AIDS care
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The aim of this study was to analyze the dynamics of ideology, power and language in the dominant discourses about childbearing by couples with HIV that were expressed by AIDS care professionals in Taiwan. Critical discourse analysis of the interview texts with 11 AIDS care professionals identified three prevailing discourses on childbearing by couples with HIV/AIDS: pro-children, conditional pro-choice and pro-rights. ⋯ The two discourses both medicalized childbearing among couples with HIV/AIDS by identifying medical authorities as the proper persons to decide which reproductive choices people with HIV/AIDS should make under what conditions. Even though the pro-rights discourse embodied an ideology of individualism, empowerment and autonomy, it was weak and relatively rare in the other two discourses.
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Randomized Controlled Trial Clinical Trial
Predictors of medical service utilization among individuals with co-occurring HIV infection and substance abuse disorders.
This study examined factors affecting medical service use among HIV-infected persons with a substance abuse disorder. The sample comprised 190 participants enrolled in a randomized trial of a case management intervention. Participants were interviewed about their backgrounds, housing status, income, alcohol and drug use problems, health status and depressive symptoms at study entry. ⋯ Homelessness was associated with higher utilization of emergency department and inpatient services; drug use severity was associated with higher inpatient and ambulatory care service use; and alcohol use severity was associated with greater use of emergency medical services. Homelessness and substance abuse exacerbate the health care needs of HIV-infected persons and result in increased use of emergency department and inpatient services. Interventions are needed that target HIV-infected persons with substance abuse disorders, particularly those that increase entry and retention in outpatient health care and thus decrease reliance on acute hospital-based services.
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This qualitative study of young people and health care workers in Adjumani, northern Uganda, found that young people are generally very knowledgeable about STD spread and prevention as well as methods for prevention of pregnancy. Health workers are the most important category of people providing information on sexual and reproductive health (SRH) for young people. However, many health workers are conservative with regard to adolescent sexuality. ⋯ In an effort to find alternative services that meet their needs better, young people visit informal and traditional health care providers despite having to pay for these services. The confidentiality and privacy that they offer could be a lesson for formal health care providers. Further training and integration of traditional health care providers is essential as they already play a major part in SRH service delivery to young people.
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Multicenter Study
Factors influencing intent to get pregnant in HIV-infected women living in the southern USA.
This descriptive study sought to identify factors that influence HIV-infected women's intent to get pregnant. Interviews were conducted with a convenience sample of n = 322 HIV-infected women at risk for pregnancy. Participants were predominantly African-American (84.4%), single (57.9%), and ranged in age from 17 to 48 years. ⋯ Following a model selection procedure, motivation for child bearing (OR = 16.05, 95% CI 7.95, 30.41) and traditional sex roles (OR = 4.49, 95% CI 1.44, 13.55) were significantly associated with greater intent to get pregnant. Traditional gender role orientation and motivation for childbearing are significant factors in predicting intent to get pregnant among HIV-infected women. These factors, as well as other non HIV-related factors, need to be routinely assessed by health care providers in developing plans of care for HIV-infected women.
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Twenty-five gay and three bisexual males with AIDS (PWAs) rated their needs for four different kinds of emotional support (expressing love and concern, expressing encouragement and positive feedback, serving as a confidant, and providing a philosophical or spiritual perspective) from five different support providers (parents, partners, friends, HIV-positive friends and physicians). Findings support the importance of emotional support for this population. ⋯ Participants also rated their needs from physicians highly for each category of emotional support. Noticeably low was the need for providers to offer philosophical or spiritual perspectives.