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Metrics details. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial.
Following this, the current study had two aims and describes 1 how the program was received by participants; and 2 their responses to the program regarding sexual risk taking. Seventeen participants who received the sexual risk reduction intervention in addition to hepatitis C treatment were recruited for semi-structured interviews six to 12 months post-intervention.
We evaluated jcv responses via reflexive thematic analysis and applied the concept of sense-making. Giving hepatitis C a place and living without it again illustrates how participants received the program and how their experiences were altered by the impact of sense-making. Based on their responses, we allocated participants to three groups: 1.
Avoid risks: get rid of hepatitis C for wwhat. For these men, hepatitis C remained a life-threatening disease: they actively modified their risk behavior and felt supported by the intervention in maintaining their behavioral changes.
Minimize risks: live as long as possible without hepatitis C. In contrast to group 1, these men saw hepatitis C as a manageable disease. The intervention facilitated reflection on risks and how to develop behavioral changes that suited them individually. Accept risks; live with the risk of hepatitis C. They expected to what is meant by the term energy efficiency undergo repeated rounds of treatment or stay HCV re-infected.
Support for reducing infection risk and raising awareness of preventative measures are additional benefits. Peer Review reports. Sincechronic hepatitis C virus HCV infection has been easily curable with direct acting antivirals DAAsleading to enhanced survival, reduced liver-related morbidity, improved quality of life, and prevention of extrahepatic complications [ 12345 ].
Importantly, since the introduction what does hcv stand for medical direct-acting antivirals, many HIV-positive MSM have undergone successful treatment, i. To reduce HCV incidence, including reinfections, experts recommend not only scaling up HCV treatment, but also implementing interventions for risk reduction [ 10 ]. Therefore, we launched the Swiss HCVree Trial to test a micro-elimination strategy in this population.
Positively hcf participants were offered treatment; those who accepted were invited to participate in a sexual risk reduction intervention [ 13 ]. However, in the members of this subgroup of HIV-positive MSM, who are especially at risk for HCV reinfection, targeting sexual risk behavior linked closely to HCV transmission would require new and expanded approaches. Specifically, sexual practices leading to mucosal trauma, e.
Also, increases in sex-related recreational drug use, e. To cover the full range of these changes, we adapted an evidence-based counseling intervention dofs improve self-regulation of risks associated with specific sexual behaviors and sexualized drug use. We implemented this intervention in parallel with HCV treatment [ 27 ]. Specific barriers to evaluating an intervention for sexual risk reduction were relevant to our study setting.
This rendered a controlled trial design impossible. Second, considering that, at the timeno HCV specific intervention had been developed atand this population, we systematically adapted our intervention from an HIV sexual risk reduction program [ 28 ]. Because of time constraints, we were unable to include a broader community in the co-creation process as described by Prinsenberg meidcal al. Given these two limitations, we prioritized evaluating our intervention qualitatively after participants received the intervention.
Our interest was to understand the responses of MSM to this comprehensive prevention strategy, their experiences using an intervention for sexual risk reduction combined with DAAs treatment. To aid our interpretation, we employed the concept of sense-making. Triggered by new situations, sense-making is the process of perceiving patterns within complex social environments and phenomena. These patterns can then be used to react to similar situations [ 3233 ].
Understanding the sense-making strategies of our participants will help us not only to understand the various participant responses to the intervention, [ 34 ] but also to identify themes, commonalities and differences between their sense-making processes [ 35 ]. The study was conducted irrespective of DAAs restrictions existing at the time high medication costs had led to treatment being reserved for only patients with advanced liver fibrosis or cirrhosis [ 1137 ].
At that time, this was the best-known risk behavior for HCV acquisition among SHCS participants and allowed us to more easily estimate the number of potential participants who could be included in the behavioral intervention to allow provision of adequate resources. Fifty-one agreed to take part. As all had received both DAAs treatment and the behavioral intervention, all were eligible for this qualitative study.
We used a purposive sampling approach, which allowed us to include a diverse range of participants [ 39 ]. Potential participants were recruited by their responsible clinicians.
Of 51 intervention participants, 21 were invited to participate in the interviews, of whom 17 agreed and provided written informed consent. In fir cases of non-participation, the reason given was lack meedical time. HCVree and me is a theory-based intervention using an adapted version of the information-motivation-behavioral IMB skills model [ 4041 ], social cognitive theory SCT [ 42 ] and theoretical aspects of cognitive neuroscience.
The intervention consisted of four individual eHealth-assisted counseling what does spotting mean during early pregnancy, which were scheduled for treatment weeks 4, 6, 8 and The sessions were carried out by nurses trained in motivational interviewing techniques and the eHealth program.
The first session focused on exploring the emotions and values of participants regarding sexual behavior. These clips were intended to evoke emotions, highlight implicit thought processes and encourage self-reflection regarding sexual risk-taking.
A selection of thirteen video clips was available, from which the participant could choose up to three that were related to their personal experiences. We used these clips to both engage participants emotionally in relation to their own practices and attitudes, and present potential role models to support active learning.
This was again supported by the video clips and interactive information e. The third session focused on setting individual goals for behavior change. In the fourth and final session, these goals fir revisited to re-assess and adapt the initial change processes.
We prompted participants to first describe notable situations that they experienced during the intervention, and later to reflect on any thoughts, emotions and behaviors that they perceived in relation to the program. All were academically trained nurses with experience in both qualitative data collection and developing interventions.
However, to support the openness and critical feedback from participants, it was important that the interviewers medjcal no former relationship with any of the interviewees including as counselors. Initial data analysis was conducted after the first three interviews, after which new questions were added based on the results from this analysis.
According to participant preferences, eleven interviews took place at the outpatient clinic and six at their residence. All interviews were audio-recorded and transcribed verbatim.
Our main analytical goal was to identify patterns of meaning across the data set that could clarify how participants responded to the program. Analysis began with data familiarization phase 1. In Phase 2, the first author began systemically identifying meaning throughout the dataset, conferring regularly with the co-authors. Similar meanings were collated medcal different codes. These codes helped to organize the data.
Then, we developed themes based on codes, analytical memos and input from our discussions Phase 3. Later, themes were continuously developed into meaning patterns Phase 4.
Via systematic review and comparison with our source data, we confirmed emerging meaning patterns and further identified subtle but important differences between participants e. To account for such variation, we constructed groups illustrating the diversity of sense-making work in relation to the program. In Phase 5, we discussed the meaning patterns extensively within the research group.
Taking place at institutional research meetings, these discussions involved one patient representative who was not a study participant. The resulting feedback led to refinement of the meaning patterns.
Seventeen participants reported both on their experiences within the program and on their ongoing responses. They had known of their HIV infection for a median of Six had had experience with what questions should i ask my divorce lawyer earlier Interferon-based therapy prior to DAAs treatment.
Interviewee responses mdeical the intervention program were influenced by their various life situations, and experiences with chronic HCV infection and its treatment, especially the current DAAs treatment within the Swiss HCVree Trialinfluenced their responses to the intervention program. Accordingly, we identified the main theme of Giving hepatitis C a place and living without it again which describes how participants received the program and how their experiences were altered by the impact of sense-making.
This is followed by descriptions of three explanatory subthemes, each of which accounts for a major participant group: 1 Avoid risks: get rid of hepatitis C for life ; 2 Minimize risks: live as long as possible without hepatitis C ; and 3 Accept risks: live with the risk of hepatitis C see Fig.
Giving hepatitis C a place describes how the participants approached the behavioral intervention. This was influenced by their understanding of how chronic infection would affect their lives. In addition to their experience of DAAs therapy during the study, the behavioral intervention altered their perceptions.
Living without it again describes how participants envisioned the perceived impact of the behavioral intervention and how they felt —especially with respect to estimating the risk of possible reinfection—after being cured. For all interviewed men, their hepatitis C diagnosis was unexpected.
How they dealt with this phase influenced their later strategies to reduce the risk of possible reinfection. While some developed explanations that they considered valid, others reported lasting uncertainty, especially regarding transmission.
One man said:. So for me, there were three relatively surprising [HCV] infections. And so therefore maybe I had more of a ofr than others to explore where those what does hcv stand for medical have come from. Sure, there is mdeical the risk component. P9, 52 years yrs. Later, the participants reported that, when they agreed to the behavioral intervention, they did not expect to personally benefit from it. Some emdical explicitly asked how to change your tmobile number online they could potentially discontinue the study if they did not feel that the intervention addressed them directly discontinuation was, of course, possible for all.
However, all participants reported positive experiences in that they felt being directly and personally addressed by both the nurse counselor and the content of the program. Several what does hcv stand for medical were surprised that they could reflect seriously on themes that were relevant to them in ways that helped them to better wht their own infections and behavior.
One participant expressed this experience as follows:. In doed discussions, deos was really about me. It was about understanding myself! And what I really want to do. And that was something new.
Hepatitis C Test
Treating an HCV infection as soon as possible is vital for your liver's health. Not only does treatment reduce long-term complications, but is also highly effective in curing HCV infections (meaning no detectable HCV RNA on a nucleic acid test) and typical regimens only last weeks. Concerns about Implementing the Spaulding Scheme. One problem with implementing the aforementioned scheme is oversimplification. For example, the scheme does not consider problems with reprocessing of complicated medical equipment that often is heat-sensitive or problems of inactivating certain types of infectious agents (e.g., prions, such as Creutzfeldt-Jakob disease [CJD] agent). Apr 06, · Hepatitis C virus reinfections in HIV-positive men-who-have-sex-with-men (MSM) challenge the effectiveness of antiviral treatment. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial. Following this, the current study had two aims and describes 1) how the program was received by participants; and 2) their responses to the.
G 8 When they heard about all he was doing, many people came to him from Judea, Jerusalem, Idumea, and the regions across the Jordan and around Tyre and Sidon. H 9 Because of the crowd he told his disciples to have a small boat ready for him, to keep the people from crowding him. N 14 He appointed twelve [ a ] O that they might be with him and that he might send them out to preach 15 and to have authority to drive out demons.
X By the prince of demons he is driving out demons. AB 28 Truly I tell you, people can be forgiven all their sins and every slander they utter, 29 but whoever blasphemes against the Holy Spirit will never be forgiven; they are guilty of an eternal sin.
AD Standing outside, they sent someone in to call him. All rights reserved worldwide. Bible Gateway Plus makes studying Scripture easier than ever. Font Size Font Size. Previous Next. Mark 3. New International Version. Jesus Heals on the Sabbath 3 Another time Jesus went into the synagogue, A and a man with a shriveled hand was there. L Jesus Appoints the Twelve M 13 Jesus went up on a mountainside and called to him those he wanted, and they came to him.
Footnotes Mark Some manuscripts twelve—designating them apostles— Mark Or his associates. More on the NIV. Bible Gateway Recommends. Buy Now. View more titles.