scholarly journals PrEP discontinuation among Latino/a and Black MSM and transgender women: A need for PrEP support services

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241340
Author(s):  
Omar Nieto ◽  
Ronald A. Brooks ◽  
Amanda Landrian ◽  
Alejandra Cabral ◽  
Anne E. Fehrenbacher
Keyword(s):  
Los Angeles ◽  
Hiv Risk ◽  
Support Services ◽  
Text Messaging ◽  
Transgender Women ◽  
Medical Systems ◽  
Structured Interviews ◽  
Latino Men ◽  
Additional Support ◽  
Hiv Sexual Risk Behaviors

Purpose Disparities persist in HIV infection among Black and Latino men who have sex with men (BLMSM) and Black and Latina transgender women (BLTW). Increasing uptake and subsequent consistent use of pre-exposure prophylaxis (PrEP), an effective biomedical strategy for preventing HIV acquisition, can dramatically reduce HIV incidence in these populations. The purpose of this study was to explore reasons for PrEP discontinuation among BLMSM and BLTW living in Los Angeles County to inform the development of support services for these populations to remain persistent with their PrEP regimen. Methods In-depth, semi-structured interviews were conducted with 15 BLMSM and 7 BLTW who reported either temporary or indefinite PrEP discontinuation. A thematic analysis approach was used to analyze qualitative data. Results Four themes emerged related to reasons for PrEP discontinuation, including: (1) lower perceived HIV risk related to changes in sexual behavior; (2) structural or logistical barriers (e.g., lapse or loss of health insurance, cost, difficulty navigating complex medical systems); (3) anticipated and experienced medication side effects, with a sub-theme of interactions between PrEP and feminizing hormone medications; and (4) challenges with medication adherence. Conclusions PrEP is an important prevention tool for BLMSM and BLTW, particularly during periods of heightened HIV risk. However, both individual (e.g., inability to adhere to medication, changes in HIV sexual risk behaviors) and structural/logistical (e.g., loss of insurance, navigating complex medical systems) factors can cause temporary or indefinite PrEP discontinuation. Additional support services, beyond those offered by medical providers, are needed to help BLMSM and BLTW PrEP users overcome barriers to discontinuation and assist them to remain persistent with their PrEP regimen. We describe potential options for support services such as PrEP case management, expanded PrEP navigation services, or text messaging services.

Strategies for Improving Mobile Technology–Based HIV Prevention Interventions With Latino Men Who Have Sex With Men and Latina Transgender Women

2019 ◽  
Vol 31 (5) ◽  
pp. 407-420 ◽  
Author(s):  
Sarah MacCarthy ◽  
Joanna L. Barreras ◽  
Alexandra Mendoza-Graf ◽  
Frank Galvan ◽  
Sebastian Linnemayr
Keyword(s):  
Los Angeles ◽  
Hiv Prevention ◽  
Mobile Technology ◽  
Rapid Assessment ◽  
Transgender Women ◽  
Lessons Learned ◽  
Assessment Process ◽  
Latino Men ◽  
Prevention Interventions ◽  
Sex With Men

Mobile technology–based interventions show promise for conveying HIV prevention information to Latino men who have sex with men (LMSM) and Latina transgender women (LTGW); however, implementing such interventions can pose serious challenges. To understand how to adapt existing interventions for these populations, we conducted nine focus groups (N = 91 participants, 52 LMSM, 39 LTGW) in Los Angeles, California. We used a rapid assessment process to create narrative reports that we examined using thematic analysis to explore differences across sites and between LMSM and LTGW. Lessons learned: requiring smartphone use could diminish participation of poor participants; sending personalized messages on the same days and times can help participants anticipate receiving study information; working with community partners is essential for building trust; recognizing different language literacies and diverse countries of origin can improve the cultural competency of intervention materials. Addressing these challenges may enhance efforts to address the HIV prevention needs of these communities.

scholarly journals Housing Status and HIV Risk Behaviors Among Transgender Women in Los Angeles

2014 ◽  
Vol 43 (8) ◽  
pp. 1651-1661 ◽  
Author(s):  
Jesse B. Fletcher ◽  
Kimberly A. Kisler ◽  
Cathy J. Reback
Keyword(s):  
Los Angeles ◽  
Risk Behaviors ◽  
Hiv Risk ◽  
Hiv Risk Behaviors ◽  
Transgender Women ◽  
Housing Status

scholarly journals Drinking Patterns and HIV Risk Behaviors Among Black and Latino Men Who Have Sex Within Los Angeles County

2015 ◽  
Vol 11 (4) ◽  
pp. 834-844 ◽  
Author(s):  
Thomas A. Washington ◽  
Shivan N. Patel ◽  
Nancy Meyer-Adams
Keyword(s):  
Los Angeles ◽  
Hiv Risk ◽  
Los Angeles County ◽  
The United States ◽  
Drinking Patterns ◽  
Exact Tests ◽  
Latino Men ◽  
Insertive Anal Intercourse ◽  
Sex With Men ◽  
Black And Latino

Alcohol, the most widely used substance among men who have sex with men (85%), remains an important factor in HIV research among this high-risk population. However, research on alcohol use among Black and Latino men who have sex with men (BLMSM), a population disproportionately affected by HIV in the United States, is limited and inconclusive. This study explored sociodemographic and HIV risk with daily heavy and low-risk drinking patterns among BLMSM. BLMSM ( N = 188) aged 18 to 40 years were recruited through social media, local colleges, heteronormative clubs, private men’s groups, gay establishments, and organized events in Los Angeles County. Participants completed self-administered questionnaires. Fisher’s exact tests revealed significant relationships between drinking patterns and condomless insertive anal intercourse ( p = .001), race ( p < .001), age ( p = .02), and perception of alcohol-related HIV risk ( p = .007). The Fisher’s exact tests findings for age held true in the multiple regression model ( p = .014). Findings suggest that BLMSM who engage in higher risk drinking also engage in alcohol-related HIV risk. Culturally competent interventions should consider including a combined focus to explore the synergy between risky drinking patterns and HIV risk among BLMSM.

Listening to Bedouin fathers of children with autism spectrum disorder

2018 ◽  
Vol 56 (2) ◽  
pp. 345-358 ◽  
Author(s):  
Iris Manor-Binyamini
Keyword(s):  
Autism Spectrum Disorder ◽  
Support Services ◽  
Cultural Context ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Structured Interviews ◽  
Raising Children ◽  
Cultural Perspectives ◽  
Children With Asd

Although children across the world experience autism spectrum disorder (ASD), most research on ASD has been conducted using Western cultural perspectives and has focused primarily on mothers, leaving significant gaps in the literature. This study aimed to address these gaps by exploring the experiences of fathers raising children with ASD in a Bedouin community. To this end, a sample of 19 fathers of children (aged 6–15 years) with ASD living in recognized and unrecognized Bedouin settlements in the Negev participated in ethnographic, semi-structured interviews designed to investigate their experiences with raising a child with ASD in their community. Two major themes emerged: the challenges that Bedouin fathers of children with ASD face, and the influence of socio-demographic and cultural characteristics on their experience. Findings reflect the complex experiences of fathers raising children with ASD in the Bedouin community, stemming from their socio-cultural context and the limited knowledge and support services that are available in the community for these children. This article concludes with recommendations on how to enhance professional sensitivity and provide more culturally tailored services for parents of children with ASD.

scholarly journals Administrative Work and Job Role Beliefs in Primary Care Physicians: An Analysis of Semi-Structured Interviews

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401989909
Author(s):  
Eric Apaydin
Keyword(s):  
Primary Care ◽  
Los Angeles ◽  
Primary Care Physicians ◽  
Theory Approach ◽  
Structured Interviews ◽  
Job Roles ◽  
Face To Face ◽  
Administrative Work ◽  
Job Role ◽  
The Relationship

Primary care physicians face increasing amounts of administrative work (e.g., entering notes into electronic health records, managing insurance issues, delivering test results, etc.) outside of face-to-face patient visits. The objective of this study is to qualitatively describe the experience that primary care physicians have with administrative work, with an emphasis on their beliefs about their job role. I conducted semi-structured interviews with 28 family physicians and internists in Chicago, Los Angeles, and Miami and qualitatively analyzed themes from interview transcripts using the grounded theory approach. Two major themes concerning the relationship between primary care physicians and administrative work were discovered: (a) Administrative work was not central to primary care physicians’ job role beliefs, and (b) “below license” work should be delegated to nonphysicians. Job roles should be considered in future efforts to reduce physician administrative work in primary care.

Formative research to underpin a text messaging home safety intervention for young mothers

2018 ◽  
Vol 78 (3) ◽  
pp. 266-272 ◽  
Author(s):  
Michael J Mello ◽  
Zoe Gilbard ◽  
Dina Burstein ◽  
Janette Baird ◽  
Mark R Zonfrillo ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Text Messaging ◽  
Unintentional Injury ◽  
Structured Interview ◽  
Health Clinic ◽  
Young Mothers ◽  
Home Safety ◽  
Structured Interviews ◽  
Safe Sleep ◽  
Mhealth Intervention

Objective: Unintentional injury is the leading cause of death for infants and young children in the USA, and the children of young mothers are at an even higher risk. Mobile health (mHealth) interventions have been successful in promoting behaviour change for many health conditions. This study assessed interest in mSafety, a text and video messaging mHealth intervention targeting injury prevention knowledge, behaviour and self-efficacy in young mothers. Design: Interviews with young mothers were conducted using a semi-structured interview guide. Setting: Interviews took place at a health clinic for teenage mothers and their children and at a local public charter high school which serves pregnant teenagers and young mothers. Method: A trained research assistant conducted semi-structured interviews with 20 young mothers (ages 15–20). Participants were asked both closed and open-ended questions to elicit opinions about their willingness to utilise mSafety. Results: The results of the interviews were positive. Participants were most interested in learning about the prevention of falls and poisonings, as well as safe sleep. Many emphasised that the language of the messages should be simple and that videos could be included to demonstrate methods of injury prevention. Most interviewees were willing to participate in a ‘virtual home safety visit’ in which participants text home photos to an expert to evaluate home safety practices. Conclusion: The concept of an mHealth intervention that would provide young mothers with the tools to prevent injuries among their children received positive feedback.

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