C-1
Agreement between Medical Record Data and Self-Reported
CD4 Counts, Viral Loads and Medication Knowledge
Joachim Voss1
Annushka Cesan1
Kristie Eilers2
Shauna Applin2
1University
of Washington, Seattle, USA
Health Care, Tacoma, USA
2Community
Background: For people living with HIV (PLWH), we expect them to see their providers routinely every
quarter to check the laboratory values, explain those results to our clients and discuss any problems with
taking antiretroviral treatment regimens (ART). While regimens have become so much easier to take, we
really do not know how well those improvements have translated into a better understanding of patient
knowledge.
Purpose: We wanted to determine whether a community sample of men and women with HIV were able
to accurately self-report their most recent CD4 count, viral load, and ART regimen, and whether
demographic
differences
such
as
age
and
gender
influenced
self-reporting.
Methods: We collected data from (N=200) PLWH and asked them to recall their last CD4 count, their last
viral load, and identify their medication regimen with a medication sheet that listed the generic and trade
name. The data was collected in a large primary HIV clinic and a community clinic in the North West
between May and July of 2010.
Findings: We found moderate agreement between self-report and medical record data for CD4 count
(k=.58, p<.001), and viral load (k=.43, p<.001), but only 43% were able to recall their ART regimens
accurately. For PLWH ≥ age 50 (k=.77, p<.001), and those with health insurance coverage (k=.61, p<.001)
were more accurate to self-report CD4. Women were more accurate in reporting viral load than men (k=.53,
p=.003 vs. k=.38, p<.001).
Conclusions: Even with the vast improvements of patient monitoring and treatment modalities, half of our
patients only partially understand the information we are trying to convey to them.
Implications for Practice: As HIV patients live longer with the disease, PLWH need multiple modalities
of education (for example, visual aids, teach-back method, video) to relate CD4 counts, viral load, and ART
regimens to their personal health understanding and to be meaningful to them.
Objectives: The learner will be able to:


Discuss the importance of self-report in relationship to medication regimens and HIV illness
indictors;
Understand the relevance of Kappa statistics.
C-2
Home-based Navigator Services for PLWH and Other Chronic Conditions
Jacquelyn Slomka1
Allison Webel1
Maryjo Prince-Paul1
Thomas Quinn2
Barbara Daly1
1Case
Western Reserve School of Nursing, Cleveland, Ohio, USA
of the Western Reserve, Cleveland, Ohio, USA
2Hospice
Background: As persons living with HIV (PLWH) survive into older adulthood, they are at risk for chronic
conditions in addition to HIV. Comprehensive palliative care services to provide physical, psychosocial and
spiritual care, symptom management, advance care planning, and improvement in overall quality of life are
needed. Models of palliative care that exist for PLWH are often institution-based. Our program was
developed to provide home-based palliative care services and health care system navigation for high-risk
PLWH.
Purpose: This presentation provides an overview of an HIV Navigator Program, developed to test the
provision of palliative services and health system navigation in addition to standard health care for PLWH
and other chronic conditions.
Methods/Practice: In partnership with and modeled after a community-based palliative care navigation
project, a program was developed to address specific health, psychosocial and spiritual needs of PLWH
and other chronic conditions. Home-based palliative care assessment, services and assistance in
navigating complexities of the health care system are provided by an Advanced Practice Nurse, a Licensed
Social Worker and trained volunteers. Measurable program outcomes over a 36-month period include
quality of life, symptom burden, coping ability, and advance care planning.
Conclusions: Specific and unique needs of high-risk PLWH can be addressed through palliative care
navigation programs, but evaluation of different models is needed.
Implications for Practice: Attention to palliative care needs of PLWH and other chronic conditions is
essential because of the increasing prevalence of HIV, the rise in chronic diseases, and the aging of the
population of PLWH.
Objectives: The learner will be able to:


Describe background and implementation of an HIV Navigation Program for early palliative care;
Discuss challenges in developing and implementing an HIV Navigation program.
C-3
Beyond KS, Importance of Nursing Assessment in
KSHV-associated Malignancies and Syndromes
Kathleen Wyvill
Karen Aleman
Robert Yarchoan
Mark Polizzotto
Thomas Uldrick
HIV and AIDS Malignancy Branch, CCR, NCI, Bethesda, MD, USA
Background: As people with HIV/AIDS live longer, malignancies are an increasingly important cause of
mortality.
Purpose: Increase awareness of KSHV-related syndromes and malignancies in HIV and Infectious
diseases practices
Methods/Practice: Kaposi’s sarcoma associated herpesvirus (KSHV) causes not only Kaposi’s sarcoma
(KS), but also KSHV-multicentric Castleman’s disease (MCD), primary effusions lymphoma (PEL) and the
more recently described KSHV inflammatory cytokine syndrome (KICS), which can accompany KS or PEL.
Our research team studies KSHV-related syndromes and malignancies. Many patients we assess come to
us critically ill as diagnosis was delayed or missed. Patients with KSHV-MCD or KICS may present with
systemic inflammatory symptoms including fevers, cachexia, and laboratory abnormalities including
cytopenias, hypoalbuminemia, hyponatremia, and elevated C-reactive protein. By recognizing the signs
and symptoms earlier, in primary care practices, emergency rooms and intensive care units, nurses can
help identify patients who may need further assessment and potentially treatment for these diseases.
Conclusions: Although our goal is an AIDS-free generation, until there is a cure for AIDS, existing
generations of HIV infected people are living longer, and cancer, including KS and PEL, will remain an
important health care issue for HIV-infected patients.
Implications for Practice: Careful nursing assessment of HIV positive patients with inflammatory
symptoms is critical to successful outcomes. Specialized multidisciplinary care is required.
Objectives: The learner will be able to:


Identify the signs and symptoms of KSHV-MCD, PEL and KICS;
Describe treatments and supportive care measures for MCD, PEL.
C-4
Role of Social Networks on Venue-Based HIV testing and Decision
Making in an Urban, Transgendered Population
Adrian Juarez1,2
1University
2Latino
at Buffalo, Buffalo, NY, USA
Commission on AIDS, New York, NY, USA
Background: “Seek, test and retain” promotes HIV testing and HIV status knowledge while decreasing
HIV infection The transgender male to female (MTF) population group has some of the highest HIV testing
rates yet continues to experience disproportionate HIV infection rates. There is little understanding
regarding the HIV risk behavioral choices in the transgender-MTF and currently no large national databases
exist regarding the HIV burden experienced by the transgender-MTF population group. For smaller urban
communities such as those in Western New York, HIV infection disparities are greater. Using the social
network analysis will help identify the components of the HIV testing trajectory unique to transgender-MTFs
and provides insight on why this marginalized group is experiencing higher overall HIV health disparities.
Purpose: Delineate and document the experiences within an HIV testing trajectory of one transgenderMTF population group in urban New York State.
Methods: A social network analysis structured this examination and data collected includes HIV test intake
variables as reported to the New York State AIDS Institute Reporting System.
Conclusions: Initial findings support known trends regarding HIV experiences in other transgender
groups. Further research must include a qualitative component as additional social network delineation can
be accomplished and include variables not measured by instruments used for the New York State AIDS
Institute Reporting System.
Implications: Understanding the social network within the context of the HIV testing trajectory provides
insight to HIV disparities in this specific transgender population group. Nurses involved in prevention
science and intervention will have increased success with the transgender-MTF population by
understanding sources of HIV testing barriers along the HIV testing trajectory. Additionally, contributing to
and increasing HIV testing data from the transgender community assists future researchers with
understanding the HIV health experiences of this simultaneously marginalized population group.
Objectives: The learner will be able to:



List several examples of self-identified trans-gender descriptors;
Develop a possible social network of the transgender HIV testing trajectory;
List several HIV health disparities in the transgender population group.
C-5
HIV-Related Sexual Risk Behaviors Among Older
Urban African American Women
Tanyka Smith
Columbia University, New York, NY, USA
Background: In the Northeastern United States, older African American women are disproportionately
affected by HIV as they constitute the fastest growing group newly infected with the disease. Sexual risk
and protective behaviors may be influenced by individual factors, including attitudes, perceptions, beliefs
and socio-cultural and contextual factors. However, there is limited research on sexual risk behaviors and
effective HIV prevention strategies that are tailored to the needs of older African American women.
Purpose: The purpose of this study was to examine the relationship among HIV-related behavioral beliefs,
normative beliefs, control beliefs and gender power and examine how such relationships influence condom
use intentions and consistent condom use behavior among older urban African American women.
Methods: A convenience sample of 175 older African American women, age 50 to 85, were recruited from
low income neighborhoods in New York City. Participants were recruited from places where older African
American women typically assemble including hair salons, senior/community centers, food markets, and
community health centers. Data were collected via self-administered paper-and-pencil questionnaires.
Results: The logistic regression model revealed several significant predictors of condom use intentions,
including: condom negotiation efficacy (OR = 1.4, p = < .01), perceived HIV risk (OR = 1.1, p < .05),
perception of main partners' beliefs (OR = 1.7, p < .01), alcohol use (OR = .69, p < .05) and marital status
(OR = .16, p < .05). Findings also indicated that consistent condom use was associated with perception of
HIV risk (OR = 1.2, p < .01), perceived social support (OR = 1.2, p = .04), condom use self-efficacy (OR =
1.1, p < .01) and sexual relationship power (OR = 1.2, p = .05).
Conclusion: The results of this study suggest that older African American women engage in high risk
sexual practices and are vulnerable to HIV. This study provides a basis for future culturally relevant HIV
prevention interventions for this population.
Implications: Nurses and other health care providers are in a prime position to assess the HIV sexual risk
practices of older African American women and provide appropriate risk reduction education and condom
negotiation training.
Objectives: The learner will be able to:


Identify the theoretically-based individual and the socio-cultural factors influencing the HIV sexual
risk and protective behaviors among older urban African American women;
Describe effective nursing strategies to promote consistent condom use that are culturallyspecific and age-appropriate to reduce the risk of HIV in this vulnerable population.
C-6
American Dream and HIV: HIV+ Asian Immigrants' Self-Actualization
Wei-Ti Chen
Yale University, NY, USA
Background: Asians and Pacific Islanders (APIs) are among the fastest growing minority groups in the
United States. This population growth has been accompanied by a notable increase in HIV incidence. APIs
are the only racial/ethnic group to show a significant increase in HIV diagnosis rate between 2001 and
2008. Despite these increasing numbers, in HIV-related studies, data are seldom collected specifically on
APIs. The availability of data on HIV among API Americans are especially limited and little is known about
the immigrants' acculturation, self-actualization, their "American Dreams", quality of life, perceived stress,
and self-management among HIV-positive API Americans.
Purpose: In this study, we explored how acculturation, self-actualization and perceived stress affect
depression symptomatology in the HIV-positive API population.
Methods: A mixed-methods study was conducted between January to June of 2013. Thirty in-depth
interviews were conducted with HIV-positive API in San Francisco (n = 16) and New York (n = 14).
Additionally, cross-sectional audio computer-assisted self-interviews (ACASI) were conducted with a
convenience sample of 50 HIV-positive API (29 in SF and 21 in NY).
Conclusion: Three major themes were extracted from the in-depth interviews: self-actualization,
acculturation stress, and depression. Then, a moderated mediation analysis for the relationship among
acculturation, self-actualization and perceived stress was deployed. For those who are highly acculturated
to the US, perceived stress was not related to depression symptomatology. For those who had low and
moderate acculturation, stress significantly mediated depression symptomatology. In addition, among those
who had low acculturation, there is a significance in depression symptomatology scores between those
who totally lost their self-actualization and who still believe they can still make the dreams come true (p =
.02). For those who had the high acculturation, their HIV is not significantly related to the self-actualization.
Implications for Practice: This study found that acculturation levels influenced perceived stress and
depression in the HIV-positive Asian immigrant population. Lower acculturated Asian Americans suffered
to achieve less self-actualization. Future interventions should focus on enhancing acculturation and
reducing perceived stress, which may prompt harmful coping behaviors, such as high-risk sex and
substance abuse, to decrease depression, then, achieve their American Dreams.
Objectives: The learner will be able to:



Understand the perceived stress in Asian & Pacific Islanders' HIV+ population;
Know the self-actualization in Asian & Pacific Islanders' HIV+ population;
Be aware that enhancing the acculturation in HIV+ API immigrants is very important to decrease
perceived stress, increasing coping strategies and later, achieve their American Dreams.
C-7
"Is Your Man Stepping Out?” An Online Pilot Study to Evaluate Facebook
Advertising and Retention using Smartphones to Deliver HIV Prevention
Videos to African American Young Adult Women
Rachel Jones
Lorraine Lacroix
Northeastern University, Boston, MA, USA
Background: Love, Sex, and Choices (LSC) is a popular online 12-episode soap opera video series to
reduce HIV risk in young urban African American women. A video guide commentator was added to LSC
to direct focus to critical themes.
Purpose: An online pilot study was conducted to evaluate: 1) acceptability of the new guide enhanced
LSC, and feasibility of, 1) Facebook (FB) advertising, 2) completing an online screening interview, 3)
inclusion of high risk 18-29 year old women, 4) consenting, 5) verifying eligibility, 6) streaming LSC to
smartphones, and, 7) retention at 30 days.
Methods: FB ads targeted zip codes in high HIV incidence areas. Ads ran for 30 days on FB users’
smartphones or computers. Clicking the ad led to the study FB page and website to consent and screen. If
high risk, participants watched LSC and completed a follow-up interview at 30 days. Viewing times and ad
clicks were tracked.
Results: FB ads appeared in newsfeeds of 383,873 FB users. Of 6,537 clicks, most (n=5,393, 82.5%)
were mobile users; 230 screened. 84 were high risk, 40 watched LSC. 39 completed follow-up. Most (n=23,
57.5%) were African American/Black. Mean age= 23. Some (n=17, 43%) had privacy concerns when
clicking the FB ad, but all 40 felt the survey was confidential on the study website. At baseline, 40 reported
unprotected sex with high-risk partners during the past 90-days, compared to 7 at 30 days post-intervention.
17 (43.6%) were HIV tested. 37 related to the video characters. 38 felt the guide emphasized important
messages. High performing ads featured, “Is your man stepping out?” The cost per completer was $37.74.
Conclusions/Implications: The Guide was highly evaluated. Online recruitment/ retention of at-risk
mostly African American young urban women over a large geographic area suggested wider reach than
traditional recruitment. A low percent clicked the ad and completed (0.61%), but recruitment of high risk
women at 10/week compared favorably to 7 /week in previous field recruitment and nearly all were retained.
Field recruitment is more targeted. Online takes less time, may be less costly, with higher geographical
reach. A substantial number went for HIV testing.
Objectives: The learner will be able to:




Describe ways to reach a target population with engaging Facebook advertisements to recruit into
an online HIV prevention study;
Describe considerations to obtain online consent, verify, track, and retain participants in an online
study;
Describe how mobile devices were utilized to receive FB ads and to deliver a video intervention
and facilitate retention;
Describe rationale for an epilogue by a video guide commentator to emphasize key messages in
entertainment-education.
C-8
Waiving Parental Consent: Panacea for Gaps in Adolescent
LGBT HIV Prevention Research?
D. Dennis Flores1
Joyell Arscott1
Julie Barroso2
1Duke
University, Durham NC, USA
of Miami, Miami, FL, USA
2University
Background: Most research on HIV prevention for young gay, lesbian, bisexual and transgender (LGBT)
individuals rely on retrospective designs due to the perceived difficulty of conducting cross-sectional studies
with self-identifying LGBT adolescents. Since retrospective studies do not capture issues as they occur,
sexual health research when LGBT youth are navigating both puberty and sexual identity formation is
sparse. Obtaining a waiver of parental consent is necessary because seeking parental permission to join
sexuality-focused studies may signal to parents that their children are not heterosexual.
Purpose: This report will detail how obtaining a waiver of parental consent is possible to enable the
participation of LGBT youth in meaningful research.
Methods: The IRB application included detailed arguments about how studies that waived parental consent
have been successfully conducted in peer institutions, how research findings produced significant and rich
results, how LGBT youth are autonomous and capable of providing informed consent similar to their
heterosexual peers, and how excluding this complex population from research violates the principles of
beneficence, justice and respect for persons. Other elements included in the waiver request was a list of
studies that effectively recruited LGBT participants under the age of 18, institutional support letters from
bioethicists and child advocacy experts, and anticipated human subjects protection concerns and how they
would be addressed.
Conclusions: The waiver of parental consent was granted by the full IRB after months of deliberation. In
order to improve HIV prevention efforts and the sexual health outcomes of LGBT youth, this population
must be allowed to participate in real time studies about their own health.
Implications for Practice: To properly safeguard self-identifying LGBT youth and to encourage research
informed by their current social milieu, waivers of parental consent may be necessary. From our experience,
these waivers can be a design feature that will assuage LGBT youths’ concerns about participating in
research about them.
Objectives: The learner will be able to:


Describe how to obtain a Waiver of Parental Consent from the IRB;
Enumerate the reasons why Waivers of Parental Consent may be necessary in HIV prevention
research.
C-9
Anal Cancer Screening and Follow Up in HIV-Infected Individuals
Jessica Holmes,
Marcia Holstad
Deborah Bruner
Emory University, Atlanta, GA, USA
Background: HIV-infected individuals are 28 times more likely to be diagnosed with anal cancer than the
general population. Screening and the timely treatment and proper follow up of anal precancerous lesions
is suspected to prevent anal cancer.
Purpose: To examine rates of anal Pap screening and follow up rates after an abnormal anal Pap test in
a sample of HIV-infected individuals.
Methods/Practice: This pilot study used a retrospective descriptive design to review randomly selected
medical records of male patients seen at a large comprehensive HIV clinic and enrolled in its Infectious
Disease Program (IDP). This chart review also used a random selection of female participants from a list
of unlinked medical record numbers from the closed KHARMA study that recruited HIV-infected women
also enrolled in the IDP. Data analyses included Pearson's or Spearman Rho correlations, Chi-square
tests, and independent sample t-tests.
Results: 175 charts were abstracted (female, n=100; male, n=75). 72% of the sample did not have a
documented anal Pap test (n=126). Of the individuals with a history of an anal Pap, 19% (n= 30) had a
documented abnormal anal Pap and of that sample, 16% (n=28) were recommended for anoscopy. 57%
(n=16) did not have a documented follow-up anoscopy. Gender (r=-.415, p=.000), sexual orientation
(r=.434, p=.000), and CD4 count (r=-.173, p=.000) were significantly correlated to receiving an anal Pap
test. Sexual orientation was related to receipt of anoscopy (r=.300, p=.000). Women were less likely to
receive an anal Pap (Chi square= 29.6, p=.000), men who have sex with men (MSM) received anal Pap
tests at a higher rate (Chi square= 30.352, p=.000), and individuals who did receive an anal Pap had a
lower mean CD4 count (t-test= 3.506, p=.02). MSMs were more likely to follow up with anoscopy (Chi
square= 14.31, p=.001).
Conclusions: Anal cancer screening is performed at very low rates in this sample and there is a significant
break down in follow up with anoscopy after an abnormal anal Pap test.
Implications: Improved screening for anal cancer and follow up in individuals infected with HIV are needed
for a successful cancer prevention plan.
Objectives: The learner will be able to:


Identify the gaps in anal cancer screening and follow up care;
Identify what groups are more likely or less likely to be screened for anal cancer or receive follow
up care.
D-4
Effects of Stigma Reduction Workshops in a New Jersey-Based
HIV Clinic: A Pilot Study
Ann Bagchi,
William Holzemer
Miguel Martinez
Rutgers University, Newark, NJ, USA
Background: As of December 2012, 36,648 persons were living with HIV/AIDS in New Jersey, 16% of
whom were living in Newark. Stigma remains a significant barrier to HIV testing and treatment. Although
many interventions have been designed to address stigma in HIV affected populations, few have used a
randomized control trial (RCT) and standardized stigma scale to assess effectiveness.
Purpose: The purpose of this pilot study was to test the effectiveness of a series of stigma reduction
workshops within a population at the epicenter of New Jersey's HIV epidemic. The specific goals were to
test the format and procedures of the workshops and test for changes in stigma perceptions using the
Berger Stigma Scale.
Methods: We held four 3-hour workshops with clients and staff of an HIV clinic in Newark. Before the start
of the first session, participants completed baseline questionnaires, which included the Berger scale.
Workshop activities included discussions, card storming, and small group work designed to raise
awareness of different types of stigma, their outcomes, and interventions to address them. During the final
session, participants designed a stigma reduction intervention that they would implement in the community
and assigned roles. They then completed the same set of questionnaires as at the study's baseline.
Conclusions: Among participants (n=13), the Berger Stigma Scale decreased by approximately one third
of a standard deviation. At the individual item level, about 58% of the items indicated an improvement in
stigma perception; 18% of these changes were statistically significant. All participants qualitatively
evaluated all aspects of the workshop favorably. Among staff, the intervention allayed fears of potential
contraction of HIV while providing services and reduced the reported frequency of differential treatment of,
and negative discussion about, clients living with HIV.
Implications for Practice: Results of this study suggest that the intervention was successful in reducing
HIV-related stigma among participants. If so, wider implementation of the workshops could help to address
stigma and encourage HIV testing and treatment within the highest risk communities. The next phase of
the study will be to test the intervention in HIV clinics throughout the state using a RCT design.
Objectives: The learner will be able to:



Learn about standardized tools for assessing HIV-related stigma;
Understand how these tools can be applied in RCT studies;
Understand the importance of using standardized tools across research studies to build the
evidence base on interventions' effectiveness.
D-5
HIV Nurses' Knowledge of HIV-Related Criminal Laws
J. Craig Phillips
Jean-Laurent Domingue
University of Ottawa, Faculty of Health Sciences,
School of Nursing, Ottawa, Ontario, Canada
Background: Health care delivery systems in North America (Canada and the United States) are
transforming to facilitate realization of the right to health for all. HIV-related criminal laws in some
jurisdictions will hamper population health efforts to manage HIV.
Purpose: The purpose of this study was to survey nurses in HIV care about their knowledge of HIV-related
criminal laws.
Methods: An online survey was administered to nurses in HIV care. Ecosocial theory guided survey
development. Content experts reviewed the survey to assure content validity.
Results: The survey website was accessed by a total of 230 nurses in HIV care and 174 of them completed
the survey from Canada (n = 23) and the United States (n = 151). Knowledge of HIV-related criminal laws
varied widely, with 55 nurses (32%) reporting no knowledge of laws related to HIV exposure/transmission.
Nearly two-thirds of respondents (n = 110; 63.2%) did not know if there were HIV-related criminal laws for
non-sexual exposure or transmission (e.g., injectable drug use). Despite this knowledge gap, nurses in HIV
care are open to discuss concerns about HIV-related criminal laws and how these laws affect clinical
practices and the patient-provider relationship. Self-study and Internet-based training were the most
preferred knowledge acquisition mediums.
Conclusions: Nurses must increase knowledge of HIV-related criminal laws to reduce stigma and
discrimination experienced by people living with HIV. The success of public health and medical
interventions to manage HIV require understanding how HIV-related criminal laws influence patient care
delivery. Nurses specialized in HIV care will be a tremendous resource for other nurses as efforts continue
to expand health care access.
Implications for Practice: Transitioning to the Patient Protection and Affordable Care Act means more
persons living with or at-risk of acquiring HIV will access care from providers who may not be aware of the
complex medical and social challenges to managing HIV-disease, including HIV-related criminal laws. This
influx of patients may create the perfect storm of confusion for nurses who may be unprepared to navigate
the conflicting ethical, legal, and professional considerations governing clinical practices.
Objectives: The learner will be able to:



Describe trends in HIV nurses’ knowledge of HIV-related criminal laws across North America;
Discuss nurses’ preferences for acquiring new knowledge about HIV-related criminal laws;
Identify strategies to engage nurses in a dialogue about HIV-related criminal laws.
D-6
Knowledge and Psychosocial Wellbeing of Nurses
Caring for People Living with HIV/AIDS (PLWH)
Lufuno Makhado
Mashudu Davhana-Maselesele
North West University - Mafikeng Campus, Mafikeng,
North West Province, South Africa
Background: The challenges of caring for people living with HIV (PLWH) in a low-resource setting has
had a negative impact on the nursing profession, resulting in a shortage of skilled nurses
Purpose: To describes the state of nurses' knowledge of HIV and their psycho-social well-being as care
givers of PLWH at a regional hospital in Limpopo Province in order to make recommendations for support
to nurses caring for PLWH.
Methods/Practice: a cross sectional descriptive study was conducted. A total of 233 nurses, the majority
being female, participated and were stratified into professional nurses (n=108), enrolled nurses (n=58) and
enrolled nursing auxiliaries (n=66). Data were collected using HIV/AIDS knowledge questionnaire, Maslach
Burnout Inventory; AIDS Impact Scale and Beck's Depression Inventory. The total score obtained by all the
participants ranged from 2 to 16, with an average of 12.93 (SD=1.92) on HIV/AIDS knowledge.
Depersonalization (D) (83.7%) and emotional exhaustion (EE) (53.2%) were reported among participating
nurses caring for PLWH. Burnout was higher among professional nurses as compared to both enrolled
nurses and enrolled nursing auxiliaries. There was a moderate negative significant association between
HIV knowledge with the nurses' emotional exhaustion (r=-0.592), depression (r=-0.584) and stigma and
discrimination (r=-0.637). A moderate to high level of burnout was evident among all levels of nurses.
Conclusions: For nurses to be well capacitated and supported in their care-giving role, nursing education
with regard to HIV&AIDS still needs an improved approach.
Implications for Practice: The provision of nursing educational and organizational support mechanisms
has the potential to create a positive practice environment for nurses in South Africa in general and the
Vhembe District of the Limpopo Province in particular, resulting in improved care for PLWH.
Objectives: The learner will be able to:


Demonstrate understanding of knowledge and psychosocial wellbeing of nurses caring for PLWH;
Have gained understanding of available support systems for nurses caring for PLWH.
D-7
A Systematic Review of mHealth Interventions for HIV Self-Management
for African American Women Living with HIV
Kimberly Adams Tufts1
Juyoung Lee2
Muna Ajzoon1
1Old
2The
Dominion University, Norfolk, VA, USA
University of Texas at Austin, Austin, TX, USA
Background: African American women continue to bear the brunt of HIV disease. Of the estimated 47,500
new HIV cases that occurred in 2010, one in four occurred in women. Among AA women, the incidence
rate is nearly 20 times higher than that of Caucasian women, and five times that of Hispanic women.
Aim: The aim of this study was to examine the extant literature and on-going studies registered at
clinicaltrials.gov for randomized control trials (RCTs) that tested mHealth self-management interventions
with HIV-positive African American (AA) women.
Method: A modified version of the PRISMA approach was used to conduct a systematic review of Englishlanguage articles indexed at PsycINFO, PubMed, CINAHL, and clinicaltirals.gov; published in peer
reviewed journals between 1985 and 2013.
Results : An extensive review of 450 records did not result in the identification of any published studies
that met our criteria. At clinicaltrials.gov, we did find several mHealth HIV intervention studies designed for
women in general; forecasting a promising future. However, most of the studies yielded are exploratory in
nature and focus on a single narrow outcome, such as medication adherence.
Conclusions: This systematic review did not result in the identification of any published studies that used
mHealth platforms for HIV self-management studies conducted in the US were specifically designed and
culturally tailored for use with African American women who are living with HIV. Given that cultural
adaptation is the key for successfully implementing any effective self-management intervention, culturally
sensitive mHealth interventions focusing on HIV positive AA women are warranted for the future.
Implications for Practice: In light of the paucity of mHealth HIV self-management interventions available
for African American women who are living with HIV, the clinical setting may be a fruitful venue for engaging
women in the design of culturally tailored and gender-specific research projects that have been informed
by them.
The use of mobile technologies as platforms for facilitating HIV self-management knowledge acquisition
and skill development for health promotion, condition management, and disease prevention may be one
more effective strategy in the armament for increasing linkages to care and promoting enhanced retention
in care for African American women.
Objectives: The learner will be able to:


Describe the state of the science of novel mHealth HIV self-management interventions for African
American women who are living with HIV;
Analyze effective strategies for adding to the body of evidence related to the efficacy of such
interventions with this target population.
D-8
A Cross-Sectional Relationship between Social Capital,
Self-Compassion and Perceived HIV Symptoms
Allison Webel1,
Carmen
Dean Wantland3, Carol Dawson-Rose2, John Brion10,
12
J. Craig Phillips , Wei-Ti Chen4, Inge Corless9, Lucille Eller3, Elizabeth Sefcik8,
Mallory Johnson2, Marta Rivero7, Jeanne Kemppaninen5, Kathy Nokes0
Portillo2,
1Case
Western Reserve University, Cleveland Ohio, USA, 2University of California San Francisco, San
Francisco, CA, USA, 3Rutgers The State University of New Jersey, Newark, NJ, USA,
4Yale University, New Haven, CT, USA, 5University of North Carolina, Wilmington, Wilmington, NC, USA,
6Hunter College, CUNY, New York, NY, USA, 7University of Puerto Rico, Toa Baja, PR, Puerto Rico,
8Texas A&M University, Corpus Christi, TX, USA, 9MGH Institute of Health Professions, Boston, MA,
USA, 10Ohio State University, Columbus, OH, USA, 11University of Washington, Seattle, WA, USA,
12University of Ottowa, Ottowa, ON, Canada
Background: Individual social capital and self-compassion are associated with health behaviors and
perceived symptoms individually; suggesting that both are positive resources that can be modified to
improve one’s perceived symptoms. However, the relationship between social capital, self-compassion,
and symptom experience in people living with HIV (PLWH) has not yet been explored.
Purpose: To examine the relationship between self-compassion and social capital and its impact on
current symptom experience in adult PLWH. We further explored the impact of age on this relationship.
Methods: We conducted a cross-sectional analysis of 2,182 PLWH at 20 sites in 5 countries. Social
capital, self-compassion, and HIV symptom experience were evaluated using valid and reliable scales. To
account for inflated significance associated with a large sample size, we took a random sample of 30% of
subjects (n=520) and conducted correlation analysis and a negative binomial regression, controlling for
known medical and demographic variables impacting symptom experience.
Results: Social capital and self-compassion were moderately correlated (r=0.41, p<0.01). Controlling for
age, sex at birth, year of HIV diagnosis, other comorbid health conditions, employment status and income
level our model significantly predicted HIV symptom experience (overall model X 2 =49.08, p<0.001,
pseudo R2 =0.01). Self-compassion was the strongest negative predictor of symptom experience
(IRR=0.97, p <0.01), followed by employment status (IRR= 0.75, p=0.01), and social capital (IRR=0.99,
p=0.08). There was no relationship between age and self-compassion, social capital and symptom
experience.
Conclusions: Self-compassion and social capital modestly predicted current HIV symptom experience;
however future research is needed to better understand this relationship. Self-compassion and social
capital can be incorporated into symptom management interventions, possibly as a way to reframe one’s
symptom appraisal. The relationship between employment status and symptom experience was
significant and should be further explored.
Implications for Practice: Symptom management interventions should consider including both
information-based strategies and social and emotional processing strategies that may influence one’s
appraisal of symptoms and subsequent symptom management behaviors.
Objectives: The learner will be able to:

Understand the relationship between social capital and self-compassion;

Understand the relationship between social capital and self-compassion and HIV symptom
intensity.
D-9
Selected Health Determinants of Hispanic Men with HIV
Infection in the U.S. – Mexico Border Region: A Pilot Study
Holly Mata1
Jacob Martinez1
Elias Provencio-Vasquez1
Joseph De Santis2
1University
2University
of Texas at El Paso School of Nursing, El Paso, TX, USA
of Miami School of Nursing & Health Studies, Coral Gables, FL, USA
Background: A wide array of social, environmental, cultural, and contextual factors contribute to HIV risk
in addition to behavioral factors. Hispanics bear a disproportionate burden of HIV risk, and Hispanic men
who have sex with men (MSM) are particularly vulnerable to HIV infection. Although recent research has
focused Hispanic MSM, few studies have focused specifically on Hispanic men in the U.S. – Mexico border
region who are HIV-infected.
Purpose: Accordingly, the purpose of this pilot study was to describe selected health determinants and
characteristics of a sample of predominantly Mexican/Mexican American men living with HIV (N = 39; 7
heterosexual and 32 MSM).
Methods: Through structured interviews, data on a variety of health topics were collected from men
recruited primarily through clinical and community-based organizations providing services to men with HIV.
Participants ranged in age from 18-55 (M = 41.44, SD = 11.16); 21% had less than a high school education;
85% were unemployed and 69% had no health insurance; 31% speak English “almost always” while 49%
speak Spanish “almost always”; 56 % were born in the U.S. and 39% in Mexico; and 74% were single.
Conclusions: 22 (56%) of the men scored 16 or higher on the CES-D, indicating clinical risk for depression
(M = 16.95, SD = 10.74). 12 (31%) reported childhood physical abuse, 15 (39%) reported childhood
psychological abuse, and 6(15%) reported childhood sexual abuse. 16 (41%) said they did not use
condoms in the past 3 months. 19 (49%) were sexually abstinent in the past 3 months while 13 (33%)
reported having 1 partner and 7 (18%) had more than 1 partner.
Implications for Practice: These data provide important information to a diverse group of healthcare
practitioners, health educators, and policymakers. Nurses have a key role to play in advocating for practice
and policy changes that respond to inequities in systems-level care provision, as well as promote culturally
and linguistically appropriate services. Medicaid expansion, integrated behavioral health services, and
scope-of-practice issues provide nurses with advocacy and practice opportunities that have the potential to
promote health and health equity among people living with HIV.
Objectives: The learner will be able to:



Discuss basic epidemiology of HIV infection among Hispanic men in the U.S.;
Describe health-related factors that are experienced by Hispanic men;
Discuss implications for nursing care of Hispanic men with HIV infection.