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    Prepare Romania: study protocol for a randomized controlled trial of an intervention to promote pre-exposure prophylaxis adherence and persistence among gay, bisexual, and other men who have sex with men
    (BMC, part of Springer Nature, 2024-07-10) Lelutiu-Weinberger C; Filimon ML; Zavodszky AM; Lixandru M; Hanu L; Fierbinteanu C; Patrascu R; Streinu-Cercel A; Luculescu S; Bora M; Filipescu I; Jianu C; Heightow-Weidman LB; Rochelle A; Yi B; Buckner N; Golub SA; van Dyk IS; Burger J; Li F; Pachankis JE
    BACKGROUND: Gay, bisexual, and other men who have sex with men (GBMSM) represent a high-risk group for HIV transmission in Romania, yet they possess few resources for prevention. Despite having no formal access to pre-exposure prophylaxis (PrEP) through the health system, GBMSM in Romania demonstrate a high need for and interest in this medication. In anticipation of a national rollout of PrEP, this study tests the efficacy of a novel strategy, Prepare Romania, that combines two evidence-based PrEP promotion interventions for GBMSM living in Romania. METHODS: This study uses a randomized controlled trial design to examine whether GBMSM living in Romania receiving Prepare Romania, a culturally adapted counseling and mobile health intervention (expected n = 60), demonstrate greater PrEP adherence and persistence than those assigned to a PrEP education control arm (expected n = 60). Participants from two main cities in Romania are prescribed PrEP and followed-up at 3 and 6 months post-randomization. PrEP adherence data are obtained through weekly self-report surveys and dried blood spot testing at follow-up visits. Potential mediators (e.g., PrEP use motivation) of intervention efficacy are also assessed. Furthermore, Prepare Romania's implementation (e.g., proportion of enrolled participants attending medical visits, intervention experience) will be examined through interviews with participants, study implementers, and healthcare officials. DISCUSSION: The knowledge gained from this study will be utilized for further refinement and scale-up of Prepare Romania for a future multi-city effectiveness trial. By studying the efficacy of tools to support PrEP adherence and persistence, this research has the potential to lay the groundwork for PrEP rollout in Romania and similar contexts. Trial registration This study was registered on ClinicalTrials.gov, identifier NCT05323123 , on March 25, 2022.
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    Counsellors in the gaze : a Foucauldian analysis of counsellors stories around being a counsellor : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 2004) Townshend, Kathrine
    Over recent years there has been in increase in the number of rules and regulations pertaining to counselling in New Zealand. This project looks at the power relations constituted in those changes for a small group of counsellors. The social constructionist perspective is evaluated and found to provide a useful epistemological basis for this inquiry, when used in combination with a critical realist epistemology. This epistemological duality allows the objects under discussion to have different types of ontological status ranging from the socially constructed to the (more or less) real. An overview of the different styles of narrative analysis is presented and the conclusion reached that structural models of identifying and analysing narrative are not appropriate for working with fragmentary narratives. A model is presented for identification and analysis of fragmentary narratives based on content. Three narratives about being a counsellor are identified; the 'counsellor as double agent', the 'unsupported counsellor' and the 'unyielding counsellor'. The story of the counsellor as double agent is the story of a counsellor who may promote either training or relationship as having primary importance, depending on context. The story of the unsupported counsellor is the story about the lack of support of the relationship aspect of counselling outside of peer circles. The story of the unyielding counsellor is the story of the counsellor who would leave rather than compromise her values. These three narratives are presented as being co­ existent. Through analysis of these narratives the type of control practise constituted in the new rules and regulations is identified as being a type of 'sovereign ' or overt power practise. This characterisation of that power practise lends validity to subsequent discussions about resistance to the cultural change constituted in the new requirements. The power practices operating prior to the recent changes are identified as being 'disciplinary' or covert in nature. The conclusion is reached that the 'counsellor' represented by the text under analysis is not necessarily operating under normative regimes, and may at times adopt a deconstructive approach to the processes underlying construction of behaviour as 'problem'.
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    The relationships between counsellors' orientation, experiences and training and their conceptualization of their tasks in the healing process in sexual abuse counselling : a qualitative analysis : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 1992) Stevens, Susan Ellen
    Eight counsellors registered with the Accident Compensation Corporation as sexual abuse counsellors participated in qualitative research employing semi-structured, in-depth interviews. A qualitative approach was used to explore previously unidentified variables in sexual abuse counselling, and the relationships among these. Transcribed interviews were analysed for recurrent regularities in themes and dynamics. Four overall themes emerged that appeared most salient in influencing counsellor's conceptualization of the tasks and processes involved in treating the effects of sexual abuse. These themes were (1) counsellor's orientation; (2) training and development; (3) understanding of the dynamics, issues, and effects of sexual abuse; and (4) personal experience of abuse. These variables have implications for both the practice of sexual abuse counselling and for future research.
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    Re-negotiating meanings : a grounded theory of core factors in healing shame in adult survivors of sexual abuse : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 1997) Cody, Tracey-Lynne
    Shame is an issue for survivors of sexual abuse that has received little attention in the literature. Eight experienced therapists following different therapeutic orientations were interviewed about their conceptualisations of shame in sexual abuse survivors and the process of healing from shame. The interview data was analysed using the grounded theory method of qualitative analysis and a theory of core factors in the healing process across therapeutic orientations was derived. Findings suggest that the child victim of sexual abuse makes meaning of their experiences, a process influenced by a number of contextual domains. The key meanings of being responsible for the abuse or being somehow defective as a consequence of abuse were found to be central to the development of shame, and were linked to a number of sequelae by respondents. The core factors in the respondents' conceptualisations of the process of healing shame involved re-negotiating the meanings the child had formed, and this process was made up of five key areas; developing trust in the therapeutic relationship, building a positive sense of self, facing the shamed self, contextualisation and integration. Attention was also given to gender issues in order to discover similarities or differences in the experiences and healing process for male survivors of sexual abuse. Findings suggest that respondents' saw shame in sexual abuse and the healing process as being the same for males and females, with differences being largely the result of socialisation practices. Implications of findings are discussed.
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    Spirituality in counselling : assisting counsellors and the depressed : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy, in Social Policy and Social Work at Massey University
    (Massey University, 1999) Stewart, Bruce William
    This study qualitatively explored the views of six people who use spirituality in their counselling work with the depressed. These findings were compared to the counselling literature on spirituality and a theoretical framework developed for this research. There are indications that spirituality in counselling is helpful in alleviating depression, as seen through the literature and through the reports from participants. However, this was more strongly supported in the literature than with the participants. Empowerment, belonging and universal sacredness emerged as helpful conceptualisations for counsellors who wish to incorporate spirituality in their work with depressed clients. In addition, spirituality assisted the counsellors personally and enhanced their practice. Increased counsellor awareness of their spiritual beliefs and values in counselling was found beneficial to counsellors working with depressed clients. This helps counsellors to become less vulnerable to imposing their views on the client, which can reduce their ability to help. The research demonstrated that a healthy spirituality might reduce vulnerability to depression while conditions that create vulnerability to depression may also reduce spirituality's capacity to enhance meaning and purpose in life. The depressed also suffer from powerlessness, isolation, and devaluation that can be alleviated through spirituality in counselling. This study further identified that in certain circumstances spirituality was not helpful and that some barriers existed for counsellors in using it in their work. On balance, the study found encouragement to integrate spirituality into counselling work for depression.