Assessing the impact of food insecurity on HIV medication adherence in the context of an integrated care programme for people living with HIV in Vancouver, Canada

2019 ◽  
Vol 23 (4) ◽  
pp. 683-690 ◽  
Author(s):  
Katrina Koehn ◽  
Taylor McLinden ◽  
Alexandra B Collins ◽  
Patrick McDougall ◽  
Rosalind Baltzer-Turje ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Integrated Care ◽  
Household Food Security ◽  
People Living With Hiv ◽  
Care Programme ◽  
Health Related ◽  
Living With Hiv ◽  
The Impact ◽  
The Relationship

AbstractObjective:Food insecurity, or self-reports of inadequate food access due to limited financial resources, remains prevalent among people living with HIV (PLHIV). We examined the impact of food insecurity on combination antiretroviral therapy (cART) adherence within an integrated care programme that provides services to PLHIV, including two meals per day.Design:Adjusted OR (aOR) were estimated by generalized estimating equations, quantifying the relationship between food insecurity (exposure) and cART adherence (outcome) with multivariable logistic regression.Setting:We drew on survey data collected between February 2014 and March 2016 from the Dr. Peter Centre Study based in Vancouver, Canada.Participants:The study included 116 PLHIV at baseline, with ninety-nine participants completing a 12-month follow-up interview. The median (quartile 1–quartile 3) age was 46 (39–52) years at baseline and 87 % (n 101) were biologically male at birth.Results:At baseline, 74 % (n 86) of participants were food insecure (≥2 affirmative responses on Health Canada’s Household Food Security Survey Module) and 67 % (n 78) were adherent to cART ≥95 % of the time. In the adjusted regression analysis, food insecurity was associated with suboptimal cART adherence (aOR = 0·47, 95 % CI 0·24, 0·93).Conclusions:While food provision may reduce some health-related harms, there remains a relationship between this prevalent experience and suboptimal cART adherence in this integrated care programme. Future studies that elucidate strategies to mitigate food insecurity and its effects on cART adherence among PLHIV in this setting and in other similar environments are necessary.

scholarly journals 1325. Inpatient Initiation of ART Improves Short-Term Mortality in People Living with HIV

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S479-S479
Author(s):  
Jamie Campbell ◽  
Christopher Polk ◽  
Danya Roshdy ◽  
Michael Leonard
Keyword(s):  
Hospice Care ◽  
Intervention Group ◽  
People Living With Hiv ◽  
Virologic Suppression ◽  
Short Term ◽  
Patient Admissions ◽  
Short Term Mortality ◽  
Living With Hiv ◽  
The Impact

Abstract Background Treatment of HIV is recommended as soon as possible and early initiation of combined antiretroviral therapy (cART) is associated with improved engagement in care; however, treatment with cART is often deferred in hospitalized patients despite being correlated with improved outcomes. We implemented an institutional intervention to ensure all people living with HIV (PLwH) were on cART during hospitalization to improve patient outcomes. Methods We prospectively identified all PLwH hospitalized at our institution and had ID physicians and pharmacists ensure they were on appropriate cART and linked to outpatient care. We retrospectively collected clinical and lab data to assess the impact of our intervention on inpatient mortality, 30-day mortality, 30-day readmission rate, and frequency of outpatient follow-up. Patients were excluded from analysis if they were admitted for hospice care. Results We identified 389 patient admissions in 275 unique patients, of which 304 admissions were already on cART at admission. After ID physician assessment, 37 of the 85 not on cART at admission were initiated on therapy. We assessed the impact of this intervention on short-term outcomes as listed in Table 1. Despite the intervention group having similar immunologic and virologic baseline characteristics to those not initiated on cART, their inpatient and 30-day mortality was similar to those already on cART. Readmission rates also decreased in the intervention group. Thirteen of 24 patients in the intervention group who could be tracked for long-term follow-up within our system achieved virologic suppression by 90 days after hospital discharge. Conclusion Inpatient treatment with cART during hospitalization improves short-term mortality outcomes. This study also demonstrates the value of inpatient cART treatment as most patients achieved virologic suppression at subsequent outpatient follow-up. Disclosures All authors: No reported disclosures.

scholarly journals Tobacco smoking and associated factors among people living with HIV in Uganda

2020 ◽  
Author(s):  
Noreen Dadirai Mdege ◽  
Fredrick Edward Makumbi ◽  
Ronald Ssenyonga ◽  
Frances Thirlway ◽  
Joseph Matovu ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Current Smoker ◽  
People Living With Hiv ◽  
Related Quality ◽  
Health Related ◽  
Smoking Patterns ◽  
The Mean ◽  
Living With Hiv ◽  
The Impact

Abstract Introduction This study aimed to assess smoking patterns, behaviours and associated factors among people living with HIV (PLWH) in Uganda. Methods A cross-sectional survey was conducted among adults in HIV care in Uganda. Descriptive statistics were used to describe smoking patterns and behaviours. Logistic regression was used to identify factors associated with current smoking status. Results We recruited 777 participants between October and November 2019: 387 (49.8%) current smokers and 390 (50.2%) non-smokers. 60.9% were males, and the mean age was 40.5 (SD 10.7) years. In multivariate logistic regression, the following increased the odds of being a current smoker: being male (OR 6.60 (95%CI= 4.34 to 10.04)), having at least two smokers among five closest friends (OR 3.97 (95%CI= 2.08 to 7.59)), living in smoking-permitted households (OR 5.83 (95%CI= 3.32 to 10.23)), alcohol use (OR 3.96 (95%CI= 2.34 to 6.71)), a higher perceived stress score (OR 2.23 (95%CI= 1.50 to 3.34)), and higher health-related quality of life (OR 5.25 (95%CI= 1.18 to 23.35)). Among smokers, the mean Fagerstrom Test for Nicotine Dependence score was 3.0 (SD 1.9), and 52.5% were making plans to quit. Self-efficacy to resist smoking and knowledge of the impact of smoking on PLWH’s health were low. Conclusions Being male, having at least two smokers among five closest friends, living in smoking-permitted households, alcohol use, higher perceived stress scores and higher health-related quality of life were associated with being a current smoker. Smokers had low to moderate nicotine dependence, high willingness to quit, and low self-efficacy. Implications Future behavioural smoking cessation interventions for PLWH should address co-consumption with alcohol and comorbid mental health conditions that are common among PLWH such as stress. In addition, they should take into account the lack of knowledge among this population of the impact of smoking on their health, and low self-efficacy. Given the relatively low levels of nicotine dependency and high levels of willingness to quit in our sample, smoking cessation interventions, if offered, are likely to support this population in achieving long-term smoking abstinence.

scholarly journals Food insecurity and associated factors among people living with HIV/AIDS on follow up receiving anti-retroviral therapy at public hospitals of Wollega zones, Oromia, Ethiopia, 2019

2019 ◽  
Author(s):  
Adugna Oluma ◽  
Muktar Abadiga ◽  
Getu Mosisa ◽  
Werku Etafa ◽  
Ginenus Fekadu
Keyword(s):  
Cigarette Smoking ◽  
Food Insecurity ◽  
Associated Factors ◽  
Dietary Diversity ◽  
Public Hospitals ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background : Food insecurity and HIV/AIDS are intertwined in a vicious cycle through nutritional, mental health, and behavioral pathways. Food insecurity is a potentially important barrier to the success of antiretroviral treatment, increased hospitalizations, and higher morbidity among HIV-infected individuals in resource-poor settings particularly in sub-Saharan Africa including Ethiopia. Therefore, the purpose of this study was to assess the prevalence of food insecurity and its associated factors among adult people living with HIV/AIDS on follow up receiving ART at public hospitals of wollega zone, west Ethiopia. Methods : An institutional-based cross-sectional study design was conducted on a sample of 428 among people living with HIV/AIDS on follow up receiving anti-retroviral therapy at public hospitals of wollega zones. Data was collected using the Household Food Insecurity Access Scale and dietary diversity scale by interviewer-administered questionnaires. The data was checked, cleaned and entered into Epi data version 3.1 and then exported into Statistical Package for the Social Sciences (SPSS) window version 21 for analysis. Descriptive statistics - cross-tabulation frequency table, mean, standard deviation, percentage, were employed. Bivariate and multiple logistic regression analyses were used with AOR at CI 95% and p<0.05 were used. Result: The overall prevalence of food insecurity among PLWHA receiving ART therapy was 68.8% which was partitioned as mild (23.32%), moderate (29.09%) and severe (16.35%) food in secured. Being single [AOR=3.507(1.377, 8.934)], illiterate [AOR=5.234(1.747, 15.686)], cigarette smoking [AOR=3.577(2.104, 6.081)], presence of anemia (AOR=2.650(1.563, 4.493)] and inadequate dietary diversity [AOR=2.870(1.088, 7.569)] were predictors of food insecurity. Conclusion : The prevalence of food insecurity was relatively high. Educational status, marital status, cigarette smoking, presence of anemia, opportunistic infection and inadequate dietary diversity were the major significant factors affecting food insecurity. We recommended Wollega Zonal Health Bureaus to effectively intervene in behavioral modification and health information dissemination (HID) which is the key strategies to improve food security.

scholarly journals Household food security and associated factors among Adult people living with HIV/AIDS attending ART clinic in Hospitals of Hawassa Town, Southern Ethiopia 2017

2019 ◽  
Author(s):  
REKIKU Fikre ABEBE ◽  
Tamrayhu seyoum
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Associated Factors ◽  
Dietary Diversity ◽  
Study Participant ◽  
Household Food Security ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Abstract Introduction: Globally 78 million peoples have been infected with HIV/AIDS. Ethiopia has one of the largest populations of HIV infected people in the sub-Saharan region of Africa. The relationship between HIV epidemic and food security situation in Ethiopia is complex. Hence, it is likely that the epidemic will contribute to worsening widespread food insecurity. The aim of study was to assess the level of food security and associated factors among adult people living with HIV /AIDS attending ART Clinic in Hospitals of Hawassa city Administration. Methodology: Thisinstitutional based cross-sectional study was conducted from October to December 2017. Systematic sampling technique was used to select a total of 532 study participant. Data entry was done with EPI-info version 3.5.3 and transferred into SPSS Version 20. Crude with adjusted odds ratio with 95% confidence interval at p- value < 0.05were computed to examine statistical significance. Results:Based on food security assessment core module scale 360 (67.3%) People living with HIV/AIDSwere food insecure. People living with HIV/AIDSwho disclose HIV status were 3.9 (AOR=3.902, 95% CI (1.238, 12.301) times more likely to be food secured compared with their counterparts.Similarly, those who were with high and medium dietary diversity were about 5 times more likely to be house hold food insecure compared to those with low dietary diversity AOR= 4.990(2.488,10.05), AOR= 4.696(1.54,14.36), respectively. Conclusions:Food Security status among People living with HIV/AIDSon ART in Hawassa town was low. Dietary diversity, household size, and disclosing HIV status were found to be significant predictors of food security. Key words: Food security, food insecurity ,Adult living with HIV/AIDS.

scholarly journals Recreational Drug Use in People Living with HIV in Spain: Factors Associated with Drug Use and the Impact on Clinical Outcomes

2021 ◽  
Author(s):  
Vanessa Castro-Granell ◽  
Noé Garin ◽  
Ángeles Jaén ◽  
José Luis Casado ◽  
Lorna Leal ◽  
...  
Keyword(s):  
Drug Use ◽  
Well Being ◽  
People Living With Hiv ◽  
Recreational Drug ◽  
Recreational Drugs ◽  
Antiretroviral Adherence ◽  
Recreational Drug Use ◽  
Living With Hiv ◽  
The Impact

AbstractWe analysed the impact of recreational drug use (RDU) on different outcomes in people living with HIV (PLHIV). A multicentre retrospective cohort study was performed with two cohorts of PLHIV included: people using recreational drugs (PURD) vs. people not using recreational drugs (PNURD). Overall, 275 PLHIV were included. RDU was associated with men having sex with men (OR 4.14, 95% CI [1.14, 5.19]), previous sexually transmitted infections (OR 4.00, 95% CI [1.97, 8.13]), and current smoking (OR 2.74, 95% CI [1.44, 5.19]). While the CD4/CD8 ratio increased amongst PNURD during the follow-up year, it decreased amongst PURD (p = 0.050). PURD presented lower scores of self-reported and multi-interval antiretroviral adherence (p = 0.017, and p = 0.006, respectively), emotional well-being (p < 0.0001), and regular follow-up (p = 0.059), but paid more visits to the emergency unit (p = 0.046). RDU worsens clinical, immunological, and mental health outcomes amongst PLHIV.

scholarly journals Follow-Up Survey of the Impact of COVID-19 on People Living with HIV during the Second Semester of the Pandemic

2021 ◽  
Vol 18 (9) ◽  
pp. 4635
Author(s):  
Joseph Nelson Siewe Fodjo ◽  
Edlaine Faria de Moura Villela ◽  
Stijn Van Hees ◽  
Pieter Vanholder ◽  
Patrick Reyntiens ◽  
...  
Keyword(s):  
Online Survey ◽  
Psychosocial Support ◽  
Well Being ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Daily Routines ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Impact

COVID-19 affects persons living with HIV (PLWH) both directly (via morbidity/mortality) and indirectly (via disruption of HIV care). From July–November 2020, an online survey was conducted to investigate the psychosocial well-being of PLWH and changes in HIV care during the second semester of the COVID-19 outbreak. Data were collected on the socio-demographic characteristics of PLWH, their psychosocial well-being, impact of COVID-19 preventive measures on their daily routines and HIV follow-up. Of the 247 responses analyzed (mean age: 44.5 ± 13.2 years; 73.7% male), 67 (27.1%) and 69 (27.9%) respondents screened positive for anxiety (GAD-2 score ≥ 3) and depression (PHQ-2 score ≥ 3), respectively. HIV care had returned to pre-COVID-19 state for 48.6% PLWH, and 108 (43.7%) had no HIV follow-up during the past month. Over three quarters (76.1%) of respondents expressed willingness to receive the COVID-19 vaccine. Compared to previous findings in April 2020, substance use increased from 58.6% to 67.2% (p < 0.001). Our findings suggest that the well-being and medical follow-up of PLWH are still affected after almost a year into the COVID-19 outbreak. Remote HIV follow-up (telemedicine) with psychosocial support should be envisaged in the medium to long-term. Given that most PLWH accept COVID-19 vaccination, they may be prioritized for this intervention.

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