{"title":"Expert Consensus on an Exercise Prescription Framework for Older People Living With HIV in a South African Setting-A Delphi Study.","authors":"Levin Chetty, Saul Cobbing, Verusia Chetty","doi":"10.1097/JNC.0000000000000519","DOIUrl":"https://doi.org/10.1097/JNC.0000000000000519","url":null,"abstract":"<p><strong>Abstract: </strong>Well-established, regular exercise interventions for older people living with HIV (OPLWH) are beneficial. However, the fundamental principles of exercise prescription for this population have not been sufficiently explored. An expert panel of health care professionals engaged in a modified Delphi technique to explore their perceptions of, and gain their consensus on, an exercise prescription framework for OPLWH in a resource-poor South African setting. A high level of agreement among participants was determined using a priori threshold of 80% agreement and an interquartile range of ≤ 1. Expert consensus was reached on a structured, multifaceted exercise prescription and also fundamental principles, such as multidisciplinary engagement and team collaboration, pre-exercise health screening, and exercise supervision. These were viewed as necessary components of a framework to improve the integration of exercise rehabilitation in the treatment, care, and support for OPLWH.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaylie Amiro, Miranda Bowser, Madison Connell, Remi Desrosiers, Evangeline MacAlpine, Anita Shahzadi, Caitlin McArthur, Adria Quigley
{"title":"Gait Speed, Mobility, Balance, and Dual-Tasking Deficits Among People Living With HIV Globally: A Systematic Review and Meta-Analysis.","authors":"Kaylie Amiro, Miranda Bowser, Madison Connell, Remi Desrosiers, Evangeline MacAlpine, Anita Shahzadi, Caitlin McArthur, Adria Quigley","doi":"10.1097/JNC.0000000000000503","DOIUrl":"10.1097/JNC.0000000000000503","url":null,"abstract":"<p><strong>Abstract: </strong>People living with HIV (PLWH) may experience premature physical deficits, including walking, mobility, and balance problems. The purpose was to measure deficits in walking, mobility, balance, and dual tasking in PLWH. The secondary objective was to make recommendations regarding the use of rehabilitation outcome measures. CINAHL, PubMed, and SPORTDiscus databases were searched. Two independent reviewers screened titles/abstracts and full-text articles, extracted data, and performed a quality assessment. Fifty-six articles with 14,053 PLWH and 8,454 uninfected controls were included. A meta-analysis revealed significantly worse performance among PLWH on the five times sit to stand mobility test versus controls (Cohen d = 0.68, 95% confidence interval [CI 0.08-1.29], p = .03). Meta-analyses revealed no differences between PLWH and controls for usual gait speed (Cohen d = -0.47, 95% CI [-1.10 to 0.15], p = .14) and fast gait speed (Cohen d = -0.39, 95% CI [-0.87 to 0.08], p = .10). Ten of 12 studies comparing PLWH with controls found differences in balance outcomes. PLWH have significantly worse mobility than uninfected controls.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"3-42"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Higinio Fernandez-Sanchez, Minerva Rocha-Fernandez, Jordana Salma, Diane M Santa Maria, Raquel A Benavides-Torres, Bukola Salami
{"title":"Sexual Health Implications of Return Migration for Women and Their Partners in Rural Mexico: A Critical Ethnography.","authors":"Higinio Fernandez-Sanchez, Minerva Rocha-Fernandez, Jordana Salma, Diane M Santa Maria, Raquel A Benavides-Torres, Bukola Salami","doi":"10.1097/JNC.0000000000000494","DOIUrl":"10.1097/JNC.0000000000000494","url":null,"abstract":"<p><strong>Abstract: </strong>The return of a migrant partner can negatively impact the sexual health of women who stayed in their communities. Understanding their sexual health needs is crucial for developing targeted interventions and support systems. Our study used a critical ethnographic approach in Agua Dulce, a rural community in Mexico, involving 50 key informants: women who stayed behind ( n = 20), returnees ( n = 12), community leaders ( n = 12), and health care professionals ( n = 6). We used participant observation, policy analysis, and interviews, using purposeful and snowball sampling methods. A gender-based thematic analysis revealed economic hardships and early separations affect the sexual well-being of women who stay behind. Infidelity, discovered through social media or calls, causes emotional distress and family disruptions. Male migrants spend an average of 8.85 years abroad, leading to fears of risky sexual behaviors. Our study highlights the urgent need for specialized support centers and comprehensive health interventions.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"81-91"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica T Campbell, Amanda N Gesselman, M Colten Staten, Gregory Carter
{"title":"U=U: \"Undetectable Equals Untransmittable\" Perceptions Among Men Who Have Sex With Men Active Duty Service Members: A Cross-Sectional Study.","authors":"Jessica T Campbell, Amanda N Gesselman, M Colten Staten, Gregory Carter","doi":"10.1097/JNC.0000000000000496","DOIUrl":"10.1097/JNC.0000000000000496","url":null,"abstract":"<p><strong>Abstract: </strong>Undetectable = Untransmittable (U=U) is a key message emphasizing that antiretroviral therapy suppresses HIV and prevents its sexual transmission. However, dissemination of U=U varies among health care providers, potentially leading to knowledge gaps among patients. Little research exists on the understanding of U=U among active duty men who have sex with men (MSM) in the U.S. military. Our cross-sectional, online study examines 222 active duty MSM to determine prevalence of accurate knowledge of U=U and demographic predictors of misinformation. Participants received a pre-exposure prophylaxis (PrEP) overview and were asked to indicate if the statement \"Undetectable equals Untransmittable\" was true or false. Although the majority accurately understood U=U (70%; n = 156), approximately 30% did not ( n = 66); a binary logistic regression revealed lower U=U understanding among White, bisexual, unmarried, and Marines/Navy participants. Standardized education on U=U is crucial for resolving knowledge gaps and combating stigmas surrounding HIV treatment.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"43-53"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander W Slaughter, Jordan Stiver, Micah Savin, Denise S Oleas, Hyunjung Lee, Angela Summers, Danqi Zhu, Heining Cham, Jessica Robinson-Papp, Monica Rivera Mindt
{"title":"Perceived Stress and Health Outcomes Among Latinx and Non-Latinx White Adult People With HIV in East Harlem, New York: A Cross-Sectional Study.","authors":"Alexander W Slaughter, Jordan Stiver, Micah Savin, Denise S Oleas, Hyunjung Lee, Angela Summers, Danqi Zhu, Heining Cham, Jessica Robinson-Papp, Monica Rivera Mindt","doi":"10.1097/JNC.0000000000000504","DOIUrl":"10.1097/JNC.0000000000000504","url":null,"abstract":"<p><strong>Abstract: </strong>Stress and HIV disproportionately affect Latinx adults in the United States, contributing to numerous health inequities. Among people living with HIV (PLWH), increased stress is associated with decreased medication adherence, effectiveness, and higher rates of immunosuppression and comorbidities. Our study ( N = 126) examined the relationship between perceived stress and HIV-related health among Latinx ( n = 83) and non-Latinx White ( n = 43) PLWH. Latinx PLWH reported better HIV-related health outcomes than non-Latinx White PLWH, despite higher viral load (all p 's < .05). An interaction effect showed that higher perceived distress was associated with worse health outcomes and lower CD4+ T cell count only in Latinx PLWH ( p 's < .05). Our findings highlight the consequences of stress on HIV-related health. Notably, higher stress may be especially detrimental among Latinx PLWH, underscoring the need for more culturally tailored interventions in HIV-related care. Future research should include additional sociocultural factors and longitudinal assessment in a larger sample.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":"69-80"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evelyn Iriarte, Allison R Webel, Paul F Cook, Ashley Turner, Grace L Ditzenberger, Kristine M Erlandson, Catherine Jankowski
{"title":"What Motivates Older Sedentary People Living With HIV in the United States to Participate in an Exercise Trial? A Qualitative Study.","authors":"Evelyn Iriarte, Allison R Webel, Paul F Cook, Ashley Turner, Grace L Ditzenberger, Kristine M Erlandson, Catherine Jankowski","doi":"10.1097/JNC.0000000000000517","DOIUrl":"10.1097/JNC.0000000000000517","url":null,"abstract":"<p><strong>Abstract: </strong>Although exercise supports the physical function and health of older people living with HIV (PLWH), less than half of PLWH globally achieve recommended levels of activity. A qualitative descriptive design was used to determine what motivates sedentary PLWH, 50 years and older, to participate in an exercise trial. Interviews were conducted with PLWH who participated in an exercise trial (n = 30) and PLWH who declined enrollment in the same exercise trial (n = 4). The theory of planned behavior (TPB) guided a directed content analysis of the interviews. Data analysis identified four themes: (a) intention or motivation (perceived benefits, maintaining the exercise behavior over time), (b) attitudes (goals and preferences), (c) perceived behavioral control (barriers, facilitators, and self-efficacy), and (d) subjective norms (pressure from health care providers and social networks). Findings from our study contribute to informing the development of future exercise interventions or trials and to planning care to encourage a physically active lifestyle.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer C Price, Kyoko Hirose, Naga Chalasani, Holly Crandall, Sonya Heath, Rohit Loomba, Susanna Naggie, Richard K Sterling, Mark Sulkowski, Laura Wilson, Jordan E Lake
{"title":"Primary Care Screening for Nonalcoholic Fatty Liver Disease Among People With HIV in the United States: A Real-World Provider Survey.","authors":"Jennifer C Price, Kyoko Hirose, Naga Chalasani, Holly Crandall, Sonya Heath, Rohit Loomba, Susanna Naggie, Richard K Sterling, Mark Sulkowski, Laura Wilson, Jordan E Lake","doi":"10.1097/JNC.0000000000000505","DOIUrl":"https://doi.org/10.1097/JNC.0000000000000505","url":null,"abstract":"<p><strong>Abstract: </strong>Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in people with HIV (PWH) and increases the risk of hepatic fibrosis and hepatocellular carcinoma. We sent an online survey to providers of the American Academy of HIV Medicine. Of respondents (n = 214, 8% response rate), 65% reported screening for NAFLD in PWH, with 28% routinely screening all patients. Most respondents refer patients to hepatology if workup suggests another coexisting liver disease or cirrhosis, with the primary goals of referral being additional diagnostic testing (60%) or specific treatments (75%). The most common barriers to screening were feeling unsure of what tests to order (28%) and how to conclusively diagnose NAFLD (29%). Most respondents were interested in society guidelines (73%) and NAFLD education for patients (57%) and providers (55%). Our findings support the development of NAFLD clinical practice guidelines for HIV providers and the inclusion of PWH in clinical trials of novel agents.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diane Santa Maria, Mary Paul, Marguerita Lightfoot, Adeline Nyamathi, Yasmeen Quadri, Nikhil Padhye, Eduardo Ocampo, Roman Babayev, Melanie Watt Ramos, Sheryl L Malone-Thomas, Margaret White, Alejandro Carrillo, Jennifer Torres Jones
{"title":"The Leaky Preexposure Prophylaxis Cascade: Barriers and Facilitators to Preexposure Prophylaxis Uptake and Adherence Among Youth Experiencing Homelessness in the US South, a Mixed Methods Study.","authors":"Diane Santa Maria, Mary Paul, Marguerita Lightfoot, Adeline Nyamathi, Yasmeen Quadri, Nikhil Padhye, Eduardo Ocampo, Roman Babayev, Melanie Watt Ramos, Sheryl L Malone-Thomas, Margaret White, Alejandro Carrillo, Jennifer Torres Jones","doi":"10.1097/JNC.0000000000000516","DOIUrl":"https://doi.org/10.1097/JNC.0000000000000516","url":null,"abstract":"<p><strong>Abstract: </strong>Adherence to preexposure prophylaxis (PrEP) is lower among high-risk populations, including youth experiencing homelessness (YEH). This study determined the feasibility of urine PrEP adherence biomarker testing and examined the barriers and facilitators to PrEP uptake and adherence among YEH. YEH were recruited from a randomized control trial conducted in a large urban setting in southern United States. Interviews (N = 40) were conducted to identify barriers and facilitators to PrEP uptake and adherence. PrEP urine-based adherence testing feasibility was conducted among those who started on PrEP. Twenty-two participants obtained a prescription and 15 youth completed at least one adherence test. Facilitators and barriers were categorized as individual, interpersonal and community, and structural among PrEP starters and nonstarters. PrEP uptake and adherence were low for eligible YEH. Enriching the understanding of the challenges and facilitators experienced with accessing PrEP for YEH can improve engagement in HIV prevention among YEH.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer S Tinman, Nqobile Nzama, Jenifer Patterson, Lesley M Harris, Jelani C Kerr
{"title":"\"Don't Tell Nobody Nothing\": A Phenomenological Study on Fear of HIV Disclosure Among Older African Americans During Incarceration Living in Kentucky, USA.","authors":"Jennifer S Tinman, Nqobile Nzama, Jenifer Patterson, Lesley M Harris, Jelani C Kerr","doi":"10.1097/JNC.0000000000000514","DOIUrl":"https://doi.org/10.1097/JNC.0000000000000514","url":null,"abstract":"<p><strong>Abstract: </strong>The intersections of HIV with aging, incarceration, and racial disparities have been well studied, but little is known about the lived incarceration experiences of older African American persons living with HIV. This phenomenological study examined the fear of HIV disclosure among older African Americans living in Kentucky who have experienced incarceration. Based on the interviews analyzed, five main themes were identified: experiences with fear, experiences pertaining to confidentiality, experiences with disclosure, experiences with stigma, and the desire to be accepted. These themes demonstrate HIV disclosure fear within incarceration settings and the desire for support and services. Findings suggest that there should be more efforts to increase HIV knowledge and awareness within incarceration settings. Participants shared that having a support network alleviates isolation. We recommend that correctional settings implement policies to protect confidentiality violations and facilitate groups to help foster a more supportive environment for individuals living with HIV.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nathaniel Albright, Dianne Morrison-Beedy, Ethan Morgan
{"title":"Initial Pre-exposure Prophylaxis Messaging Source Influences Pre-exposure Prophylaxis Use Among Older Adults: A Quantitative Survey of Older Adults in Columbus, Ohio.","authors":"Nathaniel Albright, Dianne Morrison-Beedy, Ethan Morgan","doi":"10.1097/JNC.0000000000000512","DOIUrl":"https://doi.org/10.1097/JNC.0000000000000512","url":null,"abstract":"<p><strong>Abstract: </strong>Older adults account for one in every five new HIV infections in the United States yet are often overlooked in tailored pre-exposure prophylaxis (PrEP) messaging. The aim of this study was to evaluate the original PrEP messaging source and its influence on PrEP use among a cohort of older adults. The Columbus Health Aging Project data (N = 794) were used to examine the initial PrEP information source and PrEP use in the past 6 months, adjusting for demographics and sexually transmitted infection (STI) status. Forty-six percent reported an STI, and 11.5% used PrEP. The main sources of PrEP information were peers (42.2%) and health care providers (40.2%); media (17.6%) sources were less common. Compared with those who received PrEP information from their health care provider, those informed by peers (adjusted odds ratio [aOR] = 0.58; 95% confidence interval [CI]: 0.34-0.99) or media (aOR = 0.17; 95% CI: 0.07-0.42) were less likely to use PrEP. Adjusting for STI-, media-informed remained less likely to have used PrEP compared with those informed by providers (aOR = 1.14; 95% CI: 0.55-2.35). These findings highlight the importance of tailored PrEP messaging for older adults for Ending the HIV Epidemic efforts. Media appears less impactful as a messaging approach for older adults.</p>","PeriodicalId":50263,"journal":{"name":"Janac-Journal of the Association of Nurses in Aids Care","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}