Academic literature on the topic 'AIDS (Disease) in women Needs assessment Australia'

Background Cancer treatments have the potential to cause infertility among women of reproductive age. Many cancer patients do not receive sufficient oncofertility information or referrals to reproductive specialists prior to starting cancer treatment. While health care providers cite lack of awareness on the available oncofertility resources, the majority of cancer patients use the internet as a resource to find additional information to supplement discussions with their providers. Objective Our aim was to identify and characterize Web-based oncofertility decision aids and health education materials accessible for women of reproductive age with a diagnosis of any cancer. Methods We searched five databases and the gray literature for the years 1994-2018. The developer and content information for identified resources was extracted. Each resource underwent a quality assessment. Results We identified 31 open access resources including 4 decision aids and 27 health educational materials. The most common fertility preservation options listed in the resources included embryo (31/31, 100%), egg (31, 100%), and ovarian tissue freezing (30, 97%). Notably, approximately one-third (11, 35%) contained references and 5 (16%) had a reading level of grade 8 or below. Resources were of varying quality; two decision aids from Australia and the Netherlands, two booklets from Australia and the United Kingdom, and three websites from Canada and the United States rated as the highest quality. Conclusions This comprehensive review characterizes numerous resources available to support patients and providers with oncofertility information, counseling, and decision making. More focus is required to improve the awareness and the access of existing resources among patients and providers. Providers can address patient information needs by leveraging or adapting existing resources to support clinical discussions and their specific patient population.

Little is known about the health access and end-of-life (EOL) concerns of persons living with HIV/AIDS (PLWHA) in Appalachia, where religious and cultural values are largely traditional. A qualitative, descriptive study with 9 participants was undertaken to assess EOL care needs among those from South Central Appalachian PLWHA. The focus of the study was to examine subjective data regarding EOL needs assessment related to advanced care planning. Five men and 4 women self-acknowledged a diagnosis of HIV/AIDS and completed a 2-hour face-to-face interview with the nurse researcher. Data were analyzed using qualitative descriptive content analysis methods, including data coding for emergent themes and metaphors. A common metaphor tied content to both struggle and triumph as well as the beauty and ruggedness of the Appalachian region: “Climbing Back up the Mountain.” Rich descriptions of the significance of the metaphor match with stigma as the greatest hurdle to overcome in planning and interacting with others, including health care providers and significant others, about EOL care needs and advanced planning preferences. Further, the metaphor was derived directly from quotes offered by participants. Sources of stigma were often intersecting: the disease itself, associations with “promiscuity,” sexual minority status, illicit drug use, and so on. Strong spiritual images were contrasted with a common avoidance and disdain of organized religion. Findings were used in refining plans for a larger study of EOL care needs and concerns on the population of PLWHA in 2 Southern Appalachian states. Comparison with other research and insights for providers is included.

Background: Uncertainty is common in advanced illness but is infrequently studied in this context. If poorly addressed, uncertainty can lead to adverse patient outcomes. Aim: We aimed to understand patient experiences of uncertainty in advanced illness and develop a typology of patients’ responses and preferences to inform practice. Design: Secondary analysis of qualitative interview transcripts. Studies were assessed for inclusion and interviews were sampled using maximum-variation sampling. Analysis used a thematic approach with 10% of coding cross-checked to enhance reliability. Setting/participants: Qualitative interviews from six studies including patients with heart failure, chronic obstructive pulmonary disease, renal disease, cancer and liver failure. Results: A total of 30 transcripts were analysed. Median age was 75 (range, 43–95), 12 patients were women. The impact of uncertainty was frequently discussed: the main related themes were engagement with illness, information needs, patient priorities and the period of time that patients mainly focused their attention on (temporal focus). A typology of patient responses to uncertainty was developed from these themes. Conclusion: Uncertainty influences patient experience in advanced illness through affecting patients’ information needs, preferences and future priorities for care. Our typology aids understanding of how patients with advanced illness respond to uncertainty. Assessment of these three factors may be a useful starting point to guide clinical assessment and shared decision making.

Background:There are clear educational pregnancy-related needs for both women and men living with Autoimmune Rheumatic Diseases (ARDs) who seek specific advice from their health care providers. Most of the time those subjects would seek specific information regarding their chances of pregnancy, impact of the disease, as well as safety of their medications during pregnancy and breast feeding. They also require emotional and physical support as well as advice towards practical coping strategies to manage pain and disease flares particularly during the postnatal period.Objectives:To evaluate the effectiveness of a new interactive pregnancy decision aid (DA) developed for both men and women living with inflammatory arthritis.Methods:Driven by the Cochrane review of patient decision aids (DA) and the International Patient Decision Aids framework (IPDAS), which identify shared decision making (SDM) instrument as evidence-based tools designed to help people engage in deliberative management-related decision making by providing information on the options and outcomes relevant to health status. This project involved an overall three-phase SDM aid development. It has been set up for both men and women and included information on pregnancy, contraception and breast feeding. The first phase included the development of the decision tool and review by expert faculty composed of: decision experts, patient representatives, policy makers, and patients living with RA, PsA, AS and SLE. The second phase was a pilot testing of the tool in both online and paper format styles. The third phase involved an evaluation of the decision support tool and its impact on the patients. The DA adopted an interactive style with embedded video recordings (this was converted into text in the paper format). All the patient completed these questionnaires: the ReproKnow, Decisional Conflict Scale (DCS), Hospital Anxiety and Depression Scale (HADS), and Arthritis Self-Efficacy Scale (ASES) pre- and post-intervention. A control group of 92 patients (19 men and 71 women) managed according to the standard protocols was also included. Comprehensibility of the video recordings were also assessed using VAS (0-10).Results:126 patients shared in this work (101 women and 25 men). The patients who received the DA had an 81% (women) and 83% (men) increase in ReproKnow scores and a 76 % decrease in scores on the decisional conflict (DCS), compared to the control group (10 % and 11 % respectively); p< 0.001. There were no changes in the scores of depression and anxiety symptoms (p= 0.873) indicating no adverse psychological impact detected. There was no significant difference in terms of self-efficacy assessment p=0.481. The patients rated the comprehensibility of the video recording as high (9.4/10)Conclusion:The DA which was developed to support pregnancy and breast feeding decision-making for patients with ARDs. The interactive SDM aid was found to be a simple, user-friendly tool which can be implemented in standard clinical practice. The interactive style made it more comprehensible to the patients. It is consistent with the IPDAS criteria. Results revealed its effectiveness in improving relevant knowledge and reducing decisional conflict without causing distress to the patients.Disclosure of Interests:None declared.

Background:Previous research has indicated that women with a chronic inflammatory disease (CID) are likely to discontinue treatment during pregnancy. [1] Reasons for this are complex, including sub-optimal integration of shared decision-making (SDM) into practice.Objectives:The purpose of this study was to assess: 1) physicians’ competencies in risk assessment, treatment and management of women of reproductive age (WoRA) with a CID, and 2) clinical gaps, barriers and challenges to SDM with these patients.Methods:A mixed-methods needs assessment was conducted. [2] Participants included rheumatologists and dermatologists practicing in Germany, United Kingdom, or United States, with at least three years of experience. Exposure to patients diagnosed with rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis or psoriasis was required. A first phase involved collection and thematic analysis of data from semi-structured interviews to identify main challenge areas. The second phase consisted of online surveys to validate and quantify identified challenges, gaps and barriers. Chi-square and Kruskal Wallis H statistical tests were performed to assess differences by specialty, country and gender. Qualitative and quantitative findings were triangulated with insight from experts in medical education and relevant behavioural and clinical fields. [3] The present summary reports data pertaining to rheumatologists only.Results:A total of 24 interviews and 173 surveys were completed with rheumatologists. Depending on the country and specific item, 22% to 64% reported having sub-optimal knowledge of treatment options, patient education aids, and strategies to assess treatment adherence among WoRA with a CID (see figure 1). In addition, 36% reported having sub-optimal knowledge of methods to achieve SDM. Unplanned pregnancies were reported as a barrier to prescribing biologics to WoRA with a CID. Yet, 61% of rheumatologists reported having sub-optimal skills discussing contraceptive methods with patients. In addition, 41% reported having sub-optimal skills adjusting treatment according to changes in pregnancy status or child-bearing aspirations. Few differences in clinical gaps were observed by gender. Notably, a greater proportion of male rheumatologists reported having sub-optimal skills approaching WoRA in a way that makes them feel comfortable discussing their health concerns, compared to female rheumatologists (52% vs. 30%, p=0.046). This skill gap was identified as a contributing barrier to SDM with these patients.Conclusion:This study identified multiple challenges, gaps and barriers relevant to rheumatologists that prevent optimal SDM, risk assessment, treatment and management of WoRA with CID. Findings may be used to develop medical education and continuous professional development interventions for target learners.References:[1]Tsao NW, Lynd LD, Sadatsafavi M, Hanley G and De Vera MA. Patterns of biologics utilization and discontinuation before and during pregnancy in women with autoimmune diseases: a population-based cohort study.Arthritis Care Res.,2018;70(7):979-986.[2]Creswell JW, Klassen AC, Plano Clark VL, Smith KC. Best practices for mixed methods research in the health sciences, 2nd Ed. Bethesda: NIH, 2018:541-545,.[3]Turner SF, Cardinal LB, Burton RM, A triangulation-based framework and roadmap.Organ. Res. Methods,2017;20(2): 243-26.Acknowledgments:This research was financially supported with educational funds from UCB BioPharma SRL. The authors thank T. Kellner for his contribution.Disclosure of Interests:Suzanne Murray: None declared, Rebecca Fischer-Betz Consultant of: UCB, Speakers bureau: Abbvie, Amgen, Biogen, BMS, Celgene, Chugai, GSK, Janssen, Lilly, Medac, MSD, Novartis, Roche, UCB, Pfizer., Monica Augustyniak: None declared, Jenny Murase Consultant of: I have led advisory boards for UCB., Speakers bureau: I have done non-branded talks on psoriasis management in women for UCB., Catherine Nelson-Piercy Consultant of: I have received consultancy fees from UCB, Speakers bureau: I have received fees for speaking from UCB., Ivo Vlaev Consultant of: For UCB., Speakers bureau: For UCB, Pfizer, Novartis and boehringer Ingelheim., Cecile Ecoffet Shareholder of: UCB, Employee of: UCB, Morgan Peniuta: None declared, Dean Jenkins Employee of: UCB

Objective. To study the epidemiological, medical, social and clinical factors that affect the manifestations and treatment of diseases — infections caused by the immunodeficiency virus (HIV) and the new coronavirus (SARS-CoV-2), which underlie the formation of a personalized approach to the management and treatment of people living with HIV (PLHIV).Materials and methods. Epidemiological analysis of morbidity and mortality from COVID-19 in the Leningrad region for 2021–2022 was carried out. The research team conducted a questionnaire and analysis of medical documentation of 122 HIVpositive patients registered at the Leningrad Regional Center for the Prevention and Control of AIDS and Infectious Diseases who suffered a novel coronavirus infection (COVID-19) in the period from 2020 to 2022. An assessment was made of the psychological and social characteristics of patients affecting adherence to antiretroviral therapy (ART), the clinical picture of the course of HIV infection, including in combination with COVID-19. The fact of SARS-CoV-2 disease was confirmed by polymerase chain reaction (PCR) smears from the mouth and nasopharynx. Additionally, a group of 59 PLHIV hospitalized in hospitals in St. Petersburg and the Leningrad region with a severe form of COVID-19 was isolated for analysis.Results and discussion. Number of COVID-19 cases in 2020–2021 in the Leningrad region amounted to 15.553 people, of which 1.553 had a history of HIV infection (13.5% of patients registered at the dispensary). The mortality rate among PLHIV who underwent COVID-19 was 5.1%. An equal ratio of women and men was observed among 122 surveyed patients, the average age of respondents was 41 years. When assessing the social status of the respondents, it was found that 25.4% had higher education, 56.5% had specialized secondary education. 72.9% had a permanent job. 61.4% of respondents considered themselves to be in the category of material well-being of «average level», 24.6% — to «below average». The sexual route of HIV infection was established in 50.8% of patients, injectable was 29.5%, in other cases it was not unknown. The average level of CD4 lymphocytes in the blood was 544 cl/mcl, most patients (90.2%) had an undetectable indicator of HIV viral load (VL). The average duration of the disease with the new coronavirus in HIV patients was 15.6 days. At the same time, 108 (88.5%) people noted a mild course of COVID-19 and did not need hospitalization. Coverage of COVID-19 vaccination among the surveyed PLHIV was 40.9%. According to data from 59 case histories of PLHIV hospitalized as a result of the severe course of COVID-19, 55 people died, a pathoanatomic autopsy was performed in 26 cases. The autopsy revealed the following complications and concomitant diseases: miliary tuberculosis (7.7%), purulent endocarditis (11.5%), sepsis (19.2%). Improvement in the dynamics was observed only in 4 PLHIV, whose further fate is unknown.Conclusion. The study showed that the incidence of SARS-CoV-2 among PLHIV in the Leningrad region is comparable to the general population, however, the total mortality among HIV-infected patients is higher than in the region and across the country. As a result of the analysis, we came to the conclusion that HIV infection and COVID-19 are independent in terms of co-infection at the outpatient stage. The exception is severe and aggravated comorbid cases, which required a more detailed assessment of the condition, the involvement of a larger number of specialists, as well as laboratory and instrumental research methods. The results obtained determined the need for a comprehensive interdisciplinary approach to patients with HIV infection, taking into account their personal needs. Medical personnel providing care to PLHIV should take into account not only the clinical picture of the disease, but also the psychosocial status of the patient, in order to improve the outcomes of COVID-19 and HIV infection.

Abstract BACKGROUND AND AIMS Chronic kidney disease (CKD) is likely to significantly affect the lives of patients and their carers, including increasing the economic burden. The relationship between CKD progression and these life impacts remains poorly characterized. The patient, carer and economic burden (PaCE) CKD study aims to enhance understanding of patient and carer experiences of CKD, including financial impact. METHOD In-depth, semi-structured, qualitative interviews were conducted with 20 patients with CKD and 19 informal carers in Australia, France, Germany, Italy, the UK and the USA. Participants were asked about their experiences with CKD and the associated economic burden. A quantitative online survey is ongoing, with 150–200 patients and 75–100 carers anticipated to participate per country. A Work Productivity and Activity Impairment (WPAI) questionnaire for patients and caregivers is being used to understand and estimate the financial burden of CKD on patients and caregivers. Patients are also being asked about their disease background, including the stage of CKD and treatment history. RESULTS In total, 20 patients and 19 carers participated in the qualitative interviews, with at least 3 patients and 3 carers included from each country. Eleven patients were male. Most patients were 75 years old or younger (18/20; overall range 30–81 years, overall mean 61.7 years). Patients reported their CKD stages: 3/20 stage 5; 2/20 stage 4–5; 2/20 stage 4; 2/20 stage 3–4; 8/20 stage 3; 1/20 stage 2; and 2/20 unknown. A third of patients underwent dialysis (7/20), including at least one patient from each country. Nine patients were working full- or part-time. Carers were 30–90 years old (mean 55.1 years), predominantly women (13/19) and were primarily relatives of the patient (8/19 partner, 5/19 daughter/son, 2/19 daughter-/son-in-law). More than half of the carers were employed (13/19 employed, 5/19 unemployed/retired, 1/19 unknown). Carer support varied between 4 and 35 h/week. Support included activities of daily living, visits to the hospital and emotional/psychological support; support was noted as more critical for patients with later-stage CKD. The degree of financial burden experienced by patients and carers varied between countries, potentially reflecting differences in local healthcare systems; however, the impact of reduced work hours on finances was consistent across all countries. Both patients and carers reported a loss of work hours, and in some cases, participants reported that they had to stop working. Patients who were employed reported lower productivity, and carers reported taking days off work without pay. Expenses related to the cost of managing CKD, including dietary needs, medical aids and hospital transport, further increased the economic burden. The extent of these impacts varied depending on the severity of CKD. Results from the quantitative survey will be presented at the congress. CONCLUSION Responses from qualitative interviews suggest that CKD increases the financial burden for both patients and carers, particularly as the disease progresses. When combined with data from the quantitative survey, these findings will provide important insights into the economic burden of CKD for patients and carers.

In the Philippines, many people would think that items made in other countries have better quality and are more desirable.More recently, with numerous goods coming from nearby countries also having built their reputation for similar or even betterquality – for example, those coming from Japan, Taiwan and more lately, China – goods from these countries are now alsopopular. But it remains unusual that we would generally prefer local brands, i.e., those made in the Philippines.When it comes to using scientific evidence as basis for local medical practice, it should be argued that high quality localdata is superior and should be used. After all, it is derived from our countrymen who may have a different disease biology and/or natural history, sociocultural determinants, as well as clinical practices. It is unfortunate, however, that such local data arenot always available. Even if it exists, it is also not easily accessible. In this, and other issues of Acta Medica Philippina, we see some of the efforts being made by our colleagues to look intothis local experience. They offer varied insights into how global diseases are manifested locally: are there differences that weshould be aware of? As far back as 2006, the Philippine Council for Health Research and Development (PCHRD) has already facilitatedthe creation of a National Unified Health Research Agenda (NUHRA) which is reviewed every five years to identifyresearch priorities in the Philippines.1 In its latest iteration, the 2017-2022 NUHRA prioritizes among others, the holisticapproach to health and wellness that aims to produce evidence geared towards the application and recognition of traditional,sociocultural, and alternative approaches to health.2 The study by Sanico and Medina in this issue highlights this objective.It looked into the potential health benefits and risks of an indigenous fermented rice wine called tapuy. Utilizing a modernbiotechnology technique called metagenomic sequencing, the authors found significant presence of probiotic bacteria thatcan be explored for health applications. However, they also detected the presence of harmful bacteria which may indicate theneed for possible standardization of the fermentation practices. The Acquired Immunodeficiency Syndrome (AIDS) has long plagued the global landscape ever since it was first describedin 1981.3 Because cases have not been described previously, AIDS with its increasing numbers, was soon labeled as anepidemic.4,5 In the Philippines, the HIV/AIDS epidemic has been a fairly more recent one.6-9 Sadly, our country is nowidentified as one with the fastest growing HIV epidemic in the Western Pacific.10 Identifying perceptions of the generalcommunity, especially the high risk populations, can go a long way in curtailing the rising numbers.11 The article by Jamesand colleagues looked further into this by evaluating the knowledge, attitudes and practices on prevention and transmission ofHIV/AIDS among college students in Pampanga, Philippines. The participants were found to have a low knowledge of HIV/AIDS, but had a good attitude toward HIV positive individuals. The authors recommended that education on HIV/AIDScould help control the local epidemic. The study by Rogelio and Santiago looked into screening for retinopathy in patients with gestational diabetes mellitus(GDM). Their data did not support screening to be done in this population. A study had previously reported that GDM has aprevalence of 14% in the Philippines making GDM a disease that is worth addressing.12 On a related note, several internationalguidelines define how GDM can be diagnosed.13 The Philippine Obstetrics and Gynecology Society advocates for a one-stepapproach (a single OGTT using a 75-g anhydrous glucose load with fasting blood sugar ≥92 mg/dL, and a 2-hour level of<126 mg/dL). The one-step approach may be more convenient for patients as it also needs a single visit. A recent report fromAustralia, which also follows a one-step screening process, showed at least a 25% overdiagnosis and its consequent need forfurther testing and the patient anxiety that goes with it.14 An earlier US study also showed 50% more women diagnosed withGDM using the one-step approach compared to a two-step one.15 To be fair, the US study, similar to another one done alsoin Australia, showed no significant differences in the pregnancy outcomes between the two approaches.16 Although a localstudy identified numerical differences in pregnancy outcomes (e.g., risk for primary caesarean section, large for gestational ageinfants, etc.) comparing the two criteria, these were not found to be statistically significant.13 Perhaps there is a need to lookinto this matter again using larger cohorts. As the Philippines gears up for Universal Healthcare, the outcomes of screeningfor GDM can become even more important. The article by Arcilla, et al., on validation of foreign instruments to assess disease and treatment outcomes representsanother area where local data is needed.17 Such validation seeks to investigate whether an instrument developed elsewhere willlikewise yield accurate – and comparable – data for which it was intended. The BREAST-Q is a patient-reported outcomeinstrument designed to evaluate outcomes among women undergoing different types of breast surgery.18 The authors foundhigh internal consistency, test-retest reliability, and acceptability. But there was only low to moderate construct validity inthe Filipino cohort. Among other findings, the authors report respondents having difficulty in understanding some languagetranslations, and even negative reactions to some of the questions. The authors recommend further studies with a largernumber of respondents including those who have undergone nipple reconstruction. The initial results also note that it may bebetter to interpret the “sexual well-being” subscale separately because of the influence that culture may play. The study of Manalili, et al. looked into hemoperfusion as an intervention for COVID-19. The authors report a highmortality and a long length of hospital stay. To put this into perspective, the period of study was from April to September 2020,early in the pandemic period when little is relatively known about the disease. Since then, we know more about COVID-19,with vaccination and anti-virals being available that could alter the disease severity. As of December 2021, local experts donot recommend the use of hemoperfusion among patients diagnosed with COVID-19 mostly because of low certainty ofevidence.19 The option to use it in COVID-19 patients with clinical deterioration despite standard medical therapy includingtocilizumab is however still suggested. The study published here would have been more interesting if there was a comparisonof the outcomes with a similar group who did not undergo hemoperfusion. But it certainly illustrates how generating localdata and local experience goes a long way in examining relevant medical practice/s in our Philippine setting. Case reports help to enhance clinical knowledge by describing the profile and management of patients who have anuncommon or rare disease or may have presented atypically.20-22 We have the opportunity in this issue to share four of theserare cases. The report submitted by Terencio, et al. on the combination of COVID-19 and Guillain-Barre syndrome (GBS)allows us better understanding of COVID-19 and its neurologic complications. As we continue to gain more importantinformation on COVID-19, describing the possibility of GBS as a possible consequence can help clinicians anticipate additionaltreatments as in this case. The same is true for the report submitted by Ablaza and Salonga-Quimpo on abdominal dyskinesia(with its more colorful description as “belly dancer dyskinesia”). Then we have the case of SOLAMEN syndrome, reported by Maceda and colleagues. This case is more dramatic in thatit presents with disfigurement of the patient. Its management is more nuanced as it requires a multidisciplinary approachto address all the affected body parts.23,24 Unfortunately, it also has a strong genetic component as well as predilection tomalignancy which would require longer-term care. Another genetic disease, X-linked dystonia parkinsonism, is likewisereported in this issue in the article by Jamora and others. It is a rare movement disorder that is highly prevalent in Panay Islandin the Philippines.25-28 All cases described so far have been linked to Filipino ancestry, suggesting a single genetic founder andgenetic homogeneity. Although extremely rare globally, the prevalence of XDP in the Philippines is 0.31 per 100,000; and inPanay Island, 5.74 per 100,000. Ninety-five percent of affected individuals are males; the average age is 44 years (20–70 years);and the average age at onset is 39 years (12–64 years).27 Cases in patients of Filipino descent have been described in othercountries.29 The report published here is of particular interest as it is the first time the procedure called Unilateral TranscranialMagnetic Resonance-guided Focused Ultrasound Pallidothalamic Tractotomy has been tried for this condition; a conditionwhich leads to significant progressive disability but no definite treatment.27 All of these case reports may well be the first ones in the Philippines and we have it published here in Acta MedicaPhilippina. I am certain there will be many more insightful studies done locally that will be published – and had been published – inthis journal. These are testament to the recognition that even as we are able to think following the highest global standards,we are also able to act (and do studies) locally in ways that are beneficial to our own Philippine community. Joven Jeremius Q. Tanchuco, MD, MHA Department of Biochemistry and Molecular Biology College of Medicine, University of the Philippines Manila REFERENCES1. Philippine National Health Research System. National Unified Health Research Agenda 2017-2022 [Internet]. [cited 2022 Sep 9]. Available from: https://www.healthresearch.ph/index.php/nuhra2. National Unified Health Research Agenda 2017-2022. Philippine National Health Research System [Internet]. [cited 2022 Sep 9].Available from: https://doh.gov.ph/sites/default/files/publications/NUHRA.pdf3. Schmid S. The Discovery of HIV-1. Nature Communications [Internet]. [cited 2022 Sep 9]. Available from: https://www.nature.com/articles/d42859-018-00003-x#:~:text=In%201983%2C%20Luc%20Montagnier’s%20team,AIDS)%2C%20such%20as%20lymphadenopathy.4. Curran JW, Jaffe HW, Centers for Disease Control and Prevention (CDC). AIDS: the early years and CDC’s response. MMWR Suppl.2011 Oct; 60(4):64-9.5. Sencer DJ. The AIDS Epidemic in the United States, 1981-early 1990s. Centers of Disease Control and Prevention [Internet]. [cited2022 Sep 12]. Available from: https://www.cdc.gov/museum/online/story-of-cdc/aids/index.html6. Restar A, Nguyen M, Nguyen K, Adia A, Nazareno J, Yoshioka E, et al. Trends and emerging directions in HIV risk and prevention researchin the Philippines: A systematic review of the literature. PLoS One. 2018 Dec;13(12):e0207663. doi: 10.1371/journal.pone.02076637. 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N Engl J Med. 2021 Mar;384(10): 895-904. doi: 10.1056/NEJMoa202602816. Meloncelli NJL, Barnett AG, D’Emden M, De Jersey SJ. Effects of Changing Diagnostic Criteria for Gestational Diabetes Mellitus inQueensland, Australia. Obstet Gynecol. 2020 May;135(5):1215-1221. doi: 10.1097/AOG.000000000000379017. Elangovan N, Sundaravel E. Method of preparing a document for survey instrument validation by experts. MethodsX. 2021 Apr;8:101326. doi: 10.1016/j.mex.2021.10132618. BREAST-Q User’s Manual Version 2.0 May 2015. Copyright © 2012 Memorial Sloan Kettering Cancer Center [Internet]. [cited 2022Sep 12]. Available from: https://www.rcseng.ac.uk › breastq-usermanual-2015.19. Philippine COVID-19 Living Clinical Practice Guidelines. Institute of Clinical Epidemiology, National Institutes of Health, UP Manilaand the Philippine Society of Microbiology and Infectious Diseases [Internet]. [cited 2022 Sep 1]. Available from: https://www.psmid.org/hemoperfusion-evidence-summary-2/20. 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This study explores and describes the perceived needs of women living with HIV/AIDS in Saskatchewan. A purposive sample was used to recruit women to participate in three focus groups. A total of eleven women from urban and rural areas of Saskatchewan participated. Based on seroprevalence estimates this number may represent one third to one half of all expected cases of women with HIV/AIDS in Saskatchewan. Recursive analysis was used to validate the themes identified in the first two focus groups with participants in a third focus group. Content analysis of the data identified four themes from the women's experiences: 1) medical needs, 2) economic needs, 3) mental health needs, and 4) service needs. The results support previous studies which indicate that women with HIV have a number of unmet heeds. Women from rural areas were found to have more unmet needs and limited access to appropriate services and supports than urban women. Three types of coping strategies were found to be used by the women in getting their needs met: avoidance, maintenance, and mastery. Those who utilized a mastery coping strategy were more successful in having their needs met than those who did not. A number of individual, organizational, systemic, and policy interventions are identified to assist women in moving towards mastery coping strategies. Social workers can work at the clinical, family group, and policy levels to improve the situation for women living with HIV/AIDS in Saskatchewan.

Antiretroviral therapy is an important public health strategy to reduce the risk of HIV vertical transmission. Implementation of such therapy depends on the identification of HIV-infected pregnant women. This study investigated how the biographical characteristics of the pregnant women (16-45 years) influenced their health decision-making in Bulawayo clinics. The study was guided by the theories of health behaviour. The study assumed that the respondents’ demographic characteristics will influence their attitudes towards PMTCT programme. Using a structured questionnaire, forty pregnant women who visited the Bulawayo clinics to have prenatal checkups were interviewed. The majority of respondents came from a poor, high-density township. Most of the respondents were married, but about a third were not married at the time data collection and 5% were separated. The survey items were demographic characteristics, knowledge of PMTCT, HIV risk perceptions and service utilisation. The levels of literacy among the respondents were high; more than 80% had completed primary education. Overall the respondents’ demographic characteristics influenced their attitudes towards PMTCT. Majority of the women knew that a mother with HIV can pass the virus to her child, during pregnancy, delivery and breastfeeding. The pregnant women’s health-seeking behaviour and their attitudes toward reproductive health services are influenced by their demographic situation.
Health Studies
(M.A. (Social Behavior Studies in HIV/AIDS))