scholarly journals Socioeconomic and psychosocial factors are associated with poor treatment outcomes in Australian adults living with HIV: a case-control study

Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 548 ◽  
Author(s):  
Krista J. Siefried ◽  
Stephen Kerr ◽  
Robyn Richardson ◽  
Limin Mao ◽  
John Rule ◽  
...  
Keyword(s):  
Health Care ◽  
Treatment Outcomes ◽  
Psychosocial Factors ◽  
Hiv Treatment ◽  
Hiv Disclosure ◽  
Self Report ◽  
Hiv Care ◽  
Targeted Interventions ◽  
Poor Outcomes ◽  
Living With Hiv

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 >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.

HIV treatment outcomes among newcomers living with HIV in Manitoba, Canada

2021 ◽  
pp. e20200042
Author(s):  
Charity Maritim ◽  
Leigh McClarty ◽  
Stella Leung ◽  
Sharon Bruce ◽  
Gayle Restall ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Clinical Characteristics ◽  
Cohort Analysis ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Similar Proportion ◽  
People Living With Hiv ◽  
Persons Living With Hiv ◽  
Hiv Treatment Outcomes ◽  
Living With Hiv

Background: Despite the overrepresentation of immigrants and refugees (newcomers) in the HIV epidemic in Canada, research on their HIV treatment outcomes is limited. This study addressed this knowledge gap by describing treatment outcomes of newcomers in comparison with Canadian-born persons living with HIV in Manitoba. Methods: Clinical data from 1986 to 2017 were obtained from a cohort of people living with HIV and receiving care from the Manitoba HIV Program. Retrospective cohort analysis of secondary data was completed using univariate and multivariate statistics to compare differences in socio-demographic and clinical characteristics and treatment outcomes among newcomers, Canadian-born Indigenous persons, and Canadian-born non-Indigenous persons on entry into HIV care. Results: By end of 2017, 86 newcomers, 259 Canadian-born Indigenous persons, and 356 Canadian-born non-Indigenous persons were enrolled in the cohort. Newcomers were more likely than Canadian-born Indigenous and non-Indigenous cohort participants to be younger and female and have self-reported HIV risk exposure as heterosexual contact. Average CD4 counts at entry into care did not differ significantly between groups. A higher proportion of newcomers was also diagnosed with tuberculosis within 6 months of entry into care (21%), compared with 6% and 0.6% of Canadian-born Indigenous non-Indigenous persons, respectively. Newcomers and Canadian-born non-Indigenous persons had achieved viral load suppression (< 200 copies/mL) at a similar proportion (93%), compared with 82% of Canadian-born Indigenous participants ( p < 0.05). Conclusions: The distinct demographic and clinical characteristics of newcomers living with HIV requires a focused approach to facilitate earlier diagnosis, engagement, and support in care.

scholarly journals The Influence of Neighborhood Characteristics on HIV Treatment Outcomes Among Adults: A Scoping Review Protocol

2021 ◽  
Author(s):  
Linda Jepkoech Kimaru ◽  
Magdiel Habila ◽  
Namoonga Mantina ◽  
Purnima Madhivanan ◽  
Elizabeth Connick ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Scoping Review ◽  
Hiv Treatment ◽  
Community Level ◽  
Hiv Care ◽  
Neighborhood Characteristics ◽  
Hiv Interventions ◽  
Individual Behaviors ◽  
Hiv Treatment Outcomes ◽  
Living With Hiv

Abstract BackgroundThe HIV pandemic has caused enormous suffering and loss of life in the last forty years. Currently more than 34 million people have died as a result of HIV infection and over 37 million people are currently living with HIV. There have been tremendous global efforts to address the HIV pandemic and although significant progress has been made in treatment and prevention of HIV, many people living with HIV still do not have appropriate access to treatment and care. Current HIV interventions have focused more on individual factors than on community level factors. Community level factors influence individual behavior by enhancing or limiting access to- and utilization of HIV care. The objective of this scoping review is to assess and critically examine the association between neighborhood characteristics and outcomes of HIV treatment.Methods The following databases will be searched for studies published on and prior to May 31, 2021: PubMed, PsycINFO, CINAHL, and EMBASE. We will include published full text studies with both experimental and observational study designs that discussed neighborhood characteristics and HIV treatment outcomes. We will exclude abstracts only publications and studies reporting opinion. Data generated from the search will be managed using Mendeley 1.19.8. The review will be conducted using Arskey and Levac’s methodological framework for scoping reviews. A narrative synthesis will be conducted on the included studies. Discussion Sustainability of HIV interventions that focus on individual behaviors rely on the community level factors that influence those individual behaviors. This review will enhance the understanding of the impact of neighborhood characteristics on HIV treatment outcomes among adults, and possibly shed a light on potential points of intervention that will aid in improving ART initiation, ART adherence, and HIV viral load suppression.Scoping Review Registration: OSF 10.17605/OSF.IO/MD89T

scholarly journals Influence of Material Deprivation on Clinical Outcomes Among People Living with HIV in High-Income Countries: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Vasiliki Papageorgiou ◽  
Bethan Davies ◽  
Emily Cooper ◽  
Ariana Singer ◽  
Helen Ward
Keyword(s):  
Systematic Review ◽  
Social Determinants ◽  
Meta Analysis ◽  
Hiv Treatment ◽  
Material Deprivation ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Living With Hiv

AbstractDespite developments in HIV treatment and care, disparities persist with some not fully benefiting from improvements in the HIV care continuum. We conducted a systematic review to explore associations between social determinants and HIV treatment outcomes (viral suppression and treatment adherence) in high-income countries. A random effects meta-analysis was performed where there were consistent measurements of exposures. We identified 83 observational studies eligible for inclusion. Social determinants linked to material deprivation were identified as education, employment, food security, housing, income, poverty/deprivation, socioeconomic status/position, and social class; however, their measurement and definition varied across studies. Our review suggests a social gradient of health persists in the HIV care continuum; people living with HIV who reported material deprivation were less likely to be virologically suppressed or adherent to antiretrovirals. Future research should use an ecosocial approach to explore these interactions across the lifecourse to help propose a causal pathway.

Mapping Evidence Of Patient-centered Care For Persons Living With Hiv: A Protocol For A Systematic Scoping Review

2019 ◽  
Author(s):  
Delarise Mulqueeny ◽  
Manduleli Herald Pokiya ◽  
Praba Naidoo
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Hiv Treatment ◽  
World Health ◽  
Hiv Care ◽  
Future Research ◽  
Clinical Settings ◽  
Keywords Hiv ◽  
Persons Living With Hiv ◽  
Living With Hiv

Abstract Background: The Human Immunodeficiency virus (HIV) is a global, chronic health challenge that warrants a multidimensional approach to treatment and care. Notwithstanding the strides made in suppressing the virus, evidence illustrates challenges in persons living with HIV (PLHIV) experiences of treatment and care. Such experiences threaten HIV patients’ retention, adherence, mortality, comorbidities and the global community’s efforts to end the AIDS epidemic by 2030. A patient-centred approach (PCC) to HIV care and treatment could improve patients’ health care experiences, wellbeing, retention and adherence and strengthen patient-provider relationships, Hence, the aim of this scoping review is to comprehensively map existing evidence of PCC in HIV treatment and care. Additionally, the review will identify and describe gaps that could inform future research and interventional programmes or the need for systematic reviews. Methods and analysis: As HIV PCC is a broad topic, a systematic scoping review, that includes peer-reviewed journal articles and grey literature will be conducted. Online databases: (Google scholar, Scopus, EBSCOhost, PsycINFO via ProQuest, PsycARTICLES via ProQuest, International Bibliography of the Social Sciences (IBSS) via ProQuest, UNAIDS databases will be accessed. Humanitarian databases such as the World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO) will also be accessed to identify literature on PCC for PLHIV. Such literature will be published between 2009 and 2019. Two reviewers will independently extract data from relevant search engines, utilising specific inclusion and exclusion standards. Thereafter thematic content analysis will be performed, and a narrative account of the findings will be presented. Discussion: As this is a scoping review, no ethical approval is required. Once the review is completed all summarized data will be disseminated in peer-reviewed journals, at national and international conferences, clinical settings and to policy makers. This is aimed at improving PLHIV’s experiences in clinical settings, practice and care. Keywords: HIV, patient-centred care, patient experiences, ART programme; ARVS; patients

‘What will it take’: addressing alcohol use among people living with HIV in South Africa

2019 ◽  
Vol 30 (11) ◽  
pp. 1049-1054 ◽  
Author(s):  
K Sorsdahl ◽  
NK Morojele ◽  
CD Parry ◽  
CT Kekwaletswe ◽  
N Kitleli ◽  
...  
Keyword(s):  
South Africa ◽  
Alcohol Use ◽  
Brief Intervention ◽  
Hiv Treatment ◽  
Hiv And Aids ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Screening And Brief Intervention ◽  
Treatment Services ◽  
Living With Hiv

Given that hazardous and harmful alcohol use has been identified as a significant barrier to adherence to antiretroviral therapy (ART) in South Africa, alcohol reduction interventions delivered within HIV treatment services are being investigated. Prior to designing and implementing an alcohol-focused screening and brief intervention (SBI), we explored patients’ perceptions of alcohol as a barrier to HIV treatment, the acceptability of providing SBIs for alcohol use within the context of HIV services and identifying potential barriers to patient uptake of this SBI. Four focus groups were conducted with 23 participants recruited from three HIV treatment sites in Tshwane, South Africa. Specific themes that emerged included: (1) barriers to ART adherence, (2) available services to address problematic alcohol use and (3) barriers and facilitators to delivering a brief intervention to address alcohol use within HIV care. Although all participants in the present study unanimously agreed that there was a great need for SBIs to address alcohol use among people living with HIV and AIDS, our study identified several areas that should be considered prior to implementing such a programme.

scholarly journals “Our Tradition Our Enemy”: A Qualitative Study of Barriers to Women’s HIV Care in Jimma, Southwest Ethiopia

2020 ◽  
Vol 17 (3) ◽  
pp. 833
Author(s):  
Hailay Gesesew ◽  
Pamela Lyon ◽  
Paul Ward ◽  
Kifle Woldemichael ◽  
Lillian Mwanri
Keyword(s):  
Treatment Outcomes ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Negative Consequences ◽  
Framework Analysis ◽  
Southwest Ethiopia

Evidence exists that suggests that women are vulnerable to negative HIV treatment outcomes worldwide. This study explored barriers to treatment outcomes of women in Jimma, Southwest Ethiopia. We interviewed 11 HIV patients, 9 health workers, 10 community advocates and 5 HIV program managers from 10 institutions using an in-depth interview guide designed to probe barriers to HIV care at individual, community, healthcare provider, and government policy levels. To systematically analyze the data, we applied a thematic framework analysis using NVivo. In total, 35 participants were involved in the study and provided the following interrelated barriers: (i) Availability— most women living in rural areas who accessed HIV cared less often than men; (ii) free antiretroviral therapy (ART) is expensive—most women who have low income and who live in urban areas sold ART drugs illegally to cover ART associated costs; (iii) fear of being seen by others—negative consequences of HIV related stigma was higher in women than men; (iv) the role of tradition—the dominance of patriarchy was found to be the primary barrier to women’s HIV care and treatment outcomes. In conclusion, barriers related to culture or tradition constrain women’s access to HIV care. Therefore, policies and strategies should focus on these contextual constrains.

scholarly journals Training Exposure and Self-Rated Competence among HIV Care Providers Working with Adolescents in Kenya

2020 ◽  
Vol 19 ◽  
pp. 232595822093526
Author(s):  
Elizabeth Karman ◽  
Kate S. Wilson ◽  
Cyrus Mugo ◽  
Jennifer A. Slyker ◽  
Brandon L. Guthrie ◽  
...  
Keyword(s):  
Health Care ◽  
Work Experience ◽  
Hiv Care ◽  
Care Providers ◽  
Care Workers ◽  
Competence Training ◽  
Expert Input ◽  
Living With Hiv ◽  
Care Worker ◽  
Youth Friendly

Lack of health care worker (HCW) training is a barrier to implementing youth-friendly services. We examined training coverage and self-reported competence, defined as knowledge, abilities, and attitudes, of HCWs caring for adolescents living with HIV (ALWH) in Kenya. Surveys were conducted with 24 managers and 142 HCWs. Competence measures were guided by expert input and Kalamazoo II Consensus items. Health care workers had a median of 3 (interquartile range [IQR]: 1-6) years of experience working with ALWH, and 40.1% reported exposure to any ALWH training. Median overall competence was 78.1% (IQR: 68.8-84.4). In multivariable linear regression analyses, more years caring for ALWH and any prior training in adolescent HIV care were associated with significantly higher self-rated competence. Training coverage for adolescent HIV care remains suboptimal. Targeting HCWs with less work experience and training exposure may be a useful and efficient approach to improve quality of youth-friendly HIV services.

Fertility Intentions and Reproductive Health Care Needs of People Living with HIV in Cape Town, South Africa: Implications for Integrating Reproductive Health and HIV Care Services

2009 ◽  
Vol 13 (S1) ◽  
pp. 38-46 ◽  
Author(s):  
Diane Cooper ◽  
Jennifer Moodley ◽  
Virginia Zweigenthal ◽  
Linda-Gail Bekker ◽  
Iqbal Shah ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Reproductive Health ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Health Care Needs ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services ◽  
Living With Hiv

scholarly journals Depression, sexual behavior, and HIV treatment outcomes among transgender women, cisgender women and men who have sex with men living with HIV in Brazil and Thailand: a short report

AIDS Care ◽  
2019 ◽  
Vol 32 (3) ◽  
pp. 310-315
Author(s):  
Tonia C. Poteat ◽  
David D. Celentano ◽  
Kenneth H. Mayer ◽  
Chris Beyrer ◽  
Matthew J. Mimiaga ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Treatment Outcomes ◽  
Transgender Women ◽  
Hiv Treatment ◽  
Short Report ◽  
Sex With Men ◽  
Hiv Treatment Outcomes ◽  
Living With Hiv

scholarly journals Poverty stigma is associated with suboptimal HIV care and treatment outcomes among women living with HIV in the United States

AIDS ◽  
2019 ◽  
Vol 33 (8) ◽  
pp. 1379-1384 ◽  
Author(s):  
Anna M. Leddy ◽  
Janet M. Turan ◽  
Mallory O. Johnson ◽  
Torsten B. Neilands ◽  
Mirjam-Colette Kempf ◽  
...  
Keyword(s):  
United States ◽  
Treatment Outcomes ◽  
The United States ◽  
Hiv Care ◽  
Women Living With Hiv ◽  
Care And Treatment ◽  
Living With Hiv
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