Perceptions About Local ART Adherence Norms and Personal Adherence Behavior Among Adults Living with HIV in Rural Uganda

Background: Comorbidity rates and service needs are high among people living with HIV/AIDS (PLWHA). The effects of service utilization and unmet service needs on antiretroviral therapy (ART) adherence are not well understood. The purpose of this study was to investigate associations among PLWHA’s service utilization, unmet service needs, and ART adherence. Methods: PLWHA (N=162) 18 years or older were recruited from a Nevada statewide needs assessment project in 2016. Participants completed a self-administered questionnaire on paper or online. The independent variables were service utilization and unmet service needs. The outcome variable was ART adherence. Multivariable logistic regression analyses were conducted to examine associations between the amount of utilized services and unmet service needs with ART adherence. Results: Only 12 (7.5%) participants reported they received all needed services. The ART non-adherence group showed significantly higher unmet medical service needs compared to the ART adherence group (p=0.007). Unmet medical service needs (Adjusted Odds Ratio (AOR) 0.69, CI 0.53-0.90) and unmet support service needs (AOR 0.68, CI 0.48-0.97) were negatively associated with ART adherence. However, utilizing medical services (AOR 1.06, CI 0.87-1.30) and support services (AOR 0.88, CI 0.74-1.04) in the current year were not significantly associated with ART adherence. Conclusion: The results of this study indicate that health promotion programming should focus not only on introducing new services at the community level, but also work to optimize the availability and awareness of current services. Furthermore, health promotion programs should focus on filling service coverage gaps and improving the facilitation of services.

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Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2021-049824 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049824

Author(s):

Andreas D Haas ◽

Cordelia Kunzekwenyika ◽

Stefanie Hossmann ◽

Josphat Manzero ◽

Janneke van Dijk ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Suicidal Ideation ◽

Mental Disorders ◽

Common Mental Disorders ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Art Adherence ◽

Sectional Study ◽

Cross Sectional ◽

Living With Hiv

ObjectivesTo examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).SettingSixteen government-funded health facilities in the rural Bikita district of Zimbabwe.DesignCross-sectional study.ParticipantsHIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months.Outcome measuresThe primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence.ResultsOut of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40–49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50–59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70).ConclusionsA substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe.Trial registration numberNCT03704805.

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Predictive factors of ART adherence in people living with HIV in Guangxi, China: a retrospective cross-sectional study

AIDS Care ◽

10.1080/09540121.2021.1967851 ◽

2021 ◽

pp. 1-6

Author(s):

Jingzhen Lai ◽

Zhongsheng Jiang ◽

Hong Zhang ◽

Wudi Wei ◽

Xu Li ◽

...

Keyword(s):

Predictive Factors ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Art Adherence ◽

Sectional Study ◽

Cross Sectional ◽

Living With Hiv

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“How am I going to live?”: exploring barriers to ART adherence among adolescents and young adults living with HIV in Uganda

BMC Public Health ◽

10.1186/s12889-018-6048-7 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 7

Author(s):

Sarah MacCarthy ◽

Uzaib Saya ◽

Clare Samba ◽

Josephine Birungi ◽

Stephen Okoboi ◽

...

Keyword(s):

Young Adults ◽

Adolescents And Young Adults ◽

Art Adherence ◽

Living With Hiv

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Call For Life, Uganda: Acceptability Of A Mobile Phone Support To Promote Adherence To Anti-Retroviral Therapy For Young Adults In A Randomised Control Trial: A Qualitative Review (Preprint)

10.2196/preprints.17418 ◽

2019 ◽

Author(s):

Agnes Bwanika Naggirinya

Keyword(s):

Human Immunodeficiency Virus ◽

Young Adults ◽

Mobile Phone ◽

Interactive Voice Response ◽

Text Messages ◽

Randomised Control Trial ◽

People Living With Hiv ◽

Art Adherence ◽

Immunodeficiency Virus ◽

Living With Hiv

BACKGROUND : Adherence to treatment is critical to obtain successful treatment outcomes. While factors influencing antiretroviral therapy (ART) adherence vary, young adults are less likely to adhere because of psychosocial issues such as stigma, ART-related side effects as well as lack of access to treatment. Call for Life mHealth tool (C4LU), is a mobile phone- based technology that provides text messages or Interactive Voice Response (IVR) functionalities, through a web-interface and offers four modules including pill reminders, clinic visit reminders, health tips and symptom self-reporting support. Within a randomised control trial, we assessed perspectives and experiences of young adults living with human immunodeficiency virus towards the C4LU- system, with the objective to improve ART adherence among young people living with HIV with help of mHealth tool. OBJECTIVE To improve ART adherence among young people living with HIV through use of mHealth tool. METHODS This was an exploratory qualitative design at two study sites nested within an open label randomized controlled trial (RCT) entitled: “Improving outcomes in human immunodeficiency virus (HIV) patients using mobile phone based interactive software support “Call for Life study A total of 600 participants were randomly assigned 1:1 to either Standard of Care (SoC)- face-to-face counsellor adherence support or SoC plus mHealth call for life system (C4LU). C4LU uses Interactive voice response or text messages delivered via mobile phone. The qualitative study explored perspectives and experiences of young adults (18-24 years) towards the mHealth tool “C4LU”. A purposive sample of twenty-one vulnerable youth, seventeen from the intervention and four from the SoC arm were selected. We used semi-structured interviews to facilitate an in-depth exploration of experiences of young adults regarding C4LU-System. Thirteen in-depth interviews and one focus group discussion were conducted. The young adults were from four categories of population of interest that were targeted to be offered specialised care: young adults on PMTCT, switching to / or on second line ART, positive partners in a discordant relationship and initiating 1st line ART. Data was managed using Nvivo version 11 and analysed thematically. RESULTS C4LU-mHealth tool was perceived as an acceptable intervention for young adults. While on the system, participants reported: improvement in medication adherence, strengthened doctor /clinician -patient relationships, increased health knowledge through educative health tips. Appointment reminders and symptom reporting were singled out as beneficial because the system would address and manage the problems of forgetfulness, and stigma related issues. CONCLUSIONS The system was described as an acceptable and feasible strategy to improve ART adherence and retention among young adults in resource limited settings CLINICALTRIAL Trial Registration: ClinicalTrials.gov NCT 02953080

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A model to predict adherence to antiretroviral therapy among people living with HIV

Sexually Transmitted Infections ◽

10.1136/sextrans-2021-055222 ◽

2021 ◽

pp. sextrans-2021-055222

Author(s):

Hui Chen ◽

Rusi Long ◽

Tian Hu ◽

Yaqi Chen ◽

Rongxi Wang ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Hiv Treatment ◽

Poor Adherence ◽

People Living With Hiv ◽

Art Adherence ◽

Snowball Sampling ◽

Hiv Viral Load ◽

Temporal Validation ◽

Suboptimal Adherence ◽

Living With Hiv

ObjectivesSuboptimal adherence to antiretroviral therapy (ART) dramatically hampers the achievement of the UNAIDS HIV treatment targets. This study aimed to develop a theory-informed predictive model for ART adherence based on data from Chinese.MethodsA cross-sectional study was conducted in Shenzhen, China, in December 2020. Participants were recruited through snowball sampling, completing a survey that included sociodemographic characteristics, HIV clinical information, Information-Motivation-Behavioural Skills (IMB) constructs and adherence to ART. CD4 counts and HIV viral load were extracted from medical records. A model to predict ART adherence was developed from a multivariable logistic regression with significant predictors selected by Least Absolute Shrinkage and Selection Operator (LASSO) regression. To evaluate the performance of the model, we tested the discriminatory capacity using the concordance index (C-index) and calibration accuracy using the Hosmer and Lemeshow test.ResultsThe average age of the 651 people living with HIV (PLHIV) in the training group was 34.1±8.4 years, with 20.1% reporting suboptimal adherence. The mean age of the 276 PLHIV in the validation group was 33.9±8.2 years, and the prevalence of poor adherence was 22.1%. The suboptimal adherence model incorporates five predictors: education level, alcohol use, side effects, objective abilities and self-efficacy. Constructed by those predictors, the model showed a C-index of 0.739 (95% CI 0.703 to 0.772) in internal validation, which was confirmed be 0.717 via bootstrapping validation and remained modest in temporal validation (C-index 0.676). The calibration capacity was acceptable both in the training and in the validation groups (p>0.05).ConclusionsOur model accurately estimates ART adherence behaviours. The prediction tool can help identify individuals at greater risk for poor adherence and guide tailored interventions to optimise adherence.

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Barriers to ART adherence among school students living with HIV in Kenya

African Journal of AIDS Research ◽

10.2989/16085906.2021.1979606 ◽

2021 ◽

Vol 20 (3) ◽

pp. 232-237

Author(s):

Edith Apondi ◽

Juddy Wachira ◽

Rose Ayikukwei ◽

Catherine Kafu ◽

Jael Onyango ◽

...

Keyword(s):

Art Adherence ◽

School Students ◽

Living With Hiv

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The Beat Goes On: Stimulant Use and HIV in the Era of COVID-19 (Preprint)

10.2196/preprints.30897 ◽

2021 ◽

Author(s):

Mariya Petrova ◽

Michael Miller-Perusse ◽

Sabina Hirshfield ◽

Adam Carrico ◽

Keith Horvath

Keyword(s):

Data Analysis ◽

Antiretroviral Therapy ◽

Qualitative Study ◽

Vulnerable Populations ◽

Art Adherence ◽

Racially Diverse ◽

Differential Impact ◽

Stimulant Use ◽

Virtual Focus Groups ◽

Living With Hiv

UNSTRUCTURED This qualitative study identified how coronavirus pandemic has affected stimulant use and antiretroviral therapy (ART) adherence among a sample of MSM living with HIV (LWH). Twelve ethnically/racially diverse men over the age of 25 participated in two virtual focus groups. A general inductive approach was used to analyze the data. Analysis revealed that the COVID-19 pandemic had different effects on stimulant use and ART adherence for men LWH who use stimulants. Results showcase that the COVID-19 pandemic is having differential impact on MSM’s stimulant use and ART adherence and highlight the need for comprehensive support to vulnerable populations.

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