A systematic analysis of the needs of people with HIV in Australia: stakeholder views of the key elements for a healthy life

Sexual Health ◽  
2016 ◽  
Vol 13 (5) ◽  
pp. 444 ◽  
Author(s):  
Sarity Dodson ◽  
Roy Batterham ◽  
Karalyn McDonald ◽  
Julian H. Elliott ◽  
Richard H. Osborne ◽  
...  
Keyword(s):  
Social Justice ◽  
Research And Development ◽  
Unmet Needs ◽  
Healthcare Quality ◽  
Aged Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Access To Services ◽  
Care Services

Background: The HealthMap project is developing an intervention to reduce cardiovascular risk in people living with HIV. As part of the formative stages of the intervention design, we sought to understand the needs of people with HIV (PWHIV). Methods: Two concept-mapping workshops with PWHIV (n = 10), and one with HIV care providers (n = 6) were conducted. The workshop findings were consolidated into a questionnaire administered to PWHIV (n = 300) and HIV care providers (n = 107). Participants were asked to rate the importance of each of 81 presented needs and the degree to which it was currently being met. Results: Workshops provided insights into what PWHIV perceive they need, to live with and manage their condition, and its impact on their life; these included: (1) clinical science research and development; (2) information and support; (3) personal situation; (4) healthcare quality; (5) access to services; (6) access to services specific to ageing; and (7) social justice. Questionnaire results revealed that PWHIV considered information and support, and research and development most important. For providers, healthcare quality, clients’ personal situation, and social justice were most important. In terms of unmet needs, PWHIV and providers both highlighted issues in the areas of social justice, and access to aged care services. Conclusions: PWHIV and HIV providers continue to report unmet needs in the areas of social justice and emerging concerns about access to aged care services. Services must continue to address these issues of access and equity.

scholarly journals Willingness to Offer HIV Self-testing Among Health Care Providers From Specialized HIV Care Services in the Northeast of Brazil

2021 ◽  
Author(s):  
Tiago Jordão ◽  
Laio Magno ◽  
Marcos Pereira ◽  
Thais Aranha Regis Rossi ◽  
Pedro Almeida Silva ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Large Scale ◽  
Northeastern Brazil ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Factors Associated ◽  
Care Services ◽  
Self Testing

Abstract Background: The lack of knowledge of the serological status of people living with HIV is still a concern in Brazil. HIV self-testing (HIVST) has proved to have great potential for expanding testing, especially among more vulnerable populations. The large-scale distribution of HIVST by the Brazilian public health system has been ramped up in recent years.Methods: This study investigates the awareness, acceptability, and factors associated with willingness to offer HIV self-testing (HIVST) among health care providers (HCP) in northeastern Brazil. Cross-sectional study with HCP in 29 specialized care services (SCS) from 21 cities from state of Bahia. The inclusion criterion was that HCP had been working at least six months in the service. Sociodemographic, occupational, and behavioral data were collected using a questionnaire. Descriptive, bivariate and multivariate analysis, estimating the respective adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) by logistic regression, were performed.Results: The awareness and acceptability of HIVST, and willingness to offer it were 79.8%, 55.2%, and 47.1%, respectively. Few of the professionals reported that the SCS where they worked dispensed HIVST (3.6%), and 13.5% said they had received some kind of information or training on HIVST. Factors associated with willingness to offer HIVST were: HIVST acceptability (aOR = 9.45; 95% CI: 4.53 – 19.71), agreement to use it oneself (aOR = 4.45; 95% CI: 1.62 – 12.24), confidence in offering HIVST to service users (aOR = 5.73; 95% CI: 2.26 – 12.72), and considering the general public eligible for HIVST (aOR = 2.88; 95% CI: 1.25–6.59).Conclusions: Although HIVST awareness among the HCP was high, its acceptability and their willingness to offer it was moderate. More training in HIVST is needed among HCP in Brazil.

scholarly journals Evolving Toward Shared HIV Care Using the Champlain BASE eConsult Service

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831986821
Author(s):  
Claire E. Kendall ◽  
Janessa E. Porter ◽  
Esther S. Shoemaker ◽  
Rachel Seoyeon Kang ◽  
Michael Fitzgerald ◽  
...  
Keyword(s):  
At Risk ◽  
Primary Care Providers ◽  
Question Type ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Local Health ◽  
Care Providers ◽  
Patients At Risk ◽  
Survey Responses ◽  
Living With Hiv

Background. Electronic consultation (eConsultation) is a potential strategy to improve access to specialist expertise and facilitate collaborative care models. The Champlain BASE eConsult service allows for asynchronous communication between primary care providers (PCP) and specialists on a secure, web-based system. HIV experts accessible include HIV physician specialists, HIV pharmacists, and social workers with expertise in HIV. Objective. This study aims to describe the use, value, and utility of this eConsultation service in the care of people living with HIV and to characterize the common question types and clinical topics asked by PCPs. Methods. We analyzed the data from eConsults sent to the HIV specialty group in Ontario’s Champlain Local Health Integration Network between February 2015 and December 2017. Usage data and close-out survey responses were analyzed using descriptive statistics, eConsults were classified using a predefined list of validated taxonomy, and a thematic analysis was performed on the consultation logs to identify common clinical themes. Results. Among the 46 eConsults, the most common question type related to drug treatment (58.7%, n = 27) and management (19.6%, n = 9). The main clinical themes involved the care of significant complexities in people living with HIV, such as comorbidities and drug interactions, and suggestions of coordinated patient care. As well, eConsult was used for advice regarding pre-exposure prophylaxis for HIV-negative patients at risk of HIV infection. PCPs highly valued the eConsult service (average rating 4.8/5). Conclusion. Overall, this study demonstrates that eConsult provides an efficient and valuable service to PCPs caring for patients living with or at risk for HIV by improving access to HIV specialists and facilitating the delivery of team-based comprehensive care.

scholarly journals Exploring peer navigation and support in the quality of HIV care experiences of female sex workers in the Dominican Republic

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Tahilin Sanchez Karver ◽  
Clare Barrington ◽  
Yeycy Donastorg ◽  
Martha Perez ◽  
Hoisex Gomez ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Care Providers ◽  
Female Sex ◽  
Care Services ◽  
Peer Navigation

Abstract Background Despite evidence on peer navigation’s association with positive HIV outcomes, such as engagement in HIV care and antiretroviral therapy (ART) initiation, the mechanisms through which peer navigation may influence these outcomes have been less explored. The purpose of this study is to describe the role of peer navigation and support on enhancing the quality of HIV treatment and care services experienced by female sex workers (FSWs). Methods Survey data was derived from a quantitative cohort (n = 211) of FSWs living with HIV in the Dominican Republic and complemented with data from two rounds of in-depth interviews (IDIs) from a qualitative subsample (n = 20 per round). Descriptive statistics and multivariable logistic regressions were used to explore the association between peer navigation and relational aspects of care and overall satisfaction of the quality of HIV treatment and care. Thematic analysis was employed to code and synthesize textual data from IDIs. Results 41.2% of the participants reported having had contact with a peer navigator in the last 6 months. Qualitative data revealed that peer navigation and support was instrumental in assisting FSWs linkage to HIV care after diagnosis, elevating FSWs’ ability to access more comprehensive clinical care facilities, and promoting agency by improving FSWs’ skills to more strategically and effectively engage with the clinic environment and health care providers. Peer navigation was positively associated with experiencing more respectful treatment by clinic staff (AOR: 6.65, 95% CI: 2.32–19.02), and greater satisfaction with overall HIV care services (AOR: 2.57, 95% CI: 1.77–3.74). Conclusion Promoting the full integration of peer navigation into healthcare structures is a strategic approach to enhance the quality of HIV care experienced by FSWs and improve their HIV-related outcomes.

scholarly journals Transitioning behaviourally infected HIVpositive young people into adult care: Experiences from the young person’s point of view

2013 ◽  
Vol 14 (1) ◽  
pp. 20-24 ◽  
Author(s):  
C Katusiime ◽  
R Parkes-Ratanshi ◽  
A Kambugu
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Young People ◽  
Best Practice ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Adult Care ◽  
Transition Clinic

Background. There is limited literature on the transition of young people living with HIV/AIDS (YPLHIV) from adolescent/young adult HIV care to adult HIV care in sub-Saharan Africa. Objective. We aimed to share the experiences of HIV-seropositive young adults transitioning into adult care, to inform best practice for such transitioning. Methods. We conducted a retrospective evaluation of the transition of 30 young adults aged ≥25 years from our adolescent/young adult HIV clinic at the Infectious Diseases Institute, Makerere University, Kampala, Uganda, to adult HIV healthcare services between January 2010 and January 2012. Results. Six major themes emerged from the evaluation: (i) adjustment to adult healthcare providers, (ii) the adult clinic logistics, (iii) positive attributes of the adult clinic, (iv) transfer to other health centres, (v) perceived sense of stigma, and (vi) patient-proposed recommendations. A model for transitioning YPLHIV to adult care was proposed. Conclusion. Th ere is a paucity of evidence to inform best practice for transitioning YPLHIV to adult care in resource-limited settings. Ensuring continuity in HIV care and treatment beyond young adult HIV programmes is essential, with provision of enhanced support beyond the transition clinic and youth-friendly approaches by adult-oriented care providers. S Afr J HIV Med 2013;14(1):20-23. DOI:10.7196/SAJHIVMED.885

scholarly journals Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study

2020 ◽  
Author(s):  
Odala Sande ◽  
Doris Burtscher ◽  
Daneck Kathumba ◽  
Hannock Tweya ◽  
Sam Phiri ◽  
...  
Keyword(s):  
Care Delivery ◽  
Quality Care ◽  
Waiting Times ◽  
Physical Structure ◽  
Models Of Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Health Care Information ◽  
Community Based

Abstract Background Differentiated models of care (DMOC) are used to make antiretroviral therapy (ART) accessible to people living with HIV (PLHIV). In Malawi, Lighthouse Trust has piloted various DMOCs aimed at providing quality care while reducing personal and logistical barriers when accessing clinic-based healthcare. One of the approaches was community-based provision of ART by nurses to stable patients. Methods To explore how the nurse-led community ART programme (NCAP) is perceived, we interviewed eighteen purposively selected patients receiving ART through NCAP and the four nurses providing the community-based health care. Information obtained from them was complemented with observations by the study team. Interviews were recorded and transcribed. Data was analysed using manual coding and thematic analysis. Results Through the NCAP, patients were able to save money on transportation and the time it took them to travel to a health facility. Caseloads and waiting times were also reduced, which made patients more comfortable and gave nurses the time to conduct thorough consultations. Closer relationships were built between patients and care providers, creating a space for more open conversations (although this required care providers to set clear boundaries and stick to schedule). Patients’ nutritional needs and concerns related to stigma remain a concern, while operational issues affect the quality of the services provided in the community. Considerations for community-led healthcare programmes include the provision of transportation for care providers; the physical structure of community sites (in regard to private spaces); the timely consolidation of data collected in the field to a central database; and the need for care providers to cover multiple facility-based staff roles. Conclusions The patients interviewed in this study preferred the NCAP approach to the facility-based model of care because it saved them money on transport, reduced waiting-times, and allowed for a more thorough consultation, while continuing to provide quality HIV care. However, when considering a community-level DMOC approach, certain factors – including staff transportation and workload – must be taken into consideration and purposefully planned.

scholarly journals Comfort Among Older Lesbian and Gay People in Disclosing Their Sexual Orientation to Health and Aged Care Services

2020 ◽  
pp. 073346482092533 ◽  
Author(s):  
Anthony Lyons ◽  
Beatrice Alba ◽  
Andrea Waling ◽  
Victor Minichiello ◽  
Mark Hughes ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Service Providers ◽  
Care Service ◽  
Internalized Homophobia ◽  
Well Being ◽  
Aged Care ◽  
Care Providers ◽  
Community Connectedness ◽  
Lesbian And Gay ◽  
Care Services

Being comfortable in disclosing one’s sexual orientation to health and aged care providers is important for older lesbian and gay adults, given that nondisclosure is associated with poorer health and well-being outcomes. In a sample of 752 lesbian and gay adults aged 60 years and older living in Australia, we found only 51% of lesbian women and 64% of gay men felt fully comfortable to disclose their sexual orientation to health and aged care service providers. For both the women and the men, those who felt fully comfortable to disclose reported significantly less internalized homophobia; had fewer experiences of discrimination in the past year; and reported greater lesbian, gay, bisexual, transgender, and intersex (LGBTI) community connectedness. Feeling fully comfortable was also predicted by fewer experiences of lifetime discrimination among the men. These findings may help those seeking to assist older lesbian and gay people in feeling comfortable and being open with health and aged care service providers.

Quality of life measurement in community-based aged care – understanding variation between clients and between care service providers

2021 ◽  
Author(s):  
Joyce Siette ◽  
Mikaela L. Jorgensen ◽  
Andrew Georgiou ◽  
Laura Dodds ◽  
Tom McClean ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Participation ◽  
Service Providers ◽  
Care Service ◽  
Aged Care ◽  
Care Quality ◽  
Care Providers ◽  
Community Based ◽  
Care Services

Abstract Background Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets.Methods A retrospective sample of 1141 Australians aged ≥ 60 years receiving community-based care services from a large service provider within 19 service outlets. Clients’ QoL was captured using the ICEpop CAPability Index. QoL scores and predictors of QoL (i.e.sociodemographic, social participation and service use) were extracted from clients’ electronic records and examined using multivariable regression.Funnel plots were used to examine variation in risk-adjusted QoL scores across service outlets.Results Mean age was 81.5 years (SD = 8) and 75.5% were women. Clients had a mean QoL score of 0.81 (range 0–1, SD = 0.15). After accounting for other factors, being older (p < 0.01), having lower-level care needs (p < 0.01), receiving services which met needs for assistance with activities of daily living (p < 0.01), and having higher levels of social participation (p < 0.001) were associated with higher QoL scores. Of the 19 service outlets, 21% (n = 4) had lower mean risk-adjusted QoL scores than expected (< 95% control limits) and 16% (n = 3) had higher mean scores than expected.Conclusion Using QoL as an indicator to compare care quality may be feasible, with appropriate risk adjustment. Implementing QoL tools allows providers to measure and monitor their performance and service outcomes, as well as identify clients with poor quality of life who may need extra support.Trial registration: Australian and New Zealand clinical trial registry number: ACTRN12617001212347. Registered 18/08/2017

Smarter Safer Homes Solution to Support Older People Living in Their Own Homes through Enhanced Care Models: Methodologies for a Stratified Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Qing Zhang ◽  
Marlien Varnfield ◽  
Liesel Higgins ◽  
Vanessa Smallbon ◽  
Julia Bomke ◽  
...  
Keyword(s):  
Service Providers ◽  
Care Service ◽  
Controlled Trial ◽  
Aged Care ◽  
Ageing Population ◽  
Care Providers ◽  
Randomized Controlled ◽  
Care Services ◽  
Limited Opportunity

BACKGROUND An ageing population, accompanied by the prevalence of age-related diseases, present significant burden to health systems. This is exacerbated by an increasing shortage of aged care staff due to existing workforce entering their retirement and fewer young people being attracted to work in aged care. In line with consumer preferences and potential cost-efficiencies, government and aged care providers are increasingly seeking options to move care and support to the community or home, as opposed to residential care facilities. However, compared to residential care, home environments may provide limited opportunity for monitoring patients progression/decline in functioning and therefore limited opportunity to provide timely intervention. To address this, the Smarter Safer Homes (SSH) platform was designed to enable self-monitoring and/or management, and to provide aged care providers with support to deliver their services. The platform uses open Internet of Things (IoT) communication protocols to easily incorporate commercially available sensors into the system. OBJECTIVE Our research aims to detail the benefits of utilising the SSH platform as a service in its own right as well as a complimentary service to more traditional/historical service offerings in aged care. It is anticipated to validate the capacity and benefits of the SSH platform to enable older people to self-manage, and aged care service providers to support their clients to live functionally and independently in their own home, for as long as possible. METHODS A single-blinded, stratified, 12-month randomized controlled trial with participants recruited from three aged care providers, in Queensland, Australia. The study aimed to recruit 200 people, including 145 people from metropolitan- and 55 from regional areas. Participants were randomised to the intervention group (having SSH platform installed to assist age care service providers to monitor and provide timely supports) and the control group (receiving their usual aged care services from providers). Data on community care, health and social related quality of life, health service utilization, care giver burden and user experience of both groups were collected at the start, the middle (6 month) and the end of the trial (12 month). RESULTS The trial recruited its first participant in April 2019, and finished data collection of the last participant in November 2020. The study also received participants’ health service data from government data resources in June 2021. CONCLUSIONS A crisis is looming to support the ageing population. Digital solutions, such as the SSH platform, has the potential to address this crisis and support aged care in the home and community. The outcomes of this study could improve and support the delivery of aged care services and provide better quality of life to older Australians in various geographical locations. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12618000829213

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