career outcomes. The study recognises the limitations of this survey data in terms of the size of the sample, number of HEIs evaluated and its point in time design. The HEI sector must evaluate its practices and measure the effectiveness of its graduates in terms of achieving sustainable business start-up. In course design, the evidence suggested that students value both the enterprising and entrepreneurial skills and knowledge components and discern value between them in their later careers. The findings suggest that EE graduates typically experience portfolio careers with multiple occupations in different sectors and roles within both employment and self-employment. Thus it is important that EE programme design includes both enterprising and entrepreneurial components to meet the future requirements of their graduates postgraduation. This study contributes new evidence regarding the value of EE in UK HEIs. This evidence should inform course design and policy makers regarding the value of EE in creating self-employment and creating enterprising employees

Diversity in Digital Pill Systems: Differences in Perceptions and Attitudes Towards Use of a Digital Pill System for HIV Pre-Exposure Prophylaxis Among Men Who Have Sex With Men with Diverse Racial and Ethnic Identities

Nonadherence, particularly among men who have sex with men (MSM) with substance use disorders increases the risk of both HIV acquisition in those who are uninfected and the risk of disease progression and transmission in those with HIV. Measuring adherence to HIV pre-exposure chemoprophylaxis (PrEP) and antiretroviral therapy (ART), and responding to suboptimal adherence or changes in adherence behavior, remains a challenging public health problem. Despite the importance of accurate adherence measurement, there remains no gold standard for detecting medication ingestion events in HIV research. Technologies have been developed that indirectly infer ingestion events (e.g., via smart pill bottles) or directly measure adherence over periods of time (e.g., via drug concentration in plasma and red blood cells), yet such approaches fail to provide direct confirmation of ingestions and contextual information surrounding adherence and nonadherence. The use of a digital pill system (DPS) – a novel tool that leverages ingestible radiofrequency sensors to measure actual ingestion events – has the potential to advance adherence measurement in HIV research. In this study, we examined the willingness of MSM across racial and ethnic identities to operate a DPS in the context of PrEP adherence measurement and suggest potential future applications of this technology