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Jaibat L, Cui Z, Mitra S, Loh J, Reddon H, Fairbairn N, Milloy MJ. Perceived Mistreatment in Health Care Settings and its Relationship with HIV Clinical Outcomes in HIV-positive People who Use Drugs in Vancouver, Canada. AIDS Behav 2023; 27:1636-1646. [PMID: 36318426 PMCID: PMC10149567 DOI: 10.1007/s10461-022-03895-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
People living with HIV (PLWH) often experience stigma and discrimination by health care professionals. We investigated the prevalence of perceived mistreatment in health care settings and its associations with HIV clinical outcomes and health care-seeking behaviour using data from a long-running prospective cohort of PLWH who use drugs. Of the 857 participants included, 19% reported at least one instance of perceived mistreatment during the study period. In adjusted longitudinal analyses, perceived mistreatment was positively associated with not being on ART in the same follow-up period, and participants who reported perceived mistreatment were less likely to report seeing a physician in the subsequent follow-up period. Daily use of injection drugs was positively associated with reporting perceived mistreatment. These findings demonstrate the implications of negative health care interactions in a population that must consistently engage with the health care system, and the need for stigma-reducing educational interventions for health care professionals.
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Affiliation(s)
- Laura Jaibat
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zishan Cui
- British Columbia Centre on Substance Use, St. Paul's Hospital, 400-1045 Howe St, V6Z2A9, Vancouver, BC, Canada
| | - Sanjana Mitra
- British Columbia Centre on Substance Use, St. Paul's Hospital, 400-1045 Howe St, V6Z2A9, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jane Loh
- British Columbia Centre on Substance Use, St. Paul's Hospital, 400-1045 Howe St, V6Z2A9, Vancouver, BC, Canada
| | - Hudson Reddon
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Nadia Fairbairn
- British Columbia Centre on Substance Use, St. Paul's Hospital, 400-1045 Howe St, V6Z2A9, Vancouver, BC, Canada
- Division of social medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M-J Milloy
- British Columbia Centre on Substance Use, St. Paul's Hospital, 400-1045 Howe St, V6Z2A9, Vancouver, BC, Canada.
- Division of social medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Park H, Brenner B, Ibanescu RI, Cox J, Weiss K, Klein MB, Hardy I, Narasiah L, Roger M, Kronfli N. Phylogenetic Clustering among Asylum Seekers with New HIV-1 Diagnoses in Montreal, QC, Canada. Viruses 2021; 13:v13040601. [PMID: 33915869 PMCID: PMC8066823 DOI: 10.3390/v13040601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 01/08/2023] Open
Abstract
Migrants are at an increased risk of HIV acquisition. We aimed to use phylogenetics to characterize transmission clusters among newly-diagnosed asylum seekers and to understand the role of networks in local HIV transmission. Retrospective chart reviews of asylum seekers linked to HIV care between 1 June 2017 and 31 December 2018 at the McGill University Health Centre and the Jewish General Hospital in Montreal were performed. HIV-1 partial pol sequences were analyzed among study participants and individuals in the provincial genotyping database. Trees were reconstructed using MEGA10 neighbor-joining analysis. Clustering of linked viral sequences was based on a strong bootstrap support (>97%) and a short genetic distance (<0.01). Overall, 10,645 provincial sequences and 105 asylum seekers were included. A total of 13/105 participant sequences (12%; n = 7 males) formed part of eight clusters. Four clusters (two to three people) included only study participants (n = 9) and four clusters (two to three people) included four study participants clustered with six individuals from the provincial genotyping database. Six (75%) clusters were HIV subtype B. We identified the presence of HIV-1 phylogenetic clusters among asylum seekers and at a population-level. Our findings highlight the complementary role of cohort data and population-level genotypic surveillance to better characterize transmission clusters in Quebec.
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Affiliation(s)
- Hyejin Park
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.P.); (J.C.); (M.B.K.)
| | - Bluma Brenner
- McGill AIDS Centre, Lady Davis Institute, Jewish General Hospital, Montreal, QC H3T 1E2, Canada; (B.B.); (R.-I.I.)
| | - Ruxandra-Ilinca Ibanescu
- McGill AIDS Centre, Lady Davis Institute, Jewish General Hospital, Montreal, QC H3T 1E2, Canada; (B.B.); (R.-I.I.)
| | - Joseph Cox
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.P.); (J.C.); (M.B.K.)
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 0G4, Canada
| | - Karl Weiss
- Department of Medicine, Division of Infectious Diseases and Medical Microbiology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
| | - Marina B. Klein
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.P.); (J.C.); (M.B.K.)
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Isabelle Hardy
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montréal, QC H3T 1J4, Canada; (I.H.); (M.R.)
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Lavanya Narasiah
- Direction Régionale de Santé Publique, CIUSSS Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H2L 1M3, Canada;
- Clinique des Réfugiés, CISSS Montérégie Centre, Brossard, QC J4Z 1A5, Canada
| | - Michel Roger
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montréal, QC H3T 1J4, Canada; (I.H.); (M.R.)
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.P.); (J.C.); (M.B.K.)
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Correspondence: ; Tel.: +1-514-934-1934; Fax: +1-514-843-2092
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Peless T, Chenneville T, Gabbidon K. Challenges to the conceptualization and measurement of resilience in HIV research. AIDS Care 2021; 33:1525-1533. [PMID: 33486975 DOI: 10.1080/09540121.2021.1871722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to evaluate the conceptualization and measurement of resilience in HIV research. Terms related to resilience and HIV were searched in three databases to identify peer-reviewed research articles. Of the 156 articles identified, 49 were included in the analyses. Applied thematic analysis was used to analyze the definitions and measurement of resilience. Articles were reviewed independently by two raters to establish inter-rater reliability. Six recurring themes were identified in the definitions of resilience: adaptation, positive mental health symptoms, the absence of negative mental health symptoms, hardiness, coping, and the ability to "bounce back". Among the articles examined, 14 measures were used to assess resilience, half of which were indirect. These findings help make sense of the available literature on resilience and highlight the importance of clearly operationalizing resilience and measuring it in a way that is congruent with its definition in future HIV research studies.
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Affiliation(s)
| | | | - Kemesha Gabbidon
- Department of Psychology, University of South Florida, St. Petersburg, USA
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Tariq S, Elford J, Chau C, French C, Cortina-Borja M, Brown A, Delpech V, Tookey PA. Loss to Follow-Up After Pregnancy Among Sub-Saharan Africa-Born Women Living With Human Immunodeficiency Virus in England, Wales and Northern Ireland: Results From a Large National Cohort. Sex Transm Dis 2017; 43:283-9. [PMID: 27100763 PMCID: PMC4841179 DOI: 10.1097/olq.0000000000000442] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Combining 2 national United Kingdom data sets, we found that 1 in 8 human immunodeficiency virus–positive women were lost to follow-up in the year after pregnancy. This was associated with being Sub-Saharan Africa-born and recent migration. Background Little is known about retention in human immunodeficiency virus (HIV) care in HIV-positive women after pregnancy in the United Kingdom. We explored the association between loss to follow-up (LTFU) in the year after pregnancy, maternal place of birth and duration of UK residence, in HIV-positive women in England, Wales, and Northern Ireland. Methods We analyzed combined data from 2 national data sets: the National Study of HIV in Pregnancy and Childhood; and the Survey of Prevalent HIV Infections Diagnosed, including pregnancies in 2000 to 2009 in women with diagnosed HIV. Logistic regression models were fitted with robust standard errors to estimate adjusted odds ratios (AOR). Results Overall, 902 of 7211 (12.5%) women did not access HIV care in the year after pregnancy. Factors associated with LTFU included younger age, last CD4 in pregnancy of 350 cells/μL or greater and detectable HIV viral load at the end of pregnancy (all P < 0.001). On multivariable analysis, LTFU was more likely in sub-Saharan Africa-born (SSA-born) women than white UK-born women (AOR, 2.17; 95% confidence interval, 1.50–3.14; P < 0.001). The SSA-born women who had migrated to the UK during pregnancy were 3 times more likely than white UK-born women to be lost to follow-up (AOR, 3.19; 95% confidence interval, 1.94–3.23; P < 0.001). Conclusions One in 8 HIV-positive women in England, Wales, and Northern Ireland did not return for HIV care in the year after pregnancy, with SSA-born women, especially those who migrated to the United Kingdom during pregnancy, at increased risk. Although emigration is a possible explanatory factor, disengagement from care may also play a role.
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Affiliation(s)
- Shema Tariq
- From the *School of Health Sciences, City University London; †Population and Practice Programme, UCL Institute of Child Health; and ‡Public Health England, London, United Kingdom
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