Publications by authors named "John B F De Wit"

74 Publications

Bridging the serodivide: attitudes of PrEP users towards sex partners living with HIV.

AIDS Care 2021 Jul 19:1-4. Epub 2021 Jul 19.

Department of Work & Social Psychology, Maastricht University, Maastricht, the Netherlands.

The introduction of biomedical HIV prevention methods, such as pre-exposure prophylaxis (PrEP), holds the potential to overcome the serodivide. We investigated the attitudes of PrEP users towards having sex with partners living with HIV. PrEP users in the Netherlands were recruited online and completed three questionnaires over a period of six months. We investigated changes over time in feelings of fear of HIV, comfort, and attitudes towards condom use when having sex with men living with HIV (MLHIV). A majority of PrEP users in our sample (up to 71.6%) had sex with MLHIV. Feeling comfortable to have sex with MLHIV did not change over time, but was already at a high level at T1. Most importantly, feeling safe not to use condoms with HIV-positive partners significantly increased, and did so in a rather short period of time after the onset of PrEP use (3-6 months). Taken together, the findings suggest that that PrEP may contribute to decreasing the serodivide between MSM rather quickly after the onset of PrEP use.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09540121.2021.1954588DOI Listing
July 2021

Social Inequality and Solidarity in Times of COVID-19.

Int J Environ Res Public Health 2021 Jun 11;18(12). Epub 2021 Jun 11.

Department of Interdisciplinary Social Science, Utrecht University, 3584 CH Utrecht, The Netherlands.

The enormous public health burdens of the COVID-19 pandemic are not distributed equally. Inequalities are noticeable along socio-economic and socio-cultural fault lines. These social determinants of health affect both the prevalence and severity of COVID-19 infections as well as the magnitude of negative impacts of the measures taken to slow the spread of the virus. This perspective paper summarizes key inequalities in who is affected by SARS-CoV-2 infection and in who is affected by COVID-19 prevention measures, based on evidence presented in state-of-the-art literature, and discusses the scope of challenges that these inequalities pose to solidarity and social justice. Key challenges for solidarity are highlighted across three areas: challenges to intergenerational solidarity, to global solidarity, and to intergroup solidarity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18126339DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296166PMC
June 2021

Actions Speak Louder Than Words: Workplace Social Relations and Worksite Health Promotion Use.

J Occup Environ Med 2021 Jul;63(7):614-621

Department of Sociology, Faculty of Social and Behavioral Sciences, Utrecht University, The Netherlands (Ms van der Put, Dr Mandemakers, and Dr van der Lippe); Interdisciplinary Social Science: Public Health, Faculty of Social and Behavioral Sciences, Utrecht University, The Netherlands (Dr de Wit).

Objective: To study whether workplace social relations explain use of worksite health promotion (WHP), by examining colleagues' and team managers' WHP encouragement of a healthy lifestyle, and colleague WHP uptake.

Methods: Multilevel data came from the second wave of the European Sustainable Workforce Survey (4345 employees of 402 team in 9 countries). Linear probability models were used to test use of two types of WHP: healthy menus and sport facilities.

Results: Employees are more likely to use healthy menus and sport facilities when more colleagues do so too and when colleagues encourage a healthy lifestyle. Surprisingly, encouragement by one's manager plays no role.

Conclusions: Social contact among colleagues can facilitate WHP use, and WHP initiatives should pay attention to the influential role of colleagues.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/JOM.0000000000002196DOI Listing
July 2021

Quality of Sex Life and Perceived Sexual Pleasure of PrEP Users in the Netherlands.

J Sex Res 2021 Jun 15:1-6. Epub 2021 Jun 15.

Department of Work & Social Psychology, Maastricht University.

Next to its benefits for HIV prevention, PrEP may have psychosocial benefits relating to improved quality of sex life. The aim of the current study was to investigate the onset of changes in the quality of sex life and sexual pleasure of PrEP users in the first months of commencing PrEP use. Moreover, we investigated what factors were related to the quality of sex life of PrEP users. We recruited 145 participants via the Dutch PrEP-advocacy website PrEPnu.nl, and they received follow-up questionnaires after three and six months. We found that PrEP users reported an increase in the quality of their sex life, which was related to reduced fear of HIV since they started using PrEP but not to decreased condom use. PrEP users were more interested in experimenting with sex practices, but they did not always feel more desirable as a sex partner because of PrEP use. Health-care providers and health promotion campaigns could emphasize the positive effects of PrEP on the quality of sex life, in addition to the HIV-preventive effects of PrEP, to decrease PrEP stigma and increase PrEP uptake.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/00224499.2021.1931653DOI Listing
June 2021

The Development of an Electronic Clinical Decision and Support System to Improve the Quality of Antenatal Care in Rural Tanzania: Lessons Learned Using Intervention Mapping.

Front Public Health 2021 20;9:645521. Epub 2021 May 20.

Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands.

It is widely recognised that high quality antenatal care is a key element in maternal healthcare. Tanzania has a very high maternal mortality ratio of 524 maternal deaths per 100,000 live births. Most maternal deaths are due to preventable causes that can be detected during pregnancy, and antenatal care therefore plays an important role in reducing maternal morbidity and mortality. Unfortunately, quality of antenatal care in Tanzania is low: Research has shown that healthcare workers show poor adherence to antenatal care guidelines, and the majority of pregnant women miss essential services. Digital health tools might improve the performance of healthcare workers and contribute to improving the quality of antenatal care. To this end, an electronic clinical decision and support system (the Nurse Assistant App) was developed and implemented in Tanzania in 2016 to provide digital assistance during antenatal care consultations to healthcare workers. The current study systematically evaluated the development and implementation process of the Nurse Assistant App in Magu District, Tanzania, with the aim of informing future programme planners about relevant steps in the development of a digital health intervention. Desk research was combined with semi-structured interviews to appraise the development process of the digital health tool. We employed the criteria stipulated by Godin et al., which are based on the six steps of Intervention Mapping [IM; Bartholomew Eldredge et al.]. Findings indicated that five of the six steps of IM were completed during the development and implementation of the Nurse Assistant App. Tasks related to community engagement, adjustment to local context, implementation in the practical context in collaboration with local partners, and rigorous evaluation were accomplished. However, tasks related to identifying theory-based behaviour change methods were not accomplished. Based on the lessons learned during the process of developing and implementing the Nurse Assistant App, we conclude that programme developers are recommended to (1) engage the community and listen to their insights, (2), focus on clear programme goals and the desired change, (3), consult or involve a behaviour change specialist, and (4), anticipate potential problems in unexpected circumstances.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpubh.2021.645521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8172617PMC
June 2021

Slow Uptake of PrEP: Behavioral Predictors and the Influence of Price on PrEP Uptake Among MSM with a High Interest in PrEP.

AIDS Behav 2021 Aug 21;25(8):2382-2390. Epub 2021 Feb 21.

Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.

Despite the improved availability and affordability of PrEP in the Netherlands, PrEP uptake is low among men who have sex with men (MSM). To optimize uptake, it is important to identify facilitators and barriers of PrEP use. During our study period, the price of PrEP dropped significantly after generic PrEP was introduced. We investigated whether the price drop predicts PrEP uptake, alongside behavioral and demographic characteristics. Participants (N = 349) were recruited online and completed three questionnaires over a period of 6 months, between February 2017 and March 2019. After 6 months, 159 (45.6%) participants were using PrEP. PrEP uptake was greater among MSM who ever had postexposure prophylaxis (PEP) treatment, among MSM with a better perceived financial situation, and when the price of PrEP dropped. MSM in a tighter perceived financial situation may use PrEP more when it would be free or fully reimbursed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10461-021-03200-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222036PMC
August 2021

Socio-Sexual Experiences and Access to Healthcare Among Informal PrEP Users in the Netherlands.

AIDS Behav 2021 Apr 16;25(4):1236-1246. Epub 2020 Nov 16.

Department of Work & Social Psychology, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands.

The aim of this qualitative study was to explore the experiences of informal PrEP users regarding access to PrEP and PrEP-related healthcare, community responses, sexual behavior and well-being. We interviewed 30 men who have sex with men (MSM) in semi-structured online interviews between March and August 2018. Interviews were analyzed using interpretive description. Informal PrEP users were well informed about the use of PrEP, but sometimes did not make use of renal testing. Participants reported a lack of PrEP knowledge among healthcare providers, which limited their access to PrEP and put them at risk, as they received incorrect information. Although some participants reported negative reactions from potential sex partners, most received positive reactions and were sometimes seen as more desirable sex partners. PrEP healthcare services should not only be accessible to formal PrEP users, but also to PrEP users who procure PrEP informally.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10461-020-03085-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7973587PMC
April 2021

Risk factors for loss to follow-up from antiretroviral therapy programmes in low-income and middle-income countries.

AIDS 2020 07;34(9):1261-1288

Department of Interdisciplinary Social Science, Utrecht University, the Netherlands.

Introduction: Loss to follow-up (LTFU) rates from antiretroviral treatment (ART) programmes in low- and middle-income countries (LMIC) are high, leading to poor treatment outcomes and onward transmission of HIV. Knowledge of risk factors is required to address LTFU. In this systematic review, risk factors for LTFU are identified and meta-analyses performed.

Methods: PubMed, Embase, Psycinfo and Cochrane were searched for studies that report on potential risk factors for LTFU in adults who initiated ART in LMICs. Meta-analysis was performed for risk factors evaluated by at least five studies. Pooled effect estimates and their 95% confidence intervals (95% CI) were calculated using random effect models with inverse variance weights. Risk of bias was assessed and sensitivity analyses performed.

Results: Eighty studies were included describing a total of 1 605 320 patients of which 87.4% from sub-Saharan Africa. The following determinants were significantly associated with an increased risk of LTFU in meta-analysis: male sex, older age, being single, unemployment, lower educational status, advanced WHO stage, low weight, worse functional status, poor adherence, nondisclosure, not receiving cotrimoxazole prophylactic therapy when indicated, receiving care at secondary level and more recent year of initiation. No association was seen for CD4 cell count, tuberculosis at baseline, regimen, and geographical setting.

Conclusion: There are several sociodemographic, clinical, patient behaviour, treatment-related and system level risk factors for LTFU from ART programs. Knowledge of risk factors should be used to better target retention interventions and develop tools to identify high-risk patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/QAD.0000000000002523DOI Listing
July 2020

PrEP Interest Among Men Who Have Sex with Men in the Netherlands: Covariates and Differences Across Samples.

Arch Sex Behav 2020 08 2;49(6):2155-2164. Epub 2020 Mar 2.

Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.

Despite increased availability of pre-exposure prophylaxis (PrEP), PrEP uptake has remained low. To promote uptake, factors related to PrEP interest among relevant target populations warrant investigation. The aim of this study was to provide an analysis of PrEP interest among men who have sex with men (MSM) in the Netherlands, while taking study recruitment strategies into account. We recruited 154 MSM from an LGBT research panel (AmsterdamPinkPanel) and 272 MSM from convenience sampling. Both samples were part of the Flash! PrEP in Europe Survey and were compared on their PrEP interest, usage intentions, and sexual behavior. We conducted logistic regression analyses to discover variables associated with PrEP interest and intentions. Participants from the AmsterdamPinkPanel were less likely to use PrEP, had less knowledge of PrEP, and were less interested in PrEP than participants from convenience sampling. Significant covariates of PrEP interest were being single, more prior PrEP knowledge, sexual risk behaviors, such as not having used a condom during last sex and having ever used drugs in a sexual context, and not participating in the AmsterdamPinkPanel. Adding the recruitment strategy to the regression increased explained variance on top of predictors already described in the literature. Increased sexual risk behavior is related to increased PrEP interest and it helps to identify PrEP target groups. Recruitment strategies have a substantial impact on findings regarding PrEP interest and usage intentions. This study emphasizes the importance of using multiple strategies for recruiting participants to obtain a more comprehensive view of MSM's attitudes toward PrEP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10508-019-01620-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316842PMC
August 2020

Worksite health promotion and social inequalities in health.

SSM Popul Health 2020 Apr 17;10:100543. Epub 2020 Jan 17.

Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands.

It is well-documented that higher educated employees have better health than the lower educated. The workplace has been put forward as a contributor to this inequality. We extend previous work on workplace characteristics that could influence employee health by asking to what extent workplace health promotion (WHP) can account for the relation between education and health. Two ways in which WHP may relate to health inequalities are addressed: higher educated employees may be more likely to use WHP than lower educated employees and the effect of WHP on health may be stronger for higher educated than for lower educated employees. Using data from the European Sustainable Workforce Survey which contains information on over 11000 employees in 259 organisations, we test whether three types of WHP mediate or moderate the relation between education and health: healthy menus, sports facilities and health checks. We find that higher educated employees are in better health and that use of WHP positively relates to health. Use of healthy menus and sports facilities in the workplace can contribute to increasing health inequalities, as lower educated employees are less likely to make use of these. Health checks could contribute to diminishing health inequalities, as lower educated employees are more likely to use them compared to higher educated employees. The effect of WHP is not contingent on education. We advise stimulating lower educated employees to make more use of WHP, which can contribute to decreasing health inequalities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ssmph.2020.100543DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994707PMC
April 2020

The role of social support in moderating the relationship between HIV centrality, internalised stigma and psychological distress for people living with HIV.

AIDS Care 2020 07 4;32(7):850-857. Epub 2019 Sep 4.

Centre for Social Research in Health, The University of New South Wales, Sydney, Australia.

Research has documented the negative impact of stigma on health outcomes for people living with HIV (PLHIV). How central HIV is to the identity of the individual may increase the negative effects of stigma, including greater psychological distress, while having strong social supports may play a buffering role. This study aimed to establish whether internalised stigma mediates the relationship between the centrality of HIV identity and psychological distress, while also assessing the role of social support as a moderator. PLHIV ( = 181) responded to a survey assessing experiences of living with HIV focussed on centrality of HIV identity, internalised stigma, and wellbeing. After controlling for age and education, findings from the mediation analysis show that the more central HIV is to an individual's identity, the more stigma is internalised and the greater the negative impact on psychological wellbeing. However, this is only the case for people with low levels of social support. Regardless of how central HIV is to identity, social support appears to act as a buffer and promote positive wellbeing. For those working with PLHIV, promoting the importance of good social support systems may be one way to address some of the negative impacts of stigma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09540121.2019.1659914DOI Listing
July 2020

Protocol for an HIV Pre-exposure Prophylaxis (PrEP) Population Level Intervention Study in Victoria Australia: The PrEPX Study.

Front Public Health 2018 29;6:151. Epub 2018 May 29.

Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, VIC, Australia.

Pre-exposure prophylaxis (PrEP) is the use of HIV anti-retroviral therapy to prevent HIV transmission in people at high risk of HIV acquisition. PrEP is highly efficacious when taken either daily, or in an on-demand schedule. In Australia co-formulated tenofovir-emtricitabine is registered for daily use for PrEP, however, this co-formulation is not listed yet on the national subsidized medicines list. We describe a study protocol that aims to demonstrate if the provision of PrEP to up to 3800 individuals at risk of HIV in Victoria, Australia reduces HIV incidence locally by 25% generally and 30% among GBM. PrEPX is a population level intervention study in Victoria, Australia in which generic PrEP will be delivered to 3800 individuals for up to 36 months. Study eligibility is consistent with the recently updated 2017 Australian PrEP guidelines. Participants will attend study clinics, shared care clinics, or outreach clinics for quarterly HIV/STI screening, biannual renal function tests and other clinical care as required. Study visits and STI diagnoses will be recorded electronically through the ACCESS surveillance system. At each study visit participants will be invited to complete behavioral surveys that collect demographics and sexual risk data. Diagnosis and behavioral data will be compared between PrEPX participants and other individuals testing within the ACCESS surveillance system. A subset of participants will complete in depth surveys and interviews to collect attitudes, beliefs and acceptability data. Participating clinics will provide clinic level data on implementation and management of PrEPX participants. The population level impact on HIV incidence will be assessed using Victorian HIV notification data. This study will collect evidence on the real world impact of delivery of PrEP to 3800 individuals at risk of acquiring HIV in Victoria. This study will provide important information for the broader implementation of PrEP planning upon listing of the tenofovir-emtricitabine on the national subsidized list of medicines. The study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12616001215415).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpubh.2018.00151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987055PMC
May 2018

Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys.

Sex Health 2017 02;14(1):72-79

The University of New South Wales, The Kirby Institute, Sydney, NSW 2052, Australia.

Background In Australia, the preventative use of antiretroviral drugs [pre-exposure prophylaxis (PrEP) and treatment as prevention] is being embraced to protect individuals at high risk of HIV and reduce onward transmission.

Methods: The adaptation of a behavioural surveillance system, the Gay Community Periodic Surveys, was reviewed to monitor the uptake and effect of new prevention strategies in Australia's primary HIV-affected population (gay and bisexual men, GBM). The national trends in key indicators during 2000-15 were reviewed and a new measure to take account of antiretroviral-based prevention was developed.

Results: Between 2000 and 2015, there were significant increases (P<0.001) in annual HIV testing (56.1-64.8%), condomless sex with casual partners (26.8-38.8%) and the proportion of HIV-positive men on HIV treatment (72.5-88.4%) and with an undetectable viral load (73.7-94.7%). The proportion of casual partners who were HIV negative, not on PrEP and who engaged in receptive condomless sex also increased between 2000 and 2015 from 12.8 to 19.3%. Two scenarios anticipating the effect of PrEP highlighted the need to target GBM who engage in receptive condomless sex while also sustaining condom use at a population level.

Conclusions: Behavioural surveillance can be successfully adapted to follow the effect of antiretroviral-based prevention. It is anticipated that HIV testing and HIV treatment will continue to increase among Australian GBM, but to prevent new infections, intervention in the growing proportion of GBM who have condomless sex with casual partners is needed. For PrEP to have its desired effect, condom use needs to be sustained.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1071/SH16072DOI Listing
February 2017

When group members go against the grain: An ironic interactive effect of group identification and normative content on healthy eating.

Appetite 2016 10 6;105:344-55. Epub 2016 Jun 6.

University of Queensland, Australia.

Three studies were conducted to examine the effect of group identification and normative content of social identities on healthy eating intentions and behaviour. In Study 1 (N = 87) Australian participants were shown images that portrayed a norm of healthy vs. unhealthy behaviour among Australians. Participants' choices from an online restaurant menu were used to calculate energy content as the dependent variable. In Study 2 (N = 117), female participants were assigned to a healthy or unhealthy norm condition. The dependent variable was the amount of food eaten in a taste test. Social group identification was measured in both studies. In Study 3 (N = 117), both American identification and healthiness norm were experimentally manipulated, and participants' choices from an online restaurant menu constituted the dependent variable. In all three studies, the healthiness norm presented interacted with participants' group identification to predict eating behaviour. Contrary to what would be predicted under the traditional normative social influence account, higher identifiers chose higher energy food from an online menu and ate more food in a taste test when presented with information about their in-group members behaving healthily. The exact psychological mechanism responsible for these results remains unclear, but the pattern of means can be interpreted as evidence of vicarious licensing, whereby participants feel less motivated to make healthy food choices after being presented with content suggesting that other in-group members are engaging in healthy behaviour. These results suggest a more complex interplay between group membership and norms than has previously been proposed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.appet.2016.06.005DOI Listing
October 2016

The potential of peer social norms to shape food intake in adolescents and young adults: a systematic review of effects and moderators.

Health Psychol Rev 2016 Sep 22;10(3):326-40. Epub 2016 Mar 22.

c Centre for Social Research in Health, University of New South Wales , Sydney , Australia.

This systematic review aims to assess the role that peer social norms play in shaping young people's food intake, focusing on the important questions of for whom and when peer social norms are related to how much young people eat. Thirty-three eligible studies were reviewed (17 correlational, 16 experimental). All but one correlational studies found significant associations between norms and food intake. All experimental studies found effects of norm manipulations on food intake, and some evidence was found of behavioural spillover effects of norms. Four moderators were distilled from our literature synthesis that stipulate for whom and when peer social norms are related to food intake: identification with the norm referent group and eating-related habit strength were found to moderate the effects of social norms on food intake; forceful injunctive norms were found not to be related to food intake; and the influence of norms seemed restricted to types of foods typically consumed in the presence of peers. The findings from this literature synthesis have important implications for research, and moderators are discussed in light of psychological theory. Where applicable, potential implications for the development of social norm-based interventions to improve young people's food intake are also highlighted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/17437199.2016.1155161DOI Listing
September 2016

Does the Theory of Planned Behaviour Explain Condom Use Behaviour Among Men Who have Sex with Men? A Meta-analytic Review of the Literature.

AIDS Behav 2016 12;20(12):2834-2844

School of Psychology, Deakin University, Geelong, Australia.

The aim of this meta-analysis was to explore whether the constructs in the theory of planned behaviour (TPB; i.e., attitude, subjective norm, perceived behavioural control, intention) explain condom use behaviour among men who have sex with men (MSM). Electronic databases were searched for studies that measured TPB variables and MSM condom use. Correlations were meta-analysed using a random effects model and path analyses. Moderation analyses were conducted for the time frame of the behavioural measure used (retrospective versus prospective). Attitude, subjective norm and perceived behavioural control accounted for 24.0 % of the variance in condom use intention and were all significant correlates. Intention and PBC accounted for 12.4 % of the variance in condom use behaviour. However, after taking intention into account, PBC was no longer significantly associated with condom use. The strength of construct relationships did not differ between retrospective and prospective behavioural assessments. The medium to large effect sizes of the relationships between the constructs in the TPB, which are consistent with previous meta-analyses with different behaviours or target groups, suggest that the TPB is also a useful model for explaining condom use behaviour among MSM. However, the research in this area is rather small, and greater clarity over moderating factors can only be achieved when the literature expands.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10461-016-1314-0DOI Listing
December 2016

Hungry for an intervention? Adolescents' ratings of acceptability of eating-related intervention strategies.

BMC Public Health 2016 Jan 5;16. Epub 2016 Jan 5.

National Centre in HIV Social Research, University of New South Wales, Sydney, Australia.

Background: Effective interventions promoting healthier eating behavior among adolescents are urgently needed. One factor that has been shown to impact effectiveness is whether the target population accepts the intervention. While previous research has assessed adults' acceptance of eating-related interventions, research on the opinion of adolescents is lacking. The current study addressed this gap in the literature.

Methods: Two thousand seven hundred sixty four adolescents (aged 10-17 years) from four European countries answered questions about individual characteristics (socio-demographics, anthropometrics, and average daily intake of healthy and unhealthy foods) and the acceptability of ten eating-related intervention strategies. These strategies varied in type (either promoting healthy eating or discouraging unhealthy eating), level of intrusiveness, setting (home, school, broader out-of-home environment), and change agent (parents, teacher, policy makers).

Results: Based on adolescents' acceptability ratings, strategies could be clustered into two categories, those promoting healthy eating and those discouraging unhealthy eating, with acceptability rated significantly higher for the former. Acceptability of intervention strategies was rated moderate on average, but higher among girls, younger, overweight and immigrant adolescents, and those reporting healthier eating. Polish and Portuguese adolescents were overall more accepting of strategies than UK and Dutch adolescents.

Conclusions: Adolescents preferred intervention strategies that promote healthy eating over strategies that discourage unhealthy eating. Level of intrusiveness affected acceptability ratings for the latter type of strategies only. Various individual and behavioral characteristics were associated with acceptability. These findings provide practical guidance for the selection of acceptable intervention strategies to improve adolescents' eating behavior.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-015-2665-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700578PMC
January 2016

The need to know: HIV status disclosure expectations and practices among non-HIV-positive gay and bisexual men in Australia.

AIDS Care 2015 ;27 Suppl 1:90-8

a Centre for Social Research in Health, UNSW , Sydney , Australia.

Although there is evidence of increasing overall rates of HIV status disclosure among gay and bisexual men, little is known about men's disclosure expectations and practices. In this study, we investigate the importance non-HIV-positive men in Australia vest in knowing the HIV status of their sexual partners, and the extent to which they restrict sex to partners of the same HIV status, and their HIV disclosure expectations. Data were collected through a national, online self-report survey. Of the 1044 men included in the study, 914 were HIV negative and 130 were untested. Participants completed the assessment of socio-demographic characteristics, HIV status preferences, and disclosure expectations and practices. Participants also completed reliable multi-item measures of perceived risk of HIV transmission, expressed HIV-related stigma, and engagement with the gay community and the community of people living with HIV. A quarter (25.9%) of participants wanted to know the HIV status of all sexual partners, and one-third (37.2%) restricted sex to partners of similar HIV status. Three quarters (76.3%) expected HIV-positive partners to disclosure their HIV status before sex, compared to 41.6% who expected HIV-negative men to disclose their HIV status. Less than half (41.7%) of participants reported that they consistently disclosed their HIV status to sexual partners. Multivariate linear regression analysis identified various covariates of disclosure expectations and practices, in particular of disclosure expectations regarding HIV-positive men. Men who expected HIV-positive partners to disclose their HIV status before sex more often lived outside capital cities, were less educated, were less likely to identify as gay, perceived more risk of HIV transmission from a range of sexual practices, were less engaged with the community of people living with HIV, and expressed more stigma towards HIV-positive people. These findings suggest that an HIV-status divide is emerging or already exists among gay men in Australia. HIV-negative and untested men who are most likely to sexually exclude HIV-positive men are less connected to the HIV epidemic and less educated about HIV risk and prevention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09540121.2015.1062077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685622PMC
February 2018

Social support influences on eating awareness in children and adolescents: the mediating effect of self-regulatory strategies.

Glob Public Health 2016 13;11(4):437-48. Epub 2015 Nov 13.

j Department in Wroclaw , University of Social Sciences and Humanities , Wroclaw , Poland.

The impact of the social environment on healthy eating awareness results from complex interactions among physical, economic, cultural, interpersonal and individual characteristics. This study investigated the impact of social support and social influence on healthy eating awareness, controlling for socio-economic status, gender and age. Additionally, the mediating effect of self-regulation strategies was examined. A total of 2764 children and adolescents aged 10-17 from four European countries completed self-report measures on healthy eating awareness, social influence and the use of self-regulation strategies. Healthy eating awareness and the use of self-regulation strategies were more likely to occur among younger participants. An interaction between gender and age was related to the use of some self-regulation strategies; compared to girls, boys decreased the use of self-regulation strategies more from pre-adolescence to adolescence. Peer social influence was associated with more unhealthy eating in older participants. Results suggest a need to promote self-regulatory competences among young people in order to assist them with regulating their eating behaviours, especially in the presence of peers. Both school-based interventions and family-based interventions, focusing on self-regulation cognitions and social (peer) influence, could help children and adolescents to use self-regulatory strategies which are essential to eat healthier.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/17441692.2015.1094106DOI Listing
December 2016

Prevalence and Correlates of HIV and Hepatitis C Virus Infections and Risk Behaviors among Malaysian Fishermen.

PLoS One 2015 5;10(8):e0118422. Epub 2015 Aug 5.

Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Fishermen in Southeast Asia have been found to be highly vulnerable to HIV, with research evidence highlighting the role of sexual risk behaviors. This study aims to estimate the rate of HIV as well as hepatitis C virus (HCV) infections among Malaysian fishermen, and the risky sexual and injection drug use behaviors that may contribute to these infections. The study also includes an assessment of socio-demographic, occupational and behavioral correlates of testing positive for HIV or HCV, and socio-demographic and occupational correlates of risk behaviors. The study had a cross-sectional design and recruited 406 fishermen through respondent-driven sampling (RDS). Participants self-completed a questionnaire and provided biological specimens for HIV and HCV testing. We conducted and compared results of analyses of both unweighted data and data weighted with the Respondent-Driven Sampling Analysis Tool (RDSAT). Of the participating fishermen, 12.4% were HIV positive and 48.6% had HCV infection. Contrary to expectations and findings from previous research, most fishermen (77.1%) were not sexually active. More than a third had a history of injection drug use, which often occurred during fishing trips on commercial vessels and during longer stays at sea. Of the fishermen who injected drugs, 42.5% reported unsafe injection practices in the past month. Reporting a history of injection drug use increased the odds of testing HIV positive by more than 6 times (AOR = 6.22, 95% CIs [2.74, 14.13]). Most fishermen who injected drugs tested positive for HCV. HCV infection was significantly associated with injection drug use, being older than 25 years, working on a commercial vessel and spending four or more days at sea per fishing trip. There is an urgent need to strengthen current harm reduction and drug treatment programs for Malaysian fishermen who inject drugs, especially among fishermen who work on commercial vessels and engage in deep-sea fishing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0118422PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526636PMC
May 2016

The habitual nature of unhealthy snacking: How powerful are habits in adolescence?

Appetite 2015 Dec 10;95:182-7. Epub 2015 Jul 10.

Utrecht University, Utrecht, The Netherlands.

Many adolescents engage in unhealthy snacking behavior, and the frequency and amount of unhealthy consumption is increasing further. In this study, we aim to investigate the role that habit strength plays in unhealthy snacking during adolescence and whether self-regulation strategies can overcome habitual snacking. A total of 11,392 adolescents aged 10-17 years from nine European countries completed a cross-sectional survey about healthy eating intentions, snacking habit strength, eating self-regulation strategies, and daily intake of unhealthy snacks. The results showed that habit strength was positively associated with intake of unhealthy snack foods, also when healthy eating intentions were accounted for. Use of self-regulation strategies was negatively associated with unhealthy snacking. The interaction effect of habit strength and use of self-regulation strategies was significant. Strong snacking habits were associated with higher consumption, but this effect could be attenuated by use of temptation-oriented self-regulation strategies. The present study highlights that habit strength is associated with unhealthy snacking already in adolescents. The findings suggest that teaching self-regulation strategies may help adolescents to overcome unhealthy snacking habits.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.appet.2015.07.010DOI Listing
December 2015

Evolving views and practices of antiretroviral treatment prescribers in Australia.

Med J Aust 2015 Mar;202(5):258-61

University of New South Wales, Sydney, NSW, Australia.

Objective: To examine whether there have been recent changes in Australian antiretroviral treatment (ART) prescribers' perceptions and practices relating to early ART initiation, which was defined as commencing ART when a patient's CD4+ T-cell count approaches 500 cells/mm3 or immediately after a patient is diagnosed with HIV.

Design, Participants And Setting: Self-completed, anonymous, cross-sectional surveys, targeting all ART prescribers in Australia, were conducted online in 2012 and 2013. The surveys included questions on prescriber factors, CD4+ T-cell count at which prescribers would most strongly recommend ART initiation, and perceived patient characteristics that could change prescribers' practices of early initiation of ART.

Main Outcome Measures: Proportions of ART prescribers recommending early ART initiation.

Results: We analysed responses from 108 participants in 2012 and 82 participants in 2013. In both years, more male than female prescribers participated. The median age of participants was 49 years in 2012 and 50 years in 2013. In both rounds, over 60% had more than 10 years' experience in treating HIV-positive patients. More prescribers in 2013 stated that they would most strongly recommend early ART initiation compared with those in 2012 (50.0% [95% CI, 38.7%-61.3%] v 26.9% [95% CI, 18.8%-36.2%]; P=0.001). The prescribers' primary concern was more about individual patient than public health benefit. Out of 824 patients for whom ART was initiated, as reported by prescribers in 2013, only 108 (13.1% [95% CI, 10.9%-15.6%]) were given ART primarily to prevent onward HIV transmission. The number of patients for whom ART was initiated was significantly associated with prescribers' HIV caseload even after adjusting for prescriber type (adjusted odds ratio, 1.73 [95% CI, 1.47-2.03]; P<0.001); of the 37 who had initiated ART for 10 or more patients, 29 had a high HIV caseload. In 2013, 60 prescribers (73.2% [95% CI, 62.2%-82.4%]) reported that they routinely recommended ART to treatment-naive, asymptomatic patients with a CD4+ T-cell count of 350-500 cells/mm3.

Conclusion: Our findings show increasing acceptance of and support for early ART initiation primarily as treatment and not as prevention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5694/mja14.00443DOI Listing
March 2015

Interest in using rectal microbicides among Australian gay men is associated with perceived HIV vulnerability and engaging in condomless sex with casual partners: results from a national survey.

Sex Transm Infect 2015 Jun 21;91(4):266-8. Epub 2014 Nov 21.

Centre for Social Research in Health, UNSW Australia, Sydney, New South Wales, Australia.

Objective: We assessed interest in using rectal microbicides to prevent HIV transmission among gay men in Australia.

Methods: A national online survey was conducted in 2013. Interest in using rectal microbicides was measured on a seven-item scale (α=0.81). Factors independently associated with greater interest in using a microbicide were identified using multivariate logistic regression.

Results: Data were collected from 1223 HIV-negative and untested men. Mean age was 31.3 years (SD=10.8, range 18-65); 77% were born in Australia and 25% reported any condomless anal sex with a casual partner in the previous 6 months. Overall, there was moderate interest in using rectal microbicides (M=3.33, range 1-5). In multivariate analysis, greater interest in using microbicides was independently associated with being born outside Australia (adjusted OR (AOR)=1.59; p=0.009), greater self-perceived likelihood of becoming HIV positive (AOR=3.40; p<0.001), less uncertainty about the efficacy of microbicides (AOR=0.65; p=0.009), any condomless anal sex with casual partners in the previous 6 months (AOR=1.78; p=0.03) and ever having received postexposure prophylaxis (AOR=1.53; p=0.04). Interest in using microbicides was not associated with age, number of male sex partners or the HIV status of regular male partners.

Conclusions: Interest in using rectal microbicides was associated with self-perceived vulnerability to HIV, engaging in sexual practices that increase the risk of HIV acquisition and less uncertainty about the efficacy of microbicides. There appears to be a group of men who would benefit from, and are highly motivated to use, a rectal microbicide product.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/sextrans-2014-051694DOI Listing
June 2015

Australian gay and bisexual men's attitudes to HIV treatment as prevention in repeated, national surveys, 2011-2013.

PLoS One 2014 11;9(11):e112349. Epub 2014 Nov 11.

Centre for Social Research in Health, UNSW Australia, Sydney, New South Wales, Australia; Social and Organizational Psychology, Utrecht University, Utrecht, the Netherlands.

Objective: Assess the acceptability of HIV treatment as prevention and early antiretroviral treatment among gay and bisexual men in Australia and any changes in attitudes over time.

Methods: National, online, cross-sectional surveys of gay and bisexual men were repeated in 2011 and 2013. Changes in attitudes to HIV treatment over time were assessed with multivariate analysis of variance. The characteristics of men who agreed that HIV treatment prevented transmission and thought that early treatment was necessary were identified with multivariate logistic regression.

Results: In total, 2599 HIV-negative, untested and HIV-positive men participated (n = 1283 in 2011 and n = 1316 in 2013). Attitudes changed little between 2011 and 2013; most participants remained sceptical about the preventative benefits of HIV treatment. In 2013, only 2.6% of men agreed that HIV treatment prevented transmission; agreement was associated with being HIV-positive, having an HIV-positive regular partner, and having received HIV post-exposure prophylaxis. In contrast, 71.8% agreed that early antiretroviral treatment is necessary; younger men were more likely and HIV-positive men and participants with HIV-positive partners were much less likely to agree with this.

Conclusions: Promoting the individual health benefits of HIV treatment rather than its preventative benefits remains more acceptable to Australian gay and bisexual men.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0112349PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227707PMC
February 2016

Food culture in the home environment: family meal practices and values can support healthy eating and self-regulation in young people in four European countries.

Appl Psychol Health Well Being 2015 Mar 27;7(1):22-40. Epub 2014 Oct 27.

The University of New South Wales, Australia; Utrecht University, The Netherlands.

Background: Overweight epidemics, including among children and adolescents, are fuelled by contemporary obesogenic environments. Recent research and theory highlight the importance of socio-cultural factors in mitigating adverse impacts of the abundance of food in high-income countries. The current study examines whether family meal culture shapes young people's eating behaviors and self-regulation.

Methods: Young people aged 10-17 years were recruited through schools in four European countries: the Netherlands, Poland, Portugal and the United Kingdom. A total of 2,764 participants (mean age 13.2 years; 49.1% girls) completed a self-report questionnaire in class, providing information on healthy and unhealthy eating, joint family meals and communal meal values and use of eating-related self-regulation strategies.

Results: Path analysis found that family meal culture variables were significantly associated with young people's eating behaviors, as was self-regulation. Significant indirect effects of family meal culture were also found, through self-regulation.

Conclusions: Results confirm that family meal culture, encompassing values as well as practices, shapes young people's eating behaviors. Findings extend and link previously separate lines of enquiry by showing how food cultures can play out in the home environment. Importantly, the study contributes novel evidence suggesting that self-regulation is shaped by the home environment and mediates its influence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/aphw.12034DOI Listing
March 2015

Communicating eating-related rules. Suggestions are more effective than restrictions.

Appetite 2015 Mar 22;86:45-53. Epub 2014 Sep 22.

Department of Clinical and Health Psychology, Utrecht University, The Netherlands.

Background: A common social influence technique for curbing unhealthy eating behavior is to communicate eating-related rules (e.g. 'you should not eat unhealthy food'). Previous research has shown that such restrictive rules sometimes backfire and actually increase unhealthy consumption. In the current studies, we aimed to investigate if a milder form of social influence, a suggested rule, is more successful in curbing intake of unhealthy food. We also investigated how both types of rules affected psychological reactance.

Method: Students (N = 88 in Study 1, N = 51 in Study 2) completed a creativity task while a bowl of M&M's was within reach. Consumption was either explicitly forbidden (restrictive rule) or mildly discouraged (suggested rule). In the control condition, consumption was either explicitly allowed (Study 1) or M&M's were not provided (Study 2). Measures of reactance were assessed after the creativity task. Subsequently, a taste test was administered where all participants were allowed to consume M&M's.

Results: Across both studies, consumption during the creativity task did not differ between the restrictive- and suggested-rule-conditions, indicating that both are equally successful in preventing initial consumption. Restrictive-rule-condition participants reported higher reactance and consumed more in the free-eating taste-test phase than suggested-rule-condition participants and control-group participants, indicating a negative after-effect of restriction.

Discussion: RESULTS show that there are more and less effective ways to communicate eating-related rules. A restrictive rule, as compared to a suggested rule, induced psychological reactance and led to greater unhealthy consumption when participants were allowed to eat freely. It is important to pay attention to the way in which eating-related rules are communicated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.appet.2014.09.010DOI Listing
March 2015

The proof is in the eating: subjective peer norms are associated with adolescents' eating behaviour.

Public Health Nutr 2015 Apr 18;18(6):1044-51. Epub 2014 Jun 18.

1Department of Clinical and Health Psychology,Utrecht University,Post Box 80140,3508 TC Utrecht,The Netherlands.

Objective: To investigate associations of self-perceived eating-related peer norms (called 'subjective peer norms') with adolescents' healthy eating intentions and intake of healthy and unhealthy food.

Design: Cross-sectional data were collected in a large international survey.

Setting: Two types of subjective peer norms were assessed: perceived peer encouragement of healthy eating and perceived peer discouragement of unhealthy eating. Outcome variables were healthy eating intentions, intake of healthy food (fruits and vegetables) and intake of unhealthy food (snacks and soft drinks).

Subjects: Over 2500 European (pre-)adolescents aged between 10 and 17 years participated.

Results: Subjective peer norms were associated with all three outcome variables. While both perceived encouragement of healthy eating and perceived discouragement of unhealthy eating were related to intentions, only peer encouragement of healthy eating was related to intakes of both healthy and unhealthy food.

Conclusions: Subjective peer norms play a role in adolescent eating behaviour and as such are an important target for health promotion. Addressing norms that encourage healthy eating may be more promising in changing behaviour than norms that discourage unhealthy eating.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1368980014001268DOI Listing
April 2015

How norms work: self-identification, attitude, and self-efficacy mediate the relation between descriptive social norms and vegetable intake.

Appl Psychol Health Well Being 2014 Jul 20;6(2):230-50. Epub 2014 May 20.

Utrecht University, The Netherlands.

Background: The current studies aim to show that descriptive social norms influence vegetable intake and to investigate three potentially underlying processes (self-identification, attitude, and self-efficacy).

Methods: In two studies, descriptive social norms regarding vegetable intake were manipulated (majority vs. minority norm). Study 1 investigated both the relation between baseline vegetable intake and self-identification, attitude, and self-efficacy, as well as the effect of the norm manipulation on vegetable intake over a one-week period. Study 2 investigated potential mediation of the effect of the manipulation on vegetable intake intentions through self-identification, attitude, and self-efficacy.

Results: Study 1 showed that the proposed mediators were related to a baseline measure of vegetable intake. Moreover, in participants identifying strongly with the norm referent group, majority norms led to higher vegetable consumption than minority norms. Study 2 showed that the direct effect of the social norm manipulation on vegetable intake intentions was partly mediated by self-identification, attitude, and self-efficacy.

Conclusions: These studies shed first light on processes underlying the effect of descriptive social norms on health behavior. A norm describing the behavior of a salient social group leads people to identify more with, have more positive attitudes toward, and feel more self-efficacious regarding that behavior.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/aphw.12026DOI Listing
July 2014

Can treatment-based HIV prevention curb the epidemic among gay and other men who have sex with men? A narrative synthesis of increasing evidence for moderating and countervailing effects.

Sex Health 2014 Jul;11(2):137-45

Centre for Social Research in Health, The University of New South Wales, Sydney, NSW 2052, Australia.

As HIV epidemics among gay and other men who have sex with men (GMSM) persist worldwide, the importance of novel prevention approaches is recognised. Evidence that antiretroviral therapy (ART) can decrease the likelihood of infection is informing emerging HIV prevention approaches, encompassing early initiation of treatment as prevention by people living with HIV and use of antiretroviral drugs as pre-exposure prophylaxis for people presumed to be uninfected. Despite widespread excitement, robust evidence of the beneficial effects of ART-based HIV prevention for GMSM remains limited. Also, theoretical models project widely varying effects of ART-based prevention on the future course of HIV epidemics among GMSM, drawing attention to the possible moderating role of differences in the achievements of local HIV responses and the critical importance of sustained protective sexual practices into the future. Ecological analyses and simulations of ongoing epidemics in major gay communities illustrate that the preventive effects of ART in many settings are being offset by increased sexual risk-taking, as reflected in stable or increasing HIV infection rates. Also, the effects of scaling up HIV testing and treatment among GMSM in settings that are often considered prime examples of the success of ART-based prevention may be levelling as 'scope for improvement' diminishes. ART-based approaches further extend the HIV prevention toolkit and substantially increase people's options to protect themselves and others. The future impact of ART-based prevention on HIV epidemics among GMSM ultimately depends on whether heralded responses offset, attenuate or compound the ongoing social and behavioural changes that drive increased sexual risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1071/SH13142DOI Listing
July 2014

Challenges of providing HIV care in general practice.

Aust J Prim Health 2015 ;21(2):164-8

As the management of HIV changes and demand for HIV health services in primary care settings increases, new approaches to engaging the general practice workforce with HIV medicine are required. This paper reports on qualitative research conducted with 47 clinicians who provide HIV care in general practice settings around Australia, including accredited HIV s100 prescribers as well as other GPs and general practice nurses. Balanced numbers of men and women took part; less than one-quarter were based outside of urban metropolitan settings. The most significant workforce challenges that participants said they faced in providing HIV care in general practice were keeping up with knowledge, navigating low caseload and regional issues, balancing quality care with cost factors, and addressing the persistent social stigma associated with HIV. Strategic responses developed by participants to address these challenges included thinking more creatively about business and caseload planning, pursuing opportunities to share care with specialist clinicians, and challenging prejudiced attitudes amongst patients and colleagues. Understanding and supporting the needs of the general practice workforce in both high and low HIV caseload settings will be essential in ensuring Australia has the capacity to respond to emerging priorities in HIV prevention and care.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1071/PY13119DOI Listing
November 2015
-->