Understanding burden and lived experience of diabetes and hypertension among women living with HIV in the Dominican Republic to improve care integration
了解多米尼加共和国艾滋病毒感染者的糖尿病和高血压负担和生活经历,以改善护理一体化
基本信息
- 批准号:10538201
- 负责人:
- 金额:$ 21.05万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-07-01 至 2024-06-30
- 项目状态:已结题
- 来源:
- 关键词:AcuteAdultAgingCaribbean regionCaringCessation of lifeChronicCommunicable DiseasesCountryDecentralizationDevelopmentDiabetes MellitusDiagnosisDiscriminationDiseaseDominicanDominican RepublicEducational workshopEnvironmental Risk FactorEpidemiologyFaceFocus GroupsGenderGoalsGovernmentHIVHealthHealth Services AccessibilityHealthcareHealthcare SystemsHypertensionInequalityInterruptionInterviewLatin AmericaLifeLife StyleMental DepressionMental HealthMethodsModelingMorbidity - disease rateNon-Insulin-Dependent Diabetes MellitusPatientsPersonal SatisfactionPersonsPopulationPopulation SizesPovertyPrediabetes syndromePrevalenceProviderQualitative ResearchResearchRiskRisk FactorsSelf ManagementSeriesSiteStressSystemTreatment outcomeViolenceViralVulnerable PopulationsWomanantiretroviral therapycardiometabolic riskcare costscare outcomescare providerscis-femalecohortcopingcostexperiencefemale sex workerimprovedinformantinsightlow and middle-income countriesmortalitymultiple chronic conditionsnegative affectpublic health relevancesexsocial stigmastakeholder perspectivessubstance use
项目摘要
Project Summary/Abstract:
The health context across many low-and-middle-income countries reflects the “epidemiologic transition”, or the
shift from higher mortality and morbidity attributable to acute, infectious disease to a higher burden of
noncommunicable diseases (NCD). As a result of this transition, countries across Latin America and the
Caribbean (LAC) increasingly face a triple burden including: 1) ongoing infectious diseases; 2) increasing
NCD; and 3) mental health challenges, including substance use. The triple burden is unevenly distributed with
certain populations experiencing disproportionate burden relative to their population size. One particularly
vulnerable population is female sex workers (FSW), or cisgender women who consensually exchange sex for
money or other goods. Global HIV prevalence among FSW is 10.4% compared to 0.7% among adults
worldwide. In the Dominican Republic (DR), the site of the proposed study, adult HIV prevalence is 0.9%
compared to 4.2% among FSW. In a cohort of FSW living with HIV in Santo Domingo, our team has
documented viral suppression levels ranging from 51% to 73%. Determinants of poor HIV treatment outcomes
include depression, substance use, anti-retroviral therapy interruption, and various forms and types of stigma,
reflecting the embodiment of the triple burden among FSW living with HIV in this setting. Despite sub-optimal
levels of viral suppression, many FSW in the DR access care and treatment through a system of decentralized
care centers and live with HIV as a chronic condition. As a result, they are vulnerable to NCD associated with
HIV, aging, and environmental factors, in particular type-2 diabetes (T2D) and hypertension (HTN). An
estimated 10% of Dominican adults have T2D and 31% HTN. There is no systematic research about NCD
among FSW nor understanding of how FSW living with HIV navigate a healthcare system with limited
sensitization to their context and needs in the DR or elsewhere. The proposed study aims to improve
understanding of the burden of NCD among FSW living with HIV in Santo Domingo. Specific aims are: Aim 1:
Describe type 2 diabetes (T2D) and hypertension (HTN) prevalence among sex workers with HIV. For
Aim 1, we will re-engage our cohort of FSW living with HIV in Santo Domingo (n=200) to screen for T2D/HTN
and assess determinants. Aim 2: Explore the lived experience of multiple chronic conditions among
FSW with HIV and T2D/HTN. For Aim 2, we will conduct qualitative in-depth interviews with FSW previously
diagnosed with T2D/HTN (n=25) to explore their experiences with healthcare, self-management, mental health,
and wellbeing. Aim 3: Identify provider and stakeholder perspectives on integration of care for HIV and
T2D/HTN. For Aim 3, we will conduct key informant interviews with providers and stakeholders (n=25) to
assess the landscape of HIV and T2D/HTN care and probe on opportunities for integration. We will also
facilitate a series of focus groups (n=3) and collaborative workshops to develop a model of integrated care in a
collaborative and participatory manner.
项目总结/文摘:
项目成果
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{{ truncateString('CLARE L BARRINGTON', 18)}}的其他基金
Understanding burden and lived experience of diabetes and hypertension among women living with HIV in the Dominican Republic to improve care integration
了解多米尼加共和国艾滋病毒感染者的糖尿病和高血压负担和生活经历,以改善护理一体化
- 批准号:
10653263 - 财政年份:2022
- 资助金额:
$ 21.05万 - 项目类别:
Piloting a multi-level intervention to promote viral suppression among transgender women living with HIV
试点多层次干预措施,促进感染艾滋病毒的跨性别女性的病毒抑制
- 批准号:
10676883 - 财政年份:2022
- 资助金额:
$ 21.05万 - 项目类别:
Piloting a multi-level intervention to promote viral suppression among transgender women living with HIV
试点多层次干预措施,促进感染艾滋病毒的跨性别女性的病毒抑制
- 批准号:
10548552 - 财政年份:2022
- 资助金额:
$ 21.05万 - 项目类别:
PrEP Up!: Understanding PrEP stigma to improve uptake among men who have sex with men
PrEP Up!:了解 PrEP 耻辱以提高男男性行为者的接受度
- 批准号:
9914144 - 财政年份:2019
- 资助金额:
$ 21.05万 - 项目类别:
Patient and Provider perspectives on long acting injectable ART
患者和医疗服务提供者对长效注射 ART 的看法
- 批准号:
10116481 - 财政年份:2019
- 资助金额:
$ 21.05万 - 项目类别:
PrEP Up!: Understanding PrEP stigma to improve uptake among men who have sex with men
PrEP Up!:了解 PrEP 耻辱以提高男男性行为者的接受度
- 批准号:
9754300 - 财政年份:2019
- 资助金额:
$ 21.05万 - 项目类别:
Patient and Provider perspectives on long acting injectable ART
患者和医疗服务提供者对长效注射 ART 的看法
- 批准号:
10589878 - 财政年份:2019
- 资助金额:
$ 21.05万 - 项目类别:
Patient and Provider perspectives on long acting injectable ART
患者和医疗服务提供者对长效注射 ART 的看法
- 批准号:
10437594 - 财政年份:2019
- 资助金额:
$ 21.05万 - 项目类别:
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