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(HIV) and (ontario)

Stephanie K Y Choi, Eleanor Boyle, John Cairney, Evan J Collins, Sandra Gardner, Jean Bacon, Sean B Rourke
INTRODUCTION: Current studies of depression among people living with HIV focus on describing its point prevalence. Given the fluctuating nature of depression and its profound impacts on clinical and quality-of-life outcomes, this study aimed to examine the prevalence, recurrence and incidence of current depressive symptoms and its underlying catalysts longitudinally and systematically among these individuals. METHODS: We conducted a prospective cohort study between October 1, 2007 and December 31, 2012 using longitudinal linked data sources...
2016: PloS One
Ayden I Scheim, Greta R Bauer, Robb Travers
BACKGROUND: This study is among the first to examine factors associated with HIV-related sexual risk among transgender men and other transmasculine persons who are gay, bisexual, or who have sex with men (T-GBMSM). METHODS: In 2009-2010, 433 transgender people in Ontario, Canada participated in a multi-mode respondent-driven sampling survey, including 158 T-GBMSM. Analyses were weighted using RDS II methods to adjust for differential recruitment probabilities; confidence intervals were adjusted for clustering by shared recruiter...
October 27, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Carmen H Logie, Uzma Ahmed, Wangari E Tharao, Mona Loutfy
African and Caribbean Black (ACB) women in Canada are disproportionately impacted by new HIV infections. ACB women's HIV vulnerabilty is shaped by contexts of stigma and discrimination. HIV-related stigma compromises quality of life (QOL) among women living with HIV (WLWH), yet scant research has examined concomitant effects of racial discrimination and HIV-related stigma on QOL. We used data from a cross-sectional survey with ACB WLWH in Ontario (n=173) to test a conceptual model of pathways between HIV-related stigma, racial discrimination, depression, social support and QOL...
October 17, 2016: AIDS Research and Human Retroviruses
A Prica, F Baldassarre, L K Hicks, K Imrie, T Kouroukis, M Cheung
Rituximab is the first monoclonal antibody to be approved for use by the US Food and Drug Administration in cancer. Its role in the treatment of non-Hodgkin lymphoma, including chronic lymphocytic leukaemia (CLL), has evolved significantly. We aimed to systematically review and update the literature on rituximab in lymphoma and CLL, and provide evidence-based consensus guidelines for its rational use. Validated methodology from the Cancer Care Ontario Program in Evidence-based Care was used. A comprehensive literature search was completed by a methodologist from the Hematology Disease Site Group of Cancer Care Ontario...
October 13, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Carmen H Logie, Jesse I R Jenkinson, Valerie Earnshaw, Wangari Tharao, Mona R Loutfy
African and Caribbean Black women in Canada have new HIV infection rates 7 times higher than their white counterparts. This overrepresentation is situated in structural contexts of inequities that result in social, economic and health disparities among African and Caribbean Black populations. Economic insecurity is a distal driver of HIV vulnerability, reducing access to HIV testing, prevention and care. Less is known about how economic insecurity indicators, such as housing security, continue to influence the lives of women living with HIV following HIV-positive diagnoses...
2016: PloS One
Samantha Robinson, Sandra Gardner, Mona Loutfy, Lucia Light, Wangari Tharao, Sean B Rourke, Ann N Burchell
Understanding the sexual activities and partnerships of women living with human immunodeficiency virus (HIV) remains important to promote healthy sexuality and to reduce the transmission of HIV and other sexually transmitted infections. We described sexual behaviors of women living with HIV enrolled in an ongoing study in Ontario, Canada. Data were available from 582 women who self-completed a sexual behavior questionnaire between 2010 and 2012. Nearly half (46.1%) of women reported a sexual partner in the preceding three months; women less likely to be sexually active were older, Black/African, separated, divorced, widowed, single, and unemployed...
September 8, 2016: AIDS Care
A Durbin, F Sirotich, Y Lunsky, K Roesslein, J Durbin
BACKGROUND: The experience of having human immunodeficiency virus (HIV) is often associated with co-occurring mental health issues. Community mental health services are an important source of support for persons with HIV living in the community. Persons with intellectual disability (ID) are vulnerable to HIV and may have unique support needs beyond those without ID receiving community care. This study compared support needs of men with HIV in community mental health programmes, with and without ID...
August 10, 2016: Journal of Intellectual Disability Research: JIDR
Tyler J O'Neill, Janet M Raboud, Jill Tinmouth, Sean B Rourke, Sandra Gardner, Curtis Cooper, Sergio Rueda, Trevor A Hart, Anita Rachlis, Ann N Burchell
In the modern antiretroviral (ARV) era, there is limited knowledge about the prevalence and risk factors for HIV patient-reported gastrointestinal (GI) symptoms (diarrhoea/soft stool, nausea/vomiting, bloating/painful abdomen, loss of appetite, and weight loss/wasting) and distress. We prospectively analysed data (2007-2014) on distressing GI symptoms from the Ontario HIV Treatment Network Cohort Study, which follows people attending HIV clinics. Using generalized estimating equations with a logit link, we estimated the associations of psychosocial, demographic, behavioural, and clinical factors with each GI symptoms compared to asymptomatic and non-bothersome symptoms...
July 25, 2016: AIDS Care
Allyson Ion, Anne C Wagner, Saara Greene, Mona R Loutfy
HIV-related stigma is associated with many psychological challenges; however, minimal research has explored how perceived HIV-related stigma intersects with psychosocial issues that mothers living with HIV may experience including depression, perceived stress and social isolation. The present study aims to describe the correlates and predictors of HIV-related stigma in a cohort of women living with HIV (WLWH) from across Ontario, Canada during pregnancy and early postpartum. From March 2011 to December 2012, WLWH ≥ 18 years (n = 77) completed a study instrument measuring independent variables including sociodemographic characteristics, perceived stress, depression symptoms, social isolation, social support and perceived racism in the third trimester and 3, 6 and 12 months postpartum...
July 22, 2016: AIDS Care
Ryan Ng, Claire E Kendall, Ann N Burchell, Ahmed M Bayoumi, Mona R Loutfy, Janet Raboud, Richard H Glazier, Sean Rourke, Tony Antoniou
BACKGROUND: Emergency department use may reflect poor access to primary care. Our objective was to compare rates and causes of emergency department use between adults living with and without HIV. METHODS: We conducted a population-based study involving Ontario residents living with and without HIV between Apr. 1, 2011, and Mar. 31, 2012. We frequency matched adults with HIV to 4 HIV-negative people by age, sex and census division, and used random-effects negative binomial regression to compare rates of emergency department use...
April 2016: CMAJ Open
Stephanie K Y Choi, Eleanor Boyle, John Cairney, Sandra Gardner, Evan J Collins, Jean Bacon, Sean B Rourke
BACKGROUND: Major depression can profoundly impact clinical and quality-of-life outcomes of people living with HIV, and this disease is underdiagnosed and undertreated in many HIV-positive individuals. Here, we describe the prevalence of publicly funded primary and secondary mental health service use and antidepressant use, as well as mental health care for depression in accordance with existing Canadian guidelines for HIV-positive patients with depression in Ontario, Canada. METHODS: We conducted a prospective cohort study linking data from the Ontario HIV Treatment Network Cohort Study with administrative health databases in the province of Ontario, Canada...
2016: PloS One
Allyson Ion
In the process of receiving perinatal care, women living with HIV (WLWH) in Canada have experienced disclosure of their HIV status without their express consent. This disclosure often occurs by well-intentioned healthcare providers; however, from the perspective of WLWH, it is a breach of confidentiality and leaves WLWH to manage the consequences. This paper is a critical review of the regulatory and legislative infrastructure that exists to protect the personal health information of WLWH in Ontario and Canada; the recourse that WLWH have in the event that their confidentiality is breached; and potential approaches that could be applied to organize the system differently to decrease the chance of a privacy breach and to facilitate appropriate collection, use and disclosure of personal health information...
May 2016: Healthcare Policy, Politiques de Santé
Ramandip Grewal, Vanessa G Allen, Sandra Gardner, Veronika Moravan, Darrell H S Tan, Janet Raboud, Ahmed M Bayoumi, Rupert Kaul, Tony Mazzulli, Frank McGee, Sean B Rourke, Ann N Burchell
OBJECTIVES: Rates of chlamydia and gonorrhoea have been rising in urban centres in Canada, particularly among HIV-positive men who have sex with men (MSM). Our objective was to identify behavioural risk factors for diagnosis with chlamydia and gonorrhoea in this population, with a focus on the HIV status of sexual partners. METHODS: The OHTN Cohort Study follows people in HIV care across Ontario. We restricted the analysis to 1997 MSM who completed questionnaires in 2010-2013 at one of seven clinics that submit all chlamydia and gonorrhoea tests to the provincial public health laboratory; we obtained test results via record linkage...
May 6, 2016: Sexually Transmitted Infections
Angela A Underhill, V Logan Kennedy, Johanna Lewis, Lori E Ross, Mona Loutfy
Work has been underway to increase the availability of parenting options for people living with and affected by HIV. One option, adoption, has not yet been explored in the literature. The study aimed to gain a better understanding of the potential of adoption for individuals/couples living with HIV in Ontario, and to assess potential structural barriers or facilitators that may impact their experience navigating the adoption system by conducting an environmental scan of adoption service providers in Ontario...
October 2016: AIDS Care
Jelani Kerr, Eleanor Maticka-Tyndale, Shalanda Bynum, Robert Mihan
The disproportionate HIV burden shared by African, Caribbean, and Black (ACB) populations in Canada has not been explained by unique sexual behaviors in this population. This study investigates partner selection and sexual networking as potential contributors to HIV vulnerability. The study examines variations in the characteristics of sexual partners and sexual networking across groups based on differences in ethno-religious identity, gender, and length of Canadian residency among single, 16- to 27-year old, heterosexual-identified, ACB individuals living in Windsor, Ontario, Canada...
April 29, 2016: Archives of Sexual Behavior
Robert Mihan, Jelani Kerr, Eleanor Maticka-Tyndale
HIV-related stigma has been shown to undermine prevention, care, treatment, and the well-being of people living with HIV. A disproportion burden of HIV infection, as well as elevated levels of HIV-related stigma, is evidenced in sub-Saharan African (SSA) and African-diasporic populations. This study explores factors that influence HIV-related stigma among 16- to 25-year-old youth residing in a Canadian city who identify as African, Caribbean, or Black. Stigma, as rooted in cultural norms and beliefs and related social institutions, combined with insights from research on stigma in SSA and African-diasporic populations, guided the development of a path analytic structural equation model predicting levels of HIV-related stigmatizing attitudes...
2016: AIDS Care
Lydia Kapiriri, Wangari Tharao, Marvelous Muchenje, Khatundi I Masinde, Fanta Ongoiba
Over 60 countries criminalise 'the "willful" transmission of HIV'. Such a law has the potential to hinder public health interventions. There is limited literature discussing the perceptions of this law and the impact, it has had on HIV-positive women. This paper describes the knowledge of and attitudes of this law by HIV-positive women living in Ontario; and their experiences with its application. Three group discussions (n = 10) and 17 in-depth interviews with HIV-positive women age: 21-56 years. Data were analysed using a modified thematic approach...
December 2016: Global Public Health
Anna Durbin, Frank Sirotich, Tony Antoniou, Kay Roesslein, Janet Durbin, Yona Lunsky
While community-based mental health services play an important role in caring for persons with HIV (human immunodeficiency virus) and co-existing mental health disorders, the extent to which their support needs are addressed in this setting is unknown. Accordingly, we examined if HIV infection was associated with unmet support needs among men living with and without HIV receiving community mental health care. This cross-sectional study examined 215 men (135 living with HIV and 80 without HIV) receiving case management services in urban Ontario...
July 2016: AIDS Care
Anita C Benoit, Jasmine Cotnam, Janet Raboud, Saara Greene, Kerrigan Beaver, Art Zoccole, Doe O'Brien-Teengs, Louise Balfour, Wei Wu, Mona Loutfy
We measured stress, depression and post-traumatic stress disorder (PTSD) levels of urban Indigenous women living with and without HIV in Ontario, Canada, and identified correlates of depression. We recruited 30 Indigenous women living with HIV and 60 without HIV aged 18 years or older who completed socio-demographic and health questionnaires and validated scales assessing stress, depression and PTSD. Descriptive statistics were conducted to summarize variables and linear regression to identify correlates of depression...
October 2016: Archives of Women's Mental Health
Ann N Burchell, Vanessa G Allen, Ramandip Grewal, Paul A MacPherson, Anita Rachlis, Sharon Walmsley, Sharmistha Mishra, Sandra L Gardner, Janet Raboud, Curtis Cooper, Kevin Gough, Sean B Rourke, Rodney Rousseau, Irving Salit, Darrell H S Tan
BACKGROUND: The current syphilis epidemic among urban men who have sex with men (MSM) has serious implications for those co-infected with human immunodeficiency virus (HIV). Routine and frequent syphilis screening has the potential to ensure early detection and treatment, minimize disease burden, and help control the ongoing spread of syphilis and HIV. We aim to enhance syphilis screening among HIV-positive men by conducting a clinic-based intervention that incorporates opt-out syphilis testing into routine HIV laboratory evaluation for this population...
2016: Implementation Science: IS
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