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Browsing by Author "Turan, Janet M."

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    Adaptation and Implementation of an Intervention to Reduce HIV-Related Stigma Among Healthcare Workers in the United States: Piloting of the FRESH Workshop
    (Mary Ann Liebert, 2016) Batey, D. Scott; Whitfield, Samantha; Mulla, Mazheruddin; Stringer, Kristi L.; Durojaiye, Modupeoluwa; McCormick, Lisa; Turan, Bulent; Nyblade, Laura; Kempf, Mirjam-Colette; Turan, Janet M.; University of Alabama Birmingham; University of Alabama Tuscaloosa; Research Triangle Institute
    HIV-related stigma has been shown to have profound effects on people living with HIV (PLWH). When stigma is experienced in a healthcare setting, negative health outcomes are exacerbated. We sought to assess the feasibility and acceptability of a healthcare setting stigma-reduction intervention, the Finding Respect and Ending Stigma around HIV (FRESH) Workshop, in the United States. This intervention, adapted from a similar strategy implemented in Africa, brought together healthcare workers (HW) and PLWH to address HIV-related stigma. Two pilot workshops were conducted in Alabama and included 17 HW and 19 PLWH. Participants completed questionnaire measures pre- and post-workshop, including open-ended feedback items. Analytical methods included assessment of measures reliability, pre-post-test comparisons using paired t-tests, and qualitative content analysis. Overall satisfaction with the workshop experience was high, with 87% PLWH and 89% HW rating the workshop "excellent'' and the majority agreeing that others like themselves would be interested in participating. Content analysis of open-ended items revealed that participants considered the workshop informative, interactive, wellorganized, understandable, fun, and inclusive, while addressing real and prevalent issues. Most pre- and post-test measures had good-excellent internal consistency reliability (Cronbach's alphas ranging from 0.70 to 0.96) and, although sample sizes were small, positive trends were observed, reaching statistical significance for increased awareness of stigma in the health facility among HW (p = 0.047) and decreased uncertainty about HIV treatment among PLWH(p = 0.017). The FRESH intervention appears to be feasible and highly acceptable to HW and PLWH participants and shows great promise as a healthcare setting stigma-reduction intervention for US contexts.
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    Healthcare Empowerment and HIV Viral Control: Mediating Roles of Adherence and Retention in Care
    (Elsevier, 2018) Wilson, Tracey E.; Kay, Emma Sophia; Turan, Bulent; Johnson, Mallory O.; Kempf, Mirjam-Colette; Turan, Janet M.; Cohen, Mardge H.; Adimora, Adaora A.; Pereyra, Margaret; Golub, Elizabeth T.; Goparaju, Lakshmi; Murchison, Lynn; Wingood, Gina M.; Metsch, Lisa R.; State University of New York (SUNY) Downstate Medical Center; University of Alabama Tuscaloosa; University of Alabama Birmingham; University of California San Francisco; University of North Carolina School of Medicine; University of North Carolina; University of North Carolina Chapel Hill; Columbia University; Johns Hopkins University; Johns Hopkins Bloomberg School of Public Health; Georgetown University; Montefiore Medical Center; Yeshiva University; Albert Einstein College of Medicine
    Introduction: This study assessed longitudinal relationships between patient healthcare empowerment, engagement in care, and viral control in the Women's Interagency HIV Study, a prospective cohort study of U.S. women living with HIV. Methods: From April 2014 to March 2016, four consecutive 6-month visits were analyzed among 973 women to assess the impact of Time 1 healthcare empowerment variables (Tolerance for Uncertainty and the state of Informed Collaboration Committed Engagement) on Time 2 reports of >= 95% HIV medication adherence and not missing an HIV primary care appointment since last visit; and on HIV RNA viral control across Times 3 and 4, controlling for illicit drug use, heavy drinking, depression symptoms, age, and income. Data were analyzed in 2017. Results: Adherence of >= 95% was reported by 83% of women, 90% reported not missing an appointment since the last study visit, and 80% were categorized as having viral control. Logistic regression analyses revealed a significant association between the Informed Collaboration Committed Engagement subscale and viral control, controlling for model covariates (AOR = 1.08, p = 0.04), but not for the Tolerance for Uncertainty subscale and viral control (AOR = 0.99, p = 0.68). In separate mediation analyses, the indirect effect of Informed Collaboration Committed Engagement on viral control through adherence (beta = 0.04, SE = 0.02, 95% CI = 0.02, 0.08), and the indirect effect of Informed Collaboration Committed Engagement on viral control through retention (beta = 0.01, SE = 0.008, 95% CI = 0.001, 0.030) were significant. Mediation analyses with Tolerance for Uncertainty as the predictor did not yield significant indirect effects. Conclusions: The Informed Collaboration Committed Engagement healthcare empowerment component is a promising pathway through which to promote engagement in care among women living with HIV. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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    HIV-Related Stigma Among Healthcare Providers in the Deep South
    (Springer, 2016) Stringer, Kristi L.; Turan, Bulent; McCormick, Lisa; Durojaiye, Modupeoluwa; Nyblade, Laura; Kempf, Mirjam-Colette; Lichtenstein, Bronwen; Turan, Janet M.; University of Alabama Birmingham; Research Triangle Institute; University of Alabama Tuscaloosa
    Stigma towards people living with HIV (PLWH) in healthcare settings is a barrier to optimal treatment. However, our understanding of attitudes towards PLWH from healthcare providers' perspective in the United States is limited and out-of-date. We assessed HIV-related stigma among healthcare staff in Alabama and Mississippi, using online questionnaires. Participants included 651 health workers (60 % White race; 83 % female). Multivariate regression suggests that several factors independently predict stigmatizing attitudes: Protestant compared to other religions (beta = 0.129, p a parts per thousand currency sign 0.05), White race compared to other races (beta = 0.162, p a parts per thousand currency sign 0.001), type of clinic (HIV/STI clinic: beta = 0.112, p a parts per thousand currency sign 0.01), availability of post-exposure prophylaxis (yes: beta = -0.107, p a parts per thousand currency sign 0.05), and perceptions of policy enforcement (policies not enforced: beta = 0.058, p = p a parts per thousand currency sign 0.05). These findings may assist providers wishing to improve the quality care for PLWH. Enforcement of policies prohibiting discrimination may be a useful strategy for reducing HIV-related stigma among healthcare workers.
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    Patient and Provider Perspectives on HIV Stigma in Healthcare Settings in Underserved Areas of the US South: A Mixed Methods Study
    (Springer, 2022) Crockett, Kaylee B.; Turan, Bulent; Whitfield, Samantha; Kay, Emma Sophia; Budhwani, Henna; Fifolt, Matthew; Hauenstein, Kris; Ladner, Murray D.; Sewell, Joshua; Payne-Foster, Pamela; Nyblade, Laura; Batey, D. Scott; Turan, Janet M.; University of Alabama Birmingham; Koc University; University of Alabama Tuscaloosa; Research Triangle Institute
    Stigma experienced in healthcare settings is a barrier to ending the HIV epidemic. Using a convergent parallel mixed methods approach, we collected qualitative data from 14 focus groups with People with HIV (PWH) and Healthcare workers (HCW) and quantitative survey data (N = 762 PWH and N = 192 HCW) from seven HIV healthcare clinics outside of major urban areas in the southeastern US. Four key themes emerged: (1) HIV-related stigma and discrimination in healthcare settings; (2) experiences of intersectional stigma; (3) disclosure concerns in healthcare settings; and (4) impact of stigma on HIV-related health behavior. Implications for future stigma interventions in healthcare settings include the importance of engaging PWH in the development of interventions, the need for interventions in settings that do not specialize in HIV care, and the importance of engaging all staff when addressing HIV-related stigma.