Desktop.docx · Web viewAnn Bagchi, William Holzemer Miguel Martinez Rutgers University, Newark, NJ, USA Background: As of December 2012, 36,648 persons were living with HIV/AIDS

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Agreement between Medical Record Data and Self-Reported CD4 Counts, Viral Loads and Medication Knowledge

Joachim Voss 1 Annushka Cesan1

Kristie Eilers2

Shauna Applin2

1University of Washington, Seattle, USA2Community Health Care, Tacoma, USA

Background: For people living with HIV (PLWH), we expect them to see their providers routinely every quarter to check the laboratory values, explain those results to our clients and discuss any problems with taking antiretroviral treatment regimens (ART). While regimens have become so much easier to take, we really do not know how well those improvements have translated into a better understanding of patient knowledge.

Purpose: We wanted to determine whether a community sample of men and women with HIV were able to accurately self-report their most recent CD4 count, viral load, and ART regimen, and whether demographic differences such as age and gender influenced self-reporting. Methods: We collected data from (N=200) PLWH and asked them to recall their last CD4 count, their last viral load, and identify their medication regimen with a medication sheet that listed the generic and trade name. The data was collected in a large primary HIV clinic and a community clinic in the North West between May and July of 2010.

Findings: We found moderate agreement between self-report and medical record data for CD4 count (k=.58, p<.001), and viral load (k=.43, p<.001), but only 43% were able to recall their ART regimens accurately. For PLWH ≥ age 50 (k=.77, p<.001), and those with health insurance coverage (k=.61, p<.001) were more accurate to self-report CD4. Women were more accurate in reporting viral load than men (k=.53, p=.003 vs. k=.38, p<.001).

Conclusions: Even with the vast improvements of patient monitoring and treatment modalities, half of our patients only partially understand the information we are trying to convey to them.

Implications for Practice: As HIV patients live longer with the disease, PLWH need multiple modalities of education (for example, visual aids, teach-back method, video) to relate CD4 counts, viral load, and ART regimens to their personal health understanding and to be meaningful to them.

Objectives: The learner will be able to:

Discuss the importance of self-report in relationship to medication regimens and HIV illness indictors;

Understand the relevance of Kappa statistics.

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Home-based Navigator Services for PLWH and Other Chronic Conditions

Jacquelyn Slomka1

Allison Webel1Maryjo Prince-Paul1

Thomas Quinn2

Barbara Daly1

1Case Western Reserve School of Nursing, Cleveland, Ohio, USA2Hospice of the Western Reserve, Cleveland, Ohio, USA

Background: As persons living with HIV (PLWH) survive into older adulthood, they are at risk for chronic conditions in addition to HIV. Comprehensive palliative care services to provide physical, psychosocial and spiritual care, symptom management, advance care planning, and improvement in overall quality of life are needed. Models of palliative care that exist for PLWH are often institution-based. Our program was developed to provide home-based palliative care services and health care system navigation for high-risk PLWH.

Purpose: This presentation provides an overview of an HIV Navigator Program, developed to test the provision of palliative services and health system navigation in addition to standard health care for PLWH and other chronic conditions.

Methods/Practice: In partnership with and modeled after a community-based palliative care navigation project, a program was developed to address specific health, psychosocial and spiritual needs of PLWH and other chronic conditions. Home-based palliative care assessment, services and assistance in navigating complexities of the health care system are provided by an Advanced Practice Nurse, a Licensed Social Worker and trained volunteers. Measurable program outcomes over a 36-month period include quality of life, symptom burden, coping ability, and advance care planning.

Conclusions: Specific and unique needs of high-risk PLWH can be addressed through palliative care navigation programs, but evaluation of different models is needed.

Implications for Practice: Attention to palliative care needs of PLWH and other chronic conditions is essential because of the increasing prevalence of HIV, the rise in chronic diseases, and the aging of the population of PLWH.


Describe background and implementation of an HIV Navigation Program for early palliative care; Discuss challenges in developing and implementing an HIV Navigation program.

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Beyond KS, Importance of Nursing Assessment in KSHV-associated Malignancies and Syndromes

Kathleen WyvillKaren Aleman

Robert Yarchoan Mark Polizzotto Thomas Uldrick

HIV and AIDS Malignancy Branch, CCR, NCI, Bethesda, MD, USA

Background: As people with HIV/AIDS live longer, malignancies are an increasingly important cause of mortality.

Purpose: Increase awareness of KSHV-related syndromes and malignancies in HIV and Infectious diseases practices

Methods/Practice: Kaposi’s sarcoma associated herpesvirus (KSHV) causes not only Kaposi’s sarcoma (KS), but also KSHV-multicentric Castleman’s disease (MCD), primary effusions lymphoma (PEL) and the more recently described KSHV inflammatory cytokine syndrome (KICS), which can accompany KS or PEL. Our research team studies KSHV-related syndromes and malignancies. Many patients we assess come to us critically ill as diagnosis was delayed or missed. Patients with KSHV-MCD or KICS may present with systemic inflammatory symptoms including fevers, cachexia, and laboratory abnormalities including cytopenias, hypoalbuminemia, hyponatremia, and elevated C-reactive protein. By recognizing the signs and symptoms earlier, in primary care practices, emergency rooms and intensive care units, nurses can help identify patients who may need further assessment and potentially treatment for these diseases.

Conclusions: Although our goal is an AIDS-free generation, until there is a cure for AIDS, existing generations of HIV infected people are living longer, and cancer, including KS and PEL, will remain an important health care issue for HIV-infected patients.

Implications for Practice: Careful nursing assessment of HIV positive patients with inflammatory symptoms is critical to successful outcomes. Specialized multidisciplinary care is required.


Identify the signs and symptoms of KSHV-MCD, PEL and KICS; Describe treatments and supportive care measures for MCD, PEL.

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HIV-Related Sexual Risk Behaviors Among Older Urban African American Women

Tanyka Smith

Columbia University, New York, NY, USA

Background: In the Northeastern United States, older African American women are disproportionately affected by HIV as they constitute the fastest growing group newly infected with the disease. Sexual risk and protective behaviors may be influenced by individual factors, including attitudes, perceptions, beliefs and socio-cultural and contextual factors. However, there is limited research on sexual risk behaviors and effective HIV prevention strategies that are tailored to the needs of older African American women.

Purpose: The purpose of this study was to examine the relationship among HIV-related behavioral beliefs, normative beliefs, control beliefs and gender power and examine how such relationships influence condom use intentions and consistent condom use behavior among older urban African American women.

Methods: A convenience sample of 175 older African American women, age 50 to 85, were recruited from low income neighborhoods in New York City. Participants were recruited from places where older African American women typically assemble including hair salons, senior/community centers, food markets, and community health centers. Data were collected via self-administered paper-and-pencil questionnaires.

Results: The logistic regression model revealed several significant predictors of condom use intentions, including: condom negotiation efficacy (OR = 1.4, p = < .01), perceived HIV risk (OR = 1.1, p < .05), perception of main partners' beliefs (OR = 1.7, p < .01), alcohol use (OR = .69, p < .05) and marital status (OR = .16, p < .05). Findings also indicated that consistent condom use was associated with perception of HIV risk (OR = 1.2, p < .01), perceived social support (OR = 1.2, p = .04), condom use self-efficacy (OR = 1.1, p < .01) and sexual relationship power (OR = 1.2, p = .05).

Conclusion: The results of this study suggest that older African American women engage in high risk sexual practices and are vulnerable to HIV. This study provides a basis for future culturally relevant HIV prevention interventions for this population.

Implications: Nurses and other health care providers are in a prime position to assess the HIV sexual risk practices of older African American women and provide appropriate risk reduction education and condom negotiation training.


Identify the theoretically-based individual and the socio-cultural factors influencing the HIV sexual risk and protective behaviors among older urban African American women;

Describe effective nursing strategies to promote consistent condom use that are culturally-specific and age-appropriate to reduce the risk of HIV in this vulnerable population.

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American Dream and HIV: HIV+ Asian Immigrants' Self-Actualization

Wei-Ti Chen

Yale University, NY, USA

Background: Asians and Pacific Islanders (APIs) are among the fastest growing minority groups in the United States. This population growth has been accompanied by a notable increase in HIV incidence. APIs are the only racial/ethnic group to show a significant increase in HIV diagnosis rate between 2001 and 2008. Despite these increasing numbers, in HIV-related studies, data are seldom collected specifically on APIs. The availability of data on HIV among API Americans are especially limited and little is known about the immigrants' acculturation, self-actualization, their "American Dreams", quality of life, perceived stress, and self-management among HIV-positive API Americans.

Purpose: In this study, we explored how acculturation, self-actualization and perceived stress affect depression symptomatology in the HIV-positive API population.

Methods: A mixed-methods study was conducted between January to June of 2013. Thirty in-depth interviews were conducted with HIV-positive API in San Francisco (n = 16) and New York (n = 14). Additionally, cross-sectional audio computer-assisted self-interviews (ACASI) were conducted with a convenience sample of 50 HIV-positive API (29 in SF and 21 in NY).

Conclusion: Three major themes were extracted from the in-depth interviews: self-actualization, acculturation stress, and depression. Then, a moderated mediation analysis for the relationship among acculturation, self-actualization and perceived stress was deployed. For those who are highly acculturated to the US, perceived stress was not related to depression symptomatology. For those who had low and moderate acculturation, stress significantly mediated depression symptomatology. In addition, among those who had low acculturation, there is a significance in depression symptomatology scores between those who totally lost their self-actualization and who still believe they can still make the dreams come true (p = .02). For those who had the high acculturation, their HIV is not significantly related to the self-actualization.

Implications for Practice: This study found that acculturation levels influenced perceived stress and depression in the HIV-positive Asian immigrant population. Lower acculturated Asian Americans suffered to achieve less self-actualization. Future interventions should focus on enhancing acculturation and reducing perceived stress, which may prompt harmful coping behaviors, such as high-risk sex and substance abuse, to decrease depression, then, achieve their American Dreams.


Understand the perceived stress in Asian & Pacific Islanders' HIV+ population; Know the self-actualization in Asian & Pacific Islanders' HIV+ population; Be aware that enhancing the acculturation in HIV+ API immigrants is very important to decrease

perceived stress, increasing coping strategies and later, achieve their American Dreams.

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"Is Your Man Stepping Out?” An Online Pilot Study to Evaluate Facebook Advertising and Retention using Smartphones to Deliver HIV Prevention

Videos to African American Young Adult Women

Rachel Jones Lorraine Lacroix

Northeastern University, Boston, MA, USA

Background: Love, Sex, and Choices (LSC) is a popular online 12-episode soap opera video series to reduce HIV risk in young urban African American women. A video guide commentator was added to LSC to direct focus to critical themes.

Purpose: An online pilot study was conducted to evaluate: 1) acceptability of the new guide enhanced LSC, and feasibility of, 1) Facebook (FB) advertising, 2) completing an online screening interview, 3) inclusion of high risk 18-29 year old women, 4) consenting, 5) verifying eligibility, 6) streaming LSC to smartphones, and, 7) retention at 30 days.

Methods: FB ads targeted zip codes in high HIV incidence areas. Ads ran for 30 days on FB users’ smartphones or computers. Clicking the ad led to the study FB page and website to consent and screen. If high risk, participants watched LSC and completed a follow-up interview at 30 days. Viewing times and ad clicks were tracked.

Results: FB ads appeared in newsfeeds of 383,873 FB users. Of 6,537 clicks, most (n=5,393, 82.5%) were mobile users; 230 screened. 84 were high risk, 40 watched LSC. 39 completed follow-up. Most (n=23, 57.5%) were African American/Black. Mean age= 23. Some (n=17, 43%) had privacy concerns when clicking the FB ad, but all 40 felt the survey was confidential on the study website. At baseline, 40 reported unprotected sex with high-risk partners during the past 90-days, compared to 7 at 30 days post-intervention. 17 (43.6%) were HIV tested. 37 related to the video characters. 38 felt the guide emphasized important messages. High performing ads featured, “Is your man stepping out?” The cost per completer was $37.74.

Conclusions/Implications: The Guide was highly evaluated. Online recruitment/ retention of at-risk mostly African American young urban women over a large geographic area suggested wider reach than traditional recruitment. A low percent clicked the ad and completed (0.61%), but recruitment of high risk women at 10/week compared favorably to 7 /week in previous field recruitment and nearly all were retained. Field recruitment is more targeted. Online takes less time, may be less costly, with higher geographical reach. A substantial number went for HIV testing.


Describe ways to reach a target population with engaging Facebook advertisements to recruit into an online HIV prevention study;

Describe considerations to obtain online consent, verify, track, and retain participants in an online study;

Describe how mobile devices were utilized to receive FB ads and to deliver a video intervention and facilitate retention;

Describe rationale for an epilogue by a video guide commentator to emphasize key messages in entertainment-education.

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Waiving Parental Consent: Panacea for Gaps in Adolescent LGBT HIV Prevention Research?

D. Dennis Flores1

Joyell Arscott 1 Julie Barroso2

1Duke University, Durham NC, USA 2University of Miami, Miami, FL, USA

Background: Most research on HIV prevention for young gay, lesbian, bisexual and transgender (LGBT) individuals rely on retrospective designs due to the perceived difficulty of conducting cross-sectional studies with self-identifying LGBT adolescents. Since retrospective studies do not capture issues as they occur, sexual health research when LGBT youth are navigating both puberty and sexual identity formation is sparse. Obtaining a waiver of parental consent is necessary because seeking parental permission to join sexuality-focused studies may signal to parents that their children are not heterosexual.

Purpose: This report will detail how obtaining a waiver of parental consent is possible to enable the participation of LGBT youth in meaningful research.

Methods: The IRB application included detailed arguments about how studies that waived parental consent have been successfully conducted in peer institutions, how research findings produced significant and rich results, how LGBT youth are autonomous and capable of providing informed consent similar to their heterosexual peers, and how excluding this complex population from research violates the principles of beneficence, justice and respect for persons. Other elements included in the waiver request was a list of studies that effectively recruited LGBT participants under the age of 18, institutional support letters from bioethicists and child advocacy experts, and anticipated human subjects protection concerns and how they would be addressed.

Conclusions: The waiver of parental consent was granted by the full IRB after months of deliberation. In order to improve HIV prevention efforts and the sexual health outcomes of LGBT youth, this population must be allowed to participate in real time studies about their own health.

Implications for Practice: To properly safeguard self-identifying LGBT youth and to encourage research informed by their current social milieu, waivers of parental consent may be necessary. From our experience, these waivers can be a design feature that will assuage LGBT youths’ concerns about participating in research about them.


Describe how to obtain a Waiver of Parental Consent from the IRB; Enumerate the reasons why Waivers of Parental Consent may be necessary in HIV prevention

research.

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Anal Cancer Screening and Follow Up in HIV-Infected Individuals

Jessica Holmes,Marcia HolstadDeborah Bruner

Emory University, Atlanta, GA, USA

Background: HIV-infected individuals are 28 times more likely to be diagnosed with anal cancer than the general population. Screening and the timely treatment and proper follow up of anal precancerous lesions is suspected to prevent anal cancer.

Purpose: To examine rates of anal Pap screening and follow up rates after an abnormal anal Pap test in a sample of HIV-infected individuals.

Methods/Practice: This pilot study used a retrospective descriptive design to review randomly selected medical records of male patients seen at a large comprehensive HIV clinic and enrolled in its Infectious Disease Program (IDP). This chart review also used a random selection of female participants from a list of unlinked medical record numbers from the closed KHARMA study that recruited HIV-infected women also enrolled in the IDP. Data analyses included Pearson's or Spearman Rho correlations, Chi-square tests, and independent sample t-tests.

Results: 175 charts were abstracted (female, n=100; male, n=75). 72% of the sample did not have a documented anal Pap test (n=126). Of the individuals with a history of an anal Pap, 19% (n= 30) had a documented abnormal anal Pap and of that sample, 16% (n=28) were recommended for anoscopy. 57% (n=16) did not have a documented follow-up anoscopy. Gender (r=-.415, p=.000), sexual orientation (r=.434, p=.000), and CD4 count (r=-.173, p=.000) were significantly correlated to receiving an anal Pap test. Sexual orientation was related to receipt of anoscopy (r=.300, p=.000). Women were less likely to receive an anal Pap (Chi square= 29.6, p=.000), men who have sex with men (MSM) received anal Pap tests at a higher rate (Chi square= 30.352, p=.000), and individuals who did receive an anal Pap had a lower mean CD4 count (t-test= 3.506, p=.02). MSMs were more likely to follow up with anoscopy (Chi square= 14.31, p=.001).

Conclusions: Anal cancer screening is performed at very low rates in this sample and there is a significant break down in follow up with anoscopy after an abnormal anal Pap test.

Implications: Improved screening for anal cancer and follow up in individuals infected with HIV are needed for a successful cancer prevention plan.


Identify the gaps in anal cancer screening and follow up care; Identify what groups are more likely or less likely to be screened for anal cancer or receive follow

up care.

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Effects of Stigma Reduction Workshops in a New Jersey-Based HIV Clinic: A Pilot Study

Ann Bagchi,William HolzemerMiguel Martinez

Rutgers University, Newark, NJ, USA

Background: As of December 2012, 36,648 persons were living with HIV/AIDS in New Jersey, 16% of whom were living in Newark. Stigma remains a significant barrier to HIV testing and treatment. Although many interventions have been designed to address stigma in HIV affected populations, few have used a randomized control trial (RCT) and standardized stigma scale to assess effectiveness.

Purpose: The purpose of this pilot study was to test the effectiveness of a series of stigma reduction workshops within a population at the epicenter of New Jersey's HIV epidemic. The specific goals were to test the format and procedures of the workshops and test for changes in stigma perceptions using the Berger Stigma Scale.

Methods: We held four 3-hour workshops with clients and staff of an HIV clinic in Newark. Before the start of the first session, participants completed baseline questionnaires, which included the Berger scale. Workshop activities included discussions, card storming, and small group work designed to raise awareness of different types of stigma, their outcomes, and interventions to address them. During the final session, participants designed a stigma reduction intervention that they would implement in the community and assigned roles. They then completed the same set of questionnaires as at the study's baseline.

Conclusions: Among participants (n=13), the Berger Stigma Scale decreased by approximately one third of a standard deviation. At the individual item level, about 58% of the items indicated an improvement in stigma perception; 18% of these changes were statistically significant. All participants qualitatively evaluated all aspects of the workshop favorably. Among staff, the intervention allayed fears of potential contraction of HIV while providing services and reduced the reported frequency of differential treatment of, and negative discussion about, clients living with HIV.

Implications for Practice: Results of this study suggest that the intervention was successful in reducing HIV-related stigma among participants. If so, wider implementation of the workshops could help to address stigma and encourage HIV testing and treatment within the highest risk communities. The next phase of the study will be to test the intervention in HIV clinics throughout the state using a RCT design.


Learn about standardized tools for assessing HIV-related stigma; Understand how these tools can be applied in RCT studies; Understand the importance of using standardized tools across research studies to build the

evidence base on interventions' effectiveness.

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HIV Nurses' Knowledge of HIV-Related Criminal Laws

J. Craig PhillipsJean-Laurent Domingue

University of Ottawa, Faculty of Health Sciences, School of Nursing, Ottawa, Ontario, Canada

Background: Health care delivery systems in North America (Canada and the United States) are transforming to facilitate realization of the right to health for all. HIV-related criminal laws in some jurisdictions will hamper population health efforts to manage HIV.

Purpose: The purpose of this study was to survey nurses in HIV care about their knowledge of HIV-related criminal laws.

Methods: An online survey was administered to nurses in HIV care. Ecosocial theory guided survey development. Content experts reviewed the survey to assure content validity.

Results: The survey website was accessed by a total of 230 nurses in HIV care and 174 of them completed the survey from Canada (n = 23) and the United States (n = 151). Knowledge of HIV-related criminal laws varied widely, with 55 nurses (32%) reporting no knowledge of laws related to HIV exposure/transmission. Nearly two-thirds of respondents (n = 110; 63.2%) did not know if there were HIV-related criminal laws for non-sexual exposure or transmission (e.g., injectable drug use). Despite this knowledge gap, nurses in HIV care are open to discuss concerns about HIV-related criminal laws and how these laws affect clinical practices and the patient-provider relationship. Self-study and Internet-based training were the most preferred knowledge acquisition mediums.

Conclusions: Nurses must increase knowledge of HIV-related criminal laws to reduce stigma and discrimination experienced by people living with HIV. The success of public health and medical interventions to manage HIV require understanding how HIV-related criminal laws influence patient care delivery. Nurses specialized in HIV care will be a tremendous resource for other nurses as efforts continue to expand health care access.

Implications for Practice: Transitioning to the Patient Protection and Affordable Care Act means more persons living with or at-risk of acquiring HIV will access care from providers who may not be aware of the complex medical and social challenges to managing HIV-disease, including HIV-related criminal laws. This influx of patients may create the perfect storm of confusion for nurses who may be unprepared to navigate the conflicting ethical, legal, and professional considerations governing clinical practices.


Describe trends in HIV nurses’ knowledge of HIV-related criminal laws across North America; Discuss nurses’ preferences for acquiring new knowledge about HIV-related criminal laws; Identify strategies to engage nurses in a dialogue about HIV-related criminal laws.

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Knowledge and Psychosocial Wellbeing of Nurses Caring for People Living with HIV/AIDS (PLWH)

Lufuno Makhado Mashudu Davhana-Maselesele

North West University - Mafikeng Campus, Mafikeng, North West Province, South Africa

Background: The challenges of caring for people living with HIV (PLWH) in a low-resource setting has had a negative impact on the nursing profession, resulting in a shortage of skilled nurses

Purpose: To describes the state of nurses' knowledge of HIV and their psycho-social well-being as care givers of PLWH at a regional hospital in Limpopo Province in order to make recommendations for support to nurses caring for PLWH.

Methods/Practice: a cross sectional descriptive study was conducted. A total of 233 nurses, the majority being female, participated and were stratified into professional nurses (n=108), enrolled nurses (n=58) and enrolled nursing auxiliaries (n=66). Data were collected using HIV/AIDS knowledge questionnaire, Maslach Burnout Inventory; AIDS Impact Scale and Beck's Depression Inventory. The total score obtained by all the participants ranged from 2 to 16, with an average of 12.93 (SD=1.92) on HIV/AIDS knowledge. Depersonalization (D) (83.7%) and emotional exhaustion (EE) (53.2%) were reported among participating nurses caring for PLWH. Burnout was higher among professional nurses as compared to both enrolled nurses and enrolled nursing auxiliaries. There was a moderate negative significant association between HIV knowledge with the nurses' emotional exhaustion (r=-0.592), depression (r=-0.584) and stigma and discrimination (r=-0.637). A moderate to high level of burnout was evident among all levels of nurses.

Conclusions: For nurses to be well capacitated and supported in their care-giving role, nursing education with regard to HIV&AIDS still needs an improved approach.

Implications for Practice: The provision of nursing educational and organizational support mechanisms has the potential to create a positive practice environment for nurses in South Africa in general and the Vhembe District of the Limpopo Province in particular, resulting in improved care for PLWH.


Demonstrate understanding of knowledge and psychosocial wellbeing of nurses caring for PLWH; Have gained understanding of available support systems for nurses caring for PLWH.

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A Systematic Review of mHealth Interventions for HIV Self-Management for African American Women Living with HIV

Kimberly Adams Tufts1

Juyoung Lee2

Muna Ajzoon1

1Old Dominion University, Norfolk, VA, USA 2The University of Texas at Austin, Austin, TX, USA

Background: African American women continue to bear the brunt of HIV disease. Of the estimated 47,500 new HIV cases that occurred in 2010, one in four occurred in women. Among AA women, the incidence rate is nearly 20 times higher than that of Caucasian women, and five times that of Hispanic women.

Aim: The aim of this study was to examine the extant literature and on-going studies registered at clinicaltrials.gov for randomized control trials (RCTs) that tested mHealth self-management interventions with HIV-positive African American (AA) women.

Method: A modified version of the PRISMA approach was used to conduct a systematic review of English-language articles indexed at PsycINFO, PubMed, CINAHL, and clinicaltirals.gov; published in peer reviewed journals between 1985 and 2013.

Results : An extensive review of 450 records did not result in the identification of any published studies that met our criteria. At clinicaltrials.gov, we did find several mHealth HIV intervention studies designed for women in general; forecasting a promising future. However, most of the studies yielded are exploratory in nature and focus on a single narrow outcome, such as medication adherence.

Conclusions: This systematic review did not result in the identification of any published studies that used mHealth platforms for HIV self-management studies conducted in the US were specifically designed and culturally tailored for use with African American women who are living with HIV. Given that cultural adaptation is the key for successfully implementing any effective self-management intervention, culturally sensitive mHealth interventions focusing on HIV positive AA women are warranted for the future.

Implications for Practice: In light of the paucity of mHealth HIV self-management interventions available for African American women who are living with HIV, the clinical setting may be a fruitful venue for engaging women in the design of culturally tailored and gender-specific research projects that have been informed by them.

The use of mobile technologies as platforms for facilitating HIV self-management knowledge acquisition and skill development for health promotion, condition management, and disease prevention may be one more effective strategy in the armament for increasing linkages to care and promoting enhanced retention in care for African American women.


Describe the state of the science of novel mHealth HIV self-management interventions for African American women who are living with HIV;

Analyze effective strategies for adding to the body of evidence related to the efficacy of such interventions with this target population.

D-8

A Cross-Sectional Relationship between Social Capital, Self-Compassion and Perceived HIV Symptoms

Allison Webel1, Carmen Portillo2, Dean Wantland3, Carol Dawson-Rose2, John Brion10,

J. Craig Phillips12, Wei-Ti Chen4, Inge Corless9, Lucille Eller3, Elizabeth Sefcik8, Mallory Johnson2, Marta Rivero7, Jeanne Kemppaninen5, Kathy Nokes0

1Case Western Reserve University, Cleveland Ohio, USA, 2University of California San Francisco, San Francisco, CA, USA, 3Rutgers The State University of New Jersey, Newark, NJ, USA,

4Yale University, New Haven, CT, USA, 5University of North Carolina, Wilmington, Wilmington, NC, USA, 6Hunter College, CUNY, New York, NY, USA, 7University of Puerto Rico, Toa Baja, PR, Puerto Rico, 8Texas A&M University, Corpus Christi, TX, USA, 9MGH Institute of Health Professions, Boston, MA,

USA, 10Ohio State University, Columbus, OH, USA, 11University of Washington, Seattle, WA, USA, 12University of Ottowa, Ottowa, ON, Canada

Background: Individual social capital and self-compassion are associated with health behaviors and perceived symptoms individually; suggesting that both are positive resources that can be modified to improve one’s perceived symptoms. However, the relationship between social capital, self-compassion, and symptom experience in people living with HIV (PLWH) has not yet been explored.

Purpose: To examine the relationship between self-compassion and social capital and its impact on current symptom experience in adult PLWH. We further explored the impact of age on this relationship.

Methods: We conducted a cross-sectional analysis of 2,182 PLWH at 20 sites in 5 countries. Social capital, self-compassion, and HIV symptom experience were evaluated using valid and reliable scales. To account for inflated significance associated with a large sample size, we took a random sample of 30% of subjects (n=520) and conducted correlation analysis and a negative binomial regression, controlling for known medical and demographic variables impacting symptom experience.

Results: Social capital and self-compassion were moderately correlated (r=0.41, p<0.01). Controlling for age, sex at birth, year of HIV diagnosis, other comorbid health conditions, employment status and income level our model significantly predicted HIV symptom experience (overall model X2 =49.08, p<0.001, pseudo R2 =0.01). Self-compassion was the strongest negative predictor of symptom experience (IRR=0.97, p <0.01), followed by employment status (IRR= 0.75, p=0.01), and social capital (IRR=0.99, p=0.08). There was no relationship between age and self-compassion, social capital and symptom experience.

Conclusions: Self-compassion and social capital modestly predicted current HIV symptom experience; however future research is needed to better understand this relationship. Self-compassion and social capital can be incorporated into symptom management interventions, possibly as a way to reframe one’s symptom appraisal. The relationship between employment status and symptom experience was significant and should be further explored.

Implications for Practice: Symptom management interventions should consider including both information-based strategies and social and emotional processing strategies that may influence one’s appraisal of symptoms and subsequent symptom management behaviors.


Understand the relationship between social capital and self-compassion;

Understand the relationship between social capital and self-compassion and HIV symptom intensity.

D-9

Selected Health Determinants of Hispanic Men with HIV Infection in the U.S. – Mexico Border Region: A Pilot Study

Holly Mata1

Jacob Martinez1

Elias Provencio-Vasquez1

Joseph De Santis2

1University of Texas at El Paso School of Nursing, El Paso, TX, USA 2University of Miami School of Nursing & Health Studies, Coral Gables, FL, USA

Background: A wide array of social, environmental, cultural, and contextual factors contribute to HIV risk in addition to behavioral factors. Hispanics bear a disproportionate burden of HIV risk, and Hispanic men who have sex with men (MSM) are particularly vulnerable to HIV infection. Although recent research has focused Hispanic MSM, few studies have focused specifically on Hispanic men in the U.S. – Mexico border region who are HIV-infected.

Purpose: Accordingly, the purpose of this pilot study was to describe selected health determinants and characteristics of a sample of predominantly Mexican/Mexican American men living with HIV (N = 39; 7 heterosexual and 32 MSM).

Methods: Through structured interviews, data on a variety of health topics were collected from men recruited primarily through clinical and community-based organizations providing services to men with HIV. Participants ranged in age from 18-55 (M = 41.44, SD = 11.16); 21% had less than a high school education; 85% were unemployed and 69% had no health insurance; 31% speak English “almost always” while 49% speak Spanish “almost always”; 56 % were born in the U.S. and 39% in Mexico; and 74% were single.

Conclusions: 22 (56%) of the men scored 16 or higher on the CES-D, indicating clinical risk for depression (M = 16.95, SD = 10.74). 12 (31%) reported childhood physical abuse, 15 (39%) reported childhood psychological abuse, and 6(15%) reported childhood sexual abuse. 16 (41%) said they did not use condoms in the past 3 months. 19 (49%) were sexually abstinent in the past 3 months while 13 (33%) reported having 1 partner and 7 (18%) had more than 1 partner.

Implications for Practice: These data provide important information to a diverse group of healthcare practitioners, health educators, and policymakers. Nurses have a key role to play in advocating for practice and policy changes that respond to inequities in systems-level care provision, as well as promote culturally and linguistically appropriate services. Medicaid expansion, integrated behavioral health services, and scope-of-practice issues provide nurses with advocacy and practice opportunities that have the potential to promote health and health equity among people living with HIV.


Discuss basic epidemiology of HIV infection among Hispanic men in the U.S.; Describe health-related factors that are experienced by Hispanic men; Discuss implications for nursing care of Hispanic men with HIV infection.

Documents

Desktop.docx · Web viewAnn Bagchi, William Holzemer Miguel Martinez Rutgers University, Newark, NJ, USA Background: As of December 2012, 36,648 persons were living with HIV/AIDS