Journal of the International Association of Providers of AIDS Care最新文献

{"title":"Not a Problem at All or Excluded by Oneself, Doctors and the Law? Healthcare Workers' Perspectives on Access to HIV-Related Healthcare among Same-Sex Attracted Men in Tanzania.","authors":"Alexander Mwijage Ishungisa,&nbsp;Dan Wolf Meyrowitsch,&nbsp;Elia John Mmbaga,&nbsp;Melkizedeck Thomas Leshabari,&nbsp;Kåre Moen","doi":"10.1177/23259582221121448","DOIUrl":"https://doi.org/10.1177/23259582221121448","url":null,"abstract":"<p><p><b>Background:</b> An increasing body of literature focuses on access to healthcare services for men who engage in sex with other men in Africa, but how healthcare workers conceive of this topic of healthcare workers' views on men's care has not been much studied. Drawing on qualitative research, this article explores healthcare providers' perspectives on access to HIV-related healthcare services among gender and sexuality diverse men in Tanzania. <b>Methods:</b> A qualitative study was conducted among healthcare workers in Dar es Salaam and Tanga, Tanzania in 2018/2019. Data collection entailed qualitative interviewing, focus group discussions and participant observation. A purposive sampling strategy was used to select study participants who varied with respect to age, education level, work experience, and the type and location of the facilities they worked in. A total of 88 participants took part in the study. <b>Results:</b> This paper describes four different discourses that were identified among healthcare workers with respect to their perception of access to healthcare services for men who have sex with men. One held that access to healthcare was not a major problem, another that some same-sex attracted men did not utilize healthcare services although they were available to them, a third that some healthcare workers prevented these men from gaining access to healthcare and a fourth that healthcare for gender and sexual minority persons was made difficult by structural barriers. <b>Conclusion:</b> Although these are four rather different takes on the prevailing circumstances with respect to healthcare access for same-sex attracted men (SSAM), we suggest that they may all be \"true\" in the sense that they grasp and highlight different aspects of the same realities. More education is needed to healthcare providers to enable them accept SSAM who seek healthcare services and hence improve access to healthcare.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/c3/10.1177_23259582221121448.PMC9403446.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Timing of Antiretroviral Therapy Initiation on Retention in Care, Viral Load Suppression and Mortality in People Living with HIV: A Study in a University Hospital in Thailand.","authors":"Pruke Eamsakulrat, Sasisopin Kiertiburanakul","doi":"10.1177/23259582221082607","DOIUrl":"10.1177/23259582221082607","url":null,"abstract":"<p><p>Studies investigating same-day antiretroviral therapy (ART) initiation demonstrate different clinical outcomes depending on settings. We retrospectively reviewed adults with newly positive human immunodeficiency virus (HIV) antibody testing. The proportion of individuals who were retained in care at 12 months was compared between early (≤2 weeks) and late (>2 weeks) ART initiation groups. Of all, the median (IQR) time from HIV diagnosis to ART initiation was 18 (9-30) days. This duration was 7 (7-13) days in the early ART initiation group (n = 116) and 28 (21-46) days in the late ART initiation group (n = 154). In the multivariate logistic regression, having pneumocystis pneumonia [odds ratio (OR) 9.30, 95% CI 2.56-33.75], tuberculosis (OR 2.21, 95% CI 1.03-4.73), and weight loss (OR 12.98, 95% CI 1.00-167.68) were associated with late ART initiation. The early ART initiation group had a slightly higher proportion of individuals retained in care at 12 months than those in the late ART initiation group (88.8% vs 80.5%, <i>P</i> = .066) and had a higher significant proportion of HIV viral load suppression (81.0% vs 70.1%, <i>P</i> = .041). No significant differences were observed in the proportion of individuals who died at 12 months (2.6% vs 3.2%, <i>P</i> = 1.000) between the two groups. Early ART initiation trends to retain individuals in care and higher HIV viral load suppression was determined. Nevertheless, ART initiation timing might not be a solely important factor in improving HIV care and minimizing mortality among HIV-infected individuals in a university hospital setting.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43246545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and Worry About COVID-19 Infection are Associated with Less Confidence in Ability to Engage in Treatment: Results from a South India Cohort of People Living with HIV (PLWH)","authors":"M. Ekstrand, E. Heylen, Matilda Pereira, S. Chandy, K. Srinivasan","doi":"10.1177/23259582221080303","DOIUrl":"https://doi.org/10.1177/23259582221080303","url":null,"abstract":"Following its initial outbreak in Wuhan in December 2019, SARS-CoV-2 spread rapidly around the world and was characterized byWHO as a global pandemic onMarch 12, 2020. Given its global impact, it led to a great deal of concern among the approximately 38 million people living with HIV (PWH). Although many governments worked hard to sustain HIV services, often in collaboration with community partners, it soon became clear that PWH faced multiple barriers and challenges to remain engaged in the HIV care continuum. Containment of the global COVID-19 pandemic required that governments implemented multiple strategies, including requirements to shelter-in-place, distancing, and placing restrictions on travel, which may serve as barriers to accessing non-COVID-related healthcare. OnMarch 25, 2020, the government of India announced an initial “lockdown,” due to the global COVID-19 pandemic, which restricted movement, social gatherings and economic activity until May 31. This resulted in many citizens returning to their native homes to shelter with their extended families. It is unknown what impact the lockdowns may have had on the ability of PWH to visit ART clinics, obtain prescription refills or adhere to their regimens. Since successfulmanagement of HIV requires excellent adherence and timely prescription refills to avoid treatment interruptions, real or perceived challenges, including HIV stigma and worries about coronavirus infection may have interfered with this effort.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44256306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situating HIV Stigma in Health Facility Settings: A Qualitative Study of Experiences and Perceptions of Stigma in ‘Clinics’ among Healthcare Workers and Service Users in Zambia","authors":"S. Mulubale, S. Clay, Corinne Squire, V. Bond, Kasoka Kasoka, Lucy Stackpool-Moore, Tessa Oraro-Lawrence, M. Chonta, C. Chiiya","doi":"10.1177/23259582221100453","DOIUrl":"https://doi.org/10.1177/23259582221100453","url":null,"abstract":"The study focused on the representations, processes and effects of HIV stigma for healthcare workers living with HIV within health facilities in Zambia. A descriptive study design was deployed. A total of 56 health workers and four service user participants responded to a structured questionnaire (n = 50) or took part in key informant interviews (n = 10) in five high HIV-prevalence provinces. Most participants did not disclose if they were living with HIV, except for four participants who responded to the questionnaire and were selected for being open about living with HIV. Semi-structured interviews were carried out with health workers in key government health facility positions. The questions were standardized and used a Likert scale. Descriptive statistical and thematic analyses were applied to the data. Results show that antiretroviral treatment (ART) has an impact on stigma reduction. Almost half the participants agreed that treatment is reducing levels of HIV stigma. However, fears of exposure of HIV status and labelling and judgemental attitudes persist. No comprehensive stigma reduction policies and guidelines in healthcare facilities were mentioned. Informal flexible systems to deliver HIV services were in place for health workers living with HIV, illustrating how stigma can be quietly navigated. Lack of confidentiality in healthcare facilities plays a role in fuelling disclosure issues and hampering access to testing and treatment. Stigma reduction training needs standardization. Further, codes of conduct for ‘stigma-free healthcare settings’ should be developed.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43071969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistent Condom Utilization and its Associated Factors among Sexually Active Female Anti-Retro Viral Treatment Users in Finoteselam District Hospital, Northwest Ethiopia, 2018.","authors":"Getie Lake Aynalem, Marta Berta Badi, Abayneh Aklilu Solomon","doi":"10.1177/23259582221088430","DOIUrl":"10.1177/23259582221088430","url":null,"abstract":"<p><p>Consistent condom utilization is the key strategy to prevent new HIV strain transmissions among ART users. There are limited evidences on consistent condom utilization among women who are on ART in Ethiopia. <b>Methods:</b> A cross-sectional study design was conducted among sexually active female ART users from June to August, 2018. Data were collected using a systematic random sampling data collection method. The multivariable logistic regression model was used to identify the predictors for the outcome <b>Results:</b> study indicated that 137(34.2%) women reported that they were using condom for the last three months, of whom 81 (59.1% (n = 137)) used condoms consistently. Respondents` age group from 21-30 (AOR = 4.381, 95%CI = 1.05, 18.331), Counseling about condom utilization (ARO = 9.442, 95% CI = 4.387, 20.32) and husbands` educational status \"diploma and above\" (AOR = 3.65, 95% CI = 1.007, 13.227) were significantly associated with condom utilization.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/f3/10.1177_23259582221088430.PMC8949742.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40313991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of HIV Positive Children and Adolescents Initiated on Antiretroviral Treatment in Nigeria (2007-2016).","authors":"Onyekachi Anukam,&nbsp;Natalia Blanco,&nbsp;Jibreel Jumare,&nbsp;Julia Lo,&nbsp;Ezra Babatunde,&nbsp;Solomon Odafe,&nbsp;Dennis Onotu,&nbsp;Uzoma Ene,&nbsp;Johnson Fagbamigbe,&nbsp;Deborah Carpenter,&nbsp;Emilia D Rivadeneira,&nbsp;Austin I Omoigberale,&nbsp;Manhattan Charurat,&nbsp;Mahesh Swaminathan,&nbsp;Kristen A Stafford","doi":"10.1177/23259582221117009","DOIUrl":"https://doi.org/10.1177/23259582221117009","url":null,"abstract":"<p><p><b>Background:</b> This manuscript aimed to examine treatment outcomes of HIV-positive children and adolescents. <b>Methods:</b> We retrospectively analyzed data of a sample of patients aged 0-19 years who initiated ART (October 2007-September 2016) in participating sites in 30 states and the Federal Capital Territory in Nigeria. <b>Results:</b> Among 4006 patients alive at the end of the follow up period, 138 (3.4%) were LTFU. Adolescents had a significantly higher risk of being LTFU than children aged 3-5 years (HR 2.47 [95% CI 1.40-4.34]). Patients with advanced disease had a significantly higher risk of being LTFU (Stage IV HR, 3.66 [95% CI: 2.00-6.68]). On average, optimal ART refill adherence was met by 67.3% of patients. <b>Conclusion:</b> Our findings suggest that focusing on preventing and managing advanced disease and interventions supporting adolescents when transferring to adult care is warranted.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/13/10.1177_23259582221117009.PMC9358598.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40683294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV Related Stigma among Healthcare Providers: Opportunities for Education and Training.","authors":"Amanda Blair Spence,&nbsp;Cuiwei Wang,&nbsp;Katherine Michel,&nbsp;Joanne Michelle Ocampo,&nbsp;Michael Kharfen,&nbsp;Daniel Merenstein,&nbsp;Lakshmi Goparaju,&nbsp;Seble Kassaye","doi":"10.1177/23259582221114797","DOIUrl":"https://doi.org/10.1177/23259582221114797","url":null,"abstract":"<p><p><b>Background:</b> HIV-stigma can influence engagement in care and viral suppression rates among persons living with HIV (PLWH). Understanding HIV-provider level stigma and its associated factors may aid in development of interventions to improve engagement in care. <b>Methods:</b> We assessed HIV-related stigma, provider knowledge, and practices and beliefs among healthcare providers using an online survey tool. Generalized linear modeling was used to determine factors associated with HIV-stigma score. <b>Results:</b> Among 436 participants, the mean age was 42.3 (SD 12.3), 70% female, 62% white, 65% physicians, and 44% worked at an academic center. The mean HIV Health Care Provider Stigma Scale (HPASS) score was 150.5 (SD 18.9, total = 180 [higher score = less stigma]) with factor subscale scores of 67.1 (SD 8.2, total = 78) prejudice, 51.3 (SD 9.7, total = 66) stereotyping, and 32.1 (SD 5, total = 36) discrimination. Female sex and comfort with talking about sex and drug use had 4.97 (95% CI 0.61, 9.32) and 1.99 (95% CI 0.88, 3.10) estimated higher HPASS scores. Disagreement/strong disagreement versus strong agreement with the statement that PLWH should be allowed to have babies and feeling responsible for talking about HIV prevention associated with -17.05 (95% CI -25.96, -8.15) and -2.16 (95% CI -3.43, -0.88) estimated lower HPASS scores. <b>Conclusions:</b> The modifiable factors we identified as associated with higher HIV related stigma may provide opportunities for education that may ameliorate these negative associations.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/f9/10.1177_23259582221114797.PMC9310064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10616616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiretroviral Treatment Sharing among Female sex Workers Living with HIV in eThekwini (Durban), South Africa: Drivers and Implications for Treatment Success.","authors":"Amelia Rock,&nbsp;Carly Comins,&nbsp;Ntambue Mulumba,&nbsp;Katherine Young,&nbsp;Mfezi Mcingana,&nbsp;Vijayanand Guddera,&nbsp;Harry Hausler,&nbsp;Rene Phetlhu,&nbsp;Stefan Baral,&nbsp;Sheree Schwartz","doi":"10.1177/23259582221110820","DOIUrl":"https://doi.org/10.1177/23259582221110820","url":null,"abstract":"<p><p>In South Africa, 62% of female sex workers (FSW) are estimated to be living with HIV. Qualitative research indicates that FSW share antiretroviral therapy (ART) with peers to surmount treatment barriers. We quantitatively described ART sharing, its correlates, and its relationship with viral suppression (VS) among FSW living with HIV in eThekwini, South Africa. Among FSW on ART (n = 890), 30% ever shared (gave and/or received) ART. Sharing ART was more likely among those with higher levels of alcohol use, illicit drug use, depression severity, and physical/sexual violence in the adjusted model. There was a positive, dose-response relationship between number of pills given to peers in the last 30 days and VS likelihood (aPR: 1.05, 95% CI: 1.02, 1.08; p < 0.01). Giving pills may strengthen peer relationships, which may facilitate ART adherence. ART distribution through peer networks holds promise as a context-appropriate intervention for improving ART adherence among FSW in this setting.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/4c/10.1177_23259582221110820.PMC9263844.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40570673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and Adaptation of a Combined Economic Empowerment and Peer Support Program Among Youth Living With HIV in Rural Rwanda.","authors":"Jean Népomuscène Nshimyumuremyi,&nbsp;Gerardine Mukesharurema,&nbsp;Josée Uwamariya,&nbsp;Elise Mutunge,&nbsp;Andrea S Goodman,&nbsp;Jean d'Amour Ndahimana,&nbsp;Dale A Barnhart","doi":"10.1177/23259582211064038","DOIUrl":"https://doi.org/10.1177/23259582211064038","url":null,"abstract":"<p><p><b>Background:</b> Youth living with HIV in rural Rwanda experience poor clinical outcomes. In 2017, we implemented Adolescent Support Groups (ASGs), which provided economic incentives and peer support to youth aged 15-25. <b>Methods:</b> We assessed the ASG program using programmatic and electronic medical records. We described group composition and achievement on three indicators used to determine economic incentive levels: (1) quarterly pharmacy visit attendance, (2) biannual savings target achievement, and (3) annual viral suppression. <b>Results:</b> In total, 324 members enrolled in 34 ASGs. Group size and member ages varied more than anticipated. Groups performed well on pharmacy visit attendance (median quarterly group attendance range 91-100%) and on achieving savings targets (median biannual achievement range 80-83%). The viral suppression indicator could not be implemented as planned. <b>Conclusion:</b> To reflect contextual realities, adaptations in enrollment, indicator evaluation, and awarding of incentives occurred during implementation. Future research should assess whether these adaptations affected results.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/de/10.1177_23259582211064038.PMC8744159.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39647152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"<i>I Have Actually not Lost any Adolescent Since I Started Engaging Them one on one</i>:\" Training Satisfaction and Subsequent Practice among Health Providers Participating in a Standardized Patient Actor Training to Improve Adolescent Engagement in HIV Care.","authors":"Hellen M Okinyi,&nbsp;Cyrus M Wachira,&nbsp;Kate S Wilson,&nbsp;Margaret N Nduati,&nbsp;Alvin D Onyango,&nbsp;Caren W Mburu,&nbsp;Irene W Inwani,&nbsp;Tamara L Owens,&nbsp;David E Bukusi,&nbsp;Grace C John-Stewart,&nbsp;Dalton C Wamalwa,&nbsp;Pamela K Kohler","doi":"10.1177/23259582221075133","DOIUrl":"https://doi.org/10.1177/23259582221075133","url":null,"abstract":"<p><strong>Background: </strong>Poor health care worker (HCW) interactions with adolescents negatively influence engagement in HIV care. We assessed the impact of standardized patient actor training on HCW competence in providing adolescent HIV care in Kenya.</p><p><strong>Methods: </strong>We conducted pre-post cross-sectional surveys and qualitative exit interviews during a stepped wedge randomized trial. Cross-sectional surveys assessed self-rated competence in providing adolescent services before and after the intervention, and training satisfaction. In-depth interviews with a subset of HCW participants one year after training.</p><p><strong>Results: </strong>Over 90% of HCWs reported satisfaction with the training and there was significant improvement in self-rated competence scores (mean = 4.63 [highest possible score of 5] post-training vs 3.86 pre-training, p < 0.001). One-year following training, HCWs reported using skills in patient-centered communication and structuring an adolescent clinical encounter.</p><p><strong>Conclusions: </strong>This SP training intervention improved self-rated competence and showed sustained perceived impact on HCW skills in adolescent HIV service provision one year later.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/94/10.1177_23259582221075133.PMC8793424.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39713010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}