Conspiracy Beliefs Are Not Necessarily a Barrier to Engagement in HIV Care Among Urban, Low-Income People of Color Living with HIV

Introduction Advances in HIV treatment have proven to be effective in increasing virological suppression, thereby decreasing morbidity, and increasing survival. Medication adherence is an important factor in reducing viral load among people living with HIV (PLWH) and in the elimination of transmission of HIV to uninfected partners. Achieving optimal medication adherence involves individuals taking their medications every day or as prescribed by their provider. However, not all PLWH in the USA are engaged in care, and only a minority have achieved suppressed viral load (viral load that is lower than the detectable limit of the assay). Sexual and gender minorities (SGM; those who do not identify as heterosexual or those who do not identify as the sex they were assigned at birth) represent a high-risk population for poor clinical outcomes and increased risk of HIV transmission, as they face barriers that can prevent optimal engagement in HIV care. Research in dyadic support, specifically within primary romantic partnerships, offers a promising avenue to improving engagement in care and treatment outcomes among SGM couples. Dyadic interventions, especially focused on primary romantic partnerships, have the potential to have a sustained impact after the structured intervention ends. Methods and analysis This paper describes the protocol for a randomised control trial of a theory-grounded, piloted intervention (DuoPACT) that cultivates and leverages the inherent sources of support within primary romantic relationships to improve engagement in HIV care and thus clinical outcomes among persons who are living with HIV and who identify as SGM (or their partners). Eligible participants must report being in a primary romantic relationship for at least 3 months, speak English, at least one partner must identify as a sexual or gender minority and at least one partner must be HIV+ with suboptimal engagement in HIV care, defined as less than excellent medication adherence, having not seen a provider in at least the past 8 months, having a detectable or unknown viral load or not currently on antiretroviral therapy. Eligible consenting couples are allocated equally to the two study arms: a structured six-session couples counselling intervention (DuoPACT) or a three-session individually-delivered HIV adherence counselling intervention (LifeSteps). The primary aim is to evaluate the efficacy of DuoPACT on virological suppression among HIV+ members of SGM couples with suboptimal engagement in care. The DuoPACT study began its target enrolment of 150 couples (300 individuals) in August 2017, and will continue to enrol until June 2021. Ethics and dissemination All procedures are approved by the Institutional Review Board at the University of California, San Francisco. Written informed consent is obtained from all participants at enrolment, and study progress is reviewed twice yearly by an external Safety Monitoring Committee. Dissemination activities will include formal publications and report back sessions with the community. Trial registration number NCT02925949; Pre-results.

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‘If she gave birth to a healthy child, then she may forget about her own health’: Postpartum engagement in HIV care and treatment among women living with HIV in Russia

Global Public Health ◽

10.1080/17441692.2018.1536157 ◽

2018 ◽

Vol 14 (5) ◽

pp. 684-695 ◽

Cited By ~ 2

Author(s):

Elizabeth J. King ◽

Irina Evdokimova ◽

Julia Godunova

Keyword(s):

Healthy Child ◽

Hiv Care ◽

Women Living With Hiv ◽

Care And Treatment ◽

Engagement In Hiv Care ◽

Living With Hiv

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Structural community factors and sub-optimal engagement in HIV care among low-income women in the Deep South of the USA

Culture Health & Sexuality ◽

10.1080/13691058.2015.1110255 ◽

2015 ◽

Vol 18 (6) ◽

pp. 682-694 ◽

Cited By ~ 26

Author(s):

Melonie Walcott ◽

Mirjam-Colette Kempf ◽

Jessica S. Merlin ◽

Janet M. Turan

Keyword(s):

Low Income ◽

Hiv Care ◽

Deep South ◽

Community Factors ◽

The Usa ◽

Low Income Women ◽

Engagement In Hiv Care

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Digital HIV Care Navigation for Young People Living With HIV in San Francisco, California: Feasibility and Acceptability Study

JMIR mhealth and uhealth ◽

10.2196/16838 ◽

2020 ◽

Vol 8 (1) ◽

pp. e16838 ◽

Cited By ~ 1

Author(s):

Dillon Trujillo ◽

Caitlin Turner ◽

Victory Le ◽

Erin C Wilson ◽

Sean Arayasirikul

Keyword(s):

Young People ◽

San Francisco ◽

Text Messaging ◽

Text Message ◽

Hiv Care ◽

People Living With Hiv ◽

Newly Diagnosed ◽

Engagement In Hiv Care ◽

Living With Hiv ◽

High Engagement

Background HIV continues to be a public health challenge adversely affecting youth and young adults, as they are the fastest-growing group of new HIV infections in the United States and the group with the poorest health outcomes among those living with HIV. HIV prevention science has turned to mobile health as a novel approach to reach and engage young people living with HIV (YPLWH) experiencing barriers to HIV care. Objective This study aimed to assess the feasibility and acceptability of a text message–based HIV care navigation intervention for YPLWH in San Francisco. Health eNavigation is a 6-month text message–based HIV care navigation where YPLWH are connected to their own HIV care navigator through text messaging to improve engagement in HIV primary care. Digital HIV care navigation included delivery of the following through SMS text messaging: (1) HIV care navigation, (2) health promotion and education, (3) motivational interviewing, and (4) social support. Methods We evaluated the feasibility and acceptability of a text message–based HIV care navigation intervention among YPLWH. We assessed feasibility using quantitative data for the overall sample (N=120) to describe participant text messaging activity during the intervention. Acceptability was assessed through semistructured, in-depth interviews with a subsample of 16 participants 12 months after enrollment. Interviews were audio-recorded, transcribed, and analyzed using grounded theory. Results Overall, the text message–based HIV care navigation intervention was feasible and acceptable. The majority of participants exhibited medium or high levels of engagement (50/120 [41.7%] and 26/120 [21.7%], respectively). Of the majority of participants who were newly diagnosed with HIV, 63% (24/38) had medium to high engagement. Similarly, among those who were not newly diagnosed, 63% (52/82) had medium to high engagement. The majority of participants found that the intervention added value to their lives and improved their engagement in HIV care, medication adherence, and viral suppression. Conclusions Text message–based HIV care navigation is a potentially powerful tool that may help bridge the gaps for linkage and retention and improve overall engagement in HIV care for many YPLWH. Our results indicate that participation in text message–based HIV care navigation is both feasible and acceptable across pervasive structural barriers that would otherwise hinder intervention engagement.

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Resilience and Beliefs in the Effectiveness of Current Antiretroviral Therapies Among Recently Disengaged Low-Income People of Color Living with HIV

Behavioral Medicine ◽

10.1080/08964289.2019.1570070 ◽

2019 ◽

Vol 46 (1) ◽

pp. 75-85 ◽

Cited By ~ 1

Author(s):

J. Jaiswal ◽

S. N. Singer ◽

H.-M. Lekas

Keyword(s):

Low Income ◽

People Of Color ◽

Antiretroviral Therapies ◽

Living With Hiv

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Perspectives on Pain, Engagement in HIV Care, and Behavioral Interventions for Chronic Pain Among Older Sexual Minority Men Living with HIV and Chronic Pain: A Qualitative Analysis

Pain Medicine ◽

10.1093/pm/pnaa351 ◽

2020 ◽

Author(s):

Samantha M McKetchnie ◽

Corinne Beaugard ◽

S Wade Taylor ◽

Conall O’Cleirigh

Keyword(s):

Chronic Pain ◽

Substance Use ◽

Hiv Care ◽

Sexual Minority Men ◽

Problematic Substance Use ◽

Problematic Substance ◽

Minority Men ◽

Engagement In Hiv Care ◽

Living With Hiv ◽

The Impact

Abstract Objective and Methods The transition of HIV from an acute, fatal illness to a chronic health condition has shifted the treatment needs of people living with HIV (PLWH). PLWH, including sexual minority men (SMM), are living longer and are subject to health concerns often associated with aging. A major health concern of older SMM living with HIV who report problematic substance use is chronic pain. This qualitative analysis of 15 one-on-one interviews with older SMM living with HIV and chronic pain aimed to characterize this population’s experiences with pain, engagement in HIV care, and problematic substance use. This study was conducted in a community health center in Boston, MA. We also solicited suggestions for preferred intervention strategies. Results Three main themes emerged from the interview transcripts: 1) the impact of chronic pain and pain treatment on engagement in HIV clinical care; 2) the impact of substance use on chronic pain; and 3) response to interventions to address chronic pain and substance use. Conclusions These findings underscore the need for interventions that address the structural, physical, and psychological barriers to engagement in medical and self-care that affect older SMM living with HIV and chronic pain.

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Influence of Jail Incarceration and Homelessness Patterns on Engagement in HIV Care and HIV Viral Suppression among New York City Adults Living with HIV/AIDS

PLoS ONE ◽

10.1371/journal.pone.0141912 ◽

2015 ◽

Vol 10 (11) ◽

pp. e0141912 ◽

Cited By ~ 24

Author(s):

Sungwoo Lim ◽

Denis Nash ◽

Laura Hollod ◽

Tiffany G. Harris ◽

Mary Clare Lennon ◽

...

Keyword(s):

New York ◽

New York City ◽

York City ◽

Viral Suppression ◽

Hiv Care ◽

Hiv Viral Suppression ◽

Engagement In Hiv Care ◽

Living With Hiv ◽

Hiv Aids

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An Exploration of Syndemic Factors That Influence Engagement in HIV Care Among Black Men

Qualitative Health Research ◽

10.1177/1049732318759529 ◽

2018 ◽

Vol 28 (7) ◽

pp. 1077-1087 ◽

Cited By ~ 10

Author(s):

Katherine G. Quinn ◽

Sarah J. Reed ◽

Julia Dickson-Gomez ◽

Jeffrey A. Kelly

Keyword(s):

Black Men ◽

Hiv Treatment ◽

Hiv Care ◽

Structural Level ◽

Engagement In Care ◽

Treatment Interventions ◽

Engagement In Hiv Care ◽

Living With Hiv ◽

Syndemic Theory ◽

Study Offer

Syndemic theory seeks to understand the interactions and clustering of disease and social conditions and explain racial disparities in HIV. Traditionally applied to HIV risk, this study characterizes the syndemic challenges of engagement in care among Black men living with HIV and provides insight into potential HIV treatment interventions to retain vulnerable individuals in care. Interviews were conducted with 23 HIV-positive men who were either out-of-care or nonadherent to antiretroviral therapy (ART). Interviews were audio recorded, transcribed verbatim, and coded using MAXQDA qualitative software. Researchers analyzed data using thematic content analysis to identify syndemic factors associated with disengagement in care or suboptimal ART adherence among Black men. Analyses revealed the syndemic nature of four themes: intersectional stigma, depression, substance use, and poverty. Findings from this study offer numerous opportunities for intervention including social and structural-level interventions to address syndemic processes and the influence of stigma and poverty on engagement in care.

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Experience of fatigue and associated factors among adult people living with HIV attending ART clinic: a hospital-based cross-sectional study in Ethiopia

BMJ Open ◽

10.1136/bmjopen-2020-042029 ◽

2020 ◽

Vol 10 (10) ◽

pp. e042029

Author(s):

Moges Baye ◽

Berihu Fisseha ◽

Mulugeta Bayisa ◽

Solomon Mekonnen Abebe ◽

Balamurugan Janakiraman

Keyword(s):

Weight Loss ◽

Low Income ◽

Female Gender ◽

Cross Sectional Study ◽

Hiv Care ◽

People Living With Hiv ◽

Cross Sectional ◽

Factors Associated ◽

Gondar Town ◽

Living With Hiv

ObjectiveThis study aimed to determine the prevalence of fatigue and the factors associated among adult people living with HIV attending antiretroviral therapy clinic in Gondar town, Ethiopia.DesignCross-sectional.SettingGovernmental health facility that provides HIV care in Gondar town.Outcome measureFatigue is defined by nine items version Fatigue Severity Scale.ParticipantsAdult (aged 18 and above) people living with HIV in Gondar town (n=392).ResultA total of 408 HIV seropositive adults were approached for consent, among which 392 participants consented to participate in this study, with a response rate of 96.1%. The mean age of the participants was 40.5±8.5 years. The prevalence of HIV-related fatigue was 53.3% and about 66% of women living with HIV experienced fatigue. The factors associated with fatigue experience were; female gender (adjusted OR (AOR): 2.61, 95% CI 1.01 to 5.3), being married (AOR: 0.18, 95% CI 0.10 to 0.9), low income (AOR: 7.1, 95% CI 4.6 to 22.15), unemployed (AOR: 2.79, 95% CI 1.19 to 9.84), parity (AOR: 4.87, 95% CI 2.18 to 17.9), being anaemic (AOR: 12.45, 95% CI 5.6 to 41.01), depression (AOR: 4.51, 95% CI 1.91 to 11.20), mild weight loss (AOR: 4.2 95% CI 2.56 to 13.9) and moderate weight loss (AOR: 5.1, 95% CI 1.85 to 16.12), respectively.ConclusionThe findings of this study revealed that experiencing fatigue is quite common among adult people living with HIV. It is important for the healthcare professionals and people living with HIV to understand; the possible causes of fatigue, remedies and ways to reclaim energy. The predisposing factors and complications that cause fatigue should be aggressively diagnosed and treated by the clinicians. Further qualitative studies exploring the reasons for experiencing HIV-related fatigue might help designing interventions.

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