During a disaster, pregnant women are considered among the most vulnerable. Background: On 20 September 2017, the Caribbean was hit by a category 4 hurricane. The purpose of the study was to explore the impact on pregnant women during and after the hurricane regarding access to health care, social services, and support systems. Methods: In-depth interviews were conducted to 10 women that were pregnant during the event. Qualitative inquiry based on the Interpretative Phenomenological Analysis framework was used to interpret the narratives. Results: Five major themes emerged: meaning of living through a disaster, fear, the dual burden of protecting themselves and their unborn baby, disruption in health care, and coping mechanisms. Despite the negative feelings, most participants experienced positive transformations. They narrated how they stayed calm and coped in order to protect their pregnancy. Their overall evaluation of the healthcare system was positive. The support of friends and family was crucial pre and post-disaster. Conclusions: The interviews provided a wealth of firsthand information of women experiencing a natural disaster while pregnant. The findings underscore the need to incorporate emotional support in the preparedness and response plans for pregnant women. Educating, empowering, and incorporating families and communities is vital in these efforts.

The burden of HIV affects not only HIV-infected patients but also their families and caregivers. It is also known that family support is crucial for people living with HIV. A qualitative study was conducted to explore the life experiences, within the family context, of perinatally HIV-infected (pHIV-I) youth in Puerto Rico. Twenty in-depth interviews were performed and audio-recorded. Within the family context, study participants experienced acceptance, love and support but also stigma and discrimination. They reported that family is an essential component in their lives and treatment. Losing one or both parents at a young age was considered more difficult than having HIV. Most participants who lost their parents lived with other family members. This was a challenging situation for both pHIV-I youth and their caregivers. Participants described their healthcare providers as part of their families and would like to keep in touch as they transition to adult care. Despite the challenges, participants expressed a desire to have children. Services targeted to this population should stress social support, incorporate family members into the medical process, provide special guidance and support while transitioning to adult care, and provide them with the latest information regarding HIV and reproductive options.

Objective. To examine the impact of the HIV normalization discourse on the life of a group of perinatally HIV-infected (pHIV-I) youth in Puerto Rico.Met

Objective: The objective of this study was to assess community pharmacists’ willingness to test, treat and immunize for COVID-19 in Puerto Rico. Methods: In this cross-sectional study, a 37-item survey was distributed via email and social media in May 2020 through REDCap online software. All licensed community pharmacists in Puerto Rico (N = 1200) were invited to complete the survey. Retired community pharmacists were excluded. Analysis of frequencies and chi-square tests were performed to evaluate the willingness to test, treat and immunize for COVID-19 and their associations with sociodemographic variables. Key findings: The survey response rate was 26% (314/1200). Subjects’ mean age was 42 (±13), 86.1% were female, and most practiced in independent community or specialty pharmacy (62%). Among respondents, 44% reported willingness to test. Top concerns for testing were family (73.4%) and self (66.8%) exposure and ability to manage the workflow (53.3%). Most participants indicated their willingness to treat (88.4%) and to administer the COVID-19 vaccine (76.1%). Study participants who worked in retail pharmacies were more willing to test for COVID-19 (50.9%, P = 0.34) and to immunize (91.2%, P < 0.001). Pharmacists ≤39 years (90.3%), those who graduate in 2000 or later (88.3%), and those with a Pharm.D. degree or higher (88.6%), were more willing to immunize (P < 0.001). Conclusions: Most community pharmacists were more willing to treat and immunize, than to perform COVID-19 testing. This underscores the need for training and workflow changes to facilitate the acquisition of this new role. Local pharmacists’ associations should advocate for a safe and manageable work environment. These efforts are vital to empower pharmacists to adopt new roles during a public health emergency.

This study explores the treatment experience of people living with HIV who transitioned from oral ART to long-acting injectable therapy Cabotegravir/Rilpivirine (LAI-CAB/RPV) in Puerto Rico. Interpretative Phenomenological Analysis was used to explore the lived experiences of people with HIV 21 years old or older who transitioned from oral ART to LAI-CAB/RPV. Purposeful sampling was used to recruit study participants. Ten in-depth interviews were conducted at the clinic, audio recorded, and transcribed verbatim. Participants’ mean age was 67 years (±9), most were men (70%), and most identified themselves as heterosexual (60%). On average, they have taken oral ART for 23.2 years ± 8.7. The transition to LAI-CAB/RPV marked a profound positive change; for them, injectable ART means “freedom,” improving their quality of life, providing relief, and a sense of “normalcy.” Adherence remained robust, marked by consistent appointment attendance. They overwhelmingly encouraged others to embrace the transition, highlighting its transformative impact on their lives. Study participants’ positive experiences underscore the potential of LAI-CAB/RPV to revolutionize the standard of care, enhancing both the treatment experience and the overall well-being of people living with HIV. Continued research is crucial to refine and expand the benefits of this treatment approach.

Objective. To assess the self-reported impact of hurricane Maria on the perceived academic performance of student pharmacists at Nova Southeastern University’s (NSU) Puerto Rico Regional Campus. Methods. A 37-item electronic instrument, the Hurricane Impact Survey, was created and sent by email to all student pharmacists ≥21 years old enrolled at NSU-COP Puerto Rico Campus during the fall 2017 semester. The electronic survey was available through Redcap platform for four weeks. Descriptive statistics, bivariate analysis, and logistic regression were used to analyze students’ responses. Qualitative analysis was used to identify emerging themes in the open-ended comments. Results. A total of 150 student pharmacists completed the survey for a response rate of 69% (150/215). More than 70% of student pharmacists perceived that their academic performance was affected after the hurricane. About one third of students reported not being able to function mentally at the same level as they had prior to the storm (n=53, 35%) and reported having difficulty sleeping (n=54, 36%). Female student pharmacists were more likely than male student pharmacists to report not being able to function at the same level mentally as they had before the hurricane (41% vs 17%). In the multivariate analysis, first- and second-year student pharmacists were more likely to perceive a negative impact on their academic performance compared to third- and fourth-year student pharmacists. Lack of preparedness, gratefulness, and campus management were the themes that emerged from the qualitative analysis. Conclusion. Hurricane Maria had a significant impact on the lives of student pharmacists in Puerto Rico. This led to a perception of diminished academic performance, especially among first- and second-year students. The results can be used to guide preparedness and response to natural disasters in academic settings.