Objective: The HIV literature has largely ignored the importance of alcohol use in the quality of intimate relationships in sub-Saharan Africa (SSA), despite evidence of alcohol's role in relational ...behaviors that increase risk for HIV infection and other harms. The present study explored the association of alcohol use with relationship functioning among heterosexual couples from rural South Africa. Method: Dyadic analyses were conducted with 443 sexually active, heterosexual, South African couples (886 individuals) to examine the association between male partners' alcohol use (abstinent, nonhazardous, and hazardous), and male and female partners' reports of relationship intimacy, trust, mutually constructive communication, demand/withdraw communication, and satisfaction. Five structural equation models were fit using male partner alcohol use as a predictor of male and female reports of relationship quality. Results: Women with a hazardous-drinking male partner (compared to an abstainer) reported significantly higher levels of intimacy (p <.05) and significantly more demand/withdraw communication (p <.001); men who were hazardous drinkers reported significantly less trust in their relationship compared to men who were abstainers (p < .01). Conclusions: Hazardous alcohol use among South African couples is positively correlated with women's relationship intimacy and maladaptive communication patterns, yet negatively correlated with men's perceived trust.
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Gender-based power imbalances place women at significant risk for sexual violence, however, little research has examined this association among women living with HIV/AIDS. We performed a ...cross-sectional analysis of relationship power and sexual violence among HIV-positive women on anti-retroviral therapy in rural Uganda. Relationship power was measured using the Sexual Relationship Power Scale (SRPS), a validated measure consisting of two subscales: relationship control (RC) and decision-making dominance. We used multivariable logistic regression to test for associations between the SRPS and two dependent variables: recent forced sex and transactional sex. Higher relationship power (full SRPS) was associated with reduced odds of forced sex (AOR = 0.24; 95 % CI 0.07–0.80;
p
= 0.020). The association between higher relationship power and transactional sex was strong and in the expected direction, but not statistically significant (AOR = 0.47; 95 % CI 0.18–1.22;
p
= 0.119). Higher RC was associated with reduced odds of both forced sex (AOR = 0.18; 95 % CI 0.06–0.59;
p
< 0.01) and transactional sex (AOR = 0.38; 95 % CI 0.15–0.99;
p
= 0.048). Violence prevention interventions with HIV-positive women should consider approaches that increase women’s power in their relationships.
Abstract only
Introduction:
People living with HIV are at increased risk for cardiometabolic disorders (CMD) due to chronic inflammation, immune activation, and antiretroviral therapy. In high HIV ...prevalence areas of sub-Saharan Africa, little is known about how HIV patients and their partners understand CMD and how health services could leverage partner support.
Objective:
To explore health beliefs among HIV patients with CMD and primary partners
Methods:
We conducted a qualitative study with 25 couples recruited from 3 HIV care clinics in Zomba, Malawi. Patients managing HIV and CMD (hypertension and/or diabetes) were enrolled first, followed by their primary partners. Semi-structured interviews were conducted separately with partners to elicit health beliefs around causality, prevention, and management of CMD. Dyadic data were coded for patterns and themes within couples and between couples, and data matrices were created to compare and contrast the findings.
Results:
Most participants believed that the main causes of CMD were diet, aging, and genetics, but some believed CMD was sexually transmitted or caused by viruses such as HIV. Within couples, diet and stress were the most commonly agreed-upon cause, and over half of couples believed “thinking too much” due to stress or couple conflict was a cause of CMD. Prevention beliefs included a healthy diet, exercise, avoiding HIV, using condoms, and keeping stress levels low. Management beliefs included dietary changes, taking medication or herbs, exercising, and reducing stress. Within couples, the most agreed-upon belief was that diet, particularly salt reduction, was important for prevention and management; however, within-dyad disagreement and incorrect beliefs around other aspects of a heart-healthy diet were common.
Conclusion:
While lifestyle factors were correctly identified as important for prevention and management of CMD, misconceptions remained around transmission through a virus or sex. Partners often differed in their views of CMD, which could interfere with CMD management. Health education programs are critically needed and involving partners may offer an opportunity to solidify knowledge in couples and foster collaborative disease management around CMD.
In 2006, the Centers for Disease Control and Prevention (CDC) released revised recommendations for performing human immunodeficiency virus (HIV) testing in health care settings, including ...implementing routine rapid HIV screening, the use of an integrated opt‐out consent, and limited prevention counseling. Emergency departments (EDs) have been a primary focus of these efforts. These revised CDC recommendations were primarily based on feasibility studies and have not been evaluated through the application of rigorous research methods. This article describes the design and implementation of a large prospective controlled clinical trial to evaluate the CDC’s recommendations in an ED setting. From April 15, 2007, through April 15, 2009, a prospective quasi‐experimental equivalent time‐samples clinical trial was performed to compare the clinical effectiveness and efficiency of routine (nontargeted) opt‐out rapid HIV screening (intervention) to physician‐directed diagnostic rapid HIV testing (control) in a high‐volume urban ED. In addition, three nested observational studies were performed to evaluate the cost‐effectiveness and patient and staff acceptance of the two rapid HIV testing methods. This article describes the rationale, methodologies, and study design features of this program evaluation clinical trial. It also provides details regarding the integration of the principal clinical trial and its nested observational studies. Such ED‐based trials are rare, but serve to provide valid comparisons between testing approaches. Investigators should consider similar methodology when performing future ED‐based health services research.
Evaluations consumers apply towards the way food technologies are framed is an important overlooked domain of food communication and advertising. We explore two distinct conditions of food ...technologies—technologies that manipulate external environments (i.e., robotics) and technologies that manipulate food internally (i.e., gene editing). The current research demonstrates that food manipulated in an external environment (vs. internal manipulation) has higher purchase intent (Study 1). Further, we explore how food technologies may be framed differently in messages to influence consumers’ sense of agency. Study 2 demonstrates that food technologies that manipulate the food environment induce a higher sense of agency, whilst in contrast food technologies that manipulate food internally influence a lower sense of agency, impacting purchase intent. Study 3 explores a unique way in which sense of agency can be increased for food technologies with internal manipulations through framing the technology as agency-supportive. Investigating the impact of food technologies and how they may be framed to influence consumer psychology, and more specifically sense of agency, has rarely been explored. However, as food technologies have important upstream consequences on downstream advertising, their role on consumer psychology warrants investigation.
•The research explores technologies that manipulate external environments and technologies that manipulate food internally.•Food manipulated in an external environment (vs. internal manipulation) has higher purchase intent.•External environment manipulations induce a higher sense of agency and internal manipulations a lower sense of agency.•Purchase intent can be increased for technologies with internal manipulations through framing as agency-supportive.
risk-stratifying older people accessing urgent care is a potentially useful first step to ensuring that the most vulnerable are able to access optimal care from the start of the episode. While there ...are many risk-stratification tools reported in the literature, few have addressed the practical issues of implementation. This review sought evidence about the feasibility of risk stratification for older people with urgent care needs.
medline was searched for papers addressing risk stratification and implementation (feasibility or evaluation or clinician acceptability). All search stages were conducted by two reviewers, and selected papers were graded for quality using the CASP tool for cohort studies. Data were summarised using descriptive statistics only.
about 1872 titles of potential interest were identified, of which 1827 were excluded on title/abstract review, and a further 43 after full-text review, leaving four papers for analysis. These papers described nine tools, which took between 1 and 10 minutes to complete for most participants. No more than 52% of potentially eligible older people were actually screened using any of the tools. Little detail was reported on the clinical acceptability of the tools tested.
the existing literature indicates that commonly used risk-stratification tools are relatively quick to use, but do not cover much more than 50% of the potential population eligible for screening in practice. Additional work is required to appreciate how tools are likely to be used, by whom, and when in order to ensure that they are acceptable to urgent care teams.
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