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  1. Article ; Online: Social Support and the Association Between Certain Forms of Violence and Harassment and Suicidal Ideation Among Transgender Women - National HIV Behavioral Surveillance Among Transgender Women, Seven Urban Areas, United States, 2019-2020.

    Eustaquio, Patrick C / Olansky, Evelyn / Lee, Kathryn / Marcus, Ruthanne / Cha, Susan

    MMWR supplements

    2024  Volume 73, Issue 1, Page(s) 61–70

    Abstract: Violence and harassment toward transgender women are associated with suicidal thoughts and behaviors, and social support might moderate such association. This analysis explored the association between certain forms of violence and harassment and suicidal ...

    Abstract Violence and harassment toward transgender women are associated with suicidal thoughts and behaviors, and social support might moderate such association. This analysis explored the association between certain forms of violence and harassment and suicidal ideation and moderation by social support. Better understanding of these associations could guide mental health services and structural interventions appropriate to lived experiences of transgender women. This cross-sectional analysis used data from CDC's National HIV Behavioral Surveillance Among Transgender Women. During 2019-2020, transgender women were recruited via respondent-driven sampling from seven urban areas in the United States for an HIV biobehavioral survey. The association between experiencing certain forms of violence and harassment (i.e., gender-based verbal and physical abuse or harassment, physical intimate partner abuse or harassment, and sexual violence) and suicidal ideation was measured using adjusted prevalence ratios and 95% CIs generated from log-linked Poisson regression models controlling for respondent-driven sampling design and confounders. To examine moderation, the extents of social support from family, friends, and significant others were assessed for interaction with certain forms of violence and harassment; if p interaction was <0.05, stratified adjusted prevalence ratios were presented. Among 1,608 transgender women, 59.7% experienced certain forms of violence and harassment and 17.7% reported suicidal ideation during the past 12 months; 75.2% reported high social support from significant others, 69.4% from friends, and 46.8% from family. Experiencing certain forms of violence and harassment and having low-moderate social support from any source was associated with higher prevalence of suicidal ideation. Social support from family moderated the association between experiencing certain forms of violence and harassment and suicidal ideation (p interaction = 0.01); however, even in the presence of high family social support, experiencing certain forms of violence and harassment was associated with higher prevalence of suicidal ideation. Social support did not completely moderate the positive association between experiencing violence and harassment and suicidal ideation. Further understanding of the social support dynamics of transgender women might improve the quality and use of social support. Policymakers and health care workers should work closely with transgender women communities to reduce the prevalence of violence, harassment, and suicide by implementing integrated, holistic, and transinclusive approaches.
    MeSH term(s) Female ; Humans ; Cross-Sectional Studies ; HIV Infections ; Social Support ; Suicidal Ideation ; Transgender Persons ; United States ; Violence ; Harassment, Non-Sexual
    Language English
    Publishing date 2024-01-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2062172-3
    ISSN 2380-8942 ; 2380-8950
    ISSN (online) 2380-8942
    ISSN 2380-8950
    DOI 10.15585/mmwr.su7301a7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: HIV Injection Risk Behaviors among HIV-Negative People Who Inject Drugs Experiencing Homelessness, 23 U.S. Cities.

    Marcus, Ruthanne / Cha, Susan / Sionean, Catlainn / Kanny, Dafna

    Journal of social distress and the homeless

    2021  Volume 1, Issue 9

    Abstract: Despite recent declines in numbers of people who inject drugs (PWID) diagnosed with HIV, clusters of HIV among PWID are ongoing, especially among PWID experiencing homelessness. Using data from the National HIV Behavioral Surveillance in 2018, we ... ...

    Abstract Despite recent declines in numbers of people who inject drugs (PWID) diagnosed with HIV, clusters of HIV among PWID are ongoing, especially among PWID experiencing homelessness. Using data from the National HIV Behavioral Surveillance in 2018, we evaluated the association between homelessness and injection risk and prevention behaviors among HIV-negative PWID who were recruited by respondent-driven sampling in 23 U.S. cities. Interviewers assessed sociodemographic characteristics, history of overdose, and behavioral risk and prevention factors for HIV. Adjusted prevalence ratios (aPR) and 95% CI were obtained using Poisson regression models. Of 10,614 HIV-negative PWID participants, 7275 (68.5%) reported experiencing homelessness. Homeless PWID were more likely than those who were not to be younger age, white, unemployed, without health insurance, in poverty, experiencing psychological distress, and incarcerated in the past 12 months. PWID experiencing homelessness were significantly more likely to report injection risk behaviors [share syringes/equipment (aPR = 1.26; 95% CI = 1.20-1.33), non-fatal opioid overdose (aPR = 1.64; 95% CI = 1.49-1.79)] and prevention behaviors [testing for HIV in past 12 months (aPR = 1.18; 95% CI = 1.12-1.24) and using syringe services programs (aPR = 1.09; 95% CI = 1.03-1.16)] than PWID not experiencing homelessness. Homelessness among PWID is associated with injection risk behaviors and non-fatal overdose.
    Language English
    Publishing date 2021-07-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2017268-0
    ISSN 1573-658X ; 1053-0789
    ISSN (online) 1573-658X
    ISSN 1053-0789
    DOI 10.1080/10530789.2021.1892931
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Transgender Women Experiencing Homelessness - National HIV Behavioral Surveillance Among Transgender Women, Seven Urban Areas, United States, 2019-2020.

    Marcus, Ruthanne / Trujillo, Lindsay / Olansky, Evelyn / Cha, Susan / Hershow, Rebecca B / Baugher, Amy R / Sionean, Catlainn / Lee, Kathryn

    MMWR supplements

    2024  Volume 73, Issue 1, Page(s) 40–50

    Abstract: Transgender women experience high prevalence of homelessness, which can affect their likelihood of acquiring HIV infection and can lead to poor medical outcomes. CDC analyzed data from the National HIV Behavioral Surveillance Among Transgender Women to ... ...

    Abstract Transgender women experience high prevalence of homelessness, which can affect their likelihood of acquiring HIV infection and can lead to poor medical outcomes. CDC analyzed data from the National HIV Behavioral Surveillance Among Transgender Women to identify whether personal characteristics and social factors affecting transgender women were associated with duration of homelessness during the past 12 months. Longer duration and chronic homelessness might indicate greater unmet needs, which increases their likelihood for acquiring HIV infection. Ordinal logistic regression was conducted to calculate adjusted prevalence odds ratios and 95% CIs for transgender women from seven urban areas in the United States experiencing homelessness 30-365 nights, 1-29 nights, and zero nights during the past 12 months. Among 1,566 transgender women, 9% reported 1-29 nights homeless and 31% reported 30-365 nights homeless during the past 12 months. Among participants who reported physical intimate partner violence or forced sex, 50% and 47%, respectively, reported experiencing 30-365 nights homeless. Furthermore, 55% who had been evicted or denied housing because of their gender identity and 58% who had been incarcerated during the past year experienced 30-365 nights homeless. The odds of transgender women experiencing longer duration of homelessness was associated with being younger and having a disability; higher psychological distress scores were associated with longer duration of homelessness. Analysis of social determinants of health found transgender women experiencing longer homelessness to be less educated, living below the Federal poverty level, and having lower social support. Therefore, focusing on HIV prevention and interventions addressing housing instability to reduce the duration of homelessness among transgender women is important. Further, integrating housing services with behavioral health services and clinical care, specifically designed for transgender women, could reduce HIV acquisition risk and improve HIV infection outcomes.
    MeSH term(s) Male ; Female ; United States ; Humans ; HIV Infections ; Transgender Persons ; Gender Identity ; Social Problems ; Ill-Housed Persons
    Language English
    Publishing date 2024-01-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2062172-3
    ISSN 2380-8942 ; 2380-8950
    ISSN (online) 2380-8942
    ISSN 2380-8950
    DOI 10.15585/mmwr.su7301a5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Injection and Non-Injection Drug Use Among Adults with Diagnosed HIV in the United States, 2015-2018.

    Wu, Kathleen / Tie, Yunfeng / Dasgupta, Sharoda / Beer, Linda / Marcus, Ruthanne

    AIDS and behavior

    2021  Volume 26, Issue 4, Page(s) 1026–1038

    Abstract: Understanding behavioral characteristics and health outcomes of people with HIV (PWH) who inject drugs and PWH who use drugs, but do not inject, can help inform public health interventions and improve HIV clinical outcomes. However, recent, nationally ... ...

    Abstract Understanding behavioral characteristics and health outcomes of people with HIV (PWH) who inject drugs and PWH who use drugs, but do not inject, can help inform public health interventions and improve HIV clinical outcomes. However, recent, nationally representative estimates are lacking. We used 2015-2018 Medical Monitoring Project data to examine health outcome differences among adults with diagnosed HIV who injected drugs or who only used non-injection drugs in the past year. Data were obtained from participant interviews and medical record abstraction. We reported weighted percentages and prevalence ratios with predicted marginal means to assess differences between groups (P < 0.05). PWH who injected drugs were more likely to engage in high-risk sex; experience depression and anxiety symptoms, homelessness, and incarceration; and have lower levels of care retention, antiretroviral therapy adherence, and viral suppression. Tailored, comprehensive interventions are critical for improving outcomes among PWH who use drugs, particularly among those who inject drugs.
    MeSH term(s) Adult ; Anti-Retroviral Agents/therapeutic use ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Ill-Housed Persons ; Humans ; Prevalence ; Retention in Care ; United States/epidemiology
    Chemical Substances Anti-Retroviral Agents
    Language English
    Publishing date 2021-09-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1339885-4
    ISSN 1573-3254 ; 1090-7165
    ISSN (online) 1573-3254
    ISSN 1090-7165
    DOI 10.1007/s10461-021-03457-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Perceptions of Community Corrections and Treatment Experience: A Qualitative Study Among People With Incarceration Histories Receiving Outpatient Methadone Treatment.

    Gaeta Gazzola, Marina / Oberleitner, Lindsay M S / Hoffman, Kim / Eller, Anthony / Madden, Lynn M / Marcus, Ruthanne / Oberleitner, David / Beitel, Mark / Thompson, Emma / Zheng, Xiaoying / Barry, Declan T

    Substance use & addiction journal

    2024  , Page(s) 29767342241238837

    Abstract: Background: Community correctional experiences among individuals receiving methadone treatment (MT) for opioid use disorder (OUD) are poorly understood. We qualitatively investigated perceptions of community corrections and treatment experiences among ... ...

    Abstract Background: Community correctional experiences among individuals receiving methadone treatment (MT) for opioid use disorder (OUD) are poorly understood. We qualitatively investigated perceptions of community corrections and treatment experiences among individuals with criminal-legal system experience currently receiving outpatient MT.
    Methods: From January to December 2017, we recruited 42 individuals with history of criminal-legal system involvement enrolled in outpatient MT at a low-barrier nonprofit organization operating multiple clinics in Connecticut. An experienced qualitative research team conducted one-to-one, in-person, semistructured interviews about incarceration and treatment experiences with individuals receiving MT. Participants completed a demographics survey. The interviews were audiorecorded, transcribed, de-identified, and independently coded using NVivo.
    Results: Participants described the community corrections system as restrictive and abstinence-focused. Most participants described positive perceptions of and experiences with community corrections officers (CCOs), yet described negative perceptions of and experiences with the community corrections system overall. Participants perceived CCOs to have limited knowledge of OUD and MT. Participants described a range of CCO judgment toward their OUD, with some appearing understanding and nonjudgmental while others were perceived to have stigma and prejudice. Few participants noted assistance from CCOs with seeking MT or community-based substance use disorder care. Some participants desired improved treatment facilitation, but viewed forced or coercive treatment negatively.
    Conclusion: To our knowledge, this is the first qualitative study to examine community corrections experience among people receiving outpatient medication for OUD. While individuals receiving MT have negative experiences with the community corrections system, they perceive individual CCOs positively. Interventions addressing gaps in CCOs knowledge of OUD and MT are needed to optimize support for individuals on probation or parole with OUD. Provision of OUD treatment facilitation appears desirable to some individuals in community supervision.
    Language English
    Publishing date 2024-03-29
    Publishing country United States
    Document type Journal Article
    ISSN 2976-7350
    ISSN (online) 2976-7350
    DOI 10.1177/29767342241238837
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: New information about pediatric foodborne infections: the view from FoodNet.

    Marcus, Ruthanne

    Current opinion in pediatrics

    2008  Volume 20, Issue 1, Page(s) 79–84

    Abstract: Purpose of review: Diarrheal illness is a significant burden to children and their parents. Recent studies describing the etiologic agents that cause diarrheal illness and examining the risk factors for the most common bacterial enteric pathogens are ... ...

    Abstract Purpose of review: Diarrheal illness is a significant burden to children and their parents. Recent studies describing the etiologic agents that cause diarrheal illness and examining the risk factors for the most common bacterial enteric pathogens are presented.
    Recent findings: The most common bacterial causes of diarrheal illness among children are Campylobacter spp., Salmonella spp., Shigella spp. and Shiga toxin-producing Escherichia coli. The highest incidence of both Campylobacter and Salmonella is among infants. Risk factors for campylobacteriosis in this group include traveling outside the US, having a pet in the home with diarrhea and visiting or living on a farm. Risk factors for salmonellosis include traveling outside the US, exposure to reptiles and attending day-care with another child with diarrhea. Breastfeeding is a factor that protects against infection.
    Summary: Despite a limited diet, infants are at risk of acquiring enteric pathogens that are commonly associated with consumption of contaminated food. Exposure to these pathogens may be through cross-contamination in the home or the environment. Educational measures that focus on improving prevention of exposure to infectious agents and an emphasis on eliminating cross-contamination are needed for parents and care-takers of this vulnerable population.
    MeSH term(s) Child ; Dysentery/epidemiology ; Dysentery/microbiology ; Enterobacteriaceae Infections/epidemiology ; Food Contamination ; Humans ; Population Surveillance ; United States/epidemiology
    Language English
    Publishing date 2008-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1049374-8
    ISSN 1531-698X ; 1040-8703
    ISSN (online) 1531-698X
    ISSN 1040-8703
    DOI 10.1097/MOP.0b013e3282f43067
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Characteristics of Adults With Diagnosed HIV Who Experienced Housing Instability: Findings From the Centers for Disease Control and Prevention Medical Monitoring Project, United States, 2018.

    Marcus, Ruthanne / Tie, Yunfeng / Dasgupta, Sharoda / Beer, Linda / Padilla, Mabel / Fagan, Jennifer / Prejean, Joseph

    The Journal of the Association of Nurses in AIDS Care : JANAC

    2021  Volume 33, Issue 3, Page(s) 283–294

    Abstract: Abstract: People living with HIV (PLWH) who experience homelessness have poorer clinical outcomes than people with HIV who are not homeless; however, there is limited information on PLWH who experience other forms of housing instability. We used ... ...

    Abstract Abstract: People living with HIV (PLWH) who experience homelessness have poorer clinical outcomes than people with HIV who are not homeless; however, there is limited information on PLWH who experience other forms of housing instability. We used interviews and medical record abstraction data from the Medical Monitoring Project, collected 2018-2019 (N = 4,050), to describe sociodemographic characteristics and clinical outcomes of adults with HIV by whether people experienced unstable housing in the past 12 months. Overall, 21% were unstably housed, of which 55.2% were unstably housed but not homeless. People who were unstably housed were more likely to be younger, have lower educational attainment, be previously incarcerated, live at or below the poverty level, and have poorer mental health and clinical outcomes, independent of homelessness. Interventions to address housing instability, integrated with clinical care, could benefit not just PLWH who are homeless but also those who are unstably housed.
    MeSH term(s) Adult ; Centers for Disease Control and Prevention, U.S. ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Ill-Housed Persons ; Housing ; Housing Instability ; Humans ; United States/epidemiology
    Language English
    Publishing date 2021-11-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1159376-3
    ISSN 1552-6917 ; 1055-3290
    ISSN (online) 1552-6917
    ISSN 1055-3290
    DOI 10.1097/JNC.0000000000000314
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Needs for shelter or housing assistance among people with diagnosed HIV by jurisdiction: United States, 2015-2020.

    Dasgupta, Sharoda / Beer, Linda / Lu, Jen-Feng / Weiser, John / Yuan, Xin / Nair, Priya / Banks, Lauren / Marcus, Ruthanne

    AIDS (London, England)

    2022  Volume 37, Issue 3, Page(s) 535–540

    Abstract: Objective: To describe the landscape of needs for housing assistance among people with HIV (PWH) and availability of Housing Opportunities for People with AIDS (HOPWA) funding with respect to housing service needs, nationally and for 17 US jurisdictions. ...

    Abstract Objective: To describe the landscape of needs for housing assistance among people with HIV (PWH) and availability of Housing Opportunities for People with AIDS (HOPWA) funding with respect to housing service needs, nationally and for 17 US jurisdictions.
    Design: The CDC Medical Monitoring Project (MMP) is an annual, cross-sectional survey designed to report nationally and locally representative estimates of characteristics and outcomes among adults with diagnosed HIV in the United States.
    Methods: We analyzed 2015-2020 data from MMP and 2019 funding data from HOPWA. Weighted percentages and 95% confidence intervals (CIs) for national and jurisdiction-level estimates were reported.
    Results: Nationally, 1 in 4 (27.7%) PWH had shelter or housing service needs. Among those who needed housing services, 2 in 5 (40.4%) did not receive them (range: 21.3% in New York to 62.3% in Georgia). Reasons for unmet needs were multifactorial and varied by jurisdiction. Available 2019 HOPWA funding per person in need would cover up to 1.24 months of rent per person nationally (range: 0.53 months in Virginia to 9.54 months in Puerto Rico), and may not have matched housing assistance needs among PWH in certain jurisdictions.
    Conclusion: Addressing housing service needs necessitates a multipronged approach at the provider, jurisdiction, and national level. Locally, jurisdictions should work with their partners to understand and address housing service needs among PWH. Nationally, distribution of HOPWA funding for housing services should be aligned according to local needs; the funding formula could be modified to improve access to housing services among PWH.
    MeSH term(s) Adult ; Humans ; Acquired Immunodeficiency Syndrome ; Cross-Sectional Studies ; Georgia ; HIV Infections ; Public Housing ; United States/epidemiology ; Housing
    Language English
    Publishing date 2022-12-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 639076-6
    ISSN 1473-5571 ; 0269-9370 ; 1350-2840
    ISSN (online) 1473-5571
    ISSN 0269-9370 ; 1350-2840
    DOI 10.1097/QAD.0000000000003460
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: HIV Testing Preferences and Characteristics of Those Who Have Never Tested for HIV in the United States.

    Patel, Shilpa N / Emerson, Brian P / Pitasi, Marc A / Tripp, Natalie E / Marcus, Ruthanne / Delaney, Kevin P / Chavez, Pollyanna R

    Sexually transmitted diseases

    2022  Volume 50, Issue 3, Page(s) 175–179

    Abstract: Background: The initial phase of the federal Ending the HIV Epidemic in the U.S. (EHE) initiative prioritized efforts in 57 geographic areas. The US Centers for Disease Control and Prevention recommends persons aged 13 to 64 years be tested for HIV at ... ...

    Abstract Background: The initial phase of the federal Ending the HIV Epidemic in the U.S. (EHE) initiative prioritized efforts in 57 geographic areas. The US Centers for Disease Control and Prevention recommends persons aged 13 to 64 years be tested for HIV at least once as part of routine health care; however, it is unclear how effectively these testing recommendations have been implemented in EHE priority areas.
    Methods: In 2021 to 2022, we analyzed data from a Web-based, nationally representative survey of adults fielded in 2021. HIV testing preferences were compared by testing history, demographic characteristics, behaviors, and geography.
    Results: An estimated 72.5% of US adults had never tested for HIV. Never testing was most prevalent among those aged 18 to 29 or those 50 years or older, non-Hispanic White persons, and those living in the Midwest. Among persons living in EHE priority areas and persons reporting at least one behavior that increases risk of HIV transmission, 69.1% and 48.0%, respectively, had never tested for HIV. The top 3 HIV testing preferences among never testers were as follows: testing for HIV during a routine health care visit (41.2%), testing at an urgent care or walk-in clinic (9.6%), and self-testing (8.1%).
    Conclusions: Most adults had not been tested for HIV, confirming that US Centers for Disease Control and Prevention recommendations are not being fully implemented, even in EHE priority areas. Moreover, most adults who never tested preferred testing in clinical settings, highlighting missed opportunities. As the EHE initiative continues to advance, it is critical to leverage preferred HIV testing modalities, such as routine testing in clinical settings or HIV self-testing.
    MeSH term(s) Adult ; Humans ; United States/epidemiology ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Surveys and Questionnaires ; Ambulatory Care Facilities ; Ambulatory Care ; HIV Testing
    Language English
    Publishing date 2022-12-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 435191-5
    ISSN 1537-4521 ; 0148-5717
    ISSN (online) 1537-4521
    ISSN 0148-5717
    DOI 10.1097/OLQ.0000000000001746
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: "Choose the People Who Know": How Patient-Centered Medical Homes Reduce Disclosure Anxiety for People Living with HIV and Experiencing Homelessness.

    Tryon, Janell / Marcus, Ruthanne / Earnshaw, Valerie / Chisolm, Nicole / Darko, Tanisha / McKeithan, Lisa / Rajabiun, Serena

    Journal of health care for the poor and underserved

    2022  Volume 33, Issue 3, Page(s) 1432–1448

    Abstract: While public and medical perceptions of HIV and those living with HIV have shifted to be more accepting, many individuals still report stigmatizing experiences in clinical and non-clinical settings. Interviews with 40 people living with HIV, homelessness, ...

    Abstract While public and medical perceptions of HIV and those living with HIV have shifted to be more accepting, many individuals still report stigmatizing experiences in clinical and non-clinical settings. Interviews with 40 people living with HIV, homelessness, substance use, and mental illness participating in a patient-centered medical home (PCMH) were conducted in seven sites across the U.S. to assess experiences with stigma in social and clinical spheres. The most salient themes of the study were: 1) how current and past experiences of stigma-in interactions with friends, family, and providers-informed clients' relationships with disclosure, and 2) how, through coordinated and confidential systems of care, the PCMH minimized the necessity to disclose HIV status, thereby reducing the anxiety associated with it.
    MeSH term(s) Anxiety/epidemiology ; Disclosure ; HIV Infections ; Homeless Persons ; Humans ; Patient-Centered Care ; Qualitative Research ; Social Stigma
    Language English
    Publishing date 2022-10-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1142637-8
    ISSN 1548-6869 ; 1049-2089
    ISSN (online) 1548-6869
    ISSN 1049-2089
    DOI 10.1353/hpu.2022.0122
    Database MEDical Literature Analysis and Retrieval System OnLINE

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