Young Same-Gender-Loving Men (SGLM) Living with HIV Continue to Experience Symptoms that May Impair Their Retention in Care.

Over half of HIV infections in the U.S. are among young gay, bisexual, and other same-gender-loving men (SGLM). Symptoms affecting these individuals must be clarified in order to be detected and addressed by health care providers. This report describes the symptom prevalence in young SGLM living with HIV. Study participants in an urban context experienced high symptom burden with a median of 6.2 symptoms despite antiretroviral treatment with viral suppression. Most common symptoms included fatigue (57%), depression (54%), insomnia (53%), anxiety (44%), dizziness (33%), and headache (33%). This study showed that young SGLM with HIV experience a high number of symptoms given their age. Health care providers should work to alleviate this symptom burden that affects patients' quality of life and may influence engagement in care.

Early Use of the Palliative Approach to Improve Patient Outcomes in HIV Disease: Insights and Findings From the Care and Support Access (CASA) Study 2013-2019.

Young men of color who have sex with men (yMSM) living with human immunodeficiency virus (HIV) in syndemic environments have been difficult-to-retain in care resulting in their being at-risk for poor health outcomes despite availability of effective once-daily antiretroviral treatment (ART). Multiple methods have been implemented to improve outcomes for this cohort; none with sustainable results. Outpatient HIV staff themselves may be a contributing factor. We introduced multidisciplinary staff to the concept of using a palliative approach early (ePA) in outpatient HIV care management to enable them to consider the patient-level complexity of these young men. Young MSM (18-35 years of age) enrolled in and cared for at the intervention site of the Care and Support Access Study (CASA), completed serial surveys over 18 months. Patients' Global and Summary quality of life (QoL) increased during the study at the intervention site (IS) where staff learned about ePA, compared with patients attending the control site (CS) (p=.021 and p=.018, respectively). Using serial surveys of staff members, we found that in the era of HIV disease control, outpatient staff are stressed more by environmental factors than by patients' disease status seen historically in the HIV epidemic. A Community Advisory Panel of HIV stakeholders contributed to all phases of this study and altered language used in educational activities with staff members to describe the patient cohort.

Length of hospital stay and discharge disposition in older trauma patients.

As the number of older adults increases and life expectancies are increasing, more incidences of traumatic injury are expected in this population. In this study, the relationships between demographic variables, pain, days from admission to therapy evaluation, length of stay and discharge disposition were examined in 132 older adults who had experienced a traumatic event. Results showed that significant relationships existed between pain, age, comorbidities, injury severity and days from admission to therapy evaluation and length of stay; those with less pain, greater age and had more days between admission and when the first therapy evaluation occurred had longer lengths of stay. In addition, demographic variables, overall length of stay and pain intensity during therapy were associated with discharge location; for longer lengths of stay and higher pain, older trauma patients were less likely to be discharged to home.

Use of discussion boards in a theory-based health web site for older adults.

BACKGROUND: Hip fracture, a significant public health problem among older adults, can be prevented using multimodal approaches (e.g., bone-strengthening measures, fall prevention). Many older adults, however, are unaware of this information. With the rapid growth of older adult online users who have a specific interest in health, the Web can serve as a valuable medium to disseminate this information. OBJECTIVES: The purpose of this study was to explore the impact of the social cognitive theory-based structured hip fracture prevention Web site (TSW) on health behaviors through analysis of discussion board postings and to assess participants' experiences with the discussion board. METHODS: In an online, randomized controlled study, the effects of a social cognitive TSW, including learning modules and a moderated discussion board, were tested on older adults' health behavior-related outcomes.This was an exploratory qualitative study. The TSW group participants used the learning modules and the discussion board for 2 weeks. Their experiences with the discussion board were explored using an open-ended question. Discussion board postings and qualitative answers were analyzed using content analysis. RESULTS: Ninety older adults actively participated in the discussion board. Analysis of 316 postings revealed eight themes. Participants shared their current health behaviors and discussed specific health problems and concerns. Many recognized opportunities for improvement and identified motivators to improve health behaviors. They also offered supportive comments to others and shared helpful and practical information. More than half of the participants (n = 65, 74.4%) reported that the discussion board enhanced their learning experiences. DISCUSSION: The themes developed from the postings showed that moderated discussion boards can be used effectively to change older adults' health behavior. Further research is needed to explore the long-term impact of using this component in online health behavior change interventions.