Paying the price in an era of HIV treatment as prevention: a retrospective study of the cost burden of HIV treatment for people living with HIV in Victoria, Australia

Sexual Health ◽  
2015 ◽  
Vol 12 (1) ◽  
pp. 34 ◽  
Author(s):  
Anna L. Wilkinson ◽  
James McMahon ◽  
Yik-Siang Cheah ◽  
Catriona S. Bradshaw ◽  
Carol El-Hayek ◽  
...  
Keyword(s):  
Financial Burden ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Health Clinic ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Prevention Strategies ◽  
Cross Sectional ◽  
Patient Costs ◽  
Hiv Prevention Strategies

Background An estimated 25 700 people live with diagnosed HIV (PLWH) in Australia and ~1200 newly diagnosed cases were notified in 2012. New HIV prevention strategies focus on individual uptake of treatment; however, a potential barrier is the financial burden of antiretroviral treatment (ART). We describe HIV ART dispensed and the estimated associated costs for PLWH in Victoria. Methods: A retrospective cross-sectional study of pharmacy data on ART dispensed between January 2012 and November 2013 from a hospital network, including Victoria’s largest sexual health clinic was conducted. Estimated annual patient costs of ART were calculated by the number of items dispensed per year, concession status, dispensing site and applicable co-payment. Results: A total of 60 225 dispensing records from 3903 individuals were included; this represented 83.8% of pharmaceutical benefits scheme-recorded ART dispensed in Victoria over this period. The estimated annual co-payment costs for patients without a concession card and who were collecting two medications was $433.20. One-fifth of patients (21.3%) collected four or more items, equating to an estimated annual cost of at least $866.40 without a concession card and $141.60 with a concession card. Of those dispensed four or more items, 40.4% were concession card holders. Conclusions: There may be meaningful patient costs associated with accessing ART for some PLWH. New HIV treatment-based prevention strategies need to consider financial vulnerabilities and appropriately targeted initiatives to alleviate patient costs associated with ART, ensuring they do not act as a barrier to commencement of and adherence to HIV treatment.

scholarly journals Vulnerability of the Brazilian LGBT population in HIV treatment

2021 ◽  
Vol 15 (10) ◽  
pp. 1481-1488
Author(s):  
Thaisa Fernanda Lourenção Tauyr ◽  
Luciano Garcia Lourenção ◽  
Maria Amélia Zanon Ponce ◽  
Francisco Rosemiro Guimarães Ximenes Neto ◽  
Maria de Lourdes Sperli Geraldes Santos ◽  
...  
Keyword(s):  
High School ◽  
Viral Load ◽  
Hiv Transmission ◽  
Sexual Transmission ◽  
Undetectable Viral Load ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Lgbt People

Introduction: Human immunodeficiency virus (HIV) infection affects the lesbian, gay, bisexual, transvestite, and transsexual (LGBT) population. We aimed to identify the indidual vulnerability profile of the LGBT population ling with H/acquired immunodeficiency syndrome (AIDS) and correlate it with the treatment situation. Methodology: This cross-sectional study included 510 LGBT people living with HIV (PLHIV)/AIDS who attended the Complex of Chronic Communicable Diseases of the municipality of São José do Rio Preto, São Paulo, Brazil, between 2008 and 2015. Results: There was a predominance of indiduals who were white (70.2%), male (98.4%), single (87.1%), aged 25–44 years (70.0%), educated up to high school (47.7%), economically acte (91.2%), under treatment (80.8%), having CD4 > 350 cells/mm3 (77.1%), and having undetectable viral load (53.3%). HIV transmission was mainly sexual (97.0%) and most people used drugs (76.5%). There was a weak correlation between the variables ‘in treatment’ and acte occupation (r = 0.148, p = 0.001), single marital status (r = 0.128, p = 0.004), white race/colour (r = 0.117, p = 0.008), high school education (r = 0.111, p = 0.012), sexual transmission (r = 0.222, p = 0.000), drug use (r = 0.087, p = 0.049), and CD4 > 350 cells/mm3 (r = 0.118, p = 0.008); and strong correlation between the variables ‘in treatment’ and undetectable viral load (r = -0.937, p = 0.113). Conclusions: The characteristics of the indidual vulnerability of LGBT people involve, among other aspects, issues of gender and social exclusion, a situation that is part of the daily life of PLHIV/AIDS in many scenarios and territories. This can be alleviated with a network of social and health support and effecte and efficient, protecte, attitudinal, and behavioural public policies.

scholarly journals Stigmatization among People Living with HIV/AIDS at the Kumba Health District, Cameroon

2020 ◽  
Vol 19 ◽  
pp. 232595821989930 ◽  
Author(s):  
Thomas Obinchemti Egbe ◽  
Cynthia Adanze Nge ◽  
Hermann Ngouekam ◽  
Etienne Asonganyi ◽  
Dickson Shey Nsagha
Keyword(s):  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Health District ◽  
People Living With Hiv ◽  
Group Discussions ◽  
Cross Sectional ◽  
Stigma Reduction ◽  
Related Stigma ◽  
Living With Hiv ◽  
Hiv Aids

We determined the level, type of stigma, and risk factors associated with stigmatization of people living with HIV/AIDS (PLWHA) by conducting a cross-sectional study from April to June 2018 in 3 HIV treatment centers in the Kumba Health District (KHD), Cameroon. We reviewed hospital registers, conducted focus group discussions, and administered structured questionnaires. For data analysis, we used the Statistical Package for Social Sciences version 20.0. We recorded a total stigma index score of 59.1. Internal stigma (odds ratio [OR] 2.91; 95% confidence interval [CI]: 1.74-4.98) was common in PLWHA. Also, younger age <30 years (adjusted OR [AOR]: 0.39; 95% CI: 0.17-0.94) was linked with stigma reduction while low level of education (AOR: 1.74; 95% CI: 1.02-2.97) increased the stigma level. HIV-related stigma is pervasive in the lives of PLWHA, with most of them having internal stigmatization. Appropriate health education on HIV will be crucial in reducing stigmatization in the KHD.

scholarly journals Exploring the Patterns of Use and Acceptability of Mobile Phones Among People Living With HIV to Improve Care and Treatment: Cross-Sectional Study in Three Francophone West African Countries

10.2196/13741 ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. e13741
Author(s):  
Phillipe Lepère ◽  
Yélamikan Touré ◽  
Alexandra M Bitty-Anderson ◽  
Simon P Boni ◽  
Gildas Anago ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
West African ◽  
Hiv Care ◽  
People Living With Hiv ◽  
African Countries ◽  
Cross Sectional ◽  
Factors Associated ◽  
Living With Hiv

Background The use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa. Objective The aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa. Methods A cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability. Results A total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; P<.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; P=.01). Conclusions The use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.

scholarly journals Exploring the Patterns of Use and Acceptability of Mobile Phones Among People Living With HIV to Improve Care and Treatment: Cross-Sectional Study in Three Francophone West African Countries (Preprint)

2019 ◽  
Author(s):  
Phillipe Lepère ◽  
Yélamikan Touré ◽  
Alexandra M Bitty-Anderson ◽  
Simon P Boni ◽  
Gildas Anago ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
West African ◽  
Hiv Care ◽  
People Living With Hiv ◽  
African Countries ◽  
Cross Sectional ◽  
Factors Associated ◽  
Living With Hiv

BACKGROUND The use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa. OBJECTIVE The aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa. METHODS A cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability. RESULTS A total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; <italic>P</italic>&lt;.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; <italic>P</italic>=.01). CONCLUSIONS The use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.

scholarly journals Measuring the uptake of continuous care among people living with HIV receiving antiretroviral therapy and social determinants of the uptake of continuous care in the southwest of China: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongmei Jin ◽  
Sawitri Assanangkornchai ◽  
Meiqin Fang ◽  
Wei Guan ◽  
Bo Tian ◽  
...  
Keyword(s):  
Medical Insurance ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Treatment Center ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Continuous Care ◽  
Hiv Acquisition ◽  
Living With Hiv

Abstract Background Continuous care is essential for people living with HIV. This study aimed to measure continuous care uptake and investigate the association between higher uptake of continuous care and behavioral and social factors, including HIV-acquisition risk and socioeconomic characteristics. Methods A hospital-based cross-sectional study was conducted from April to November 2019 in an HIV treatment center of a specialized hospital in Kunming city, China. Fourteen service indicators were used to calculate composite care scores, which were classified into three levels (low, middle, and high), using principal component analysis. The Behavioral Model for Vulnerable Populations was employed to examine predisposing, enabling, and need factors associated with composite care scores among people living with HIV. Results A total of 702 participants living with HIV aged ≥ 18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1–5 years were recruited. Based on ordinal logistic regression modeling, predisposing factors: being employed (adjusted odds ratio (AOR): 1.54, 95% confidence interval (CI): 1.13–2.11), heterosexuals (AOR: 1.58, 95% CI: 1.11–2.25) and men who have sex with men (AOR: 2.05, 95% CI: 1.39–3.02) and enabling factors: Urban Employee Basic Medical Insurance (AOR: 1.90, 95% CI: 1.03–3.54), middle socioeconomic status (SES) (AOR: 1.42, 95% CI: 1.01–2.01), were positively associated with the higher level of continuous care uptake, compared to the unemployed, people who inject drugs, those with no medical insurance and low SES, respectively. Conclusion There were large differences in continuous care uptake among people living with HIV. HIV-acquisition risk categories and socioeconomic factors were significant determinants of uptake of continuous care. Our findings could inform the development of evidence-based strategies that promote equitable healthcare for all people living with HIV.

scholarly journals Smartphone Use and Willingness to Pay for HIV Treatment-Assisted Smartphone Applications among HIV-Positive Patients in Urban Clinics of Vietnam

2021 ◽  
Vol 18 (4) ◽  
pp. 1467
Author(s):  
Thu Minh Bui ◽  
Men Thi Hoang ◽  
Toan Van Ngo ◽  
Cuong Duy Do ◽  
Son Hong Nghiem ◽  
...  
Keyword(s):  
Health Services ◽  
Willingness To Pay ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Linear Regression Models ◽  
Smartphone Applications ◽  
Cross Sectional ◽  
Hiv Aids

This study aimed to examine the effectiveness of Human Immunodeficiency Virus (HIV)-assisted smartphone applications in the treatment of HIV/AIDS patients in Vietnam. A cross-sectional study was performed in two urban outpatient clinics in Hanoi from May to December 2019. A simple random sampling method and a structured questionnaire were used to recruit 495 eligible participants and to collect data. Multivariable modified Poisson regression and multivariable linear regression models were employed to investigate the factors associated with the willingness to pay (WTP) and amount of money patients were willing to pay. Approximately 82.8% of respondents were willing to pay for the hypothetical applications, with the mean amount the participants were willing to pay of Vietnam Dong (VND) 72,100/month. Marital status (separate/divorced/widow: Odds ratio (OR) = 1.28, 95% confidence interval (CI) = (1.09; 1.50) and having spouse/partner: OR = 1.18, 95% CI = (1.03; 1.36)) and using health services (OR = 1.03, 95% CI = (1.01; 1.04)) were positively associated with nominating they would be WTP for the app, whereas the duration of antiretroviral treatment (ART) (OR = 0.98, 95% CI = (0.96; 0.99)) had a negative association. The frequency of using health services (β = 0.04, 95% CI = (−0.07; −0.01)) was negatively associated with the amount of WTP. High levels of WTP revealed the feasibility of implementing smartphone-based apps for HIV treatment. This study implied the necessity to consider a co-payment system to reach populations who were in need but where such applications may be unaffordable in lieu of other treatment-associated expenses. Developers also need to pay attention to privacy features to attract single people living with HIV/AIDS and additional measures to initiate people with a long duration on ART into using the applications.

scholarly journals A Hospital Based Cross Sectional Study on Dietary Status and Associated Factors among People Living with HIV/AIDS in Kigali, Rwanda

2020 ◽  
Vol 9 (1) ◽  
pp. 50 ◽  
Author(s):  
Tafadzwa Dzinamarira ◽  
Gashema Pierre ◽  
Elyse Jeanne Umuhire ◽  
Michael Habtu ◽  
Rosemary Okova
Keyword(s):  
Associated Factors ◽  
Strong Association ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Nutrition Status ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Good Nutrition ◽  
Hiv Status Disclosure

Background Good nutrition empowers PLWH with the ability to fight against infection ultimately slowing down disease progression. Consequently, nutrition management is a crucial component of HIV treatment, care, and support. This study aimed at assessing dietary status and associated factors among PLWH in Kigali, Rwanda. Methods We conducted a cross sectional study in three selected hospitals in Kigali from over a six-week period in July &ndash; August, 2019 to collect data from 204 HIV positive adults enrolled using systematic random sampling. Data was collected using an adapted, validated and pre-tested food frequency questionnaire (FFQ). Descriptive and multiple logistic regression analyses were performed using SPSS version 25 for windows. Results The proportion of participants with poor dietary status was 15% based on FFQ responses. The study found only three factors to be independently associated with dietary status. There was an association between dietary status and HIV status disclosure (AOR 2.5; CI 1.25 - 4.83; p=0.014). There was an association between dietary status and travel time to place of collection of ARVs (AOR 3.2; CI 1.7 - 5.8; p=0.006). There was an association between dietary status and BMI (AOR 10.2; CI 8.30 &ndash; 16.0; p&lt;0.001). Conclusions Poor dietary status among PLWH remains a concern. The strong association between dietary status and BMI underlines the need for interventions that target PLWH to improve dietary status and ultimately nutrition status

The Bio/Necropolitics of ACTG 076: Lessons from Pregnant Women of Colour Living with HIV for Treatment for Prevention in the Twenty-first Century

Somatechnics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 233-253
Author(s):  
Eli Manning
Keyword(s):  
Hiv Transmission ◽  
Ethical Dilemmas ◽  
Hiv Treatment ◽  
First Century ◽  
Hiv Positive ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Hiv Positive Women ◽  
Aids Clinical Trials ◽  
Living With Hiv

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.

Prevalence of COVID-19-like Symptoms among People Living with HIV, and Using Antiretroviral Therapy for Prevention and Treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 373-380 ◽  
Author(s):  
SeyedAhmad SeyedAlinaghi ◽  
Maryam Ghadimi ◽  
Mahboubeh Hajiabdolbaghi ◽  
Mehrnaz Rasoolinejad ◽  
Ladan Abbasian ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Antiretroviral Treatment ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Shortness Of Breath ◽  
Sectional Study ◽  
Limited Data ◽  
Cross Sectional ◽  
Living With Hiv

Background: COVID-19 has spread globally with remarkable speed, and currently, there is limited data available exploring any aspect of the intersection between HIV and SARSCoV- 2 co-infection. Objective: To estimate the prevalence of clinical symptoms associated with COVID-19 among people living with HIV (PLWH) in Tehran, Iran. Design: Cross-sectional study. Methods: A total of 200 PLWH were recruited through the positive club via sampling, and completed the symptom-based questionnaire for COVID-19, which was delivered by trained peers. Results: Of 200 participants, respiratory symptoms, including cough, sputum, and shortness of breath, were the most prevalent among participants, but only one person developed symptoms collectively suggested COVID-19 and sought treatments. Conclusions: It appears that existing infection with HIV or receiving antiretroviral treatment (ART) might reduce the susceptibility to the infection with SARS-CoV-2 or decrease the severity of the infection acquired. Further research is needed to understand causal mechanisms.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

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