RESUMO
Low-income, minority women living with HIV often experience multiple barriers in care that contribute to suboptimal care outcomes. Medical case managers (MCM) and medical providers are key players involved in care coordination and aid women along the HIV care continuum. The objective of this study was to identify current and potential patient-centered practices that facilitate adherence to medication and retention in care, from the perspective of racially and ethnically diverse women living with HIV. We implemented a qualitative study using semi-structured interviews with 75 African American, Hispanic/Latina, and Haitian women who were enrolled in the Ryan White HIV/AIDS Program in South Florida in 2019. We organized domains of exploration using a patient-centered care framework to identify practices in which providers acknowledged, respected, and responded to clients' preferences, needs, and values. Interviews were analyzed using consensual thematic analysis approach. Findings reflect women valued MCMs who were proactive and directive in care, provided motivation, and aided with navigation of shame, fear, and stigma. Women valued medical providers who upheld simple educational communication. Moreover, women reported that providers who reviewed medical results with clients, incorporated questions about families, and inquired about multiple physical and clinical needs beyond HIV created opportunities for women to feel respected, valued, and in turn, enhanced their involvement in their care. Findings identify specific interpersonal practices that can enhance the ability to better meet the needs of diverse groups of women, specifically those from racial/ethnic minority groups who face multiple sociocultural barriers while in care.
Assuntos
Infecções por HIV , Humanos , Feminino , Infecções por HIV/tratamento farmacológico , Florida , Etnicidade , Haiti , Grupos MinoritáriosRESUMO
Species of Mesocoelium Odhner, 1901 (Digenea) are generally similar and are often difficult to distinguish. Currently there are 42 specimens of this genus held in the Colección Nacional de Helmintos (CNHE) of the Instituto de Biología, Universidad Nacional Autónoma de Mexico, which previously have been assigned to three species: M. monas Rudolphi, 1819, M. travassosi Pereira & Cuocolo, 1940 and M. leiperi Bhalerao, 1936. Upon reevaluation of these specimens it was determined that 27, could not be assigned to species level and 15 could only be assigned to body type (carli and leiperi) because of the poor conditions of preservation of the material. The remaining 15 specimens were of sufficient quality to be identified to species and were found to represent M. americanum Harwood, 1932, M. danforthi Hoffman, 1935, M. meggitti Bhalerao, 1927, M. cf. americanum Harwood, 1932, and M. cf. danforthi Hoffman, 1935. Neither M. monas nor M. travassosi could be confirmed among these specimens; however, Mesocoelium meggitti (syn. M. travassosi) was confirmed. Mesocoelium danforthi is recorded for the first time in the Mexican collection. The presence of M. cf. gonocephali Singh, 1967 and M. cf. microon Nicoll, 1914 also among the 15 specimens of sufficient quality to be identified to species, needs to be confirmed through collects of new material. Finally, in future studies, we propose to improve the quality of specimens by fixing them considering the modifications to this process proposed herein, and compliment these morphological studies with molecular studies.