The Journal of the Association of Nurses in AIDS Care : JANAC
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J Assoc Nurses AIDS Care · Sep 2017
Perspectives of HIV Clinic Staff on the Implementation of a Client Financial Incentives Program Targeting Viral Suppression.
We present perspectives of health care providers and clinic staff on the implementation of a financial incentive program for clients living with HIV in three Louisiana clinics. Interviews were conducted in May-June 2015 with 27 clinic staff to assess their perspectives on implementation of the Health Models financial incentive program, which was initiated in September 2013. ⋯ Most said they eventually found the program to be helpful for patients and clinic operations in general, by facilitating partnerships between providers and patients, improving appointment keeping, providing opportunities for patient education, engaging patients in care, and helping patients form new prevention habits. The findings can improve understanding of staff and leadership perceptions of incentive programs and can inform planning and implementation of these programs in the future.
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J Assoc Nurses AIDS Care · May 2017
"Taking Care of Ourselves": The Experiences of Black Women Approaching and Encouraging Male Partners to Test for HIV.
Sixty percent of young adults living with HIV in the United States are unaware of their status despite recommendations to screen everyone. Effective approaches to encourage partner testing may increase status awareness. The purpose of our study was to understand young Black women's experiences when encouraging a partner to test for HIV, preferred approaches, and whether interpersonal context influenced the approach. ⋯ Testing and sharing results fostered trust and relationship growth. If a partner was resistant, some ended relationships while others tested themselves and interpreted their results as their partners' status. Our findings could encourage HIV prevention initiatives to consider varied interpersonal contexts and enhance partner testing.
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J Assoc Nurses AIDS Care · Sep 2016
Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care.
Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient-provider relationship to disease management, a more nuanced understanding of this relationship is needed. ⋯ An expanded definition of health literacy that includes gaining a patient's trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient-provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care.
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J Assoc Nurses AIDS Care · Jul 2016
Palliative Care, Hospice, and Advance Care Planning: Views of People Living with HIV and Other Chronic Conditions.
People living with HIV (PLWH) who survive to older adulthood risk developing multiple chronic medical conditions. Health policymakers recognize the role of early palliative care and advance care planning in improving health quality for at-risk populations, but misperceptions about palliative care, hospice, and advance care planning are common. Before testing a program of early palliative care for PLWH and other chronic conditions, we conducted focus groups to elicit perceptions of palliative care, hospice, and advance care planning in our target population. ⋯ Participants misunderstood advance care planning, but valued communication about health care preferences. Accepting palliative care was contingent on distinguishing it from hospice and historical memories of HIV and dying. Provision of high-quality, comprehensive care will require changing public perceptions and individuals' views in this high-risk population.
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J Assoc Nurses AIDS Care · Jul 2016
Nurses in Supportive Housing are Associated With Decreased Health Care Utilization and Improved HIV Biomarkers in Formerly Homeless Adults.
A San Francisco study conducted in 2008 showed that the permanent supportive housing program, Direct Access to Housing, dramatically decreased the risk of death in people living with HIV. In our study, we compared the health care utilization patterns and HIV-related biological markers of formerly homeless adults with HIV before and during two types of permanent supportive housing: (a) housing with on-site nursing care for residents, and (b) housing without on-site nursing care. Using nearest-neighbor matching with propensity scoring, the difference in outcomes was calculated. In the matched analysis, adjusted for adherence to combination antiretroviral therapy, people housed at sites with nurses had 4.8 fewer emergency department visits per person (SE: 1.53, p < .01), and they had an increased mean CD4+ T cell count (101.14 cells per person [SE: 55.10, p < .05]) compared to those who lived at sites without nurses.