scholarly journals Healthcare Providers’ Perspectives and Role in Improving Patient Engagement in HIV Treatment and Care in Almaty, Kazakhstan

2021 ◽  
Vol 18 (22) ◽  
pp. 12138
Author(s):  
Elizabeth J. King ◽  
Ainur Zh. Kussainova ◽  
Jangul Erlon-Baurjan ◽  
Zhamilya S. Nugmanova
Keyword(s):  
Healthcare Providers ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Provider Communication ◽  
Patient Provider Communication ◽  
Living With Hiv ◽  
Communication Interventions ◽  
The City ◽  
Depth Interviews ◽  
Improve Patient

The HIV epidemic continues to grow in Eastern Europe and Central Asia. At the same time, there are major gaps in engagement in HIV treatment and care among people living with HIV (PLHIV) in the region, including Kazakhstan. Healthcare providers may have the potential to improve patients’ initiation of and adherence to HIV treatment; however, their perspectives and experiences are often overlooked in the research from Kazakhstan. The purpose of our study was to gain an in-depth understanding of how providers perceive the factors influencing PLHIV’s engagement in HIV treatment and care and to identify opportunities for expanding the role that providers can have in improving patient initiation and adherence to treatment in Kazakhstan. Through purposive sampling, we conducted in-depth interviews with 14 healthcare providers at the City AIDS Center in Almaty. We used team-based coding and thematic analysis in order to analyze the data. Quotes from providers were translated from Kazakh and Russian to English to illustrate the themes. Our results show that providers currently view their role as the need to break down myths around ART medications, and to educate and motivate patients to accept their diagnosis and learn to live with HIV. The need to address stigma and social isolation among PLHIV, the risk of overworked providers, and the need to improve patient-provider communication strategies are areas to consider for further interventions. Patient-provider communication interventions are needed in Kazakhstan in order to help meet the country’s 90-90-90 HIV targets.

scholarly journals Patient-Provider Text Messaging and Video Calling Among Case-Managed Patients Living With HIV: Formative Acceptability and Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Virginia A Fonner ◽  
Samuel Kennedy ◽  
Rohan Desai ◽  
Christie Eichberg ◽  
Lisa Martin ◽  
...  
Keyword(s):  
Mobile Health ◽  
Text Messaging ◽  
People Living With Hiv ◽  
Provider Communication ◽  
Provider Perspectives ◽  
Adherence Support ◽  
Patient Provider Communication ◽  
Communication Modalities ◽  
Video Calling ◽  
Living With Hiv

BACKGROUND Patient-provider communication is critical for engaging and retaining people living with HIV in care, especially among medically case-managed patients in need of service coordination and adherence support. Expanding patient-provider communication channels to include mobile health modalities, such as text messaging and video calling, has the potential to facilitate communication and ultimately improve clinical outcomes. However, the implementation of these communication modalities in clinical settings has not been well characterized. OBJECTIVE The purpose of this study is to understand patient and provider perspectives on the acceptability of and preferences for using text messaging and video calling as a means of communication; perceived factors relevant to adoption, appropriateness, and feasibility; and organizational perspectives on implementation within an HIV clinic in South Carolina. METHODS We conducted 26 semistructured in-depth interviews among patients receiving case management services (n=12) and clinic providers (n=14) using interview guides and content analysis informed by the Proctor taxonomy of implementation outcomes and the Consolidated Framework for Implementation Research. Participants were purposefully sampled to obtain maximum variation in terms of age and gender for patients and clinic roles for providers. The data were analyzed using quantitative and qualitative content analyses. RESULTS Most patients (11/12, 92%) and providers (12/14, 86%) agreed that they should have the capacity to text message and/or video call each other. Although consensus was not reached, most preferred using a secure messaging app rather than standard text messaging because of the enhanced security features. Perceived benefits to adoption included the added convenience of text messaging, and potential barriers included the cost and access of smartphone-based technology for patients. From an organizational perspective, some providers were concerned that offering text messaging could lead to unreasonable expectations of instant access and increased workload. CONCLUSIONS Patients and providers perceived text messaging and video calling as acceptable, appropriate, and feasible and felt that these expanded modes of communication could help meet patients’ needs while being safe and not excessively burdensome. Although patients and providers mostly agreed on implementation barriers and facilitators, several differences emerged. Taking both perspectives into account when using implementation frameworks is critical for expanding mobile health–based communication, especially as implementation requires active participation from providers and patients. CLINICALTRIAL

scholarly journals Patient-Provider Text Messaging and Video Calling Among Case-Managed Patients Living With HIV: Formative Acceptability and Feasibility Study

10.2196/22513 ◽  
2021 ◽  
Vol 5 (5) ◽  
pp. e22513
Author(s):  
Virginia A Fonner ◽  
Samuel Kennedy ◽  
Rohan Desai ◽  
Christie Eichberg ◽  
Lisa Martin ◽  
...  
Keyword(s):  
Mobile Health ◽  
Text Messaging ◽  
People Living With Hiv ◽  
Provider Communication ◽  
Provider Perspectives ◽  
Adherence Support ◽  
Patient Provider Communication ◽  
Communication Modalities ◽  
Video Calling ◽  
Living With Hiv

Background Patient-provider communication is critical for engaging and retaining people living with HIV in care, especially among medically case-managed patients in need of service coordination and adherence support. Expanding patient-provider communication channels to include mobile health modalities, such as text messaging and video calling, has the potential to facilitate communication and ultimately improve clinical outcomes. However, the implementation of these communication modalities in clinical settings has not been well characterized. Objective The purpose of this study is to understand patient and provider perspectives on the acceptability of and preferences for using text messaging and video calling as a means of communication; perceived factors relevant to adoption, appropriateness, and feasibility; and organizational perspectives on implementation within an HIV clinic in South Carolina. Methods We conducted 26 semistructured in-depth interviews among patients receiving case management services (n=12) and clinic providers (n=14) using interview guides and content analysis informed by the Proctor taxonomy of implementation outcomes and the Consolidated Framework for Implementation Research. Participants were purposefully sampled to obtain maximum variation in terms of age and gender for patients and clinic roles for providers. The data were analyzed using quantitative and qualitative content analyses. Results Most patients (11/12, 92%) and providers (12/14, 86%) agreed that they should have the capacity to text message and/or video call each other. Although consensus was not reached, most preferred using a secure messaging app rather than standard text messaging because of the enhanced security features. Perceived benefits to adoption included the added convenience of text messaging, and potential barriers included the cost and access of smartphone-based technology for patients. From an organizational perspective, some providers were concerned that offering text messaging could lead to unreasonable expectations of instant access and increased workload. Conclusions Patients and providers perceived text messaging and video calling as acceptable, appropriate, and feasible and felt that these expanded modes of communication could help meet patients’ needs while being safe and not excessively burdensome. Although patients and providers mostly agreed on implementation barriers and facilitators, several differences emerged. Taking both perspectives into account when using implementation frameworks is critical for expanding mobile health–based communication, especially as implementation requires active participation from providers and patients.

scholarly journals HIV Stigma and Discrimination: Perspectives and Personal Experiences of Healthcare Providers in Yogyakarta and Belu, Indonesia

2021 ◽  
Vol 8 ◽  
Author(s):  
Nelsensius Klau Fauk ◽  
Paul Russell Ward ◽  
Karen Hawke ◽  
Lillian Mwanri
Keyword(s):  
Healthcare Providers ◽  
Hiv Treatment ◽  
Hiv Stigma ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Community Members ◽  
Stigma And Discrimination ◽  
Personal Experiences ◽  
Living With Hiv ◽  
Hiv Aids

Stigma and discrimination are major challenges facing People Living with HIV/AIDS (PLWHA) globally due to their HIV status. As part of a larger qualitative study in Yogyakarta and Belu, Indonesia, using in-depth interviews with 92 PLWHA (52 women, 40 men) and 20 healthcare providers, this paper describes perspectives and personal experiences of the 20 healthcare providers, relating to HIV stigma and discrimination toward PLWHA in both study settings. The healthcare providers were recruited from healthcare facilities providing HIV-related healthcare services, using a snowball sampling technique. A qualitative framework analysis was used to guide data analysis. Health stigma and discrimination framework guided the conceptualisation and discussion of the findings. The findings presented the views and perspectives of healthcare providers that HIV stigma and discrimination toward PLWHA still occurred within families, communities and healthcare settings. These were reflected in negative labelling, separation of personal belongings, avoidance, denial of treatment and rejection of PLWHA by healthcare providers, family and community members. Some healthcare providers reported that they had personally stigmatised and discriminated against PLWHA. A lack of knowledge about HIV, fear of contracting HIV, personal values, religious thoughts and sociocultural values and norms, were reported as drivers or facilitators behind this HIV-related stigma and discrimination. The findings indicate the importance of continued HIV/AIDS education for families, community members and healthcare providers, to raise awareness and to ensure that healthy and professional support systems are in place for PLWHA. The findings indicate the need to enhance improvement within the healthcare or HIV care system to adequately address the needs of PLWHA, which may facilitate their early initiation of HIV treatment and better treatment adherence and retention to increase Cluster of Differentiation 4 (CD4) count and suppress viral load. Future studies are also needed to explore the role that government and non-government institutions can play in improving health service delivery for people newly diagnosed with HIV and those living with HIV/AIDS.

scholarly journals Problematizing transitions in relation to correctional centres for people living with HIV: Unpacking the taken for granted.

2021 ◽  
Vol 3 (2) ◽  
pp. 47-63
Author(s):  
Morgan Wadams
Keyword(s):  
Healthcare Providers ◽  
Hiv Treatment ◽  
Knowledge Generation ◽  
Hiv Care ◽  
Correctional Facilities ◽  
People Living With Hiv ◽  
Treatment Cascade ◽  
Hiv Treatment Cascade ◽  
Care Practices ◽  
Living With Hiv

Transitions into and out of correctional facilities for people living with HIV are a pivotal point in the HIV treatment cascade where adherence metrics are significantly affected. In this paper I use Alvesson and Sandberg’s problematization method of literature analysis to critique and understand the taken-for-granted assumptions underpinning how knowledge is generated within the intersecting fields of HIV, transitions, and corrections. Utilizing problematization, two assumptions underpinning knowledge generation are identified: the linearity of the HIV care continuum model and the tendency to create and perpetuate spatially segregating metaphors of transitions inside versus outside correctional facilities for people living with HIV. These assumptions are discussed in the context of how they shape dominant ways of thinking and practicing in the field. An alternative way to understand transitions for people living with HIV is proposed along with recommendations to guide the HIV care practices of nurses and other healthcare providers.

The Bio/Necropolitics of ACTG 076: Lessons from Pregnant Women of Colour Living with HIV for Treatment for Prevention in the Twenty-first Century

Somatechnics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 233-253
Author(s):  
Eli Manning
Keyword(s):  
Hiv Transmission ◽  
Ethical Dilemmas ◽  
Hiv Treatment ◽  
First Century ◽  
Hiv Positive ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Hiv Positive Women ◽  
Aids Clinical Trials ◽  
Living With Hiv

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.

scholarly journals Kebijakan Pengendalian HIV/AIDS di Denpasar

2013 ◽  
Vol 8 (1) ◽  
pp. 45
Author(s):  
Tri Rini Puji Lestari
Keyword(s):  
Local Governments ◽  
People Living With Hiv ◽  
District Health ◽  
Aids Epidemic ◽  
The Government ◽  
Living With Hiv ◽  
And Control ◽  
The City ◽  
Government Perspective ◽  
Hiv Aids

Secara nasional, Indonesia telah mengantisipasi epidemi HIV/AIDS, tetapi jumlah kasus HIV/AIDS di Provinsi Bali dari tahun ke tahun memperlihatkan peningkatan yang semakin mengkhawatirkan. Penelitian ini bertujuan untuk mengetahui perkembangan jumlah kasus dan kebijakan penanggulangan HIV/AIDS di Denpasar. Penelitian ini menggunakan metode kualitatif yang dilakukan di Denpasar pada tanggal 11-17 September 2011. Sampel penelitian ini menggunakan informan terpilih yaitu kepala bappeda, pejabat Dinas Kesehatan Kabupaten Denpasar, direktur rumah sakit, puskesmas, ketua komisi penanggulangan AIDS di kabupaten/kota dan pemerhati HIV/AIDS termasuk ODHA. Penelitian menemukan jumlah kasus HIV/AIDS di Kota Denpasar yang tertinggi dan penularan terbesarnya melalui hubungan seks. Namun, dukungan pemerintah daerah dalam upaya pencegahan dan penanggulangan HIV/AIDS terlihat belum maksimal. Padahal kebijakan penanggulangan HIV/AIDS sangat ditentukan oleh cara pandang pemerintah terhadap penyakit HIV/AIDS. Untuk itu, perlu peningkatan pemahaman tentang HIV/AIDS serta pencegahan dan penanganan semua pihak terkait sehingga penanggulangan HIV/AIDS dapat lebih efektif, efisien, dan tepat sasaran.Nationally, Indonesia anticipated HIV/AIDS epidemic, but the number of cases of HIV/AIDS in Bali province from year to year showed an increase in the increasingly alarming. This study aimed to determine the number of cases and the development of policies on HIV / AIDS in Denpasar. This research was conducted using qualitative methods in Denpasar on 11-17 September 2011. The study sample was selected using the informant is head of planning, Denpasar District health officers, the director of the hospital, health center, chairman of the commission on AIDS in the district/city and observer of HIV / AIDS, including people living with HIV. The study found the number of cases of HIV / AIDS in the city of Denpasar is the highest and greatest transmission through sexual intercourse. However, the support of local governments in efforts to prevent and control HIV/AIDS looks not maximized. In fact the policy of HIV/AIDS is largely determined by the government perspective on HIV / AIDS. To that end, should be an increased understanding of HIV/AIDS as well as prevention and treatment of all parties concerned. So that HIV/ AIDS can be more effective, efficient, and targeted.

scholarly journals Influence of Material Deprivation on Clinical Outcomes Among People Living with HIV in High-Income Countries: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Vasiliki Papageorgiou ◽  
Bethan Davies ◽  
Emily Cooper ◽  
Ariana Singer ◽  
Helen Ward
Keyword(s):  
Systematic Review ◽  
Social Determinants ◽  
Meta Analysis ◽  
Hiv Treatment ◽  
Material Deprivation ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Living With Hiv

AbstractDespite developments in HIV treatment and care, disparities persist with some not fully benefiting from improvements in the HIV care continuum. We conducted a systematic review to explore associations between social determinants and HIV treatment outcomes (viral suppression and treatment adherence) in high-income countries. A random effects meta-analysis was performed where there were consistent measurements of exposures. We identified 83 observational studies eligible for inclusion. Social determinants linked to material deprivation were identified as education, employment, food security, housing, income, poverty/deprivation, socioeconomic status/position, and social class; however, their measurement and definition varied across studies. Our review suggests a social gradient of health persists in the HIV care continuum; people living with HIV who reported material deprivation were less likely to be virologically suppressed or adherent to antiretrovirals. Future research should use an ecosocial approach to explore these interactions across the lifecourse to help propose a causal pathway.

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