Tagged / AIDS

New HIV paper by BU PhD student

The editor of HIV Research & Clinical Practice informed us that the paper ‘Stigma in UK health care: A key barrier to reaching zero HIV transmission by 2030’ has been accepted for publication [1].   This paper is based on the PhD research currently conducted by Mr. Tom Weeks in the Faculty of Health, Environment & Medical Sciences (HEMS).  Tom’s thesis focuses on the perceptions of stigmatisation of People Living with HIV in care settings in the UK and the kind of education health care staff (clinical and non-clinical) receive in relation to HIV.  His long-term aim in the PhD is to help improve education to reduce such stigma.  Tom is being supervised by Dr. Pramod Regmi and Prof. Edwin van Teijlingen. 

Both supervisors have a long experience in studying social and health promotion aspects of HIV and AIDS.  Thirty years ago Prof. van Teijlingen worked in the NHS as a researcher in the Centre for HIV/AIDS and Drugs Studies based in Edinburgh.  Whilst Dr. Regmi conducted his PhD research on sexual health and health promotion in young people in Nepal.  Both supervisors themselves have published widely on the topic of HIV and AIDS [2-23].  The first of these many publication was a letter on community care for people living with HIV in the community which was published in the Lancet in 1993 [2]

 

 

References

  1. Weeks, T., Regmi, P., van Teijlingen, E. (2026) Stigma in UK health care: A key barrier to reaching zero HIV transmission by 2030, HIV Research & Clinical Practice (accepted).
  2. Huby, G, van Teijlingen E, Porter M., Bury, J (1993) Care for HIV in community (letter) Lancet 342: 1297-1298.
  3. Huby, G, van Teijlingen, E, Robertson J, Porter, AM (1993) Community care & support for women, In: Johnson F & Johnstone M. (Eds.) HIV Infection in Women, Edinburgh: Churchill Livingstone, 123-32.
  4. Bury, J.K., Ross, A., van Teijlingen, E., Porter, AMD, Bath, G. (1996) Lothian GPs, HIV infection & Drug Misuse: Epidemiology, Experience & Confidence 1988-93 Health Bulletin, 54: 258-269.
  5. Huby, GO, van Teijlingen E, Porter, AMD, Bury, J. (1997) Co-ordination of care on discharge from hospital into the community for patients with HIV/AIDS in Lothian, Health Bulletin, 55:338-50.
  6. van Teijlingen, E, Huby, G. (1998) Evaluation within a policy-making and contracting culture: reflections of practice, In: Barbour R.S., Huby G. (Eds.), Meddling with mythology: AIDS & the social construction of knowledge, London: Routledge, 218-33.
  7. Lowis, G, van Teijlingen, E, Sheremata, W. (2000) AIDS in developing countries: A comparative epidemiological analysis, In: Rose, J. (Ed.), Population Problems, Reading: Gordon & Breach Science Publishers: 133-61
  8. Scotland, G., van Teijlingen E., van der Pol, M, Smith, WCS. (2003) A review of studies assessing costs & consequences of interventions to reduce mother-to-child HIV transmission in sub-Saharan Africa, Aids, 17: 1045-52.
  9. Nicholson, D., van Teijlingen E. (2006) Comparing level of expenditure on HIV health promotion & incidence of HIV in Greater Glasgow & Lothian Health Boards (1988-98), Salusvita, 25(1): 13-22 usc.br/Edusc/colecoes/revistas/salusvita_pdf/salusvita_v25_n.1_2006.pdf
  10. Regmi, P., Simkhada, P., van Teijlingen E. (2008) Sexual & reproductive health status among young people in Nepal: opportunities & barriers for sexual health education & service utilisation, Kathmandu University Medical Journal 6(2): 248-256.
  11. Wasti, S.P., Simkhada, P.P, Randall, J., van Teijlingen E. (2009) Issues & Challenges of HIV/AIDS Prevention & Treatment Programme in Nepal, Global Journal of Health Science 1(2): 62-72. http://ccsenet.org/journal/index.php/gjhs/article/viewFile/2460/3474
  12. Regmi P, Simkhada PP, van Teijlingen E (2010) “Boys Remain Prestigious, Girls become Prostitutes”: Socio-Cultural Context of Relationships & Sex among Young People in Nepal, Global Journal of Health Science 2(1): 60-72.
  13. Regmi P., Simkhada, P., van Teijlingen E. (2010) “There are too many naked pictures found in papers and on the net”: Factors encouraging pre-marital sex among young people of Nepal. Health Science Journal 4(3): 162-174. hsj.gr/volume4/issue3/437.pdf
  14. Regmi, P., Simkhada, P., van Teijlingen E. (2010) Dating and Sex among Emerging Adults in Nepal. Journal of Adolescence Research 26 (6): 675-700.
  15. Regmi, P., van Teijlingen, E, Simkhada, P., Acharya, D. (2010) Barriers to sexual health services for young people in Nepal. Journal of Health Population & Nutrition 28: 619-27.
  16. Wasti, SP, Simkhada, PP, van Teijlingen E (Eds.) (2015) Socio-Cultural Aspects of HIV/ AIDS. The Dynamics of Health in Nepal, Kathmandu: Soc Sci Baha/Himal Books: 47-62.
  17. Aryal, N., Regmi, P.R., van Teijlingen, E., Dhungel, D., Ghale, G., Bhatta, G.K. (2016) Knowing is not enough: Migrant workers’ spouses vulnerability to HIV, SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS 8(1):9-15.
  18. Ochillo, M., van Teijlingen, E., Hind, M. (2017) Influence of faith-based organisations on HIV prevention strategies in Africa: systematic review. African Health Sciences 17(3): 753-61.
  19. Sathian, B., Sreedharan, J., Asim, M., Menezes, R.G., van Teijlingen, E., Unnikrishnan, B. (2018) Estimation of burden of people living with HIV/AIDS in Kerala state, India. Nepal Journal of Epidemiology 8(3): 738-44.
  20. Hamidi, A., Regmi, P., van Teijlingen, E. (2021) HIV epidemic in Libya: Identifying gaps, Journal of the International Association of Providers of AIDS Care, 20 :1-5 https://doi.org/10.1177/23259582211053964 .
  21. Regmi, P.R., van Teijlingen, E.R., Silwal, R.C., Dhital, R. (2022) Role of social media for sexual communication and sexual behaviors: A focus group study among young people in Nepal. Journal of Health Promotion, 10(1):153–166. https://doi.org/10.3126/jhp.v10i1.50995
  22. Hamidi, A., Regmi, P., van Teijlingen, E. (2023) Facilitators and barriers to condom use in Middle East and North Africa: a systematic review, Journal of Public Health, 32: 1651-81 https://doi.org/10.1007/s10389-023-01923-3
  23. Hamidi, A., Regmi, P, van Teijlingen, E. (2024) Islamic perspectives on HIV: a scoping review, Discover Social Science & Health 4:6 https://link.springer.com/content/pdf/10.1007/s44155-024-00063-7.pdf

Conversation article: Social media now trumps traditional family networks in Libya – my Facebook survey reached 446,000 women

Abier Hamidi writes for The Conversation about her PhD research around HIV awareness in Libya…

Social media now trumps traditional family networks in Libya – my Facebook survey reached 446,000 women

Connected: Facebook is by far the most popular social media platform in Libya with more than six million users.
Prostock-studio via Shutterstock

Abier Hamidi, Bournemouth University

When I told my family and friends I intended to pursue a PhD researching HIV awareness among married women in Libya, my home country, the reaction was not encouraging: “You’d be lucky to even get members of your family to respond,” said one.

They weren’t being unnecessarily pessimistic but rather managing my expectations, considering I was not only researching HIV awareness in a conservative country often perceived oppressive, but I was also looking to recruit women.

Historically, Libyan women have been placed under severe social and cultural constraints that rendered them difficult to reach. Libya is shaped by and works within a patriarchal society where simply approaching women on such a taboo topic as HIV/Aids – which in Libya is often associated with immoral practices such as pre or extra-marital sex, substance abuse and homosexuality – made the research even more complex.

I knew that the lack of confidentiality and the fear of being stigmatised were going to be a problem. So I needed a method that would provide a platform whereby the women can respond to the survey without prying eyes.

This is where the power of online surveys comes in. Using an anonymous, self-completed questionnaire reduces the effect of the topic’s sensitivity and helps reduce people’s fear of the possible social stigma attached to those self-disclosures.

But online surveys have their limitations. In Libya, these include poor telecommunication infrastructure, especially away from the large cities, as well as the high cost of internet access and the relatively poor service there. But the fast-growing smartphone market is encouraging and facilitating internet use in the country. According to the most recent available figures there were 3.14 million internet users in Libya in 2023 – approximately 45.9% of the population.

My questionnaire included five main sections. I asked for some limited demographic information (age, city, educational level, employment status). There were also sections on HIV/Aids related knowledge, responsents’ perceptions of HIV risk, their attitude toward HIV and where they sourced healthcare information. I took particular care to ensure that I was gathering the maximum amount of information while remaining sensitive to Libya’s religious and social contexts.

Armed with approval from the university’s research ethics committee, I sent out a recruitment post with the questionnaire, mainly to family and friends in the Libyan diaspora in the UK and the US. The principle aim of this pilot study was to ensure that the wording, language and questions were understandable and that the mechanics of the survey functioned correctly. Within a month I’d received more than 168 complete questionnaires, which reassured me that sharing the survey with family and friends and asking them to forward the link to their various social and family networks would be the ideal approach for my main research on Libyan women in Libya.

What is ‘wasta’?

Libya has a population of around 7.1 million which is heavily skewed towards large networked tribes and well-established families, meaning the degree of separation across the whole of society is quite small. This has traditionally meant that the best way to get things done is by using these big family or tribal networks. This is known as “wasta”.

Wasta is a common practice of calling on personal connections for assistance. It’s a social norm in most Arab countries, defined by one academic as “a personal exchange system between members of society that is entrenched in the tribal structure of the country”. The concept has been tied to a tribal tradition which obliges those within the group to provide assistance in the same network.

I have a large family in Libya which straddles two different tribes, as well as family friends, so I was confident that wasta was the best approach to take. I sent the link to all the members of my wasta network through WhatsApp and asked them to forward it onto their friends and extended family. I also posted on Twitter and reached out to various Facebook pages. I only needed 323 complete questionnaires and I was confident that method would yield the best response.

Days went by and I only had a handful of responses. Much of the feedback I received from family members was worrying. People said they had exhausted their networks without much success. Clearly, recruitment using wasta wasn’t working. So I decided to fall back on my experiences of working in marketing and created a targeted post, aimed at “women, ages 18-65+ living in Libya, married, divorced, separated and widowed”. In direct contrast to wasta, this didn’t rely on who I know.

Social media has grown massively in popularity as a research tool in recent years. So, bearing in mind that Facebook is the most popular social media platform in Libya, with more than 6 million users, I created a Facebook page with the title, in Arabic: دراسة النساء الليبيات المتزوجات (Research on Libyan married women). I linked in papers I had published in the past (also in Arabic) and the recruitment poster below.

A graphic showing an Arab woman holding a Libyan flag with two young people.
The recruitment poster used by the author in her Facebook recruitment campaign.
Abier Hamidi, Author provided

I launched the post and the response was immediate, with replies and completed questionnaires and supportive comments coming in fairly rapidly to start with. But within a few days the response rate slowed down and still I wasn’t anywhere near my response target. Then I realised my mistake. The initial post targeting women who are married, divorced, separated or widowed hadn’t taken into account that the majority of women didn’t tend to include their marital status on Facebook. This meant I was only reaching a small percentage of my target audience.

I removed the status and the reach shot up. In six months, my post reached 446,906 women in Libya. The stats were impressive: 59,422 engagements, 1,549 reactions and 703 comments. I received more than 1,000 completed questionnaires.

In the end, this showed me that while for certain things, wasta can yield results, for an issue such as this, Libyan women wanted to ensure their anonymity and the confidentiality of their responses. Social media, which doesn’t mandate use of real names or photographs, was able to offer this in a way that extended family and friends, naturally, never could.The Conversation

Abier Hamidi, PhD Candidate, Faculty of Health & Social Sciences, Bournemouth University

This article is republished from The Conversation under a Creative Commons license. Read the original article.