Journal articles on the topic 'HIV-positive women Services for Australia'
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1
Hutton, Vicki. "Gendered Experiences of Living with HIV in Australia." Sexes 2, no. 3 (June 24, 2021): 244–55. http://dx.doi.org/10.3390/sexes2030020.
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Globally, women represent more than half the people living with HIV. This proportion varies by country, with an over-representation of HIV among men who have sex with men (MSM) in some regions. For example, in Australia, MSM account for over 60% of transmissions, with heterosexual sex accounting for almost a quarter of transmissions. Irrespective of geographic region, there is evidence that women can have a different lived experience of HIV due to their unequal social and economic status in society, while MSM can have a different lived experience depending on the laws and customs of their geographic location. Gender differences related to risk factors, stigma, access to services, mental health, health-related quality of life and economic consequences have been consistently reported globally. This paper explores the subjective lived experience of gender and sexuality disparities among three individuals living with HIV in Australia: a male who identified as gay, and a male and female who each identified as heterosexual. Analysis of themes from these three case reports indicated discernible differences by gender and sexuality in four areas: access to medical services, social support, stigma and mental health. It is argued that knowledge and understanding of potential gender and sexuality disparities must be factored into supportive interventions for people living with HIV in Australia.
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Tilley, Donna M., Catherine C. O'Connor, Sunil Adusumilli, Maggie Smith, Clara Marin-Zapata, Catriona Ooi, and David J. Templeton. "Cervical screening uptake and abnormalities among women attending sexual health clinics for HIV care." Sexual Health 11, no. 3 (2014): 288. http://dx.doi.org/10.1071/sh14063.
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The aim of this study was to describe cervical screening uptake and assess correlates of screen-detected abnormalities in women attending sexual health services for HIV care. Of 156 women, 115 had documentation of a Pap test at least once in 3 years and 9.6% had an annual Pap test performed. Pap abnormalities were associated with younger age, being born in Sub-Saharan Africa, more recent arrival in Australia, lower CD4 count, detectable viral load, shorter time on antiretroviral therapy and more recent HIV diagnosis. Women accessing sexual health services for HIV care, especially those from culturally and linguistically diverse backgrounds, appear to be substantially under-screened and efforts to optimise screening are needed.
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Teresa Dawson, Maria, Paul Grech, Brendan Hyland, Fiona Judd, John Lloyd, Anne M. Mijch, Jennifer Hoy, and Alan C Street. "A Qualitative Approach to the Mental Health Care Needs of People Living with HIV/AIDS in Victoria." Australian Journal of Primary Health 8, no. 3 (2002): 30. http://dx.doi.org/10.1071/py02041.
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This article reports on the findings of the qualitative stage of a larger project on the mental care needs of people with HIV/AIDS and mental illness (Tender T1176 Department of Human Services, Mental Health Branch, Victoria - Research on the Mental Health Care Needs of People with HIV/AIDS and Mental Illness). The purpose of the larger research was to evaluate the needs and treatment requirements of persons with HIV/AIDS, who also suffer from mental health problems, with a view to developing proposals for improving existing service delivery in Victoria, Australia. The qualitative stage was designed to complement and elucidate data obtained through the quantitative stages of the project. Thirty in-depth open-ended interviews were carried out with service providers including HIV physicians, general practitioners, psychiatrists, clinical and managerial staff of Area Mental Health Services, Contact Tracers and forensic mental health services staff, as well as representatives of community groups such as People Living with HIV/AIDS and Positive Women and carers. The interviews explored the perspective of both service providers and users of such services with respect to needs for psychiatric care and service delivery, ease of access or barriers to mental health services, and the perceived strengths and weaknesses in current service provision. This paper presents the main findings and recommendations submitted to the funding body.
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Thng, Caroline Chun Mei. "A Review of Sexually Transmitted Infections in Australia – Considerations in 2018." Academic Forensic Pathology 8, no. 4 (December 2018): 938–46. http://dx.doi.org/10.1177/1925362118821492.
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Sexually transmitted infections (STIs) bear a high burden of disease and, subsequently, high health costs globally. Chlamydia, gonorrhoea, syphilis, and trichomoniasis contribute to nearly one million infections every day worldwide. Sexually transmitted infections continue to be the most frequently notified condition to the Australian National Notifiable Diseases Surveillance System and the numbers continue to increase. Australia has achieved several significant successes in reducing STIs and blood-borne viruses (BBV) including the significant decrease in genital warts in those less than 30 years old since 2007 following the launch of human papillomavirus vaccines in women, the virtual elimination of mother to child transmission of HIV, and the increased uptake of successful hepatitis C treatment following the availability of direct acting antiviral treatment on the Pharmaceutical Benefits Scheme. However, several challenges remain, including the ongoing rise of chlamydia, gonorrhoea, and syphilis over the last five years; the emergence of antibiotic resistance; and the increasing disparity in the prevalence of STIs and BBV in men who have sex with men, young people, and Aboriginal and Torres Strait Islander people, and challenges in the delivery of services to rural and remote Australia. In this paper, we aim to provide a snapshot of the current landscape and challenges for chlamydia, gonorrhoea, mycoplasma, syphilis and HIV infections in Australia.
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Newman, Christy E., John B. F. de Wit, Levinia Crooks, Robert H. Reynolds, Peter G. Canavan, and Michael R. Kidd. "Challenges of providing HIV care in general practice." Australian Journal of Primary Health 21, no. 2 (2015): 164. http://dx.doi.org/10.1071/py13119.
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As the management of HIV changes and demand for HIV health services in primary care settings increases, new approaches to engaging the general practice workforce with HIV medicine are required. This paper reports on qualitative research conducted with 47 clinicians who provide HIV care in general practice settings around Australia, including accredited HIV s100 prescribers as well as other GPs and general practice nurses. Balanced numbers of men and women took part; less than one-quarter were based outside of urban metropolitan settings. The most significant workforce challenges that participants said they faced in providing HIV care in general practice were keeping up with knowledge, navigating low caseload and regional issues, balancing quality care with cost factors, and addressing the persistent social stigma associated with HIV. Strategic responses developed by participants to address these challenges included thinking more creatively about business and caseload planning, pursuing opportunities to share care with specialist clinicians, and challenging prejudiced attitudes amongst patients and colleagues. Understanding and supporting the needs of the general practice workforce in both high and low HIV caseload settings will be essential in ensuring Australia has the capacity to respond to emerging priorities in HIV prevention and care.
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Jay, Sarah M., Grace E. Vincent, Bernadette Roberts, Brad Aisbett, Amy C. Reynolds, Jessica L. Paterson, and Sally A. Ferguson. "Coping With On-Call Work: Current Knowledge to Support Women in the Emergency Services." Prehospital and Disaster Medicine 34, s1 (May 2019): s34. http://dx.doi.org/10.1017/s1049023x19000864.
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Introduction:All Fire and Emergency Services (FES) personnel must balance FES work with their other responsibilities. Given that women tend to take on a greater responsibility for management of household/domestic activities than men, the on-call component of their FES work may be associated with very different challenges. Despite this, women have rarely been the focus of on-call research.Aim:To explore women’s on-call experiences in the FES by examining coping styles and strategies, with the goal of helping to innovate the way women are supported in FES roles.Methods:Relevant findings from two studies are included. The first study involved FES personnel from two agencies in Australia (n=24) who participated in a semi-structured interview. The second study was an anonymous online survey to determine work characteristics, sleep, stress, and coping in on-call workers more broadly, with workers from all industries across Australia (n=228) invited to participate.Results:Interview data identified two major themes in terms of coping with on-call work. Support (from family, social, and work), planning, and preparation were identified as important in helping women cope in the context of on-call unpredictability. Results from the survey (43% women) showed that on-call workers were an engaged group in terms of their coping, with 67% classified as having a positive coping style and 58% of women indicating that they agreed/strongly agreed with the statement, “I cope well with on-call work.”Discussion:Taken together, these data highlight engagement with positive coping by women who do on-call work, including in the FES. Importantly, positive coping strategies, such as talking about emotions, problem-solving, and seeking support have been linked to increased shift work tolerance in other populations. Coping style and strategies represent modifiable variables which could be specifically applied to assist women to manage the unique challenges associated with on-call work in the FES.
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Lenton, Jo-ann, Eleanor Freedman, Kristie Hoskin, Vickie Knight, Darriea Turley, Bill Balding, Catherine Kennedy, Marcus Y. Chen, and Anna McNulty. "Chlamydia trachomatis infection among antenatal women in remote far west New South Wales, Australia." Sexual Health 4, no. 2 (2007): 139. http://dx.doi.org/10.1071/sh07010.
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Background: A prospective, cross-sectional study was undertaken of pregnant women attending antenatal services in the remote far west of New South Wales, Australia, between October 2004 and May 2006. Of 420 eligible women, 218 (52%) participated in the study. Six women (2.7%; 95% CI: 1.0–5.9) tested positive for Chlamydia trachomatis. The prevalence among pregnant, Indigenous women (n = 44) was 9.1% (95% CI: 2.5–21.7). Infection was significantly associated with Indigenous status (P = 0.003) and self-perceived risk for chlamydia (P = 0.05). Pregnant Indigenous women in remote areas may be at higher risk for chlamydia and targeted screening of this group should be considered.
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Mundy, Trish, and Nan Seuffert. "Integrated domestic violence services: A case study in police/NGO co-location." Alternative Law Journal 46, no. 1 (January 27, 2021): 27–33. http://dx.doi.org/10.1177/1037969x20984598.
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Australia’s National Plan to Reduce Violence against Women and their Children, launched in 2010, has emphasised the need for integrated responses across government agencies, specialist domestic and family violence services and the justice system. This article presents an evaluation of an integrated, community-based domestic and family violence response service that uses a rare model of co-location in a police station, and assesses its suitability as a model service for the future. The evaluation reveals that there are many positive aspects of such co-location and the authors argue that this model should be more widely trialled in Australia.
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Hargreaves, Sally, Sarah Young, Sarah J. Prior, and Jennifer Ayton. "Exploring Women’s Experiences of Maternity Service Delivery in Regional Tasmania: A Descriptive Qualitative Study." Healthcare 10, no. 10 (September 27, 2022): 1883. http://dx.doi.org/10.3390/healthcare10101883.
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The objective of this study is to explore and understand the experiences of women who receive antenatal, birthing, and postnatal care from an integrated maternity services model in a regional area in Tasmania, Australia. This descriptive qualitative study included semi-structured, one-on-one interviews with 14 mothers aged >18 years, who were living in a regional area of Tasmania and had accessed maternity health services. Thematic analysis revealed three key themes: (i) talking about me, (ii) is this normal? and (iii) care practices. Overall, women cited mostly negative experiences from a poorly implemented fragmented service. These experiences included feelings of isolation, frustration over receiving conflicting advice, feeling ignored, and minimal to no continuity of care. In contrast, women also experienced the euphoric feelings of birth, immense support, guidance, and encouragement. Regional women’s experiences of maternity care may be improved if health services work towards place-based continuity of care models. These models should be informed by the local women’s experiences and needs in order to achieve better communication, reduce feelings of isolation, and promote positive breastfeeding experiences.
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Tannous, Kathy W., Ajesh George, Moin Uddin Ahmed, Anthony Blinkhorn, Hannah G. Dahlen, John Skinner, Shilpi Ajwani, et al. "Economic evaluation of the Midwifery Initiated Oral Health-Dental Service programme in Australia." BMJ Open 11, no. 8 (August 2021): e047072. http://dx.doi.org/10.1136/bmjopen-2020-047072.
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ObjectivesTo critically evaluate the cost-effectiveness of the Midwifery Initiated Oral Health-Dental Service (MIOH-DS) designed to improve oral health of pregnant Australian women. Previous efficacy and process evaluations of MIOH-DS showed positive outcomes and improvements across various measures.Design and settingThe evaluation used a cost-utility model based on the initial study design of the MIOH-DS trial in Sydney, Australia from the perspective of public healthcare provider for a duration of 3 months to 4 years.ParticipantsData were sourced from pregnant women (n=638), midwives (n=17) and dentists (n=3) involved in the MIOH trial and long-term follow-up.Cost measuresData included in analysis were the cost of the time required by midwives and dentists to deliver the intervention and the cost of dental treatment provided. Costs were measured using data on utilisation and unit price of intervention components and obtained from a micro-costing approach.Outcome measuresUtility was measured as the number of Disability Adjusted Life Years (DALYs) from health-benefit components of the intervention. Three cost-effectiveness analyses were undertaken using different comparators, thresholds and time scenarios.ResultsCompared with current practice, midwives only intervention meets the Australian threshold (A$50 000) of being cost-effective. The midwives and accessible/affordable dentists joint intervention was only ‘cost-effective’ in 6 months or beyond scenarios. When the midwife only intervention is the comparator, the midwife/dentist programme was ‘cost-effective’ in all scenarios except at 3 months scenario.ConclusionsThe midwives’ only intervention providing oral health education, assessment and referral to existing dental services was cost-effective, and represents a low cost intervention. Midwives’ and dentists’ combined interventions were cost-effective when the benefits were considered over longer periods. The findings highlight short and long term economic benefits of the programme and support the need for policymakers to consider adding an oral health component into antenatal care Australia wide.Trial registration numberACTRN12612001271897; Post-results.
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Stone, Una, Marg Liddell, and Marietta Martinovic. "Incarcerated Mothers: Issues and Barriers for Regaining Custody of Children." Prison Journal 97, no. 3 (April 19, 2017): 296–317. http://dx.doi.org/10.1177/0032885517703957.
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In Victoria, Australia, the rate of female incarceration has continued to rise in the last decade. The majority of women prisoners are primary caregivers of their children. This article examines issues mothers face in mothering, both inside and outside prison, as seen by professionals and stakeholders who support them. Reunification of mothers and children is hampered by factors such as poverty, homelessness, abuse, and lack of access to services. Research and government interventions to address incarcerated mothers’ situations have had little positive impact for over 50 years.
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Lord, Sarah J., Belinda E. Kiely, Sallie-Anne Pearson, Benjamin Daniels, Dianne L. O’Connell, Jane Beith, Max K. Bulsara, and Nehmat Houssami. "Metastatic breast cancer incidence, site and survival in Australia, 2001–2016: a population-based health record linkage study protocol." BMJ Open 9, no. 2 (February 2019): e026414. http://dx.doi.org/10.1136/bmjopen-2018-026414.
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IntroductionAdvances in systemic therapy for early and metastatic breast cancer (BC) over the last two decades have improved patients’ survival, but their impact on metastatic disease outcomes at a population level is not well described. The aim of this study is to investigate changes in the incidence, site and survival of metastatic disease for women with a first diagnosis of BC in 2001–2002 vs 2006–2007.Methods and analysisPopulation-based retrospective cohort study of women with first primary invasive BC registered in the New South Wales (NSW) Cancer Registry in 2001–2002 and 2006–2007. We will use linked records from NSW hospitals, dispensed medicines, outpatient services and death registrations to determine: women’s demographic and tumour characteristics; treatments received; time to first distant metastasis; site of first metastasis and survival. We will use the Kaplan-Meier method to estimate cumulative incidence of distant metastasis, distant recurrence-free interval and postmetastasis survival by extent of disease at initial diagnosis, site of metastasis and treatment-defined tumour receptor type (hormone receptor-positive, human epidermal growth factor receptor-2-positive, triple negative). We will use Cox proportional hazards regression to estimate the relative effects of prognostic factors, and we will compare systemic therapy patterns by area-of-residence and area-level socioeconomic status to examine equity of access to healthcare.Ethics and disseminationResearch ethics committee approval was granted by the Australian Institute of Health and Welfare (#EO2017/2/255), NSW Population and Health Services (#HREC/17/CIPHS/19) and University of Notre Dame Australia (#0 17 144S). We will disseminate research findings to oncology, BC consumer and epidemiology audiences through national and international conference presentations, lay summaries to BC consumer groups and publications in international peer-reviewed oncology and cancer epidemiology journals.
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Fealy, Shanna, Jenna Hollis, Julia Martin, Lucy Leigh, Christopher Oldmeadow, Clare E. Collins, Roger Smith, Shelley Wilkinson, and Alexis Hure. "Modeling the Predictive Value of Evidence-Based Referral Criteria to Support Healthy Gestational Weight Gain among an Australian Pregnancy Cohort." Nutrients 14, no. 2 (January 17, 2022): 381. http://dx.doi.org/10.3390/nu14020381.
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Globally, there has been a renewed focus on addressing gestational weight gain (GWG). In Australia, the Department of Health pregnancy care guidelines recommend women be offered routine weighing and receive brief nutritional and physical activity support during antenatal care visits. Women gaining weight outside the Institute of Medicine (IOM)’s weight gain reference values are further recommended to be referred to a dietitian. However, professional and organizational barriers, including an absence of weight gain referral pathways and limited workforce resources, exist with the translation and scaling of these recommendations into practice. This study aimed to explore patterns of GWG among a cohort of Australian pregnant women and to determine if pregnancy weight gains of above or below 2 kg or 5 kg in the second and third trimester can be used to predict total GWG outside recommendations. Sensitivity, specificity, negative, and positive likelihood ratios were calculated. The most predictive time point was 24 weeks’ gestation using the minimum weight change parameter of +/−2 kg, demonstrating reasonable sensitivity (0.81, 95% CI 0.61–0.83) and specificity (0.72, 95% CI 0.61–0.83), resulting in 55% (n = 72/131) of the cohort qualifying for dietetic referral. Given the current health service constraints, a review of dietetic services within maternity care is warranted.
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Kavian, Foorough, Kaye Mehta, Eileen Willis, Lillian Mwanri, Paul Ward, and Sue Booth. "Migration, Stress and the Challenges of Accessing Food: An Exploratory Study of the Experience of Recent Afghan Women Refugees in Adelaide, Australia." International Journal of Environmental Research and Public Health 17, no. 4 (February 21, 2020): 1379. http://dx.doi.org/10.3390/ijerph17041379.
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This study explored the migration and food experiences of Afghani women refugees residing in Adelaide, South Australia for 2 years or less. In-depth semi-structured qualitative interviews were conducted with 10 women between May and September 2017. The data were thematically analysed, and the Social Determinants of Health Framework was used to discuss the findings. Five key themes emerged from the data. In the transition country (Iran/Pakistan), respondents experienced (i) trauma, discrimination and exclusion and (ii) familiar food culture, but food stress. In the destination country (Adelaide, Australia) respondents experienced (iii) a sense of precariousness, (iv) unfamiliar food culture and (v) challenges in accessing halal food. Afghani refugees experienced considerable stressors both in the transition and the final destination country but for different reasons. In the transition country, stresses related to the lack of social services and support, discrimination, racism and poverty seemed to have affected their ability to afford food. In Australia stressors pertaining to socioeconomic, housing and employment precariousness, as well as difficulties in accessing halal foods were identified as challenges. Furthermore, food stress in Australia was associated with the cultural appropriateness of food, the complexity of the food system, and the women’s lack of skills and experiences in navigating the food system. With increasing refugee and immigration flows globally, it is necessary to acknowledge how food and social determinants intersect for refugee immigrants to ensure positive health outcomes.
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Corr, L., H. Rowe, and J. Fisher. "Mothers’ perceptions of primary health-care providers: thematic analysis of responses to open-ended survey questions." Australian Journal of Primary Health 21, no. 1 (2015): 58. http://dx.doi.org/10.1071/py12134.
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General practitioners and maternal, child and family health nurses have a central role in postpartum primary health care for women and their infants. Positive client-provider relationships are particularly important for women experiencing mental health problems or unsettled infant behaviour. However, little is known about their experiences of postnatal primary health care. The study aimed to describe views of postnatal primary health care among women completing a residential early parenting programme and to identify potential strategies to enhance provider-patient interactions. Participants (n = 138) were women admitted with their infants to a private or a public early parenting service in Melbourne, Australia. Women completed a detailed self-report survey, including open-ended questions about experiences of primary health-care services, and a structured psychiatric interview to diagnose anxiety and depression. Survey responses were analysed thematically. Womens’ experiences of primary health care were influenced by their perceptions of provider competence and the quality of interactions. While similar positive characteristics of doctor and nurse care were valued, medical and nursing practices were judged in different ways. Women described GPs who listened, understood and were thorough as providing good care, and maternal, child and family health nurses were valued for providing support, advice and encouragement. Threats to therapeutic relationships with doctors included feeling rushed during consultations, believing that GPs were not mental health-care providers and the clinician not being ‘good’ with the infant; with nurses, problems included feeling judged or given advice that was inconsistent or lacked an evidence-base. Postpartum primary health care will be improved by unhurried consultations, empathic recognition, encouragement, evidence-informed guidance and absence of criticism.
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Jacups, Susan P., Caroline Potter, Trent Yarwood, Simon Doyle-Adams, and Darren Russell. "How accurate is presumptive Chlamydia trachomatis treatment? A 6-month clinical audit of a walk-in sexual health service." Sexual Health 18, no. 5 (2021): 413. http://dx.doi.org/10.1071/sh21078.
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Background Chlamydia trachomatis (chlamydia) is highly prevalent and is an important sexually transmitted infection as it can lead to increased risk of HIV seroconversion; and if left untreated, can cause infertility in women. Clinical guidelines recommend treating chlamydia presumptively when presenting symptomatically; however, clinicians are now questioning this due to increasing prevalence of antimicrobial resistance. Methods To determine the accuracy of presumptive chlamydia treatment practices at a walk-in sexual health service in regional Australia, we audited all same-day screen and treat presentations prescribed azithromycin over a 6-month period in 2018. Results A total of 325 cases were included in the analysis. Over half (54%) the presentations returned negative pathology for all pathogens investigated. One quarter (25%) of presentations were positive for chlamydia, and (4%) reported a dual infection. A further one fifth (20%) were negative for chlamydia but positive for another pathogen. More symptomatic males than females returned positive pathology for chlamydia (8% vs 4%). Conclusions While presumptive treatment is recommended in the current guidelines, our findings indicate this resulted in over-treatment. Considering the increasing resistance patterns for Mycoplasma genitalium, which include azithromycin, presumptive treatments need to balance immediate client care needs against long-term community antimicrobial resistance outcomes. This internal audit provided a feedback mechanism to the walk-in sexual service, enabling modification of practices to provide more precise, individual clinical care within the bounds of current STI guidelines, while balancing wider the objectives of antimicrobial stewardship.
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Schoenwald, Anthony V. "Two hundred days of nurse practitioner prescribing and role development: a case study report from a hospital-based acute pain management team." Australian Health Review 35, no. 4 (2011): 444. http://dx.doi.org/10.1071/ah10946.
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Purpose. This report evaluates a beginning Nurse Practitioner (NP) role in Acute Pain Management. Healthcare setting. The role was implemented within an anaesthesiology-based pain service. The NP author developed this pain service in 2002 and was endorsed as an NP 6 years later. The NP reviews all clients undergoing major surgery or trauma and provides pain management to women for caesarean section. Prior to this role, there were significant delays for some patients requiring prompt analgesia. This was because of the decreased availability of anaesthetists to fully participate in the pain service due to the demand for complex anaesthesiology practice. Method of data collection. Data were conveniently collected by the NP on prescription and service provision over 200 working days. Main findings. Therapeutic activity reflected contemporary pain management practice and espouse the NP as a safe and effective clinician. The role has improved patient access to pain management through the prompt use of non-pharmacological interventions, drugs used to treat analgesic side effects, opioids and non-opioid analgesics. Principal conclusions. These initial positive outcomes are consistent with NP role development described elsewhere in Australia and overseas across a variety of healthcare settings. To sustain this role, robust continuing education and clinical support is required. What is known about the topic? There is little published information on the development of the Nurse Practitioner (NP) role in acute pain services in Australia or overseas. The acute pain role is a new development in Australia and so previous descriptions of NP practice have focussed on other specialty areas such as Emergency or Mental Health. What does this paper add? This report demonstrates positive and safe client outcomes as a result of a NP role in acute pain management. More importantly, it may contribute to accumulating evidence that NPs are safe prescribers of opioids and other analgesics in acute settings. What are the implications for practitioners? Novice NPs and Candidates practising in this specialty need to use this information as support for their own role development and implementation in other acute pain services in Australia.
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Tabrizi, Sepehr N., Barbara A. Paterson, Christopher K. Fairley, Francis J. Bowden, and Suzanne M. Garland. "Comparison of tampon and urine as self-administered methods of specimen collection in the detection of Chlamydia trachomatis , Neisseria gonorrhoeae and Trichomonas vaginalis in women." International Journal of STD & AIDS 9, no. 6 (June 1, 1998): 347–49. http://dx.doi.org/10.1258/0956462981922386.
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1 Department of Microbiology, The Royal Women's Hospital, Victoria, 2 Menzies School of Health Research, Rocklands Drive, Tiwi, 3 Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Prahran, Victoria and 4 AIDS/STD Unit, Centre for Disease Control, Territory Health Services, Darwin, Australia Summary: Self-administered sampling techniques for the detection of sexually transmitted diseases (STDs) are particularly useful due to their ease of collection and better patient compliance. Urine specimens, and recently tampons, have been described as methods of specimen collection for the detection of some STDs in women. In this study, 660 women had both first-void urine (FVU) and tampon specimens analysed by polymerase chain reaction (PCR) for the detection of Chlamydia trachomatis , Neisseria gonorrhoeae and Trichomonas vaginalis . Overall 6.5%, 10.1% and 17.9% of urine samples were positive whereas 7%, 21.2% and 22% of tampon specimens were positive for C. trachomatis , N. gonorrhoeae and T. vaginalis respectively. Tampon-collected specimens tested by PCR were more sensitive than urine specimens for the detection of N. gonorrhoeae and T. vaginalis ( P 0.001) and equally sensitive for the detection of C. trachomatis ( P =0.45). <
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De Guingand, D. L., C. K. Fairley, S. Garland, S. Tabrizi, S. Grover, E. Wallace, J. Hocking, et al. "58. CHLAMYDIA SCREENING OF ANTENATAL WOMEN IN MELBOURNE BETWEEN 16-25 YEARS." Sexual Health 4, no. 4 (2007): 307. http://dx.doi.org/10.1071/shv4n4ab58.
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Objective: Routine chlamydia screening of pregnant women is not widely practiced in Australia and limited data are available on the prevalence of infection in this population. This cross-sectional study sought to determine the prevalence of genital chlamydial infection among pregnant women aged 16-25 attending antenatal clinics in Melbourne. Methods: Consecutive women attending 4 major maternity services covering northern, western, eastern and south-eastern Melbourne were approached between October 2006 and May 2007. Of 931 eligible women (those aged 16-25 who had not already been tested for chlamydia) attending the clinics at the time of recruitment, 882 (95%) were approached and 845 (96%) agreed to participate. Participants completed a questionnaire which was translated into Chinese, Vietnamese and Arabic, and provided first-void urine which was tested for Chlamydia trachomatis using polymerase chain reaction. Results: Eighteen percent of women had a preferred language other than English. Of the 826 tests which were non assessable, 30 were positive representing a prevalence rate of 3.6% (95% CI: 2.5-5.1%). However, among women aged 16-20, 14 of 203 women were infected, representing a prevalence rate of 6.9% (95% CI: 3.8-11.3%). All infected women received treatment with azithromycin and all who have had repeat chlamydia tests to date have been negative. Conclusion: In this study of a wide cross-section of pregnant Melbourne women, chlamydial infection was common, particularly among teenagers. Screening was highly acceptable, with the great majority of women approached agreeing to be screened.
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Fletcher, Justine R., Jane E. Pirkis, Bridget Bassilios, Fay Kohn, Grant A. Blashki, and Philip M. Burgess. "Australian primary mental health care: improving access and outcomes." Australian Journal of Primary Health 15, no. 3 (2009): 244. http://dx.doi.org/10.1071/py08072.
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The progressive achievements over time of the Access to Allied Psychological Services (ATAPS) component of the Better Outcomes in Mental Health Care program are examined using a web-based, purpose-designed minimum dataset that collects provider-, consumer- and session-level data on the projects. Findings indicate that the ATAPS projects have established themselves over time as a cornerstone of mental health service provision in Australia. Despite the more recent introduction of the complementary Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule program, the ATAPS projects have continued, since 2001, to attract substantial numbers of general practitioners and allied health professionals and deliver services to significant numbers of consumers. The profile of consumers being referred to the projects is now very consistent, with the majority being women with high prevalence disorders who may have had difficulty accessing mental health care in the past. The nature of sessions being delivered through the projects has also reached a point of consistency, with the majority being individual-level, cognitive behavioural therapy-based sessions of around 1 h in length. The only variation in session delivery is related to the charging of a co-payment. There is good evidence that the projects are achieving positive outcomes for consumers.
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Gamble, Jenny, Jocelyn Toohill, Valerie Slavin, Debra K. Creedy, and Jennifer Fenwick. "Identifying Barriers and Enablers as a First Step in the Implementation of a Midwife-Led Psychoeducation Counseling Framework for Women Fearful of Birth." International Journal of Childbirth 7, no. 3 (2017): 152–68. http://dx.doi.org/10.1891/2156-5287.7.3.152.
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BACKGROUND:Around 20% of women report high levels of childbirth fear. An evidence-based psychoeducation intervention delivered by midwives reduced maternal childbirth fear and increased confidence for birth. Implementation of the intervention into practice is now required. Translating evidence into practice, however, remains challenging.AIM:This study aimed to explore organizational factors, including barriers and possible solutions that may impact on the successful application of the midwife psychoeducation intervention in practice.METHODS:Mixed methods data collection included a self-administered survey (n= 62), clinician-led focus groups (n= 28), and interviews with key stakeholders (n= 5). Simple descriptive statistics were used to analyze the quantitative data. Latent content analysis was used to analyze the qualitative data.RESULTS:Midwives were perceived to be best placed to deliver psychoeducation to women fearful of birth. Support for normal birth was high. There was, however, disparity between positive attitudes toward evidence-based practice in theory and its clinical application. Similarly, although the workplace learning culture was generally assessed as positive, many participants believed changing practice was difficult and reported a low sense of agency for challenging or facilitating change. Participants reported that barriers to implementing the evidence included time constraints and heavy workloads. There was a lack of awareness and confidence to implement evidence-based practice (EBP) with participants identifying that resistance to change was often the result of clinician fear and self-interest. The way services were routinely structured was considered problematic as fragmentation actively worked against midwives forming meaningful relationships with women. Enablers included organizational support, education, local champions, and continuity of midwifery care.CONCLUSION:The study identified the clinicians’ readiness, barriers, and possible solutions to the widespread implementation of an evidence-based psychoeducation intervention delivered by midwives for women fearful of birth at one maternity facility in South East Queensland, Australia. Many of the identified barriers were commensurate with the international literature on translating evidence into practice.
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Hayes, Sandra Christine, Megan Steele, Rosa Spence, Christopher Pyke, Christobel Saunders, John Bashford, and Elizabeth Eakin. "Can exercise influence survival following breast cancer: Results from a randomised, controlled trial." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 10067. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.10067.
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10067 Background: Exercise for Health was a randomised, controlled trial designed to evaluate an 8-month translational exercise intervention, commencing 6-weeks post-surgery for newly diagnosed breast cancer. Outcomes for this follow-up exploratory analysis were overall- and disease-free survival. Methods: Consenting urban-based women (n = 194) were randomized to one of two exercise groups (intervention delivered either face-to-face or over the telephone) or a usual care group, while consenting rural/regional women (n = 143) were randomised to either the telephone-delivered exercise group or usual care group. For the purposes of these analyses, exercise groups and usual care groups were combined (exercise group, n = 207; usual care group, n = 130). Analyses were done on an intention-to-treat basis and trials were registered with the Australian New Zealand Clinical Trials Registry (ACTRN12606000233527; 12609000809235). Results: Participant disease and treatment characteristics were similar to the wider breast cancer population in Queensland, Australia, and 42% of the sample resided in rural or regional areas. After a median follow-up of 101 months, there were 15/130 (11.5%) survival events in the usual care group, compared with 11/207 (5.3%) events in the exercise group. Disease-free events for the usual care versus exercise group were 23/130 (17.7%) and 25/207 (12.1%), respectively. The corresponding unadjusted hazard ratio for the exercise group for overall survival was 0.45 (95% CI = 0.21-0.97; p = 0.037), and for disease-free survival was 0.66 (95% CI = 0.38-1.17; p = 0.155). Conclusions: Epidemiological evidence consistently shows a positive relationship between physical activity and survival post-breast cancer, but is unable to establish causality. These exploratory findings suggest that an exercise intervention delivered during and beyond conventional treatment for breast cancer and that was designed to cater for all women, irrespective of place of residence and access to medical services, has clear potential to influence survival. Clinical trial information: ACTRN12606000233527; 12609000809235.
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Rice, Lauren J., Tracey W. Tsang, Emily Carter, Marmingee Hand, Jadnah Davies, Sue Thomas, Eric Bedford, et al. "Bigiswun Kid Project: a longitudinal study of adolescents living with high rates of prenatal alcohol exposure, fetal alcohol spectrum disorder and early life trauma in remote Australian Aboriginal communities." BMJ Open 12, no. 4 (April 2022): e058111. http://dx.doi.org/10.1136/bmjopen-2021-058111.
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IntroductionThe Lililwan Project was the first Australian population-based prevalence study of fetal alcohol spectrum disorder (FASD) using active case ascertainment. Conducted in 2010–2011, the study included 95% of all eligible children aged 7–9 years living in the very remote Aboriginal communities of the Fitzroy Valley, Western Australia. Women from Marninwarntikura Women’s Resource Centre, a local Aboriginal-led organisation, are concerned that some participants from the study are struggling in adolescence so partnered with researchers from the University of Sydney to follow up the Lililwan cohort in 2020–2022 at age 17–19 years.The overarching aim of the Bigiswun Kid Project is to identify adolescents’ needs and build knowledge to inform services to improve the health and well-being of adolescents in remote Aboriginal communities. The specific aims are to: (1) provide a voice to adolescents and their families to understand the health and well-being status of the Lililwan cohort at 17–19 years. (2) Examine relationships between exposures during pregnancy, birth characteristics, and health and neurodevelopment at 7–9 years, and positive/adverse adolescent outcomes at 17–19 years. This information will identify prenatal and early life factors that predict good health and well-being in adolescence. (3) Determine whether management plans provided in the Lililwan Project were followed, and identify past and present service gaps, support needs and barriers to service use. (4) Determine if key physical characteristics of FASD change between childhood and adolescence in this Aboriginal population.Ethics and disseminationApproved by the Kimberley Aboriginal Health Planning Forum and relevant ethics committees.
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Fernández-Huerta, Miguel, María-Jesús Barberá, Juliana Esperalba, Candela Fernandez-Naval, Marti Vall-Mayans, Maider Arando, Judit Serra-Pladevall, et al. "Prevalence of Mycoplasma genitalium and macrolide resistance among asymptomatic people visiting a point of care service for rapid STI screening: a cross-sectional study." Sexually Transmitted Infections 96, no. 4 (August 26, 2019): 300–305. http://dx.doi.org/10.1136/sextrans-2019-054124.
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ObjectivesAlthough rapid screening and treatment programmes have been recently implemented to tackle STIs, testing Mycoplasma genitalium (MG) among asymptomatic populations is not currently recommended due to the lack of scientific evidence and the emergence of antibiotic resistance. The main objective of this study was to estimate the prevalence of MG and macrolide resistance among asymptomatic people visiting a point of care service for rapid STI screening and to identify risk factors associated with the acquisition of this infection.MethodsBetween October 2017 and January 2018, a total of 890 asymptomatic individuals attending to the STI screening service Drassanes Exprés in Barcelona, Spain, were tested for MG and macrolide resistance using the molecular ResistancePlus MG assay (SpeeDx, Australia). Asymptomatically infected individuals were invited to attend the STI Unit for resistance-guided antimicrobial therapy.ResultsOverall, the prevalence of MG was 7.4% (66/890; 95% CI 5.8% to 9.3%), being higher among men who have sex with men (MSM) (46/489) compared with heterosexual men and women (20/401; p=0.012). Macrolide resistance was found in 32/46 (69.6%; 95% CI 54.2% to 82.3%) MSM, while only 2/20 (10.0%; 95% CI 1.2% to 31.7%) infections among heterosexuals presented macrolide resistance-mediated mutations (p<0.001). MSM behaviour, receptive anal intercourse, HIV positive status, syphilis history and high-risk sexual activity (more than five sexual partners in the last 3 months) were significantly associated with MG infection. Furthermore, the resistance-guided therapy approach was implemented in 36/66 (54.6%) individuals.ConclusionsThe research provides further data regarding the prevalence of MG and macrolide resistance among asymptomatic individuals. It also identifies higher risk subpopulations which might be targets for MG screening. Nevertheless, there is insufficient data to justify MG testing among asymptomatic individuals and current STI guidelines should be followed until evidence shows the cost and effectiveness of screening.
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Biggs, Laura J., Helen L. McLachlan, Touran Shafiei, Rhonda Small, and Della A. Forster. "Peer supporters’ experiences on an Australian perinatal mental health helpline." Health Promotion International 34, no. 3 (January 16, 2018): 479–89. http://dx.doi.org/10.1093/heapro/dax097.
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SummaryPerinatal mental health is an important public health issue, and peer support is a potentially important strategy for emotional well-being in the perinatal period. PANDA Perinatal Anxiety & Depression Australia provides support to individuals impacted by perinatal mental health issues via the National Perinatal Anxiety & Depression Helpline. Callers receive peer support from volunteers and counselling from paid professional staff. The views and experiences of PANDA peer support volunteers have not previously been studied. We conducted two focus groups and an online survey to explore the experiences of women providing volunteer peer support on the Helpline. Data collection took place in October and November 2013. Two social theories were used in framing and addressing the study aims and in interpreting our findings: the Empathy–Altruism Hypothesis, and the Helper Therapy Principle. All PANDA volunteers were invited to participate (n = 40). Eight volunteers attended a focus group, and 11 survey responses were received. Descriptive statistics were used to analyse quantitative data. All survey respondents ‘strongly agreed’ that they felt positive about being part of PANDA. Thematic analysis of data from focus groups and open-ended survey responses identified the following themes: motivated to help others, supported to support callers, helping to make a difference and emotional impacts for volunteers. Respondents described a strong desire to support others experiencing emotional distress as a motivator to volunteer. Although perinatal peer support services are designed to benefit those who receive support, this study suggests volunteers may also experience personal benefits from the role.
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Cockburn, Jill, Margaret Staples, Susan F. Hurley, and Trudy De Luise. "Psychological Consequences of Screening Mammography." Journal of Medical Screening 1, no. 1 (January 1994): 7–12. http://dx.doi.org/10.1177/096914139400100104.
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To examine the psychological consequences at a number of stages in the screening process for women attending a screening mammography programme. Setting- A pilot mammographic screening programme in Melbourne, Australia. Method — The psychological consequences questionnaire (PCQ; a reliable and valid measure of the psychological consequences of screening mammography) was used to measure the emotional, social, and physical functioning of women in a mammographic screening programme and a control community sample. A screening group (in whom no abnormality was detected at initial screen; n=142) had four measurements: at screening clinic; before results were received; one week after all-clear results were received; and eight months after initial visit. The recall group (who were recalled for further investigation which showed the detected abnormality to be benign; n = 58) had measurements at the same points as the screening group and an additional measurement while waiting at the recall assessment clinic. A randomly selected community control group (n = 52) had measurements one week, two weeks, three weeks; and eight months after consenting to participate. Emotional, social, and physical functioning of women in the screening group did not change over time and at no point differed significantly from that of community controls. The profiles of emotional and physical dysfunction of women in the recall group differed significantly from those of the screening and control groups. The level of emotional and physical dysfunction in the recall group was highest while waiting at recall assessment clinic, and scores were still significantly higher than scores obtained at comparable times from screening and control groups one week after obtaining notification that there was no sign of cancer (emotional P< 0·001; physical P < 0·05). This difference had disappeared eight months after the screening visit, when the level of emotional and physical functioning was similar to that of the screening and control groups. Social dysfunction scores did not change significantly over time and were similar for all three groups. Given that up to 10% of women are recalled for further investigations on first round screening, significant numbers of women may have psychological consequences. This speaks for the necessity for accurate reading of mammograms to minimise the false positive recall rate, and for counselling services to be available at recall assessment centres.
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Cummins, Denise, and Kristine H. J. Millar. "Experiences of HIV-Positive Women in Sydney, Australia." Journal of the Association of Nurses in AIDS care 15, no. 3 (May 2004): 70–74. http://dx.doi.org/10.1177/1055329003261959.
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Zablotska, I., A. Frankland, J. Imrie, P. Adam, R. Westacott, P. Canavan, and G. Prestage. "Current issues in care and support for HIV-positive gay men in Sydney." International Journal of STD & AIDS 20, no. 9 (September 2009): 628–33. http://dx.doi.org/10.1258/ijsa.2008.008432.
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We explored current access to care among HIV-positive people in Australia. In 2006, 270 HIV-positive gay men from a community-based Positive Health cohort in Sydney were asked about their health (including medical and social) service needs and, subsequently, about difficulty in accessing services. We report the prevalence of specific needs, barriers and associated factors. Participants most commonly used general practitioners (64%) for HIV management and needed at least one HIV-related medical service (usually several: doctors experienced in HIV management, dentists and hospital pharmacies). Most participants were able to access them. Barriers in accessing services were related to their convenience rather than lack or quality. Cost emerged as a substantial barrier to dental care and psychological counselling (91% and 48% respectively of those in need). Need for an HIV-related social service was reported by 46% of respondents. Difficulties in accessing these related to poor services and staff attitudes. Income was associated with limited access to multiple services. In Australia, HIV-related medical service needs outweigh those for social services. Complex health services remain essential to HIV-positive people, but some services are currently not meeting their needs. To remain adequate, services need to understand and constantly adapt to the changing needs of HIV-positive people.
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Procopio, Pietro, Sabine Deij, Louiza S. Velentzis, Amanda Tattam, Lara Petelin, and Carolyn Nickson. "Abstract P2-10-05: The estimated impact of COVID-19 on population breast cancer screening outcomes, and options for risk-based recovery." Cancer Research 82, no. 4_Supplement (February 15, 2022): P2–10–05—P2–10–05. http://dx.doi.org/10.1158/1538-7445.sabcs21-p2-10-05.
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Abstract OBJECTIVES AND RATIONALE Estimating the impact of COVID-19 on cancer screening programs and related outcomes can help health services prepare for potential delays in diagnoses and different demands on treatment services and plan for best approaches to recovery. Simulation modelling enables estimation of outcomes for a range of scenarios. In this study, we estimate the impact of various disruptions and recovery strategies for the Australian biennial mammographic breast screening program (BreastScreen). METHOD Policy1-Breast is a continuous-time, multiple-cohort micro-simulation model that simulates the whole Australian female population, incorporating breast cancer risk and natural history, breast density, menopause, hormone therapy use and breast cancer screening. Firstly, in the early stages of the COVID pandemic we used Policy1-Breast to evaluate how 3, 6, 9 and 12-month pauses to BreastScreen would impact on population-level breast cancer diagnoses, tumour staging, and breast cancer survival, compared to business-as-usual (BAU) outcomes. Secondly, to explore options for recovery after an actual one-month screening pause in April 2020, we evaluated a range of assumed throughput levels following screening resumption (50% or 80% up to December, then 100% to 120% from Jan 2021), comparing various protocols where specific sub-groups of clients were prioritised for screening during the recovery period. Outcomes are reported for the target age range for the BreastScreen program (50-74 years). RESULTS For 3- to 12-month pauses, we estimated a slight reduction in 5-year survival following diagnosis for women directly affected by a pause, but no discernible changes to population-level breast cancer mortality rates up to 2023. We estimated marked fluctuations in population rates of invasive breast cancer diagnoses with a 10% increase in cancer diagnoses between 2020-2021 and 2022-2023. For a 12-month pause to screening we estimate that population-level breast cancers would increase in size (with an additional 4% >15mm at diagnosis) and be more likely to involve the nodes (increasing from 26% to 30% of all cancers). We estimate that median screening intervals during 2020-2021 would increase from 104 weeks under BAU up to 130 weeks with a 12-month pause, and BreastScreen recall rates and false positive recall rates would fluctuate markedly over time. For the second evaluation of a one-month pause followed by various throughput and prioritisation scenarios, we estimated that screen-detected cancer rates would vary markedly with throughput but interval cancer rates would not, leading to fluctuations in program sensitivity of up to 6%. Reflecting the periodic nature of screening participation, we estimated the extent to which longer-term future screening participation rates are expected echo the peaks and troughs in participation due to the impacts of the COVID pandemic in 2020. We estimate that for a given throughput assumption, client prioritisation could lead to different rescreening rates, screening intervals, and time required for prioritisation protocols, with little change to cancer outcomes. CONCLUSION These modelled evaluations estimate short and longer-term effects of COVID-19 on the impact of population breast cancer screening in Australia. The estimated changes in breast cancer rates and characteristics would be expected to have a flow-on effect on the demand for treatment services in terms of throughput and case-mix. Preparing for such outcomes is critical given that treatment services are also directly impacted by the pandemic. The modelled outcomes are likely to be relevant to other high-income settings with established population breast cancer screening programs. Citation Format: Pietro Procopio, Sabine Deij, Louiza S Velentzis, Amanda Tattam, Lara Petelin, Carolyn Nickson. The estimated impact of COVID-19 on population breast cancer screening outcomes, and options for risk-based recovery [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-10-05.
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Gamage, Deepa G., Mohsin Sidat, Tim Read, Rosey Cummings, Catriona S. Bradshaw, Kerri Howley, Glenda Fehler, Jun Kit Sze, Marcus Chen, and Christopher K. Fairley. "Evaluation of Health Map: a patient-centred web-based service for supporting HIV-infected patients." Sexual Health 8, no. 2 (2011): 194. http://dx.doi.org/10.1071/sh10072.
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Background: Our aim was to describe the use of and responses to a self-management website, ‘Health Map’, established to address the key chronic health issues of HIV-positive people. Methods: Health Map assessed health issues against current recommendations for: treatment adherence, monitoring CD4 counts and viral load, psychological health and physical activity, vaccination, cholesterol, fasting blood sugar, blood pressure, alcohol consumption, smoking, body mass index, and cervical screening for women and sexually transmissible infection (STI) screening for men who have sex with men (MSM). Results: A total of 552 people, with a mean age of 37 years, completed the full ‘Health Map’ program, of whom 536 (97%) were Australian, 425 (77%) were male, including 268 (63%) MSM. Online responses to several health indices were of concern: 49% missed at least one dose of antiretroviral therapy per month and only 41% had had an HIV viral load test in the 4 months prior. Only 43% reported regular physical activity, and 49% and 61% reported vaccination for hepatitis A and B. The proportion tested within the recommended periods for fasting cholesterol (40%), fasting blood sugar (35%) and cervical screening (43%) in women or STI screening for MSM (53%) were low. Conclusions: A substantial proportion of individuals completing the online survey reported information that would suggest their HIV and more general health care is suboptimal. These data are consistent with community surveys and indicate the need for improvement in the chronic management of HIV.
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Suryanti, Putu Emy, Komang Ayu Kartika Sari, Pande Putu Januraga, and Dinar Lubis. "Why do HIV-positive pregnant women discontinue with comprehensive PMTCT services? A qualitative study." Public Health and Preventive Medicine Archive 6, no. 1 (July 1, 2018): 73. http://dx.doi.org/10.15562/phpma.v6i1.13.
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AbstractBackground and purpose: Prevention of mother to child transmission (PMTCT) is a government program aimed at preventing mother-to-child transmission of HIV. A comprehensive PMTCT program involves the implementation of HIV testing up to antiretroviral (ARV) treatment for mothers with positive HIV test results. Coverage of comprehensive PMTCT remains low, with many HIV-positive pregnant women who discontinued ARV treatment. This study aims to explore the reasons of HIV-positive pregnant women to discontinue with the comprehensive PMTCT program.Methods: A qualitative study was carried out in Badung District, Bali Province, with seven respondents: one HIV-positive pregnant woman who did not continue the ARV treatment, two HIV-positive women who gave birth the previous year and did not take ARV, three public health centre (PHC) providers, and one head of PHC. Respondents were selected using a purposive sampling technique. Data were collected through in-depth interviews and analyzed thematically. The results presented narratively to illustrate the reasons why HIV-positive pregnant women discontinued with the comprehensive PMTCT program.Results: The emerging themes related to the reasons of HIV-positive pregnant women discontinued with the comprehensive PMTCT program included the lack of comprehensive PMTCT-related information, the lack of health provider assistance, and the high stigma towards people living with HIV (PLHIV). These barriers were affecting the willingness of HIV-positive pregnant women to continue with the program.Conclusions: Lack of comprehensive PMTCT-related information, lack of assistance by health care providers, and high public stigma impacts upon HIV-positive pregnant women’s willingness to continue with comprehensive PMTCT program. There is a need for a minimum service standard in the implementation of comprehensive PMTCT services and comprehensive information on HIV infection in order to reduce the stigma towards PLHIV.
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Suryanti, Putu Emy, Komang Ayu Kartika Sari, Pande Putu Januraga, and Dinar Lubis. "Why do HIV-positive pregnant women discontinue with comprehensive PMTCT services? A qualitative study." Public Health and Preventive Medicine Archive Journal 6, no. 1 (July 1, 2018): 1. http://dx.doi.org/10.15562/pphma.v6i1.13.
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AbstractBackground and purpose: Prevention of mother to child transmission (PMTCT) is a government program aimed at preventing mother-to-child transmission of HIV. A comprehensive PMTCT program involves the implementation of HIV testing up to antiretroviral (ARV) treatment for mothers with positive HIV test results. Coverage of comprehensive PMTCT remains low, with many HIV-positive pregnant women who discontinued ARV treatment. This study aims to explore the reasons of HIV-positive pregnant women to discontinue with the comprehensive PMTCT program.Methods: A qualitative study was carried out in Badung District, Bali Province, with seven respondents: one HIV-positive pregnant woman who did not continue the ARV treatment, two HIV-positive women who gave birth the previous year and did not take ARV, three public health centre (PHC) providers, and one head of PHC. Respondents were selected using a purposive sampling technique. Data were collected through in-depth interviews and analyzed thematically. The results presented narratively to illustrate the reasons why HIV-positive pregnant women discontinued with the comprehensive PMTCT program.Results: The emerging themes related to the reasons of HIV-positive pregnant women discontinued with the comprehensive PMTCT program included the lack of comprehensive PMTCT-related information, the lack of health provider assistance, and the high stigma towards people living with HIV (PLHIV). These barriers were affecting the willingness of HIV-positive pregnant women to continue with the program.Conclusions: Lack of comprehensive PMTCT-related information, lack of assistance by health care providers, and high public stigma impacts upon HIV-positive pregnant women’s willingness to continue with comprehensive PMTCT program. There is a need for a minimum service standard in the implementation of comprehensive PMTCT services and comprehensive information on HIV infection in order to reduce the stigma towards PLHIV.
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Mandala, Justin, Prisca Kasonde, Titilope Badru, Rebecca Dirks, and Kwasi Torpey. "HIV Retesting of HIV-Negative Pregnant Women in the Context of Prevention of Mother-to-Child Transmission of HIV in Primary Health Centers in Rural Zambia: What Did We Learn?" Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (January 1, 2019): 232595821882353. http://dx.doi.org/10.1177/2325958218823530.
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Background: This observational study describes implementation of HIV retesting of HIV-negative women in prevention of mother-to-child transmission (PMTCT) services in Zambia. Methods: Uptake of retesting and PMTCT services were compared across age, parity, and weeks of gestation at the time of the first HIV test, antiretrovirals regime, and HIV early diagnosis results from infants born to HIV-positive mothers. Results: A total of 19 090 pregnant women were tested for HIV at their first antenatal visit, 16 838 tested HIV-negative and were offered retesting 3 months later: 11 339 (67.3%) were retested; of those, 55 (0.5%) were HIV positive. Uptake of the PMTCT package by women HIV positive at retest was not different but HIV-exposed infants born to women who retested HIV positive were infected at a higher rate (11.1%) compared to those born to women who tested HIV positive at their initial test (3.2%). Conclusion: We suggest rigorously (1) measuring the proportion of MTCT attributable to women who seroconvert during pregnancy and possibly adjust PMTCT approaches and (2) addressing the substantial loss to follow-up of HIV-negative pregnant women before HIV retesting.
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Tuchel, Tammy, and Douglas Feldman. "A Preliminary Ethnography of HIV-Positive Women in Dade County Jails." Practicing Anthropology 15, no. 4 (September 1, 1993): 52–55. http://dx.doi.org/10.17730/praa.15.4.eq25x27882707779.
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As the population of women in jails and prisons in the United States has increased in recent years, so has interest in directing health services, social support, and education to this population more effectively. One of the major health problems of all imprisoned populations today is human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). HIV seroprevalence rates are often higher for women than for men in correctional facilities, and the rates are also higher in municipal jail systems than in state prison systems. Jails and prisons need to be prepared to deal with the health needs of their growing HIV-positive population. In addition, the social and cultural factors associated with high-risk behaviors for HIV need to be identified for the inmate population so that jail and prison health services and educational programs can better prevent further transmission of the disease.
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Fauk, Nelsensius Klau, Maria Silvia Merry, Theodorus Asa Siri, Fabiola Tazrina Tazir, Mitra Andhini Sigilipoe, Kristin Oktanita Tarigan, and Lillian Mwanri. "Facilitators to Accessibility of HIV/AIDS-Related Health Services among Transgender Women Living with HIV in Yogyakarta, Indonesia." AIDS Research and Treatment 2019 (July 1, 2019): 1–10. http://dx.doi.org/10.1155/2019/6045726.
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The study aimed to explore facilitators or enabling factors that enhance accessibility (defined as the opportunity to be able to use) to HIV/AIDS-related health services among HIV positive transgender women, also known as Waria in Yogyakarta, Indonesia. A qualitative study employing one-on-one in-depth interviews was conducted from December 2017 to February 2018. Participants were HIV positive Waria recruited using purposive and snowball sampling techniques. Data were analysed using the framework analysis for qualitative research. The findings showed that participants’ knowledge of HIV/AIDS and the availability of HIV/AIDS-related health services were enablers to the services accessibility. Emotional support from fellow Waria displayed in various ways, such as kind and caring attention, attentive listening, and encouraging words, was an important social support that played a role in supporting Waria’s accessibility to the services. HIV/AIDS-related health service information shared personally or jointly by fellow Waria and instrumental support including helping each other to collect antiretroviral (ARV) from hospitals or community health centres, contacting ambulance in emergency situations, accompanying each other to health service facilities, and helping those without the health insurance to receive free health services were also the social support enabling accessibility to the services among the study participants. Appraisal support such as providing constructive feedback and affirmation was another enabling factor to Waria’s accessibility to the services. The findings indicate the needs to broadly disseminate information and educate Waria populations and their significant others about HIV/AIDS and related health services to raise their awareness of HIV/AIDS and acceptance of HIV/AIDS positive individuals. Educating and broadly disseminating this information in other settings in the country will also increase accessibility to the HIV/AIDS services among Waria, their families, and communities addressing the currently existing inequities in health. The findings also reinforce the importance of the establishment of Waria peer-support groups within Waria communities and the involvement of Waria in HIV/AIDS activities and programs, which may increase their awareness of HIV/AIDS, and accessibility to HIV/AIDS-related health services.
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Maru, Isaac, Rose Olayo, and Mary Kipmerewo. "Socio-Cultural and Societal Demands Influencing Pregnancy among HIV Positive Women in Kakamega County, Kenya." European Journal of Medical and Health Sciences 3, no. 6 (November 16, 2021): 31–38. http://dx.doi.org/10.24018/ejmed.2021.3.6.1097.
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Globally, the number of women living with HIV who desire pregnancy has been increasing and little is known as what motivates them, with test and treat women accessing ART desiring pregnancy will increase. Kakamega County has been leading in the region on women living with HIV accessing antenatal services. Past literature in the subject matter failed to look at socio-cultural and societal factors influencing pregnancy among HIV positive women in Kakamega County, Kenya; a gap that informed this study. A descriptive cross-sectional research design was employed. The target population were women aged 18-49 years receiving their family planning services in sub-county hospitals in Kakamega County. Key informants were made up of health care workers at comprehensive care clinics. Purposive sampling was used to select 4 sub-county hospitals, systematic random sampling to select 319 known HIV positive women and 4 focus group discussions. Questionnaires focused on group discussions and key informant interviews were used to collect data. Data collected were entered into Statistical Package for Social Sciences version 25.0. Descriptive results were presented in proportionate tables. The results showed that age, education, employment status and parity influenced the desire for pregnancy among HIV positive women in Kakamega County. Society influenced the number of children a woman should have. The community held a negative perception of childless women, especially HIV positive women; the community members did not attach value and pride over the childless HIV positive women. The socio-cultural and societal demand on HIV positive women influenced pregnancy; however, there decreasing association, which meant that the society was 71% less likely to influence the number of children; the spouse was 63% less likely to influence pregnancy. In conclusion, age, education level, marital status parity and employment status, medical cover influenced pregnancy among the known HIV positive women in Kakamega County. Socio-cultural and societal demands were predictors of pregnancy among known HIV positive women in Kakamega County. The community should treat HIV positive women with respect and dignity, thus permitting them to continue their family legacy and sire children. It recommends that there is a need for the county government, department of health services to provide health education to the community on stigma reduction and discrimination meted on these women and negative perception of childlessness women in the society especially known HIV positive women. Further works on the myths and misconception that barrenness is blamed on women leaving men scot-free for the cloud to be the culprits of childlessness in the family.
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Johnson, Leigh F., Themba Mutemaringa, Alexa Heekes, and Andrew Boulle. "Effect of HIV Infection and Antiretroviral Treatment on Pregnancy Rates in the Western Cape Province of South Africa." Journal of Infectious Diseases 221, no. 12 (July 23, 2019): 1953–62. http://dx.doi.org/10.1093/infdis/jiz362.
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Abstract Background Previous studies suggest that untreated human immunodeficiency virus (HIV) infection is associated with a reduced incidence of pregnancy, but studies of the effect of antiretroviral treatment (ART) on pregnancy incidence have been inconsistent. Methods Routine data from health services in the Western Cape province of South Africa were linked to identify pregnancies during 2007–2017 and maternal HIV records. The time from the first (index) pregnancy outcome date to the next pregnancy was modeled using Cox proportional hazards models. Results During 2007–2017, 1 042 647 pregnancies were recorded. In all age groups, pregnancy incidence rates were highest in women who had started ART, lower in HIV-negative women, and lowest in ART-naive HIV-positive women. In multivariable analysis, after controlling for the most recent CD4+ T-cell count, pregnancy incidence rates in HIV-positive women receiving ART were higher than those in untreated HIV-positive women (adjusted hazard ratio, 1.63; 95% confidence interval, 1.59–1.67) and those in HIV-negative women. Conclusion Among women who have recently been pregnant, receipt of ART is associated with high rates of second pregnancy. Better integration of family planning into HIV care services is needed.
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Butler, Tony, Stephen Allnutt, Azar Kariminia, and David Cain. "Mental Health Status of Aboriginal and Non-Aboriginal Australian Prisoners." Australian & New Zealand Journal of Psychiatry 41, no. 5 (May 2007): 429–35. http://dx.doi.org/10.1080/00048670701261210.
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Objective: To compare the mental health of Aboriginal and non-Aboriginal prisoners in New South Wales. Methods: The sample consisted of a cross-sectional random sample of sentenced prisoners, and a consecutive sample of reception prisoners. The sample was drawn from 29 correctional centres (27 male, two female) across New South Wales. Overall, 1208 men (226 Aboriginal), and 262 women (51 Aboriginal) participated in the study. Mental illness was detected using the Composite International Diagnostic Interview (CIDI-A) and a number of other screening measures incorporated into the programme. Results: No differences were detected in mental illness between Aboriginal and non-Aboriginal men, apart from depression, which was lower in the latter group. Aboriginal woman were more likely than non-Aboriginal women to screen positive for symptoms of psychosis in the prior 12 months and have a higher 1 month and 12 month prevalence of affective disorder; they also had higher psychological distress scores. Suicidal thoughts and attempts were the same in both groups. Conclusions: These findings confirm that the demand for mental health services in prisons is considerable, and that Aboriginal women are one of the most vulnerable groups. Services and programmes providing an alternative to incarceration are needed, as are culturally sensitive approaches to treatment.
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Montandon, Michele, Timothy Efuntoye, Ijeoma U. Itanyi, Chima A. Onoka, Chukwudi Onwuchekwa, Jerry Gwamna, Amee Schwitters, et al. "Improving uptake of prevention of mother-to-child HIV transmission services in Benue State, Nigeria through a faith-based congregational strategy." PLOS ONE 16, no. 12 (December 2, 2021): e0260694. http://dx.doi.org/10.1371/journal.pone.0260694.
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Background Nigeria has low antiretroviral therapy (ART) coverage among HIV-positive pregnant women. In a previous cluster-randomized trial in Nigeria, Baby Shower events resulted in higher HIV testing coverage and linkage of pregnant women to ART; here, we assess outcomes of Baby Shower events in a non-research setting. Methods Baby Shower events, including a prayer ceremony, group education, music, gifting of a “mama pack” with safe delivery supplies, and HIV testing with ART linkage support for HIV-positive pregnant women, were conducted in eighty sites in Benue State, Nigeria. Client questionnaires (including demographics, ANC attendance, and HIV testing history), HIV test results, and reported linkage to ART were analyzed. Descriptive data on HIV testing and ART linkage data for facility-based care at ANC clinics in Benue State were also analyzed for comparison. Results Between July 2016 and October 2017, 10,056 pregnant women and 6,187 male partners participated in Baby Shower events; 61.5% of women attended with a male partner. Nearly half of female participants (n = 4515, 44.9%) were not enrolled in ANC for the current pregnancy, and 22.3% (n = 2,241) of female and 24.8% (n = 1,532) of male participants reported they had never been tested for HIV. Over 99% (n = 16,240) of participants had their HIV status ascertained, with 7.2% of females (n = 724) and 4.0% of males (n = 249) testing HIV-positive, and 2.9% of females (n = 274) and 2.3% of males (n = 138) receiving new HIV-positive diagnoses. The majority of HIV-positive pregnant women (93.0%, 673/724) were linked to ART. By comparison, at health facilities in Benue State during a similar time period, 99.7% of pregnant women had HIV status ascertained, 8.4% had a HIV-positive status, 2.1% were newly diagnosed HIV-positive, and 100% were linked to ART. Conclusion Community-based programs such as the faith-based Baby Shower intervention complement facility-based approaches and can reach individuals who would not otherwise access facility-based care. Future Baby Showers implementation should incorporate enhanced support for ART linkage and retention to maximize the impact of this intervention on vertical HIV transmission.
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Persson, Asha, and Wendy Richards. "Vulnerability, gender and “proxy negativity”: Women in relationships with HIV-positive men in Australia." Social Science & Medicine 67, no. 5 (September 2008): 799–807. http://dx.doi.org/10.1016/j.socscimed.2008.05.010.
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Price, Pam, and Katherine Leane. "The impact of the impact evaluation: Evaluation of the HIV/AIDS Women's Project 1998." Australian Journal of Primary Health 5, no. 3 (1999): 65. http://dx.doi.org/10.1071/py99035.
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The HIV/AIDS Women's Project (Women's Health Statewide) was established under the auspices of Women's Health Statewide and is supported by a reference group which meets monthly to oversee the work of the Project. The role of the Project is to enhance the health and wellbeing of HIV-positive women and their families in South Australia. In 1998 a consultant was employed to review the role and effectivness of this Project in the HIV/AIDS sector. The evaluation soon evolved beyond its review and evaluation roles, identifying the complex work of the Project and broadening the understanding of women's perspectives in the context of the HIV/AIDS epidemic in South Australia. This paper explores the evaluation process and comments on the effects that participation in the review process has had on both HIV-positive women who participated in the evaluation and on the future work of the Project.
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Ferguson, Laura, Alison D. Grant, Deborah Watson-Jones, Tanya Kahawita, John O. Ong’ech, and David A. Ross. "Linking women who test HIV-positive in pregnancy-related services to long-term HIV care and treatment services: a systematic review." Tropical Medicine & International Health 17, no. 5 (March 7, 2012): 564–80. http://dx.doi.org/10.1111/j.1365-3156.2012.02958.x.
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Dillabaugh, Lisa L., Jayne Lewis Kulzer, Kevin Owuor, Valerie Ndege, Arbogast Oyanga, Evelyne Ngugi, Starley B. Shade, Elizabeth Bukusi, and Craig R. Cohen. "Towards Elimination of Mother-to-Child Transmission of HIV: The Impact of a Rapid Results Initiative in Nyanza Province, Kenya." AIDS Research and Treatment 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/602120.
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Many HIV-positive pregnant women and infants are still not receiving optimal services, preventing the goal of eliminating mother-to-child transmission (MTCT) and improving maternal child health overall. A Rapid Results Initiative (RRI) approach was utilized to address key challenges in delivery of prevention of MTCT (PMTCT) services including highly active antiretroviral therapy (HAART) uptake for women and infants. The RRI was conducted between April and June 2011 at 119 health facilities in five districts in Nyanza Province, Kenya. Aggregated site-level data were compared at baseline before the RRI (Oct 2010–Jan 2011), during the RRI, and post-RRI (Jul–Sep 2011) using pre-post cohort analysis. HAART uptake amongst all HIV-positive pregnant women increased by 40% (RR 1.4, 95% CI 1.2–1.7) and continued to improve post-RRI (RR 1.6, 95% CI 1.4–1.8). HAART uptake in HIV-positive infants remained stable (RR 1.1, 95% CI 0.9–1.4) during the RRI and improved by 30% (RR 1.3, 95% CI 1.0–1.6) post-RRI. Significant improvement in PMTCT services can be achieved through introduction of an RRI, which appears to lead to sustained benefits for pregnant HIV-infected women and their infants.
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Hope, M., M. S. Nabaggala, F. Mubiru, S. Nakalema, I. Kyohairwe, L. Mbabazi, R. Nakijoba, A. Nakajubi, B. Castelnuovo, and M. Lamorde. "PIH45 UPTAKE OF ANTENATAL CARE SERVICES AMONG HIV POSITIVE WOMEN ATTENDING AN URBAN HIV CLINIC IN UGANDA." Value in Health 22 (November 2019): S635—S636. http://dx.doi.org/10.1016/j.jval.2019.09.1226.
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Camellia, Artha, Plamularsih Swandari, Irwanto Irwanto, Gusni Rahma, and Tuti Parwati Merati. "Peer facilitators’s role to support pregnant women in utilizing HIV services during the COVID-19 pandemic." International Journal of Public Health Science (IJPHS) 12, no. 1 (March 1, 2023): 377. http://dx.doi.org/10.11591/ijphs.v12i1.21921.
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<p>Human immunodeficiency virus (HIV) prevalence on pregnant women in Indonesia is estimated around 0.3%. The prevention of mother-to-child disease transmission (PMTCT) program has been implemented nationally since 2008, though, less than 50% of the total pregnant women each year get an HIV test and only 18% of those who are HIV positive get antiretroviral (ARV) treatment until now. COVID-19 pandemic, occurred since 2019, has brought significant changes to public health aspects including the utilization of HIV services. This study is aimed to determine factors influencing the PMTCT program services utilization during pandemic. This study used mix method approach with quantitative approach using a cross-sectional study design (174 HIV mothers from six provinces in Indonesia) and qualitative approach with in-depth interviews of 13 informants consisting of HIV mothers, health workers, program holders and peer facilitators. The results showed the HIV services utilization during pandemic was 52.3%. The most influenced factor was peer facilitators support (POR 2.96; 95% CI=1.45-6.03), HIV mothers who did not receive assistance from peer facilitators had 2.96 times chance of not utilizing the services compared to them who received. It requires to strengthen cooperation between health services and peer facilitators to support HIV mothers in accessing HIV services.</p>
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Carman, Marina, Jeffrey Grierson, Marian Pitts, Michael Hurley, and Jennifer Power. "Trends in the location of the HIV-positive population in Australia: Implications for access to healthcare services and delivery." Sexual Health 7, no. 2 (2010): 154. http://dx.doi.org/10.1071/sh09063.
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Background: Examining existing and potential trends in the HIV-positive population in Australia is important for current and future healthcare service development and delivery. Methods: A new analysis of existing data on this population from the HIV Futures 5 survey was based on linking a geographic breakdown of respondents based on ‘area type’ – capital city or inner suburban, outer suburban, regional centre and rural – with patterns of healthcare service access. In addition, the distance between the postcode of the respondent’s residence and the postcode of the doctor seen for HIV-related treatment was calculated. An analysis of ‘area type’ by income and age was also conducted. Results: The ‘area type’ analysis showed important differences in patterns of access to antiretroviral prescriptions and choice of provider for HIV-related and general healthcare. The median distance travelled to see a doctor for HIV-related treatment was higher for those living in outer suburbs than those living in regional centres. Discussion: Differences in service use appear to be related to geographic accessibility of different service types. However, there may be other important social, economic and cultural factors involved. Ageing and socio-economic pressures may be influencing a move away from inner suburban areas where most HIV-specific care is located. This new analysis assists in finding the right balance between increasing the accessibility of HIV-specific services and ‘mainstreaming’. Longitudinal data collection would further assist in tracking trends in geographic location, and how often and at what intervals people living with HIV utilise healthcare services.
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Kastner, Jasmine, Lynn T. Matthews, Ninsiima Flavia, Francis Bajunirwe, Susan Erikson, Nicole S. Berry, and Angela Kaida. "Antiretroviral Therapy Helps HIV-Positive Women Navigate Social Expectations for and Clinical Recommendations against Childbearing in Uganda." AIDS Research and Treatment 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/626120.
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Understanding factors that influence pregnancy decision-making and experiences among HIV-positive women is important for developing integrated reproductive health and HIV services. Few studies have examined HIV-positive women’s navigation through the social and clinical factors that shape experiences of pregnancy in the context of access to antiretroviral therapy (ART). We conducted 25 semistructured interviews with HIV-positive, pregnant women receiving ART in Mbarara, Uganda in 2011 to explore how access to ART shapes pregnancy experiences. Main themes included: (1) clinical counselling about pregnancy is often dissuasive but focuses on the importance of ART adherence once pregnant; (2) accordingly, women demonstrate knowledge about the role of ART adherence in maintaining maternal health and reducing risks of perinatal HIV transmission; (3) this knowledge contributes to personal optimism about pregnancy and childbearing in the context of HIV; and (4) knowledge about and adherence to ART creates opportunities for HIV-positive women to manage normative community and social expectations of childbearing. Access to ART and knowledge of the accompanying lowered risks of mortality, morbidity, and HIV transmission improved experiences of pregnancy and empowered HIV-positive women to discretely manage conflicting social expectations and clinical recommendations regarding childbearing.
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Napierala, Sue, Sungai T. Chabata, Calum Davey, Elizabeth Fearon, Joanna Busza, Phillis Mushati, Owen Mugurungi, et al. "Engagement in HIV services over time among young women who sell sex in Zimbabwe." PLOS ONE 17, no. 6 (June 28, 2022): e0270298. http://dx.doi.org/10.1371/journal.pone.0270298.
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Introduction Young female sex workers (FSW) are disproportionately vulnerable to HIV. Zimbabwe data show higher HIV incidence and lower engagement in services compared to older FSW. Utilizing data from a combination HIV prevention and treatment intervention, we describe engagement in the HIV services over time among FSW 18–24 years, compared to those ≥25 years of age. Materials and methods Data were collected via respondent-driven sampling (RDS) surveys in 14 communities in 2013 and 2016, with >2500 FSW per survey. They included blood samples for HIV and viral load testing. As the intervention had no significant impact on HIV care cascade outcomes, data were aggregated across study arms. Analyses used RDS-II estimation. Results Mean age in 2013 and 2016 was 31 and 33 years, with 27% and 17% aged 18–24 years. Overall HIV prevalence was 59% at each timepoint, and 35% and 36% among younger FSW. From 2013 to 2016 there was an increase in young HIV-positive FSW knowing their status (38% vs 60%, OR = 2.51, p<0.01). Outcomes for all FSW improved significantly over time at all steps of the cascade, and the relative change over time was similar among older versus younger FSW for most cascade variables. Discussion Young FSW had improvements in care cascade outcomes, and proportionate improvements similar to older FSW, yet they remain less engaged in services overall. This implies that the dedicated FSW services in Zimbabwe are having a comparably positive impact across age groups, however more is likely required to address young FSW’s unique vulnerabilities and needs.
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Sibiya, Maureen Nokuthula, Dorinda Borg, Shanaz Ghuman, Poovendhree Reddy, Thembilihle Ngxongo, Firoza Haffejee, Nalini Govender, and Laura O’Connor. "Societal Influences on the Utilization of Contraception Amongst Women in South Africa." Global Journal of Health Science 12, no. 2 (January 30, 2020): 41. http://dx.doi.org/10.5539/gjhs.v12n2p41.
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The strong desire to experience motherhood, mediated by prevailing social and cultural norms encourage childbearing in society. Contraceptive use and pregnancy among HIV positive women in South Africa is of growing concern as it may be associated with various adverse factors having socio-economic and health impacts. The timeous initiation and optimal utilisation of antenatal care services is imperative to ensure positive pregnancy outcomes and good maternal health; not always possible due to various challenges in developing countries. Motherhood is a component of a women’s identity in cultural societies and important for female social status. Major challenges are gender-based violence and gender inequality as well as physiological factors that place women at risk like cultural and behavioural practices requiring parental consent for access to reproductive and sexual health services tend to discourage girls and women in their pursuit for decision making in reproductive health. This study examines the societal influences on contraceptive usage amongst women attending an antenatal clinic, their contraceptive use and HIV status in the city of Durban, province KwaZulu-Natal, South Africa. A cross-sectional study was conducted at a Primary Health Care (PHC) facility with a total of 283 pregnant women in trimester one visiting the antenatal clinic for the first time who completed a self-administered questionnaire. Results evidenced that almost 70% of the study population are aware of their HIV status prior to conceiving. Contraceptive usage in HIV positive participants was similar 82 (81%) to 97 (75%) in HIV negative participants. The HIV positive participants were aware of the consequences of non-contraceptive use. HIV positive women were not deterred by the desire to use contraception nor conceive (OR: 1.04, CI: 0.61 - 1.79). The study reports a high number of the women are single (>75%), low level of education (90%), unemployed (>70%). HIV status has no impact on contraceptive use and the prevalence of pregnancy among HIV positive women. The number of miscarriages (11%) and early neonatal deaths (6%) reported appeared higher in HIV positive women. Smoking (>50%) and alcohol consumption (>50%) were equally high amongst the pregnant women. Comprehensive programs for planned pregnancies in HIV positive women is necessary for a paradigm shift in the prevailing social and cultural norms worldwide. Reproductive health education extending to embrace the boys and men in the population will increase the importance and acceptance of contraception usage for both HIV positive and negative women in reproductive health care.
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Cysique, Lucette A., Margaret P. Bain, Bruce J. Brew, and John M. Murray. "The burden of HIV-associated neurocognitive impairment in Australia and its estimates for the future." Sexual Health 8, no. 4 (2011): 541. http://dx.doi.org/10.1071/sh11003.
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Background The growing number of older individuals with HIV in Australia implies that the prevalence of dementia and additional HIV-associated neurocognitive disorders will increase. There are currently no estimates of the future burden of neurocognitive disease in this population. Methods: We estimated the number and age profile of people living with HIV to the end of 2009 using HIV/AIDS Registry data, and extrapolated these estimates to 2030. Prevalence of HIV-associated dementia (HAD) from 2005 to 2010 from a large Sydney hospital and cost estimates from the AIDS Dementia and HIV Psychiatry Service were used to estimate future HAD burden and costs. Results: Based on our calculations, the number of HIV-positive individuals in Australia will increase from 16 228 men and 1797 women in 2009 to 26 963 men and 5224 women in 2030, while the number of individuals aged 60+ years will increase from 1140 men and 78 women to 5442 men and 721 women, i.e. a 377% increase of older men and an 825% increase in older women. Based on a 7.8% (157/2004) HAD prevalence obtained from hospital data, individuals with HAD will increase in number from 1314 men and 143 women in 2009 to 2204 men and 421 women in 2030. An estimated 22 men and 2 women with non-HIV dementia in 2009 will increase to 104 men and 12 women by 2030. The annual cost of care will increase from ~$29 million in 2009 to $53 million in 2030, mostly for full-time residential care. Conclusions: Neurocognitive disorders will place an increasing burden on resources, especially as those living with HIV age. Because it is unclear if HAD is an increased risk factor for non-HIV dementia, our calculations may be conservative.