N C Ware
Biographic Data
| ID | 3558 |
|---|---|
| NAME | N C Ware |
| GIVEN NAMES | N C |
| FAMILY NAME | Ware |
| SIGNATURE | WARE N C |
| AFFILIATIONS | Harvard University |
| ORCID | 0000-0002-5039-9991 |
| VERIFIED | Yes |
| TOTAL WORKS | 51 |
| TOTAL CITATIONS | 173 |
| AUTHOR COUNT | 51 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1985 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 6 |
Visible wounds, invisible rights
In 2014, the Islamic State of Iraq and Syria targeted the Yazidi ethno-religious minority in Sinjar, northern Iraq, abducting Yazidi boys aged 8 to 14 who endured violence, family separation and significant trauma exposure. Upon return, these children needed mental health care. This study investigates the availability of mental health services for male Yazidi former CAAFAGs (children associated with armed forces and armed groups) and discusses th…
Oral PrEP Use by Transgender Men in Uganda
Impact of Covid-19 Public Health Measures on Antiretroviral Therapy Use Among Ugandans Living with HIV in Sero-Different Couples
Antiretroviral therapy (ART) use and HIV suppression among people living with HIV (PLHIV) are critical for HIV control and prevention. Extreme restrictions on movement early during the COVID-19 pandemic in Uganda may have impeded the ability to initiate and sustain access to and use of ART. From our stepped-wedge cluster-randomized trial of an integrated PrEP and ART intervention for HIV-serodifferent couples at 12 ART clinics in Uganda, we ident…
How PrEP delivery was integrated into public ART clinics in central Uganda
Tailored delivery strategies are important for optimizing the benefit and overall reach of PrEP in sub-Saharan Africa. An integrated approach of delivering time-limited PrEP in combination with ART to serodifferent couples encourages PrEP use in the HIV-negative partner as a bridge to sustained ART use. Although PrEP has been delivered in ART clinics for many years, the processes involved in integrating PrEP into ART services are not well underst…
Social networks and HIV treatment adherence among people with HIV initiating treatment in rural Uganda and peri-urban South Africa
Timely initiation of and adherence to antiretroviral therapy (ART) is critical for improving HIV outcomes and reducing HIV transmissibility. Social networks, or the social relationships individuals have with each other, have been linked with positive health outcomes, but less is known about the extent to which social network composition and structure are associated with improved ART adherence among people living with HIV (PLWH). We conducted an e…
Integrated PrEP and STI Services for Transgender Women in Uganda
Behavioral Modeling and its Association with PrEP and ART Use in Ugandan HIV-Serodifferent Couples
Integrating Pre-Exposure Prophylaxis (PrEP) delivery into Antiretroviral Therapy (ART) programs bridges the Human Immunodeficiency Virus (HIV) prevention gap for HIV-serodifferent couples prior to the partner living with HIV achieving viral suppression. Behavioral modeling is one mechanism that could explain health-related behavior among couples, including those using antiretroviral medications, but few tools exist to measure the extent to which …
How Central Ugandan HIV Clinics Adapted During Covid-19 Lockdown Restrictions to Promote Continuous Access to Care
Health Care Worker Perspectives of HIV Pre-exposure Prophylaxis Service Delivery in Central Uganda
Background: Scale-up of HIV pre-exposure prophylaxis (PrEP) services in Uganda is ongoing. However, health care workers (HCWs) may not be aware of PrEP nor what offering this service entails. We explored the impact of standardized HCW training on the knowledge and perspectives of PrEP service delivery in Uganda. Methods: We recruited HCWs from facilities that offered HIV-related services in Central Uganda. Using the Uganda Ministry of Health curr…
Influences on PrEP Uptake and Adherence Among South African Women During Periconception and Pregnancy
Understanding PrEP Acceptability Among Priority Populations
Daily oral pre-exposure prophylaxis (PrEP) can safely and effectively prevent HIV acquisition in HIV-negative individuals. However, uptake of PrEP has been suboptimal in sub-Saharan Africa. The goal of this qualitative study was to identify facilitators of and barriers to PrEP acceptability among target users not taking PrEP. Fifty-nine individuals belonging to Ugandan priority populations participated in a single in-depth interview. Participants…
Him Leaving Me – That is My Fear Now”
Influences on Adherence to Antiretroviral Therapy (ART) in Early-Stage HIV Disease
A Social-Ecological Framework to Understand Barriers to HIV Clinic Attendance in Nakivale Refugee Settlement in Uganda
The social-ecological model proposes that efforts to modify health behaviors are influenced by constraints and facilitators at multiple levels. We conducted semi-structured interviews with 47 clients in HIV care and 8 HIV clinic staff to explore how such constraints and facilitators (individual, social environment, physical environment, and policies) affect engaging in HIV clinical care in Nakivale Refugee Settlement in Uganda. Thematic analysis …
A qualitative approach to understand antiretroviral therapy (ART) adherence for refugees living in Nakivale Refugee Settlement in Uganda
By learning about refugees' experiences we can design informed interventions to enhance ART adherence, thus minimizing morbidity and mortality, preventing transmission of HIV, and supporting refugees' abilities to move freely toward repatriation, resettlement or integration in their host country
The Technology Acceptance Model for Resource-Limited Settings (TAM-RLS)
Exploring critical questions for the implementation of “universal test and treat” approaches to HIV prevention and care
More than three decades into the HIV epidemic in Africa, new biomedical technologies have brought the real possibility of ending the epidemic into view (The Lancet HIV, 2015; UNAIDS, 2015). Drawing
The role of social support on HIV testing and treatment adherence
Little is known about the factors that encourage or discourage refugees to test for HIV, or to access and adhere to HIV care. In non-refugee populations, social support has been shown to influence HIV testing and utilisation of services. The present study enrolled HIV-infected refugees on anti-retroviral therapy (ART) in Uganda, who participated in qualitative interviews on HIV testing, treatment, and adherence. Interviews were analysed for theme…
Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda
SMS is a widely used technology globally and may also improve ART adherence, yet SMS notifications to social supporters following real-time detection of missed doses showed no clear benefit in a recent pilot trial. We examine the demographic and social-cultural dynamics that may explain this finding. In the trial, 63 HIV-positive individuals initiating ART received a real-time adherence monitor and were randomized to two types of SMS reminder int…
Qualitative Study of Changes in Alcohol Use Among HIV-Infected Adults Entering Care and Treatment for HIV/Aids in Rural Southwest Uganda
Alcohol has a substantial negative impact on the HIV epidemic in sub-Saharan Africa, particularly in Uganda, where heavy alcohol consumption is common. Using a content analytic approach, this qualitative study characterizes changes in alcohol use among 59 HIV-infected Ugandan adults (>18 years old), who reported any alcohol use in the previous year as they entered HIV care. Most participants reported attempting to cease or reduce alcohol intake o…
Lay Social Resources for Support of Adherence to Antiretroviral Prophylaxis for HIV Prevention Among Serodiscordant Couples in sub-Saharan Africa
Effectiveness of antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention will require high adherence. Using qualitative data, this paper identifies potential lay social resources for support of PrEP adherence by HIV serodiscordant couples in Uganda, laying the groundwork for incorporation of these resources into adherence support initiatives as part of implementation. The qualitative analysis characterizes support for PrEP adherence pro…
HIV Providers’ Perceived Barriers and Facilitators to Implementing Pre-exposure Prophylaxis in Care Settings
Explaining Antiretroviral Therapy Adherence Success Among HIV-Infected Children in Rural Uganda
Understanding Treatment Refusal Among Adults Presenting for HIV-Testing in Soweto, South Africa
Socio-cultural and economic antecedents of adolescent sexual decision-making and HIV-risk in rural Uganda
With more than half of new infections occurring among youth, HIV/AIDS remains a major contributor to morbidity and mortality in Uganda. Semi-structured interviews were performed with 48 adolescents and 15 adult key informants in a rural Ugandan community to identify influences on adolescent sexual decision-making. Inductive data analytic methods revealed five thematic influences: (1) social pressure, (2) decline of the Senga (a familial figure wh…
Suffering and the Social Construction of Illness
The author examines suffering engendered by the socially constituted nature of illness through the delegitimation of illness experience in chronic fatigue syndrome. Cultural meanings of physical and mental illness are shown to be reflected in interactions with others to construct an illness reality in which chronic fatigue syndrome is defined as either nonexistent or psychosomatic. Disconfirmation of the subjective experience of illness leads to …
Clinician Experiences of Managed Mental Health Care
The threat mental health professionals perceive in managed care, as indicated by their writings on the subject, is re-examined in light of evidence from an ethnographic study. Fieldwork focusing on clinician experiences of managed care was carried out at an urban community mental health center. Existing explanations of "the threat"-the possibility of deprofessionalization and the potential for deterioration in the quality of care-proved inadequat…
Sex Differences in Choice of College Science Majors
The process of choosing a scientific major was examined in a nationally representative sample of male and female college students of above-average ability. Science majoring was predicted by different constellations of factors for male and female students. Women who were attending a 4-year college, who reported having been influenced by high school teachers and guidance counselors in making plans for college, and who placed a high priority upon as…
Undergraduate Women
Despite the gains of recent years, women continue to be underrepresented in scientific fields at every educational level. In 1981, only 27 percent of the nation's bachelor's degrees in science and mathematics were awarded to women. The gap widens at higher educational levels; in the same year only 17 percent of all science and mathematics doctorates went to women. At the same time, labor force statistics show that in 1980 women represented 13 per…
Funneling Child Welfare Consumers into and through the Mental Health System
This qualitative study explores how consumers of child welfare services reach nonpsychiatric mental health providers and the perceived quality of these services. It relies on iterative interviews with individuals and groups, as well as on court observations from one metropolitan area. Results suggest that, consistent with theories of street-level bureaucracy, efficiency issues drive mental health service use, as clients are routinely subjected to…
The prevalence of bulimia among college students
A survey was conducted to determine the prevalence of bulimia and bulimic symptoms in a nonclinical sample of 907 college freshmen and seniors. Using criteria based on the Diagnostic and Statistical Manual of Mental Disorders, 4 per cent of the women and 0.4 per cent of the men were classified as bulimic. Symptoms of bulimia, such as binge eating, purging behaviors, and extreme fear of gaining weight, were much more prevalent
Adherence, stereotyping and unequal HIV treatment for active users of illegal drugs
Ethnography and Measurement in Mental Health
Ethnography contributes to measure development by enhancing validity and providing a basis for qualitative validation. Validating research measures means making cases for their "trustworthiness." The authors argue for the trustworthiness of CONNECT, a measure of continuity of care, by presenting the interpretive logic through which they elaborated continuity for measure construction purposes. They used category construction methods to identify me…
Neurasthenia and the Social Construction of Psychiatric Knowledge
The diagnostic category of neurasthenia is examined as a cultural construct with social uses and implications for psychiatric nosologies. The legitimation of otherwise stigmatized symptoms through a diagnosis of neuras thenia is discussed. The re-thinking and re-definition of the category in Chinese psychiatry in the 1980s is reviewed to illustrate the social construction of knowl edge and DSM's influence abroad. The proposal to include neurasthe…
Undergraduate Women
Despite the gains of recent years, women continue to be underrepresented in scientific fields at every educational level. In 1981, only 27 percent of the nation's bachelor's degrees in science and mathematics were awarded to women. The gap widens at higher educational levels; in the same year only 17 percent of all science and mathematics doctorates went to women. At the same time, labor force statistics show that in 1980 women represented 13 per…
The prevalence of bulimia among college students
A survey was conducted to determine the prevalence of bulimia and bulimic symptoms in a nonclinical sample of 907 college freshmen and seniors. Using criteria based on the Diagnostic and Statistical Manual of Mental Disorders, 4 per cent of the women and 0.4 per cent of the men were classified as bulimic. Symptoms of bulimia, such as binge eating, purging behaviors, and extreme fear of gaining weight, were much more prevalent
Sex Differences in Choice of College Science Majors
The process of choosing a scientific major was examined in a nationally representative sample of male and female college students of above-average ability. Science majoring was predicted by different constellations of factors for male and female students. Women who were attending a 4-year college, who reported having been influenced by high school teachers and guidance counselors in making plans for college, and who placed a high priority upon as…
Culture and somatic experience
An anthropological view of culture and somatic experience is presented through elaboration of the notion that illness has a social course. Contemporary anthropology locates culture in local worlds of interpersonal experience. The flow of events and processes in these local worlds influences the waxing and waning of symptoms in a dialetic involving body and society over time. Conversely, symptoms serve as a medium for the negotiation of interperso…
Suffering and the Social Construction of Illness
The author examines suffering engendered by the socially constituted nature of illness through the delegitimation of illness experience in chronic fatigue syndrome. Cultural meanings of physical and mental illness are shown to be reflected in interactions with others to construct an illness reality in which chronic fatigue syndrome is defined as either nonexistent or psychosomatic. Disconfirmation of the subjective experience of illness leads to …
Advancing Health in Developing Countries
Neurasthenia and the Social Construction of Psychiatric Knowledge
The diagnostic category of neurasthenia is examined as a cultural construct with social uses and implications for psychiatric nosologies. The legitimation of otherwise stigmatized symptoms through a diagnosis of neuras thenia is discussed. The re-thinking and re-definition of the category in Chinese psychiatry in the 1980s is reviewed to illustrate the social construction of knowl edge and DSM's influence abroad. The proposal to include neurasthe…
Advancing Health in Developing Countries
Sociosomatics and Illness Course in Chronic Fatigue Syndrome
OBJECTIVE: This study examines social processes that construct the course of chronic illness. Specifically, it identifies and describes mechanisms that constitute the process of role constriction in employment for individuals with chronic illness. METHOD: Sixty-six persons meeting the Centers for Disease Control case definition of chronic fatigue syndrome (CFS) participated in a longitudinal study involving three waves of data collection over 3 y…
Toward A Model of Social Course in Chronic Illness
Clinician Experiences of Managed Mental Health Care
The threat mental health professionals perceive in managed care, as indicated by their writings on the subject, is re-examined in light of evidence from an ethnographic study. Fieldwork focusing on clinician experiences of managed care was carried out at an urban community mental health center. Existing explanations of "the threat"-the possibility of deprofessionalization and the potential for deterioration in the quality of care-proved inadequat…
Ethnography and Measurement in Mental Health
Ethnography contributes to measure development by enhancing validity and providing a basis for qualitative validation. Validating research measures means making cases for their "trustworthiness." The authors argue for the trustworthiness of CONNECT, a measure of continuity of care, by presenting the interpretive logic through which they elaborated continuity for measure construction purposes. They used category construction methods to identify me…
Family Consequences of Refugee Trauma
Objective: To construct a model on the consequences of political violence for refugee families based upon a qualitative investigation. Methods: This study used a grounded‐theory approach to analyze qualitative evidence from the CAFES multi‐family support and education groups with Bosnian refugee families in Chicago. Textual coding and analysis was conducted using ATLAS/ti for Windows. Results: A grounded‐theory model of Family Consequences of Ref…
Adherence, stereotyping and unequal HIV treatment for active users of illegal drugs
Social relationships, stigma and adherence to antiretroviral therapy for HIV/Aids
Research on adherence to combination antiretroviral therapy has up to now focused largely upon problems of definition and measurement, and on the identification of barriers and supports. This paper examines the intersection between taking HAART and building a life with HIV/AIDS. Data consist of 214 qualitative interviews with 52 HIV-positive, active illegal drug users. A interpretive analysis drawing upon stigma and fear of disclosure as analytic…
Associations Between Adherence to Guidelines for Antipsychotic Dose and Health Status, Side Effects, and Patient Care Experiences
BACKGROUND: One approach to improving quality of care is to encourage physicians to follow evidence-based practice guidelines. Examples of evidence-based guidelines are the PORT recommendations for the treatment of schizophrenia. However, few studies have examined the relationship between adherence to guidelines and patient outcomes in clinical settings. OBJECTIVE: The purpose of this article is to report the relationship between guideline adhere…
Connectedness and Citizenship
Despite decades of deinstitutionalization, individuals with psychiatric disabilities living outside the hospital may be described as in the community, but not of it. To effectively address the persisting problem of social exclusion of persons with psychiatric disabilities, new conceptual tools are needed. To address this need, a new definition of social integration is offered.The definition is based on data from a qualitative study. Data collecti…
Response to Letter from Dr. Alexander S. Young
Dickey, Barbara PhD; Normand, Sharon-Lise PhD; Cleary, Paul PhD; Hermann, Richard MD, MS; Eisen, Sue PhD; Cortés, Dharma PhD; Ware, Norma PhD Author Information
Funneling Child Welfare Consumers into and through the Mental Health System
This qualitative study explores how consumers of child welfare services reach nonpsychiatric mental health providers and the perceived quality of these services. It relies on iterative interviews with individuals and groups, as well as on court observations from one metropolitan area. Results suggest that, consistent with theories of street-level bureaucracy, efficiency issues drive mental health service use, as clients are routinely subjected to…
Explaining Adherence Success in Sub-Saharan Africa
BACKGROUND: Individuals living with HIV/AIDS in sub-Saharan Africa generally take more than 90% of prescribed doses of antiretroviral therapy (ART). This number exceeds the levels of adherence observed in North America and dispels early scale-up concerns that adherence would be inadequate in settings of extreme poverty. This paper offers an explanation and theoretical model of ART adherence success based on the results of an ethnographic study in…
Transportation Costs Impede Sustained Adherence and Access to Haart in a Clinic Population in Southwestern Uganda
The cost of transportation for monthly clinic visits has been identified as a potential barrier to antiretroviral (ARV) adherence in sub-Saharan Africa and elsewhere, although there is limited data on this issue. We conducted open-ended interviews with 41 individuals living with HIV/AIDS and attending a clinic in Mbarara, Uganda, to understand structural barriers to ARV adherence and clinical care. Almost all respondents cited the need to locate …
Reproductive Decision-Making and Periconception Practices Among HIV-Positive Men and Women Attending HIV Services in Durban, South Africa
Understanding reproductive decisions and periconception behavior among HIV-discordant couples is important for designing risk reduction interventions for couples who choose to conceive. In-depth interviews were conducted to explore reproductive decision-making and periconception practices among HIV-positive women with recent pregnancy (n = 30), and HIV-positive men (n = 20), all reporting partners of negative or unknown HIV-status, and attending …
How Treatment Partners Help
Treatment partnering is an adherence intervention developed in sub-Saharan Africa. This paper describes the additional social functions that treatment partners serve and shows how these functions contribute to health and survival for patients with HIV/AIDS. Ninety-eight minimally structured interviews were conducted with twenty pairs of adult HIV/AIDS patients (N = 20) and treatment partners (N = 20) treated at a public HIV-care setting in Tanzan…
What's Love Got to Do With It? Explaining Adherence to Oral Antiretroviral Pre-Exposure Prophylaxis for HIV-Serodiscordant Couples
OBJECTIVE: Adherence may be the "Achilles heel" of pre-exposure prophylaxis (PrEP), a promising biomedical approach to HIV prevention. This article presents an explanation of PrEP adherence for African serodiscordant couples derived from qualitative data. DESIGN: Explaining quantitative findings is one way qualitative investigation contributes to research in medicine and public health. This qualitative interview study was nested in the Partners P…
A conceptual framework for understanding HIV risk behavior in the context of supporting fertility goals among HIV-serodiscordant couples
Integrated reproductive health services for people living with HIV must address their fertility intentions. For HIV-serodiscordant couples who want to conceive, attempted conception confers a substantial risk of HIV transmission to the uninfected partner. Behavioral and pharmacologic strategies may reduce HIV transmission risk among HIV-serodiscordant couples who seek to conceive. In order to develop effective pharmaco-behavioral programs, it is …
Medicine (42 works) · Psychology (34 works) · HIV/AIDS Research and Interventions (32 works) · Family medicine (26 works) · Nursing (26 works) · Qualitative research (25 works) · Sociology (23 works) · Psychiatry (22 works) · Public health (22 works) · HIV, Drug Use, Sexual Risk (20 works)