Biomedical subjects

Karen Vernon

Publications and source records attributed to Karen Vernon.

6 recordsLinked to original sources

PubMed2005

HIV surveillance in theory and practice: assessing the acceptability of California's non-name HIV surveillance regulations.

In 2002, California adopted a non-name system for HIV case reporting. This study focused on the acceptability of a non-name reporting system among key stakeholders implementing the system. We conducted qualitative research during the pre- and post-implementation period of the non-name HIV reporting regulations. During both study periods we conducted key informant in-depth interviews (n = 48 and 52, respectively) with health department surveillance staff, laboratory personnel, health care providers and clinic staff; and we conducted four focus group discussions (n = 28 and 30, respectively) with representatives of community-planning group members and advocacy groups. We found that overall, California's non-name HIV reporting regulations were acceptable to most key stakeholders. Acceptability of a non-name system was highest among advocates and healthcare providers. Views of health department staff varied across the four counties, with some expressing a strong preference of a names based system and others accepting the non-name system.

California↗

PubMed2005

What's community got to do with it? Implementation models of syringe exchange programs.

Syringe exchange programs (SEPs) have been shown to be highly effective in reducing HIV transmission among injection drug users (IDUs). Despite this evidence, SEPs have not been implemented in many communities experiencing HIV epidemics among IDUs. We interviewed 17 key informants in nine U.S. cities to identify factors and conditions that facilitated or deterred the adoption of SEPs. Cities were selected to represent diversity in size, geographic location, AIDS incidence rates, and SEP implementation. Key informants included HIV prevention providers, political leaders, community activists, substance use and AIDS researchers, and health department directors. SEPs were established by one or more of three types of implementation models: (a) broad community coalition support, (b) community activist initiative, and (c) top-down decision making by government authorities. In each model, coalition building and community consultation were critical steps for the acceptance and sustainability of SEPs. When others were not prepared to act, community activists spearheaded SEP development, taking risks in the face of opposition, but often lacked the resources to sustain their efforts. Leadership from politicians and public health officials provided needed authority, clout, and access to resources. Researchers and scientific findings lent force and legitimacy to the effort. Rather than adopting adversarial positions, successful SEP implementers worked with or avoided the opposition. Fear of repercussions and lack of leadership were the greatest barriers to implementing SEPs. Communities that successfully implemented SEPs were those with activists willing to push the agenda, public officials willing to exercise leadership, researchers able to present authoritative findings, and proponents who effectively mobilized resources and worked to build community coalitions, using persistent but nonadversarial advocacy.

Community Health Services↗

PubMed2004

Missed opportunities: prevention with HIV-infected patients in clinical care settings.

OBJECTIVE: To assess current practices related to prevention with HIV-positive patients in Ryan White-funded primary care settings and the barriers to providing such services. METHOD: Exit surveys about HIV prevention services were conducted with 618 HIV-infected patients at 16 primary HIV care clinics receiving Ryan White CARE Act funding. To place the exit survey findings in context, qualitative in-depth interviews were conducted with 16 clinic administrators, 32 primary care providers, 32 support service providers, and 64 patients. RESULTS: One quarter of patients reported having had a general discussion of "safer sex and ways to prevent transmission to others" during that day's primary care visit. However, only 6% reported discussing specific sexual activities. HIV prevention counseling was less common than counseling for adherence to antiretroviral therapy, emotional issues, and diet and nutrition (P < 0.001). Patients in clinics with established procedures for HIV prevention counseling were significantly more likely to report receiving such services (odds ratio = 2.17). Qualitative interviews identified barriers to providing prevention services as lack of time, training, funding for staffing, and providers' understanding of their roles and responsibility. CONCLUSIONS: HIV prevention counseling is not routine in most clinics, and the low frequency of such services represents missed opportunities for HIV prevention.

Adolescent↗

PubMed2003

Why HIV infections have increased among men who have sex with men and what to do about it: findings from California focus groups.

A resurgence of sexual risk taking, STDs, and HIV incidence has been reported among men who have sex with men (MSM) in several countries. We asked 113 MSM in 12 focus groups conducted in five California cities to identify factors leading to increased risk taking and assess prevention messages to reduce risk in this population. Participants perceived that HIV risk taking has increased because (1) HIV is not the threat it once was due to more effective therapies, (2) MSM communicate less about HIV, and social support for being safe has decreased, and (3) community norms have shifted such that unsafe sex is more acceptable. The prevention messages ranked most likely to motivate risk reduction encouraged individuals to seek social support from friends. Themes ranked least likely to succeed were those that described the negative consequences of HIV or reinforced existing safer sex messages.

Adolescent↗

PubMedDate not supplied

Attitudes to long-term care in multiple sclerosis.

At a recent conference workshop, a group of specialist nurses examined their attitudes towards individuals with multiple sclerosis moving into long-term care. This article summarises how the group members examined their attitudes, the literature reviewed and what was learnt by sharing experiences. It also suggests how nurses could promote positive attitudes towards, and ease, the transition of patients into long-term residential care.

Attitude of Health Personnel↗

PubMedDate not supplied

Specialist nurse network improves MS practice.

This article looks at the development of a group dedicated to meeting the clinical supervision and networking needs of multiple sclerosis nurse specialists. It describes the evolution of the group, the structure and content of group meetings and how they have both improved practice and reduced the isolation of MS specialists who work independently. The nurses involved have found that working collaboratively and developing an interactive network has not only significantly affected their clinical practice but also helped to address work-related stress.

Community Networks↗