scholarly journals Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters

2021 ◽  
Author(s):  
Wendee M. Wechsberg ◽  
Felicia A. Browne ◽  
Courtney Peasant Bonner ◽  
Yukiko Washio ◽  
Brittni N. Howard ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Intervention Studies ◽  
Alcohol Misuse ◽  
Small Samples ◽  
People Living With Hiv ◽  
Alcohol Intervention ◽  
The World ◽  
Significant Efficacy ◽  
Hiv Research ◽  
Living With Hiv

Abstract Purpose of Review Alcohol is the most misused substance in the world. For people living with HIV (PLWH), alcohol misuse may impact ART adherence and viral suppression. This review of the most recently published alcohol intervention studies with PLWH examines how these studies considered gender in the samples, design, and analyses. Recent Findings Three searches were conducted initially, and 13 intervention studies fit our criteria with alcohol outcomes. In general, most studies did not consider gender and had used small samples, and few demonstrated significant efficacy/effectiveness outcomes. Five studies considered gender in their samples or analyses and/or were woman-focused with larger samples and demonstrated significant outcomes. Summary It is essential for women who misuse alcohol to not only be well represented in alcohol and HIV research but also for studies to consider the barriers to reaching them and their contextual demands and/or co-occurring issues that may affect participation and outcomes in intervention research.

scholarly journals Law, Criminalisation and HIV in the World: Have countries that criminalise achieved more or less successful AIDS pandemic response?

2021 ◽  
Author(s):  
Matthew M Kavanagh ◽  
Schadrac C Agbla ◽  
Mara Pillinger ◽  
Marissa Joy ◽  
Alaina Case ◽  
...  
Keyword(s):  
Drug Use ◽  
Sex Work ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
People Living With Hiv ◽  
Gender Based Violence ◽  
Same Sex ◽  
The World ◽  
Laws And Policies ◽  
Living With Hiv

How does the use of criminal law affect disease-fighting efforts, particularly in a pandemic? This longstanding question for governments around the world is felt acutely in the context of the COVID-19 and HIV pandemics. Many countries have laws and policies that criminalise behaviours, making same-sex relationships, illicit drug use, and sex work illegal. Meanwhile, some countries have enshrined gender- and rights-protective institutions in law. Under the global AIDS strategy of the last five years, national AIDS response efforts in countries have focused on reaching people living with HIV with testing and antiretroviral treatment to suppress the HIV virus, preventing mortality and HIV transmission. At the end of this 5-year push, this article provides an ecological analysis of whether those countries with criminalising legal environments achieved more or less success. In countries where same-sex relationships were fully criminalised, the portion of people living with HIV who knew their status was 11% lower and viral suppression rates were 8% lower. Under sex-work criminalization, the rate of people living with HIV who knew their status was 10% lower and viral suppression 6% lower. Drug use criminalisation was associated with 14% lower knowledge of status and viral. On the other hand in countries with laws advancing non-discrimination, human rights institutions, and gender-based violence response, HIV services indicators were significantly better. This ecological evidence on the relationships between the legal environment and successful HIV response provides support for a strategy that includes a focus on law reform to achieve goals missed in 2020.

scholarly journals Law, criminalisation and HIV in the world: have countries that criminalise achieved more or less successful pandemic response?

2021 ◽  
Vol 6 (8) ◽  
pp. e006315
Author(s):  
Matthew M Kavanagh ◽  
Schadrac C Agbla ◽  
Marissa Joy ◽  
Kashish Aneja ◽  
Mara Pillinger ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Transmission ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Gender Based Violence ◽  
Hiv Virus ◽  
The World ◽  
Gender Based ◽  
And Gender ◽  
Living With Hiv

How do choices in criminal law and rights protections affect disease-fighting efforts? This long-standing question facing governments around the world is acute in the context of pandemics like HIV and COVID-19. The Global AIDS Strategy of the last 5 years sought to prevent mortality and HIV transmission in part through ensuring people living with HIV (PLHIV) knew their HIV status and could suppress the HIV virus through antiretroviral treatment. This article presents a cross-national ecological analysis of the relative success of national AIDS responses under this strategy, where laws were characterised by more or less criminalisation and with varying rights protections. In countries where same-sex sexual acts were criminalised, the portion of PLHIV who knew their HIV status was 11% lower and viral suppression levels 8% lower. Sex work criminalisation was associated with 10% lower knowledge of status and 6% lower viral suppression. Drug use criminalisation was associated with 14% lower levels of both. Criminalising all three of these areas was associated with approximately 18%–24% worse outcomes. Meanwhile, national laws on non-discrimination, independent human rights institutions and gender-based violence were associated with significantly higher knowledge of HIV status and higher viral suppression among PLHIV. Since most countries did not achieve 2020 HIV goals, this ecological evidence suggests that law reform may be an important tool in speeding momentum to halt the pandemic.

scholarly journals Antiretroviral Drugs Impact Autophagy with Toxic Outcomes

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 909
Author(s):  
Laura Cheney ◽  
John M. Barbaro ◽  
Joan W. Berman
Keyword(s):  
Quality Control ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Viral Suppression ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Foreign Material ◽  
Complete Understanding ◽  
Living With Hiv ◽  
Target Effects

Antiretroviral drugs have dramatically improved the morbidity and mortality of people living with HIV (PLWH). While current antiretroviral therapy (ART) regimens are generally well-tolerated, risks for side effects and toxicity remain as PLWH must take life-long medications. Antiretroviral drugs impact autophagy, an intracellular proteolytic process that eliminates debris and foreign material, provides nutrients for metabolism, and performs quality control to maintain cell homeostasis. Toxicity and adverse events associated with antiretrovirals may be due, in part, to their impacts on autophagy. A more complete understanding of the effects on autophagy is essential for developing antiretroviral drugs with decreased off target effects, meaning those unrelated to viral suppression, to minimize toxicity for PLWH. This review summarizes the findings and highlights the gaps in our knowledge of the impacts of antiretroviral drugs on autophagy.

scholarly journals Clinical situation of Venezuelan migrants living with HIV in a hospital in Lima, Peru

2021 ◽  
pp. 095646242110240
Author(s):  
Genesis S Huerta-Vera ◽  
Manuel A Amarista ◽  
Fernando A Mejía ◽  
Ana B Graña ◽  
Elsa V Gonzalez-Lagos ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Clinical Situation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Epidemiological Trends ◽  
Clinical Conditions ◽  
Living With Hiv

Due to a huge crisis extensive to health services many Venezuelan people living with HIV (PLWH) had migrated abroad, including Peru where favorable laws were in place until June 2019. We describe the health status and epidemiological trends of PLWH from Venezuela at an HIV program in Lima. We analyzed baseline and follow-up data of all Venezuelan PLWH enrolled in our HIV program from January 2017 to December 2019. A cross-sectional study in a subsample served to describe ARV adherence and context of migration. Between 2017-2019 our HIV Program registered 398 Venezuelan PLWH, representing 20% of the 2018 annual enrollments; numbers decreased since mid-2019. The median age was 30 years (IQR 26;37) and 90.5% were men. Between 2017 and 2019, the proportion with diagnosis in Peru increased from 14.3% to 60.9%; of AIDS stage at entry, from 8.8% to 27.2%. By December 2019, 182/250 (72.8%) were still in care, and 43 (10.8%) had not started ART. Viral suppression evaluated in 195, was achieved in 71.8%. From 2017 to 2019, migrant PLWH arrived in worsened clinical conditions, with increasing diagnosis in Peru; the flow of migrant PLWH entering care diminished with less favorable laws. Viral suppression rates were suboptimal.

scholarly journals Beyond viral suppression: the quality of life of people living with HIV in Sweden

AIDS Care ◽  
2018 ◽  
Vol 31 (4) ◽  
pp. 403-412 ◽  
Author(s):  
Galit Zeluf-Andersson ◽  
Lars E. Eriksson ◽  
Lena Nilsson Schönnesson ◽  
Jonas Höijer ◽  
Peter Månehall ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression Amongst HIV-infected Prisoners in South Ethiopia: A Prospective Cohort Study

2021 ◽  
Author(s):  
Terefe Gone Fuge ◽  
George Tsourtos ◽  
Emma R Miller
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
South Ethiopia ◽  
Pharmacy Refill ◽  
Living With Hiv ◽  
Optimal Adherence

Abstract ObjectivesMaintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of treatment adherence and viral suppression in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors amongst prisoners in South Ethiopia. MethodsA prospective cohort study was conducted between June 1, 2019 and May 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information (including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration related characteristics) was collected using a structured questionnaire. Adherence was determined based on the participants’ self-report and pharmacy refill records. Plasma viral load measurements undertaken within the study period were prospectively extracted to determine viral suppression. Univariate and multivariate regression models were used to analyse data. ResultsWhile prisoners had a significantly higher pharmacy refill adherence compared to non-incarcerated PLWHA (89% vs 75%), they had a slightly lower dose adherence (81% vs 83%). The prevalence of viral failure (VF) was also slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31to 35 years and in those who experienced social stigma, regardless of their incarceration status. ConclusionsThis study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to ART doses and to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors were found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

scholarly journals The impact of drug coverage on viral suppression among people living with HIV in Ontario, Canada

2018 ◽  
Vol 109 (5-6) ◽  
pp. 800-809 ◽  
Author(s):  
Beth Rachlis ◽  
Lucia Light ◽  
Sandra Gardner ◽  
Ann N. Burchell ◽  
Janet Raboud ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Drug Coverage ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Resolution of possible acquired protein S deficiency after viral suppression in HIV infection

2021 ◽  
Vol 14 (11) ◽  
pp. e244983
Author(s):  
Leigh Cervino ◽  
Jillian Raybould ◽  
Patricia Fulco
Keyword(s):  
Viral Suppression ◽  
Treatment Guidelines ◽  
Protein S ◽  
People Living With Hiv ◽  
Protein S Deficiency ◽  
Anticoagulation Management ◽  
S Deficiency ◽  
Increased Risk ◽  
Undiagnosed Hiv ◽  
Living With Hiv

Current literature suggests an increased risk of venous thromboembolism (VTE) in people living with HIV (PLWH) with poorly controlled viraemia and immunodeficiency. VTE treatment guidelines do not specifically address anticoagulation management in PLWH. We report a case of a 33-year-old woman diagnosed with an unprovoked pulmonary embolism (PE) and deemed protein S deficient. Three years later, she was diagnosed with AIDS. Antiretroviral therapy (ART) was promptly initiated with viral suppression and immune reconstitution within 12 months. Eight years after her initial PE, the patient self-discontinued warfarin. Multiple repeat protein S values were normal. ART without anticoagulation has continued for 3 years with no thrombotic events. This case describes a patient with VTE presumably secondary to undiagnosed HIV with possible consequent acquired protein S deficiency. Additional research is needed to understand the characteristics of PLWH with VTE who may warrant long-term anticoagulation as opposed to shorter courses.

Dolutegravir-based regimen for maintenance of viral suppression in people living with HIV: 48‐week results in real life setting.

2021 ◽  
Author(s):  
Daniele Di Carlo ◽  
Francesca Falasca ◽  
Enrico Palermo ◽  
Ivano Mezzaroma ◽  
Caterina Fimiani ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Real Life ◽  
People Living With Hiv ◽  
Real Life Setting ◽  
Living With Hiv

Socio-cultural Factors affecting People Living with HIV/AIDS Attendance at Hawassa and Yirgalem Hospital ART Clinics, South Ethiopia. Quantitative and Qualitative Mixed Approach.

2021 ◽  
Author(s):  
Alemante A Ayalew ◽  
Zeytu G Asfaw ◽  
Solomon A Lemma
Keyword(s):  
Cultural Practices ◽  
Cultural Factors ◽  
Complete Healing ◽  
People Living With Hiv ◽  
Long Distance ◽  
Factors Affecting ◽  
Care Givers ◽  
The World ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background: HIV/AIDS pandemic seriously ravaged the world for the past three decades. It left the world with full of complicated social, economic and political problems. The problem has continued as major health problems for most developing countries, including Ethiopia. Socio-cultural practices which are predominantly determining the life of most of these peoples have structured the spread of HIV/AIDS. The aim of this study was to investigate how socio-cultural factors are affecting patients' adherence at ART clinics in Hawassa and Yirgalem Referral Hospitals. Methods: Qualitative and quantitative designs were used to collect the data. Results: The findings have shown that for fear of stigma and discrimination at family and community levels forced patients' affected adherence at ART clinics. People living with HIV were forced to travel long distance to get rid of social exclusion and isolation that resulting in drug interruptions and drop outs. The findings have also shown that most of the followers of protestant religion make believe that HIV could be cured and boycotted them from taking ART drugs. Moreover, confidentiality of information about HIV positive children living with care givers and newly tested patients found to be resistant to start or continue their drugs. Sense of wellbeing elicited form long term ART drugs effects made patients to imagine complete healing thereby dropping their treatment. Conclusions: The findings made clear that multidimensional socio-cultural factors structure and restructure adherence problems at the ART clinics in the study hospitals. Interventions targeting to change socio-cultural factors play crucial roles to prevent and control new infections, occurrence of drug resistant strains, and social and economic repercussions in the society.

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