Conectar
To seek consensus among global experts on concepts, measures and approaches to guide national and global action to address HIV-related stigma and formulate a call to action. This outlines priorities to unite actors in more effectively responding to and resourcing efforts to address HIV-related stigma.
An adapted Delphi consensus-building process using two rounds of online questionnaires.
Online questionnaires sent to a global expert panel.
50 global experts on HIV-related stigma and discrimination representing sectors including civil society, people living with HIV and key populations, research and academia, clinical practice, law, non-profit organisations, the United Nations, and policy and donor organisations.
The panel reached consensus on 55 points relating to the 12 broad themes extracted from the evidence base. These comprised the importance of addressing HIV-related stigma at scale; HIV-related stigma terms and definitions; Frameworks; Programming and approaches; Community leadership in HIV-related stigma-reduction implementation; Intersectional stigma and discrimination; Stigma and discrimination measures and assessment scales; Monitoring and evaluation; Stakeholder and community participation in monitoring and evaluation; Knowledge gaps and research needs; Funding and Commitment calls. From these, a consensus statement and call to action were formulated on priorities for strong political and financial commitments by all countries to reduce and mitigate HIV-related stigma and achieve global HIV targets adopted in 2021.
This study illustrated that global experts across sectors consider that action is needed to support the three critical enablers of the HIV response—society, systems and services—to ensure that HIV services are non-discriminatory and person-centred. The importance of attention and action to reduce stigma is critical in the current geopolitical and funding crisis affecting HIV and global health.
Prenatal opioid exposure (POE) is a major public health consequence of the opioid epidemic. Long-term health outcomes associated with POE remain unclear, especially for children with POE without a diagnosis of neonatal abstinence syndrome (NAS). Here, we aimed to describe the health outcomes of children with POE and with POE and NAS compared to unexposed children during the first 7 years of life.
In this retrospective observational cohort study, children born between 2015 and 2022 were identified from the Maternal and Infant Data Hub (MIDH), a data repository that continuously integrates maternal, neonatal, and pediatric records from two academic medical centers and one pediatric hospital system in the Midwest, USA.
International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10 CM) chapters A00-N99 served as outcomes of interest. Annual incidence and crude incidence rate ratios were calculated to explore descriptive differences between the exposed and unexposed groups.
The study included 22,002 children, 20,130 (91.5%) of whom were unexposed and 1872 (8.5%) were exposed. Of the 1872 exposed children, 371 (19.8%) received a diagnosis of NAS (POE + NAS) and 1501 were in the POE-NAS group. Across all 7 years, exposed children had a higher incidence of diagnoses in most ICD-10 CM chapters compared to unexposed children. A consistently higher incidence rate ratio of diagnosis was observed in both POE-NAS and POE + NAS groups (vs. unexposed) related to mental and behavioral disorders, eye diagnoses, and diseases of the musculoskeletal system and gastrointestinal systems.
POE is associated with an increased risk of diagnoses in a number of ICD-10 CM chapters throughout childhood. These findings underscore the need for early screening and targeted interventions to support exposed children and improve their well-being. Further research is required to explore underlying mechanisms and develop preventive measures for at-risk populations.
Understanding the conditions more often diagnosed in children with prenatal opioid exposure will help to improve care provided to this population. As a result of study findings, nurses who provide care to children with prenatal opioid exposure can prioritize their assessments and allocate time, resources, and education toward areas more likely to be affected.
FreshRSS 