scholarly journals Knowledge of HIV pre-exposure prophylaxis among immigrant Asian gay men living in New Zealand

2019 ◽  
Vol 11 (4) ◽  
pp. 351 ◽  
Author(s):  
Jeffery Adams ◽  
Rommel Coquilla ◽  
Jed Montayre ◽  
Stephen Neville
Keyword(s):  
Health Promotion ◽  
New Zealand ◽  
Gay Men ◽  
Individual Level ◽  
Care Services ◽  
Primary Care Services ◽  
The Individual ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis

ABSTRACT INTRODUCTIONHIV pre-exposure prophylaxis (PrEP) is a new bio-medical means of reducing the risk of HIV infection. It’s use by individuals at high risk of HIV acquisition is recommended. AimsThis study identifies the ways immigrant Asian gay men living in New Zealand talk about and understand issues related to PrEP. METHODSA qualitative descriptive methodology was used. Individual interviews were conducted with 18 immigrant Asian gay men who were not users of PrEP. Participants were aged 21 – 36 years and one-third had arrived in New Zealand within 3 years of completing the interview. Data were analysed using thematic analysis. RESULTSThree themes evident across the men’s talk in relation to pre-exposure prophylaxis were identified: ‘I’m not sure what PrEP is’; ‘PrEP is not proven’; and ‘PrEP is for others, not me’. DISCUSSIONPrEP is necessary for working towards the elimination of HIV. To improve uptake among Asian gay men, improved literacy around HIV and pre-exposure prophylaxis is required. This knowledge needs to be improved at both the individual level in primary care services and collectively through health promotion initiatives. These services and health promotion initiatives need to be provided in ways that encourage engagement by Asian gay men.

Engaging older people in healthy and active lifestyles: a systematic review

2015 ◽  
Vol 36 (10) ◽  
pp. 2036-2060 ◽  
Author(s):  
JULIA MENICHETTI ◽  
PIETRO CIPRESSO ◽  
DARIO BUSSOLIN ◽  
GUENDALINA GRAFFIGNA
Keyword(s):  
Systematic Review ◽  
Health Promotion ◽  
World Health ◽  
Active Ageing ◽  
Individual Level ◽  
Active Lifestyles ◽  
Health Organization ◽  
The Individual ◽  
Health Promotion Interventions ◽  
Older Citizens

ABSTRACTIn 2002, the World Health Organization emphasised the concept of active ageing to manage and increase the last third of life. Although many efforts have been made to optimise treatment management, less attention has been paid to health promotion initiatives. To date, few shared guidelines exist that promote an active life in healthy older targets. To fill this gap, we conducted a systematic review to map health promotion interventions that targeted an active and healthy ageing among older citizens. Articles containing the key term active ageing and seven synonyms were searched for in the electronic databases. Because we were interested in actions aimed to promote healthier lifestyles, we connected the string with the term health. A total of 3,918 titles were retrieved and 20 articles were extracted. Twelve of the 20 studies used group interventions, five interventions targeted the individual level and three interventions targeted the community level. Interventions differed for the health focus of the programmes, which ranged from physical activity interventions to social participation or cognitive functioning. Most of the studies aimed to act on psychological components. The review suggests that different interventions promoted for active ageing are effective in improving specific healthy and active lifestyles; however, no studies were concerned directly with a holistic process of citizen health engagement to improve long-term outcomes.

What's Gay about Being Single? A Qualitative Study of the Lived Experiences of Older Single Gay Men

2015 ◽  
Vol 20 (3) ◽  
pp. 48-61 ◽  
Author(s):  
Yiu Tung Suen
Keyword(s):  
Gay Men ◽  
Lived Experiences ◽  
Sociological Research ◽  
Positive Aspect ◽  
Negative Experience ◽  
Individual Level ◽  
Gay Community ◽  
The Individual ◽  
Sexual Exploration ◽  
Depth Interviews

This paper contributes to the theorization of ‘choice’ within sociological understanding of singlehood. Previous sociological research on singlehood has largely focused on the lives of heterosexual singles. A choice narrative permeates such literature, depicting singlehood as a celebratory story that brings about the potential to disrupt the couplehood culture in society. Based on in-depth interviews with 25 self-identified single gay men over the age of 50 in England, this article finds that although gay singles share similarities with straight singles, there are gay-specific features of singlehood that can be identified, in terms of the limit of ‘choice’. Although some older single gay men drew on the cultural discourse in the gay community, which decentres the conjugal couple, and claimed freedom of sexual exploration as a positive aspect of being single, there was also a strong sense that many older gay men's status of being single was shaped by a larger history, and hence, they were afforded no choice in choosing whether to be single or not. Taking these findings together, this paper suggests that there are ideological, historical and cultural factors that distinguish the lived experiences of single gay men as being different from those of heterosexual singles. This paper argues that although the discourse of ‘choice’ helps sociologists to understand that singlehood need not be understood as necessarily a negative experience, older gay men's experiences of singlehood caution that the choice narrative shall not mislead the analysis to focus singlehood merely on the individual level. Instead, singlehood needs to be understood as deeply socially and historically embedded.

Bridging Domains in Efforts to Reduce Disparities in Health and Health Care

2006 ◽  
Vol 33 (4) ◽  
pp. 440-458 ◽  
Author(s):  
Shiriki K. Kumanyika ◽  
Christiaan B. Morssink
Keyword(s):  
Health Care ◽  
Population Health ◽  
Health Care Services ◽  
Social Dynamics ◽  
Task Force ◽  
Integrated Approach ◽  
Individual Level ◽  
Advantages And Disadvantages ◽  
Care Services ◽  
The Individual

The concept of health disparities is a familiar one, but we must continually challenge our thinking on how disparities issues are framed. The 1985 Report of the Secretary’s Task Force on Black and Minority Health established a disease-oriented focus on “excess deaths” as the primary targets of disparities initiatives. However, progress in reducing disparities has been limited. The disease focus, which emphasizes the individual-level and health care services, may be too narrow. A “population health” perspective can foster a more comprehensive and integrated approach. Both disease-oriented and population health perspectives have advantages and disadvantages, for both policy and practical purposes. The challenge is to effectively leverage both approaches to improve the health of ethnic minority and other disadvantaged populations. We need bridge builders who can articulate and hear diverse perspectives, work with systems, and maintain a long-term vision for affecting the social dynamics of society

scholarly journals Addressing the Pension Decumulation Phase of Employee Retirement Planning

2020 ◽  
Author(s):  
Jorge Miguel Ventura Bravo
Keyword(s):  
Mortality Data ◽  
Term Care ◽  
Individual Level ◽  
Bequest Motives ◽  
Care Services ◽  
Life Annuity ◽  
Financial Options ◽  
Income Stream ◽  
The Individual

Longevity increases and population ageing create challenges for all societal institutions, particularly those providing retirement income, healthcare, and long-term care services. At the individual level, an obvious question is how to ensure all retirees have an adequate, secure, stable, and predictable lifelong income stream that will allow them to maintain a target standard of living for, however, long the individual lives. In this chapter, we review and discuss the main pension decumulation options by explicitly modelling consumers’ behaviour and objectives though an objective function based on utility theory accounting for consumption and bequest motives and different risk preferences. Using a Monte-Carlo simulation approach calibrated to US financial market and mortality data, our results suggest that purchasing a capped participating longevity-linked life annuity at retirement including embedded longevity and financial options that allow the annuity provider to periodically revise annuity payments if observed survivorship and portfolio outcomes deviate from expected (or guaranteed) values at contract initiation deliver superior welfare results when compared with classical annuitization and non-annuitization decumulation strategies.

High uptake of pre-exposure prophylaxis (PrEP) during early roll-out in Belgium: results from surveillance reports

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 80 ◽  
Author(s):  
Bea Vuylsteke ◽  
Thijs Reyniers ◽  
Catherine Lucet ◽  
Christiana Nöstlinger ◽  
Jessika Deblonde ◽  
...  
Keyword(s):  
Disability Insurance ◽  
Aggregated Data ◽  
Increased Risk ◽  
Event Driven ◽  
Sub Saharan ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Roll Out

Background Since 1 June 2017, oral pre-exposure prophylaxis (PrEP) could be prescribed and reimbursed in Belgium as prophylactic medication for people who are at increased risk of HIV acquisition. The aim of this study was to determine the uptake of daily and event-driven PrEP in Belgium during the first 9 months of roll-out. Methods: Routine aggregated data on the number of reimbursement requests and the number of boxes of Truvada (Gilead Sciences, Cambridge, UK) delivered for PrEP through the Belgian pharmacies were obtained from the National Institute for Health and Disability Insurance. We also collected aggregated data from seven Aids Reference Centres (ARCs) currently providing most of the PrEP care in Belgium. Results: From 1 June 2017 to 28 February 2018, 1352 requests for reimbursement were approved by the National Institute for Health and Disability Insurance. Almost 98% of those who bought at least one box of 30 tablets of emtricitabine 200mg/tenofovir disoproxil fumarate 300mg (FTC/TDF) in a Belgian pharmacy were male, and most (67%) were between 30 and 50 years of age. According to data obtained from ARCs, the proportion of those choosing event-driven PrEP initially ranged between 29% and 73%. Conclusions: The uptake of PrEP in Belgium since the start of the roll-out in June 2017 has been high, and almost entirely limited to men who have sex with men, of whom 43% initially prefer a non-daily regimen. A better understanding is needed as to why other populations, such as sub-Saharan African migrants, are not accessing PrEP, as well as the development of a more sustainable PrEP delivery model.

Early experience of implementing a national HIV pre-exposure prophylaxis service in Wales, United Kingdom 2017

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 56 ◽  
Author(s):  
Laia Fina ◽  
Amy L. Phillips ◽  
Adam T. Jones ◽  
Zoë M. Couzens ◽  
Rachel Drayton ◽  
...  
Keyword(s):  
Sexual Health ◽  
Early Experience ◽  
Hiv Positive ◽  
Transgender People ◽  
Positive Individual ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis

Background Pre-exposure prophylaxis (PrEP) was introduced in Sexual Health Services of the Welsh National Health Service (NHS Wales) in July 2017 as a 3-year pilot service. Methods: Data were collected through the pre-existing Sexual Health in Wales Surveillance System, to which codes were added to capture PrEP eligibility, outcome of offer of PrEP, reasons for declining and adherence. Eligibility categories were defined based on nationally agreed criteria: men who have sex with men (MSM) and transgender people at high risk of HIV acquisition; partners of HIV-positive individuals not known to be virally suppressed; and heterosexuals reporting condomless intercourse with a HIV-positive individual not known to be virally suppressed. Results: During the first 6 months, 516 people were eligible, 96% of which were MSM. Overall, 57% of those eligible (296/516) started PrEP. Reasons for declining PrEP were given by 88 (56%) of 157 people; 50 (57%) of whom did not believe themselves to be at risk. Of the available adherence assessments, 89% considered that all risk episodes had been covered. Persistence at 3 months was assessed for 141 people, of which 93 (66%) were still using PrEP. There were no HIV diagnoses in people taking PrEP during the first 6 months. Twenty-nine people were diagnosed with 37 episodes of sexually transmissible infections (STIs) while on PrEP. STI incidence was 105.7 per 100 person-years. Conclusions: The early trend indicates that implementation of PrEP is progressing as planned, and the service has been utilised by clients. This analysis can help refine implementation, inform planning and research around uptake, use and effect in Wales and internationally.

Missed opportunities for HIV pre-exposure prophylaxis during a rapid scale-up program at Sydney Sexual Health Centre

Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 591
Author(s):  
David Atefi ◽  
Ruthy McIver ◽  
Christopher Bourne
Keyword(s):  
Sexual Health ◽  
Medical Records ◽  
Health Centre ◽  
Scale Up ◽  
Missed Opportunities ◽  
Standard Component ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Missed Opportunity

We aimed to estimate HIV pre-exposure prophylaxis (PrEP) uptake and missed opportunities for PrEP through a retrospective review of medical records of clients at high risk of HIV attending the Sydney Sexual Health Centre. Most clients (69%) were taking PrEP, and 7% of those eligible for PrEP were classified as a missed opportunity for PrEP. Although missed opportunities were uncommon, PrEP discussions should be a standard component of care for all clients at risk of HIV acquisition.

Professional practice.

2021 ◽  
pp. 148-185
Author(s):  
James Woodall ◽  
Simon Rowlands
Keyword(s):  
Health Promotion ◽  
Ethical Issues ◽  
Evidence Based ◽  
Individual Level ◽  
Private And Public ◽  
Settings Approach ◽  
Societal Level ◽  
The Individual

Abstract This book chapter seeks to: (i) explore the role of the settings approach to health promotion and the need for organizational change; (ii) discuss the importance of evidence-based practice and evaluation; (iii) describe some of the ethical issues in practising health promotion; (iv) suggest a means of overcoming the top-down/bottom-up tensions in practice; (v) explore the need for developing partnerships between civil society, NGOs, and private and public sectors; and (vi) outline the skills and competencies of health promoters practising in the 21st century. This chapter has attempted to discuss some challenges in the practice of health promotion, ending on the challenges in terms of the skills required to do health promotion work. Some of these challenges reoccur in the next chapter, particularly when discussing capacity building for health promotion at a societal level rather than the individual level.

Professional practice.

2021 ◽  
pp. 148-185
Author(s):  
James Woodall ◽  
Simon Rowlands
Keyword(s):  
Health Promotion ◽  
Ethical Issues ◽  
Evidence Based ◽  
Individual Level ◽  
Private And Public ◽  
Settings Approach ◽  
Societal Level ◽  
The Individual

Abstract This book chapter seeks to: (i) explore the role of the settings approach to health promotion and the need for organizational change; (ii) discuss the importance of evidence-based practice and evaluation; (iii) describe some of the ethical issues in practising health promotion; (iv) suggest a means of overcoming the top-down/bottom-up tensions in practice; (v) explore the need for developing partnerships between civil society, NGOs, and private and public sectors; and (vi) outline the skills and competencies of health promoters practising in the 21st century. This chapter has attempted to discuss some challenges in the practice of health promotion, ending on the challenges in terms of the skills required to do health promotion work. Some of these challenges reoccur in the next chapter, particularly when discussing capacity building for health promotion at a societal level rather than the individual level.

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