scholarly journals Heavy episodic drinking and HIV disclosure by HIV treatment status among People with HIV in IeDEA Cameroon

2021 ◽  
Vol 98 ◽  
pp. 103431
Author(s):  
Kathryn E. Lancaster ◽  
Molly Remch ◽  
Anastase Dzudie ◽  
Rogers Ajeh ◽  
Adebola Adedimeji ◽  
...  
2020 ◽  
Vol 14 (1) ◽  
pp. 84-89
Author(s):  
A. O. Olaseni

Introduction: The spate of non-disclosure among individuals diagnosed with Human-Immunodeficiency-Virus and Acquired-Immune-Deficiency-Syndrome (HIV/AIDS) has continually been a primary global concern, especially in developing countries. Meta-analysis findings in Nigeria reported poor disclosure rates of 12.5% - 39.5%, which were far below the average disclosure benchmark of 79.0% standard stipulated for developing nations by the World Health Organization. There is no consensus regarding the roles of CD4 counts in disclosure intention. In Nigeria, there is a paucity of literature providing detailed understanding of the predictors of disclosure intention by the duration of diagnosis knowledge and CD4 counts. Methods: This study, therefore, investigated the implication of duration of diagnosis knowledge and CD4 counts in the prediction of HIV disclosure intention among people seeking HIV treatment. Longitudinal survey research designs were adopted. 390 participants were purposively selected to respond to HIV Self-Disclosure Intention Index (α=0.92), while information on CD4 counts and Duration of Diagnosis Knowledge was obtained from the selected respondents’ case files periodically. Binomial logistic regression analysis was used to analyze data at 0.05. Respondents’ mean age was 39.5±10.5 years. Results: Findings revealed that the duration of diagnosis knowledge and CD4 counts interactively predicted the outcome of disclosure intention among treatment-seeking PLHIV. (χ2 = 12.78, df = 2, p < 0.001) and further showed that the likelihood of disclosing HIV positive status increases by 13% between Time 1 (OR = -0.49, p < 0.01; 95%CI = 01.14-12.74) and Time 2 (OR = -0.36, p < 0.05; 95%CI = 01.11-10.93). Increase in CD4 counts was also found to increase the likelihood of HIV self-disclosure by 15% between Time 1 (OR = - 0.84, p < 0.01; 95%CI = 01.09-03.06) and Time 2 (OR = - 0.99, p < 0.01; 95%CI = 00.29-03.06). Conclusion: It was concluded that the duration of diagnosis knowledge and CD4 counts have significant implications in determining the intention to disclose HIV positive status. The study limitations and recommendations were further discussed.


Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 548 ◽  
Author(s):  
Krista J. Siefried ◽  
Stephen Kerr ◽  
Robyn Richardson ◽  
Limin Mao ◽  
John Rule ◽  
...  

Background A substantial minority of patients living with HIV refuse or cease antiretroviral therapy (ART), have virological failure (VF) or develop an AIDS-defining condition (ADC) or serious non-AIDS event (SNAE). It is not understood which socioeconomic and psychosocial factors may be associated with these poor outcomes. Methods: Thirty-nine patients with poor HIV treatment outcomes, defined as those who refused or ceased ART, had VF or were hospitalised with an ADC or SNAE (cases), were compared with 120 controls on suppressive ART. A self-report survey recorded demographics, physical health, life stressors, social supports, HIV disclosure, stigma or discrimination, health care access, treatment adherence, side effects, health and treatment perceptions and financial and employment status. Socioeconomic and psychosocial covariates significant in bivariate analyses were assessed with conditional multivariable logistic regression, adjusted for year of HIV diagnosis. Results: Cases and controls did not differ significantly with regard to sex (96.2% (n = 153) male) or age (mean (± s.d.) 51 ± 11 years). Twenty cases (51%) had refused or ceased ART, 35 (90%) had an HIV viral load &gt;50 copies mL–1, 12 (31%) were hospitalised with an ADC and five (13%) were hospitalised with a new SNAE. Three covariates were independently associated with poor outcomes: foregoing necessities for financial reasons (adjusted odds ratio (aOR) 3.1, 95% confidence interval (95% CI) 1.3–7.6, P = 0.014), cost barriers to accessing HIV care (aOR 3.1, 95% CI 1.0–9.6, P = 0.049) and lower quality of life (aOR 3.8, 95% CI 1.5–9.7, P = 0.004). Conclusions: Despite universal health care, socioeconomic and psychosocial factors are associated with poor HIV outcomes in adults in Australia. These factors should be addressed through targeted interventions to improve long-term successful treatment.


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Joseph Mugisha Okello ◽  
Stephen Nash ◽  
Paul Kowal ◽  
Nirmala Naidoo ◽  
Somnath Chatterji ◽  
...  

AIDS Care ◽  
2013 ◽  
Vol 25 (9) ◽  
pp. 1067-1076 ◽  
Author(s):  
Grace C. John-Stewart ◽  
Grace Wariua ◽  
Kristin M. Beima-Sofie ◽  
Barbra A. Richardson ◽  
Carey Farquhar ◽  
...  

2020 ◽  
Vol 15 (3) ◽  
pp. 162-166
Author(s):  
Krisna Yetti ◽  
Linlin Lindayani ◽  
Mei-Chih Huang

Informing children about their HIV status is a complex challenge and the most difficult part for parents and health care providers. As more children with HIV reaching adolescence and adulthood, they begin to take part in the management of their health care and potentially initiate HIV-risk behaviours. Thus, it is increasing attention to address the concrete disclosure process. There is no clear direction regarding the disclosure process, particularly when the children starting to take HIV medication and what is the information has to be told, children. This paper was presented as an example case scenario, according to the real experiences. This case reflects an ethical dilemma faced by parents and health care providers to deal with issues related children HIV disclosure especially when the appropriate time to disclose regarding initiation of HIV treatment and the content of information have to be told to children. Parent and health care providers often lay informing the children about the medication required to take every day. In reality, they inform the children that this medicine is for fever or malaria, etc. it will have a significant impact on adherence to medication and further success of HIV treatment. The reason for making such lied information due to fear that disclosure may distress the child. Therefore, policymakers need to have consensus regardless of whether or not to disclose HIV status to children before the treatment and develop a local guideline that can accommodate specific cultural issues. There is potential to state law that more uniform for public health prevention and successful HIV treatment. Future studies can explore the most effective approach for children HIV disclosure to minimalize potential harm to children.


Author(s):  
George Palattiyil ◽  
Dina Sidhva

AbstractPolitical instability, armed unrest, religious intolerance, human rights violations, ethnic conflict and environmental disasters that threaten one’s life, displace people and often compel them to seek asylum elsewhere. Over the years, the UK has been a major recipient of asylum seekers, some of whom have come to Scotland, especially since 2000, and among these there are a number who present health issues including being HIV-positive. HIV-positive asylum seekers experience poverty, isolation, vulnerability, stigma and discrimination, which when coupled with a lack of appropriate medical care and support, have the potential of adding another layer on the denial of fundamental human rights and further stigmatising people who are already fleeing circumstances threatening their very existence. This paper discusses findings from a recent study that examined the lived experiences of HIV-positive asylum seekers since their arrival in Scotland. A flexible qualitative research design that included in-depth interviews that used life history and a phenomenological approach was adopted. Underpinned by ethics approval, nineteen HIV-positive Black African asylum seekers were recruited through third sector organisations in Glasgow, Scotland. Additional data were gathered from two emotive and discursive focus group meetings. Findings were developed using narrative analysis. The accounts of the asylum seekers reflect continued fear of stigma in the face of HIV disclosure, but also pervasive poverty and inequality. Their experiences include denial of rights to family and security, fear of being detained and deported, denial of appropriate medical care, symptoms of post-traumatic disorder and the culturally insensitive and sometimes inhumane attitude of the UK Immigration Agency. These themes depict an everyday struggle in a context of denial of support and risk of potential deportation to a country where HIV treatment is limited or inaccessible. Their narratives also attest to the life-giving, unstinting care and support they receive from a handful of voluntary agencies and one specialist HIV clinic in Scotland. The findings from this study raise issues for a debate about the treatment of HIV-positive asylum seekers in Scotland. Poverty, inequality, stigma and discrimination continue to pose difficulties in accessing care and treatment and wider community integration. Often treated in a piecemeal and ‘service-siloed’ fashion, the needs and human rights of HIV-positive asylum seekers require a greater, more holistic practice and policy attention.


AIDS Care ◽  
2019 ◽  
Vol 31 (12) ◽  
pp. 1461-1470 ◽  
Author(s):  
Kennedy Nkhoma ◽  
Aabid Ahmed ◽  
Zipporah Alli ◽  
Lorraine Sherr ◽  
Richard Harding

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kennedy Nkhoma ◽  
Aabid Ahmed ◽  
Zipporah Alli ◽  
Lorraine Sherr ◽  
Richard Harding

Abstract Background The World Health Organisation (WHO) advocates early initiation of HIV treatment as a prevention strategy among people living with HIV. There is strong evidence for the effectiveness of antiretroviral therapy (ART) as a preventive tool for HIV transmission. We aimed to determine the sexual behaviour of HIV outpatients and assess if it reflects the current preventive strategy for HIV transmission. Methods We conducted a cross-sectional study among adult (aged at least 18 years) patients with confirmed HIV diagnosis, and aware of their diagnosis, attending HIV outpatient care in Kenya. Data were gathered through self-report (using validated questionnaires) and file extraction. Multivariate logistic regression assessed the association between sexual risk taking behaviour controlling for gender, HIV clinical stage, HIV treatment status, Tuberculosis (TB) treatment status, and CD4 count. Results We recruited n = 400 participants (n = 280[70%] female gender). The mean age was 39.4 (SD = 9.9) years. The mean CD4 count was 393.7 (SD = 238.2) and ranged from 2 to 1470 cells/mm3. N = 61 (15.64%) were on TB treatment. The majority (n = 366, 91.5%) were on ART. Just over half (n = 202, 50.5%) reported having a sexual partner. Of these n = 33 (16.1%) reported having unprotected sexual intercourse with a person of unknown HIV status in the previous 3 months. Multivariate analysis showed that participants not on ART (HIV treatment) were more likely to report unprotected sexual intercourse compared to those who were on ART (odds ratio .25, 95% CI .09 to .69; P = 0.007). Participants at early stage of HIV infection (stages 1/2) were more likely to report unprotected sexual intercourse compared to participants at advanced HIV infection (stages 3/4) (odds ratio .34, 95% CI .13 to .92; P = 0.035). Males participants were more likely to be involved in sexual risk taking behaviours compared to female participants (odds ratio .36, 95% CI .16 to .82; P = 0.015). TB treatment status, and CD4 count were not significantly associated with sexual risk taking. Conclusion Participants not on ART have more unprotected sexual intercourse than those who are on ART. This calls for the need to scale up coverage and early ART initiation in order to reduce transmission of HIV.


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