scholarly journals Noncommunicable Diseases in People Living With HIV: Time for Integrated Care

2017 ◽  
Vol 216 (12) ◽  
pp. 1481-1483 ◽  
Author(s):  
Marc van der Valk ◽  
Peter Reiss
Keyword(s):  
Integrated Care ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
Living With Hiv

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.

South Africa’s Key Health Challenges

2014 ◽  
Vol 652 (1) ◽  
pp. 166-185 ◽  
Author(s):  
Alan Whiteside
Keyword(s):  
South Africa ◽  
Economic Development ◽  
Health Sector ◽  
Transition To Democracy ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
South Africans ◽  
Aids Epidemic ◽  
The Government ◽  
Living With Hiv

South Africa has an estimated 6.4 million people living with HIV, with more than 2 million already on treatment. The disease emerged in South Africa at the same time as the transition to democracy began in 1990. Although the country has seen considerable advances in many social spheres, the health sector has lagged. This lag is primarily because the HIV/AIDS epidemic results in an increased burden of disease in a cohort of people who would otherwise be healthy. This article warns that the all-pervasive nature of the epidemic will put other areas of development at risk. With economic development come new threats to the health of South Africans, including noncommunicable diseases and environmental change. Service delivery remains a challenge for the government at all levels, and the demands of not only South Africans but of migrants and refugees need to be considered.

scholarly journals FACTORS RELATED TO INSOMNIA SYMPTOMS AMONG PEOPLE LIVING WITH HIV

2019 ◽  
Vol 5 ◽  
Author(s):  
Luciana Fidalgo Ramos Nogueira ◽  
Pollyanna Pellegrino ◽  
Thais Carvalho Da Fonseca ◽  
Patrick Herman Paterlini ◽  
Adriana De Sousa Duarte ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Gastrointestinal Symptoms ◽  
Cross Sectional Study ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
Weight Changes ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Insomnia Symptoms

Objective: To evaluate the prevalence of insomnia symptoms and its relationship with nutritional aspects, gastrointestinal symptoms and chronic diseases among people living with HIV. Methods: a cross-sectional study of 307 people living with HIV in antiretroviral therapy attended by the Specialized AIDS Service of the municipality of Santos (SP), Brazil. The variables evaluated were insomnia symptoms, gastrointestinal symptoms and chronic noncommunicable diseases. Results: the prevalence of insomnia symptoms was 79.2%. There was a greater proportion of people living with HIV with insomnia symptoms who had weight changes after HIV diagnosis, unpleasant stomach sensations, poor digestion, poor appetite, respiratory and skin diseases. Conclusion: the high prevalence of insomnia symptoms was related to the presence of gastrointestinal symptoms, as well as respiratory and dermatological diseases.

scholarly journals Expansion of a National Differentiated Service Delivery Model Increases Access to Treatment for HIV and Other Chronic Conditions in South Africa

2021 ◽  
Author(s):  
Lingrui Liu ◽  
Sarah Christie ◽  
Maggie Munsamy ◽  
Phil Roberts ◽  
Merlin Pillay ◽  
...  
Keyword(s):  
South Africa ◽  
Service Delivery ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
Service Delivery Model ◽  
Differentiated Service ◽  
National Scale ◽  
Access To Treatment ◽  
Delivery Model ◽  
Living With Hiv

Abstract Background: South Africa is home to 7.7 million people living with HIV and supports the largest antiretroviral therapy (ART) program worldwide. Despite global investment in HIV service delivery and the parallel threat of non-communicable diseases (NCDs), there are few examples of integrated programs addressing both HIV and NCDs through differentiated service delivery. In 2014, the National Department of Health (NDoH) launched the Central Chronic Medicines Dispensing and Distribution (CCMDD) program to provide patients with chronic disease, including HIV, with differentiated access to medications via community-based pick-up points. This study describes the expansion of CCMDD to national scale.Methods: Yale monitors CCMDD enrollment as part of its mixed methods evaluation of Project Last Mile (PLM), a national technical support partner for CCMDD since 2016. From March 2016 through October 2019, cumulative weekly data on CCMDD uptake [patients enrolled, facilities registered, pick-up points contracted], type of medication collected [ART only; NCD only; and ART-NCD] and of collection site used [external pick-up points; adherence/outreach clubs; or facility-based fast lanes], were extracted for descriptive, longitudinal analysis.Results: As of October 2019, 3,436 health facilities were registered with CCMDD across 46 health districts (88% national coverage), and 2,037 external pick-up points had been established. A total of 2,069,039 patients were active on CCMDD, a significant increase since 2018 (p<0.001), including 76% collecting ART [64% ART only, 12% ART plus NCD/comorbidities] and 479,120 [24%] collecting for chronic diseases only. Further, 734,005 (35%) of patients were collecting from external pick-up points, a 73% increase in patient volume from 2018.Discussion: This longitudinal description of CCMDD provides an example of a path to national scale for a differentiated service delivery model that integrates management of HIV and noncommunicable diseases. This study demonstrates the success of the program in engaging patients who are not living with HIV, which bodes well for the potential of the program to address the rising burden of NCDs in South Africa.Conclusion: The results signal potential for expansion in resource-limited settings, particularly in the context of private sector strategic support.

scholarly journals Identificación de creencias y actitudes relacionadas con la desprescripción en pacientes VIH+ de edad avanzada: Proyecto ICARD

2020 ◽  
Author(s):  
Reyes Serrano Giménez ◽  
◽  
Jara Gallardo Anciano ◽  
María Aguas Robustillo Cortés ◽  
José Ramón Blanco Ramos ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Therapeutic Change ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
Medication Knowledge ◽  
Highly Active ◽  
Positive Attitudes ◽  
Living With Hiv ◽  
Beliefs And Attitudes ◽  
Chronic Hiv Infection

Objectives. HIV population is aging at an earlier age than those uninfected, requiring more non-HIV medications to treat noncommunicable diseases. In the context of chronic HIV infection, the next therapeutic change would be the polymedication control. This paper has the purpose of explore the attitudes of older people living with HIV toward deprescribing. Material and methods. This was an observational, prospective and multicenter study conducted from March-April, 2018. People living with HIV (PLWH) on highly active antiretroviral therapy and older than 65 years were included. In addition to demographic and pharmacotherapeutic data, attitudes regarding deprescribing were collected through the “Revised Patients’ Attitudes Towards Deprescribing Questionnaire”. Results. A total of 42 patients were included in this study. Regarding their attitudes in relation to deprescription, there were three statements with the most consensuses. The first (“I have a good understanding of the reasons I was prescribed each of my medicines”) had 91.9% consensus. The second and third questions showed 89.2% consensus in both cases; “Overall, I am satisfied with my current medicines” and “I like to be involved in making decisions about my medicines with my doctors”. Conclusions. This study is the first to explore the beliefs and attitudes of older PLWH in relation to deprescription process. There are positive attitudes regarding medication knowledge but there also is a percentage of patients who had a negative opinion regarding deprescription. We must study and go deeper in our knowledge of techniques that could help us to better understand their preferences, in order to establish effective and successful deprescription strategies.

scholarly journals Title: Expansion of a national differentiated service delivery model to support people living with HIV and other chronic conditions in South Africa: a descriptive analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lingrui Liu ◽  
Sarah Christie ◽  
Maggie Munsamy ◽  
Phil Roberts ◽  
Merlin Pillay ◽  
...  
Keyword(s):  
South Africa ◽  
Service Delivery ◽  
Chronic Diseases ◽  
Descriptive Analysis ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
Service Delivery Model ◽  
Differentiated Service ◽  
Delivery Model ◽  
Living With Hiv

Abstract Background South Africa is home to 7.7 million people living with HIV and supports the largest antiretroviral therapy (ART) program worldwide. Despite global investment in HIV service delivery and the parallel challenge of non-communicable diseases (NCDs), there are few examples of integrated programs addressing both HIV and NCDs through differentiated service delivery. In 2014, the National Department of Health (NDoH) of South Africa launched the Central Chronic Medicines Dispensing and Distribution (CCMDD) program to provide patients who have chronic diseases, including HIV, with alternative access to medications via community-based pick-up points. This study describes the expansion of CCMDD toward national scale. Methods Yale monitors CCMDD expansion as part of its mixed methods evaluation of Project Last Mile, a national technical support partner for CCMDD since 2016. From March 2016 through October 2019, cumulative weekly data on CCMDD uptake [patients enrolled, facilities registered, pick-up points contracted], type of medication provided [ART only; NCD only; and ART-NCD] and collection sites preferred by patients [external pick-up points; adherence/outreach clubs; or facility-based fast lanes], were extracted for descriptive, longitudinal analysis. Results As of October 2019, 3,436 health facilities were registered with CCMDD across 46 health districts (88 % of South Africa’s districts), and 2,037 external pick-up points had been contracted by the NDoH. A total of 2,069,039 patients were actively serviced through CCMDD, a significant increase since 2018 (p < 0.001), including 76 % collecting ART [64 % ART only, 12 % ART plus NCD/comorbidities] and 479,120 [24 %] collecting medications for chronic diseases only. Further, 734,005 (35 %) of patients were collecting from contracted, external pick-up points, a 73 % increase in patient volume from 2018. Discussion This longitudinal description of CCMDD provides an example of growth of a national differentiated service delivery model that integrates management of HIV and noncommunicable diseases. This study demonstrates the success of the program in engaging patients irrespective of their chronic condition, which bodes well for the potential of the program to address the rising burden of both HIV and NCDs in South Africa. Conclusions The CCMDD program expansion signals the potential for a differentiated service delivery strategy in resource-limited settings that can be agnostic of the patients chronic disease condition.

scholarly journals Experience of chronic noncommunicable disease in people living with HIV: a systematic review and meta-aggregation of qualitative studies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhongfang Yang ◽  
Zheng Zhu ◽  
Lucylynn Lizarondo ◽  
Weijie Xing ◽  
Shuyu Han ◽  
...  
Keyword(s):  
Qualitative Studies ◽  
Noncommunicable Disease ◽  
Financial Hardship ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
Term Care ◽  
Care Continuity ◽  
Stigma And Discrimination ◽  
Living With Hiv ◽  
Multiple Conditions

Abstract Background An increasing number of people living with HIV (PLWH) have had chronic noncommunicable diseases (NCDs) over the last 5 years. However, robust evidence regarding the perception and challenges of having NCDs among PLWH is limited. Therefore, this study aimed to synthesize qualitative evidence regarding the experiences of PLWH with NCDs. Methods We used a meta-aggregation approach to synthesize qualitative studies. Peer-reviewed and gray literature published in English and Chinese from 1996 to November 2020 was searched using electronic databases. Two reviewers independently appraised the methodological quality and extracted data from the included studies. The Joanna Briggs Institute (JBI) meta-aggregation approach was used to synthesize the findings. Results In total, 10,594 studies were identified in the initial database search. Fourteen eligible studies were included in the meta-synthesis. Among these studies, nine synthesized findings regarding the following topics were identified: fragmented healthcare systems, care continuity, manifestations of multiple conditions, financial hardship, stigma and discrimination, polypharmacy burden and adherence, reciprocal relationships between HIV and NCDs, and coping strategies. Conclusions In recent years, attempts have been made to institutionalize NCD preventive and control services in HIV long-term care. However, considering the growing problem of HIV and NCD comorbidity globally, integrated primary health care systems are needed to address the problems of PLWH with NCDs. Healthcare professionals should help PLWH develop strategies to better monitor their polypharmacy burden and adherence, stigma and discrimination, financial hardship, and manifestations of multiple conditions to achieve high levels of care continuity.

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