Care Outcomes in People Living with HIV and Cancer

2021 ◽  
Author(s):  
Kareshma Mohanty ◽  
Helen W. Cheung ◽  
Kristen A. Stafford ◽  
David J. Riedel
Keyword(s):  
People Living With Hiv ◽  
Care Outcomes ◽  
Hiv And Cancer ◽  
Living With Hiv

scholarly journals The Problem of Relationships between Doctor and HIV-Infected Patient

2016 ◽  
Vol 5 (2) ◽  
pp. 23-32
Author(s):  
A. Makhamatova
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Social Factor ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Services Utilization ◽  
Highly Active ◽  
Health Practitioners ◽  
Care Outcomes ◽  
Living With Hiv ◽  
Methodological Difficulties

This paper presents the foreign literature review on the relationships between doctor and patient as a psycho-social factor affecting the various HIV treatment and care outcomes. While some researchers have found an association between the "patient-provider" relationships and missed clinic visits, following the medical advice (adherence to highly active antiretroviral therapy), some diagnostic services’ utilization and the length of hospitalizations, the other researchers did not find such evidences. In general, "patient-provider" relationships research involves methodological difficulties, such as the accuracy and validity of the scales used; it indicates the need for further theoretical and empirical research in this field. The article may be of interest to researchers in the fields of sociology and social psychology of health, practitioners and also specialists developing prevention programs for people living with HIV.

scholarly journals Association Between Depression and HIV Care Engagement Outcomes Among Patients Newly Initiating ART in Lilongwe, Malawi

2020 ◽  
Author(s):  
Melissa A. Stockton ◽  
Bradley N. Gaynes ◽  
Mina C. Hosseinipour ◽  
Audrey E. Pettifor ◽  
Joanna Maselko ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Load Testing ◽  
Art Initiation ◽  
Retention In Hiv Care ◽  
Hiv Care Engagement ◽  
Care Outcomes ◽  
Sub Saharan ◽  
Living With Hiv

Abstract As in other sub-Saharan countries, the burden of depression is high among people living with HIV in Malawi. However, the association between depression at ART initiation and two critical outcomes—retention in HIV care and viral suppression—is not well understood. Prior to the launch of an integrated depression treatment program, adult patients were screened for depression at ART initiation at two clinics in Lilongwe, Malawi. We compared retention in HIV care and viral suppression at 6 months between patients with and without depression at ART initiation using tabular comparison and regression models. The prevalence of depression among this population of adults newly initiating ART was 27%. Those with depression had similar HIV care outcomes at 6 months to those without depression. Retention metrics were generally poor for those with and without depression. However, among those completing viral load testing, nearly all achieved viral suppression. Depression at ART initiation was not associated with either retention or viral suppression. Further investigation of the relationship between depression and HIV is needed to understand the ways depression impacts the different aspects of HIV care engagement.

scholarly journals Social determinants of health and care outcomes among people living with HIV in the United States

2021 ◽  
Author(s):  
Timothy W Menza ◽  
Lindsay K Hixson ◽  
Lauren Lipira ◽  
Linda Drach
Keyword(s):  
United States ◽  
Social Determinants ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
Economic Disadvantage ◽  
People Living With Hiv ◽  
Care Outcomes ◽  
Durable Viral Suppression ◽  
Living With Hiv

Abstract Background Fewer than 70% of people living with HIV (PLHIV) in the United States have achieved durable viral suppression. To end the HIV epidemic in the United States, clinicians, researchers, and public health practitioners must devise ways to remove barriers to effective HIV treatment. To identify PLHIV who experience challenges to accessing healthcare, we created a simple assessment of social determinants of health (SDOH) among PLHIV and examined the impact of cumulative social and economic disadvantage on key HIV care outcomes. Methods We used data from the 2015-2019 Medical Monitoring Project, a yearly cross-sectional survey of PLHIV in the United States (N=15,964). We created a ten-item index of SDOH and assessed differences in HIV care outcomes of missed medical appointments, medication adherence, and durable viral suppression by SDOH using this index using prevalence ratios with predicted marginal means. Results Eighty-three percent of PLHIV reported at least one SDOH indicator. Compared to PLHIV who experienced none of the SDOH indicators, people who experienced one, two, three, and four or more SDOH indicators, were 1.6, 2.1, 2.6 and 3.6 as likely to miss a medical appointment in the prior year; 11%, 17%, 20% and 31% less likely to report excellent adherence in the prior 30 days; and, 2%, 4%, 10% and 20% less likely to achieve durable viral suppression in the prior year, respectively. Conclusions Among PLHIV, cumulative exposure to social and economic disadvantage impacts care outcomes in a dose-dependent fashion. A simple index may identify PLHIV experiencing barriers to HIV care, adherence, and durable viral suppression in need of critical supportive services.

scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2020 ◽  
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
Gbenga Ayodele Kayode ◽  
...  
Keyword(s):  
Clinical Data ◽  
Hiv Treatment ◽  
Prognostic Models ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Care Outcomes ◽  
Living With Hiv ◽  
Lost To Follow Up

Abstract Background: The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup to learn how elderly people living with HIV (EPLHIV) in Nigeria fare, despite not being prioritized by the national treatment program, and to deepen knowledge for their differentiated care and achieve better outcomes. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018. Methods: Patient-level data spanning the period 2004 to 2018, obtained from comprehensive HIV treatment hospitals, that are supported by four major PEPFAR-implementing partners in Nigeria were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified treatment records, demographic and clinical data of EPLHIV ≥50-year-old at ART initiation during the review period was extracted, merged into a single REDcap® database, and described using STATA 13. Results: A total of 101,652 unique EPLHIV entries were analysed. This cohort’s data was of 53,608(52.7%) women, 51,037(71.4%) of EPLHIV identified as married and 33,446(51.1%) unemployed. Mean age was 57.1 years (SD=6.9) with average duration on ART as 4.6 years (SD=3.5). ART profile showed that 88,792(95.7%) were on 1st-line and 55,905 (64.9%) were on TDF-based regimens. Mean-body mass index (BMI) was 23.0 kg/m2 (SD=5.4 kg/m2) with 56,010(55.1%), 19,619(19.3%) and 8844(8.7%) showing normal (18.5kg/m2–24.9kg/m2), overweight (BMI 25 -<30kg/m2) and obese (BMI ≥30kg/m2) ranges respectively. prevalence of hypertension (systolic-BP >140mmHg or diastolic-BP >90mmHg) was 21,550(21.2%) EPLHIV records. Mean CD4 count was 420cells/μL (SD=285cells/μL) and 83,660(82.3%) had a viral load result showing <1000copies/ml. As for treatment outcomes, available records showed that 54.1% were active-in-treatment, 28.4% were lost-to-follow-up and 6.8% died. Poor population death records and aversion to autopsies makes it almost impossible to estimate AIDS-related deaths. Conclusions: This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.

scholarly journals Cohort Profile: The Nigerian HIV Geriatric Cohort Study

2020 ◽  
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
Michael Kolawole Odutola ◽  
James Okuma ◽  
Gbenga Ayodele Kayode ◽  
...  
Keyword(s):  
Clinical Data ◽  
Hiv Treatment ◽  
Prognostic Models ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Review Period ◽  
Level Data ◽  
Care Outcomes ◽  
Living With Hiv ◽  
Lost To Follow Up

Abstract Background: The Nigerian HIV Geriatric Cohort (NHGC) is a longitudinal cohort setup to learn how elderly people living with HIV (EPLHIV) in Nigeria fare, despite not being prioritized by the national treatment program, and to deepen knowledge for their differentiated care and achieve better outcomes. In this paper, we describe data collected on sociodemographic and clinical data from EPLHIV from the inception of Nigeria’s national HIV program to 2018.Methods: Patient-level data spanning the period 2004 to 2018, obtained from comprehensive HIV treatment hospitals, that are supported by four major PEPFAR-implementing partners in Nigeria were used. These 4 entities collaborated as member organizations of the Nigeria Implementation Science Alliance. We defined elderly as those aged 50 years and above. From deidentified treatment records, demographic and clinical data of EPLHIV ≥50-year-old at ART initiation during the review period was extracted, merged into a single REDcap® database, and described using STATA 13.Results: A total of 101,652 unique EPLHIV entries were analysed. This cohort’s data was of 53,608(52.7%) women, 51,037(71.4%) of EPLHIV identified as married and 33,446(51.1%) unemployed. Mean age was 57.1 years (SD=6.9) with average duration on ART as 4.6 years (SD=3.5). ART profile showed that 88,792(95.7%) were on 1st-line and 55,905 (64.9%) were on TDF-based regimens. Mean-body mass index (BMI) was 23.0 kg/m2 (SD=5.4 kg/m2) with 56,010(55.1%), 19,619(19.3%) and 8844(8.7%) showing normal (18.5kg/m2–24.9kg/m2), overweight (BMI 25 -<30kg/m2) and obese (BMI ≥30kg/m2) ranges respectively. Prevalence of hypertension (systolic-BP >140mmHg or diastolic-BP >90mmHg) was 21,550(21.2%). EPLHIV Mean CD4 count was 420cells/μL (SD=285cells/μL) and 83,660(82.3%) had a viral load result showing <1000copies/ml. As for treatment outcomes, available records showed that 54.1% were active-in-treatment, 28.4% were lost-to-follow-up and 6.8% died. Poor population death records and aversion to autopsies makes it almost impossible to estimate AIDS-related deaths.Conclusions: This cohort describes the clinical and non-clinical profile of EPLHIV in Nigeria. We are following up the cohort to design and implement intervention programs, develop prognostic models to achieve better care outcomes for EPLHIV. This cohort would provide vital information for stakeholders in HIV prevention, care and treatment to understand the characteristics of EPLHIV.

HIV Infection and AIDS-Associated Neoplasms

2021 ◽  
pp. 226-232
Author(s):  
Joanna S. Dognin ◽  
Peter A. Selwyn
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Cancer Education ◽  
Sharp Decrease ◽  
Behavioral Risk ◽  
People Living With Hiv ◽  
Social Unit ◽  
Infected People ◽  
Highly Active ◽  
Hiv And Cancer ◽  
Living With Hiv

Since the advent of highly active antiretroviral therapy (HAART), people living with HIV have aged and shown a growing vulnerability to a variety of comorbidities, including cancer. While the availability of HAART has led to a sharp decrease in the rates of non-AIDS-defining malignancies (non-ADMs), HIV-infected people exhibit increased risks for a range of non-AIDS-defining cancers, both at younger ages and in more aggressive forms than non-HIV-infected persons. The uncertainty of living with both HIV and cancer places significant stressors on the patient and their family and social unit. This chapter describes the prevalence of cancer in the HIV-infected population and presents behavioral risk factors for developing cancer. It discusses three patient vignettes to illustrate how the additional burden of cancer interfaces with psychological and systemic resources required for living with HIV. As HIV extends into its fifth decade, medical practices treating HIV require additional cancer education, prevention, and intervention initiatives to better serve this vulnerable population. Finally, given the tremendous mortality still exacted by HIV disease and malignancies, HIV team models must also incorporate and integrate palliative care and end-of-life care expertise into the comprehensive care of patients living with and dying from HIV.

scholarly journals Anti-PD-1 and Anti-PD-L1 Monoclonal Antibodies in People Living with HIV and Cancer

2020 ◽  
Vol 17 (5) ◽  
pp. 547-556
Author(s):  
Kathryn Lurain ◽  
Ramya Ramaswami ◽  
Robert Yarchoan ◽  
Thomas S. Uldrick
Keyword(s):  
Monoclonal Antibodies ◽  
People Living With Hiv ◽  
Hiv And Cancer ◽  
Living With Hiv

scholarly journals Correlates of psychological intimate partner violence with HIV care outcomes on patients in HIV care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. J. Fredericksen ◽  
R. M. Nance ◽  
B. M. Whitney ◽  
B. N. Harding ◽  
E. Fitzsimmons ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Behavioral Outcomes ◽  
Intimate Partner ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Outcomes ◽  
Multivariable Analyses ◽  
Using Data ◽  
Living With Hiv

Abstract Background Among people living with HIV (PLWH), physical intimate partner violence (IPV) is associated with poor virologic, psychiatric, and behavioral outcomes. We examined non-physical, psychological intimate partner violence (psy-IPV) and HIV care outcomes using data from two U.S. consortia. Methods We conducted multivariable analyses with robust standard errors to compare patients indicating/not indicating psy-IPV. Results Among PLWH (n = 5950), 9.5% indicated psy-IPV; these individuals were younger (− 3; 95% CI [− 2,-4], p-value < 0.001), less likely to be on antiretroviral treatment (ART) (0.73 [0.55,0.97], p = 0.03), less adherent to ART (− 4.2 [− 5.9,-2.4], p < 0.001), had higher odds of detectable viral load (1.43 [1.15,1.78], p = 0.001) and depression (2.63 [2.18,3.18], p < 0.001), and greater use of methamphetamines/crystal [2.98 (2.30,3.87),p < 0.001], cocaine/crack [1.57 (1.24,1.99),p < 0.001], illicit opioids [1.56 (1.13,2.16),p = 0.007], and marijuana [1.40 (1.15,1.70), p < 0.001]. Conclusion Psychological IPV, even in the absence of physical or sexual IPV, appears to be associated with HIV care outcomes and should be included in IPV measures integrated into routine HIV care.

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