Research News: Updated HIV Treatment Guidelines

Background.Criteria for antiretroviral treatment (ART) were adjusted to enable early HIV treatment for people living HIV/AIDS (PLHIV) in China in recent years. This study aims to determine how pretreatment waiting time after HIV confirmation affects subsequent adherence and outcomes over the course of treatment.Methods.A retrospective observational cohort study was conducted using treatment data from PLHIV in Yuxi, China, between January 2004 and December 2015.Results.Of 1,663 participants, 348 were delayed testers and mostly initiated treatment within 28 days. In comparison, 1,315 were nondelayed testers and the median pretreatment waiting time was 599 days, but it significantly declined over the study period. Pretreatment CD4 T-cell count drop (every 100 cells/mm3) contributed slowly in CD4 recovery after treatment initiation (8% less,P<0.01) and increased the risk of poor treatment adherence by 15% (ARR = 1.15, 1.08–1.25). Every 100 days of extensive pretreatment waiting time increased rates of loss to follow-up by 20% (ARR = 1.20, 1.07–1.29) and mortality rate by 11% (ARR = 1.11, 1.06–1.21), based on multivariable Cox regression.Conclusion.Long pretreatment waiting time in PLHIV can lead to higher risk of poor treatment adherence and HIV-related mortality. Current treatment guidelines should be updated to provide ART promptly.

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Views of Medical Doctors Regarding the 2013 WHO Adult HIV Treatment Guidelines Indicate Variable Applicability for Routine Patient Monitoring, for Their Family Members and for Themselves, in South-Africa

PLoS ONE ◽

10.1371/journal.pone.0145911 ◽

2016 ◽

Vol 11 (1) ◽

pp. e0145911 ◽

Cited By ~ 1

Author(s):

Willem Daniel Francois Venter ◽

Lee Fairlie ◽

Charles Feldman ◽

Peter Cleaton-Jones ◽

Matthew Chersich

Keyword(s):

South Africa ◽

Patient Monitoring ◽

Treatment Guidelines ◽

Family Members ◽

Hiv Treatment ◽

Medical Doctors

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When do HIV-infected persons start with antiretroviral therapy? A retrospective analysis of patients' monitoring and treatment status in general practice, as compared with the 1991 Dutch HIV treatment guidelines

Family Practice ◽

10.1093/fampra/15.6.525 ◽

1998 ◽

Vol 15 (6) ◽

pp. 525-528 ◽

Cited By ~ 3

Author(s):

M Reedijk

Keyword(s):

General Practice ◽

Antiretroviral Therapy ◽

Retrospective Analysis ◽

Treatment Guidelines ◽

Hiv Treatment ◽

Treatment Status

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Factors facilitating trained NIMART nurses’ adherence to treatment guidelines: A vital matter in the management of TB/HIV treatment in South Africa

10.21203/rs.3.rs-15526/v7 ◽

2020 ◽

Author(s):

LUFUNO MAKHADO ◽

Mashudu Davhana-Maselesele ◽

Rachel Tsakani Lebese ◽

Sonto Maria Maputle

Keyword(s):

South Africa ◽

Treatment Guidelines ◽

Behavioural Change ◽

Hiv Treatment ◽

World Health ◽

Adherence To Treatment ◽

African Region ◽

Continuous Training ◽

North West ◽

Training Support

Abstract Background: Globally, the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% and this alarming rate compelled the World Health Organization (WHO) to declare the African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The study aimed to determine the factors facilitating nurse-initiated management of antiretroviral therapy (NIMART) trained nurses’ adherence to TB/HIV treatment guidelines. Methods: The study employed an exploratory-descriptive design. The study was conducted in Ugu and Ngaka Modiri Molema Districts of KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussions were conducted and ATLAS T.I. was used for data analysis following the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and adherence to ethics were ensured. Results: The singular theme of factors facilitating NIMART trained nurses’ adherence to treatment guidelines which included positive attitudinal needs and positive behavioural change emerged from raw data. Conclusion: Continuous training, support supervision, and improved relationships with colleagues need to be enhanced to enable NIMART trained nurses to adhere to treatment guidelines.

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