scholarly journals 1042. The Attitude of Patients With HIV about Telehealth for Their HIV Care

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S550-S551
Author(s):  
Dima Dandachi ◽  
Bich Dang ◽  
Thomas Giordano Giordano
Keyword(s):  
Hiv Transmission ◽  
Personal Information ◽  
Critical Role ◽  
Retention In Care ◽  
Hiv Care ◽  
Structural Factors ◽  
Personal Factors ◽  
Response Distribution ◽  
Related Factors ◽  
Clinic Visits

Abstract Background The world is facing a pandemic of SARS-CoV-2 that disrupted our healthcare system and the way we deliver healthcare. For people with HIV (PWH), the ability to be retained in care plays a critical role in improving health outcomes and in preventing HIV transmission. Several definitions exist for retention in care, but they are centered around outpatient clinic visits. It is now more important than ever to understand PWH’s attitudes about using telemedicine for HIV care instead of face-to face clinic visits. Methods We administered a one-time survey to PWH presenting to an outpatient HIV center in Houston, Texas, from February–June 2018. The survey items were used to assess PWH’s attitudes towards and concerns for telehealth and explanatory variables. Results 371 participants completed the survey; median age was 51, 36% were female, and 63% African-American. Overall, 57% of respondents were more likely to use telehealth for their HIV care if available, as compared to one-on-one in-person care, and 37% would use telehealth frequently or always as an alternative to clinic visits. Participants reported many benefits including ability to fit better their schedule, decreasing travel time, and privacy but expressed concerns about the ability to effective communication and examination and the safety of personal information. Factors associated with likelihood of using telehealth include personal factors (US-born, men who have sex with men, higher educational attainment, higher HIV-related stigma perception), HIV-related factors (long standing HIV), and structural factors (having difficulty attending clinic visits, not knowing about or not having the necessary technology). There was no association between participants with uncontrolled HIV, medication adherence, and likelihood of using telehealth. Survey items and response distribution Conclusion Telehealth programs for PWH can improve retention in care. A modification of the definition for retention in care, incorporating telehealth, should be considered. Availability and confidence using various telehealth technologies need to be addressed to increase acceptability and usage of telehealth among PWH. Disclosures All Authors: No reported disclosures

scholarly journals Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036832
Author(s):  
Elfride Irawati Sianturi ◽  
Elmiawati Latifah ◽  
Ari Probandari ◽  
Christantie Effendy ◽  
Katja Taxis
Keyword(s):  
Qualitative Study ◽  
Healthcare Providers ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Free Access ◽  
Personal Factors ◽  
Long Distance ◽  
Related Factors ◽  
Healthcare Environment ◽  
Living With Hiv

ObjectiveThe aim of the study was to explore the experiences of Papuans living with HIV to take antiretroviral therapy (ART) from the patient and the healthcare providers (HCPs) perspective.DesignThis was a qualitative study covering all five tribes located in Papua Provinces one of two Indonesian provinces on Papua Island. Semistructured interviews were conducted with Papuans living with HIV and their HCPs. Interviews were transcribed verbatim and coded to find themes.ResultsOverall, we conducted interviews with 13 Papuans living with HIV (mean age: 33 years, 61% female) and 14 HCPs (mean age: 42 years, 64% female) within five customary areas. HCPs included three physicians, nine nurses, two others. Two main themes were identified: (1) personal factors and (2) healthcare environment-related factors. Personal factors were beliefs and knowledge of ART, stigma from family, community and HCPs as well as practical problems such as transportation because of long distance. Within the theme of healthcare environment, the competences and attitudes of HCPs were particularly relevant. The findings are important in refining HIV treatment strategies implemented in Papua, especially when extending HIV care provided by community centres.ConclusionsDespite free access to ART, Papuans living with HIV struggle to remain on treatment. Considering local culture and religion in strategies to reduce stigma should be a priority.

scholarly journals Factors influencing adherence to antiretroviral treatment among adults accessing care from private health facilities in Malawi

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lusungu Chirambo ◽  
Martha Valeta ◽  
Tifiness Mary Banda Kamanga ◽  
Alinane Linda Nyondo-Mipando
Keyword(s):  
Retention In Care ◽  
Health Facilities ◽  
Hiv Care ◽  
Adherence Rate ◽  
Related Factors ◽  
The Public ◽  
Study Sites ◽  
Privacy And Confidentiality ◽  
Privately Owned

Abstract Background Private health facilities are increasingly being recognized as the neglected partner in the provision of HIV services. The non-adherence rate in the study sites ranged from 19 to 22%. This study explored the factors associated with non-adherence from antiretroviral therapy (ART) among adult patients accessing ART services at two privately owned urban health facilities in Malawi. Methods We conducted a descriptive qualitative approach employing in-depth interviews among adults who either defaulted or were retained in HIV care in two privately owned facilities in Malawi from March to July 2017. We purposively selected participants and interviewed a total of 6 ART providers and 24 ART clients. Data were analyzed manually using a thematic approach. Results Overall, participants identified four facilitators for retention in care and four broad categories of barriers namely individual, psychological, drug related and human resource related factors. The factors that facilitated retention in care included follow up visits after missing a visit, adequate information education and counseling, and supportive relationships. Conclusion The main reason for defaulting from antiretrovirals (ARVs) was fear of disclosing an HIV status to avert potential stigma and discrimination. In implementing ART clinics due consideration and strategies need to be adopted to ensure that privacy and confidentiality is preserved. Although adoption of all the key Malawi Implementing strategies like expert clients and a guardian may optimize retention in care, there is need for prior analysis of how those may lead to unintended disclosure which inadvertently affects adherence. Furthermore, private facilities should orient their clients to the public facilities within the catchment area so that clients have an option for alternative access to HIV care in the event of financial constraints.

scholarly journals Estimating the HIV undiagnosed population in Catalonia, Spain: descriptive and comparative data analysis to identify differences in MSM stratified by migrant and Spanish-born population

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018533 ◽  
Author(s):  
Juliana Maria Reyes-Urueña ◽  
Colin N J Campbell ◽  
Núria Vives ◽  
Anna Esteve ◽  
Juan Ambrosioni ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Retention In Care ◽  
Hiv And Aids ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Undiagnosed Hiv ◽  
Sex With Men ◽  
Living With Hiv

ObjectiveUndiagnosed HIV continues to be a hindrance to efforts aimed at reducing incidence of HIV. The objective of this study was to provide an estimate of the HIV undiagnosed population in Catalonia and compare the HIV care cascade with this step included between high-risk populations.MethodsTo estimate HIV incidence, time between infection and diagnosis and the undiagnosed population stratified by CD4 count, we used the ECDC HIV Modelling Tool V.1.2.2. This model uses data on new HIV and AIDS diagnoses from the Catalan HIV/AIDS surveillance system from 2001 to 2013. Data used to estimate the proportion of people enrolled, on ART and virally suppressed in the HIV care cascade were derived from the PISCIS cohort.ResultsThe total number of people living with HIV (PLHIV) in Catalonia in 2013 was 34 729 (32 740 to 36 827), with 12.3% (11.8 to 18.1) of whom were undiagnosed. By 2013, there were 8458 (8101 to 9079) Spanish-born men who have sex with men (MSM) and 2538 (2334 to 2918) migrant MSM living with HIV in Catalonia. A greater proportion of migrant MSM than local MSM was undiagnosed (32% vs 22%). In the subsequent steps of the HIV care cascade, migrants MSM experience greater losses than the Spanish-born MSM: in retention in care (74% vs 55%), in the proportion on combination antiretroviral treatment (70% vs 50%) and virally suppressed (65% vs 46%).ConclusionsBy the end of 2013, there were an estimated 34 729 PLHIV in Catalonia, of whom 4271 were still undiagnosed. This study shows that the Catalan epidemic of HIV has continued to expand with the key group sustaining HIV transmission being MSM living with undiagnosed HIV.

A Qualitative Study of HIV “Test-and-Treat” Experience Among Men Who Have Sex With Men in Malaysia

2019 ◽  
Vol 31 (3) ◽  
pp. 193-205 ◽  
Author(s):  
Sin How Lim ◽  
Haridah Alias ◽  
Jeremy Kwan Wing Kien ◽  
Mohd Akbar ◽  
Adeeba Kamarulzaman ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Blood Donation ◽  
Wait Time ◽  
Good Health ◽  
Hiv Care ◽  
Structural Factors ◽  
Health Providers ◽  
Personal Factors ◽  
Hiv Test ◽  
Sex With Men

This study aimed to examine the barriers and facilitators to HIV testing and treatment among Malaysian MSM. Between June 2014 and December 2015, in-depth interviews were conducted in 20 HIV-positive MSM recruited from a teaching hospital and NGO in Kuala Lumpur. Thematic analysis was used to identify, analyze, and report themes. Most participants investigated their HIV status after long period of sickness. Others sought testing upon partner's diagnosis and some were diagnosed via blood donation. Barriers to testing include personal (perceived good health, fear of positive result, denial); social and structural factors (stigmatization by health providers and family, lack of information about free HIV testing and long wait time). Barriers to treatment comprise personal factors (perceived HIV as incurable and treatment as complicated), social factors (HIV and homosexual stigma), and cost. Promoting benefits of regular testing and early treatment is needed to improve HIV care continuum among MSM in Malaysia.

scholarly journals Why do patients interrupt and return to antiretroviral therapy? Retention in HIV care from the patient’s perspective in Johannesburg, South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256540
Author(s):  
Melanie A. Bisnauth ◽  
Natasha Davies ◽  
Sibongile Monareng ◽  
Fezile Buthelezi ◽  
Helen Struthers ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Health Services ◽  
Healthcare Providers ◽  
Retention In Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Related Factors ◽  
Retention In Hiv Care

Background Retention in care is required for optimal clinical outcomes in people living with HIV (PLHIV). Although most PLHIV in South Africa know their HIV status, only 70% are on antiretroviral therapy (ART). Improved retention in care is needed to get closer to sustained ART for all. In January 2019, Anova Health Institute conducted a campaign to encourage patients who had interrupted ART to return to care. Methods Data collection was conducted in one region of Johannesburg. This mixed methods study consisted of two components: 1) healthcare providers entered data into a structured tool for all patients re-initiating ART at nine clinics over a nine-month period, 2) Semi-structured interviews were conducted with a sub-set of patients. Responses to the tool were analysed descriptively, we report frequencies, and percentages. A thematic approach was used to analyse participant experiences in-depth. Results 562 people re-initiated ART, 66% were women, 75% were 25–49 years old. The three most common reasons for disengagement from care were mobility (30%), ART related factors (15%), and time limitations due to work (10%). Reasons for returning included it becoming easier to attend the clinic (34%) and worry about not being on ART (19%). Mobile interview participants often forgot their medical files and expressed that managing their ART was difficult because they often needed a transfer letter to gain access to ART at another facility. On the other hand, clinics that had flexible and extended hours facilitated retention in care. Conclusion In both the quantitative data, and the qualitative analysis, changing life circumstances was the most prominent reason for disengagement from care. Health services were not perceived to be responsive to life changes or mobility, leading to disengagement. More client-centred and responsive health services should improve retention on ART.

Fundamentals of HIV Medicine 2017

2017 ◽  
Author(s):  
American Academy of HIV Medicine
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Retention In Care ◽  
Hiv Care ◽  
Coordination Of Care ◽  
Accountable Care ◽  
Care Providers ◽  
Prevention Strategies ◽  
Economic Issues ◽  
Transmission Prevention

Fundamentals of HIV Medicine is the nation’s most frequently utilized HIV patient care and reference textbook. Authored by leading HIV care providers, researchers, and experts, the new 2017 edition provides a comprehensive review of all facets of the medical management of individuals with HIV. The following topics are discussed in the book: epidemiology and the spread of HIV, mechanisms of HIV transmission, transmission prevention strategies, immunology, HIV elimination strategies, linkage into care, retention in care and accountable care, complementary and alternative medicine approaches, coordination of care, antiretroviral therapy, antiretroviral therapy in special populations, comorbidities and complications, social and economic issues, and clinical research.

scholarly journals A Novel Combined Mother-Infant Clinic to Optimize Post-Partum Maternal Retention, Service Utilization, and Linkage to Services in HIV Care in Rural Rwanda

2017 ◽  
Vol 6 (1) ◽  
pp. 36 ◽  
Author(s):  
Guillaine Neza, BSc ◽  
Wilberforce Mwizerwa, BA ◽  
Jackline Odhiambo, BA ◽  
Bethany L. Hedt-Gauthier, PhD ◽  
Lisa R. Hirschhorn, MD, MPH ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Service Utilization ◽  
Hiv Transmission ◽  
Post Partum ◽  
Retention In Care ◽  
Hiv Care ◽  
Program Outcomes ◽  
Modern Contraception ◽  
Retention In Hiv Care ◽  
Mother To Child

Background and Objectives: Despite recent improvements in accessibility of services to prevent mother-to-child transmission of HIV, maternal retention in HIV care remains a challenge in the postpartum period. This study assessed service utilization, program retention, and linkage to routine services, as well as clinical outcomes for mothers and infants, following implementation of an integrated mother-infant clinic in rural Rwanda.Methods: We conducted a retrospective cohort study of all HIV-positive mothers and their infants enrolled in the integrated clinics in two rural districts between July 1, 2012, and June 30, 2013. At 18 months post-partum, data on mother-infant service utilization and program outcomes were reported.Results: Of the 185 mother-infant pairs in the clinics, 98.4% of mothers were on antiretroviral therapy (ART) and 30.3% used modern contraception at enrollment. At 18 months post-partum, 98.4% of mothers were retained and linked back to adult HIV program. All mothers were on ART and 72.0% on modern contraception. For infants, 93.0% completed follow-up. Two (1.1%) infants tested HIV positive.Conclusion and Global Health Implication: An integrated clinic was successfully implemented in rural Rwanda with high mother retention in care and low mother to child HIV transmission rates. This model of integration of services may contribute to improved mother-infant retention in care during post-partum period and should be considered as one approach to addressing this challenge in similar settings.Key words: HIV • Integrated Clinic • Combined Clinic • Antiretroviral Therapy • Post-partum Retention • Linkages • ART • PMTCT • Option B+ • AfricaCopyright © 2017 Neza Guillaine et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.affect economic and health promotion.

scholarly journals Structural, Personal and Socioenvironmental Determinants of HIV Transmission among Transgender Women in Indonesia

2021 ◽  
Vol 18 (11) ◽  
pp. 5814
Author(s):  
Nelsensius Klau Fauk ◽  
Maria Silvia Merry ◽  
Theodorus Asa Siri ◽  
Lillian Mwanri ◽  
Paul Russell Ward
Keyword(s):  
Sex Work ◽  
Hiv Transmission ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Transgender Women ◽  
Qualitative Inquiry ◽  
Living Environment ◽  
Structural Factors ◽  
Work Practices ◽  
Personal Factors

Transgender populations are considered as a highly vulnerable group to HIV infection. This study aimed to understand structural, personal and socioenvironmental factors and the mechanisms through which these factors facilitate HIV transmission among transgender women (waria) in Yogyakarta, Indonesia. A qualitative inquiry using one-on-one in-depth interviews was employed to collect data from participants (n = 29). Thematic analysis was used to guide data analysis. Findings showed that poverty in families, a sense of responsibility to support family necessities, limited employment options and low education attainment were the structural factors driving participants’ engagement in sex work practices and unprotected anal intercourse, which facilitated HIV transmission among them. Personal need fulfilment and the desire for savings were personal factors driving their engagement in these high-risk practices that supported HIV transmission. Social relationships, social influence and the participants’ living environment were socioenvironmental factors that also supported sex work practices and HIV transmission among the participants. The findings indicate the need for capacity building in terms of knowledge and skills for waria populations to prepare and enable them to gain meaningful employment to prevent the vicious cycle of HIV transmission among them. As structural factors seemed to be the main drivers predisposing waria to HIV acquisition, further studies to explore effective HIV/AIDS interventions that address economic aspects of waria in Yogyakarta and other similar settings in Indonesia are recommended.

Fraud Detection Protocol for Web-Based Research Among Men Who Have Sex With Men: Development and Descriptive Evaluation (Preprint)

2018 ◽  
Author(s):  
April M Ballard ◽  
Trey Cardwell ◽  
April M Young
Keyword(s):  
Survey Research ◽  
Hiv Transmission ◽  
Personal Information ◽  
Fraud Detection ◽  
Detection Algorithm ◽  
Cross Sectional ◽  
Web Based ◽  
Young Msm ◽  
Data Survey ◽  
Sex With Men

BACKGROUND Internet is becoming an increasingly common tool for survey research, particularly among “hidden” or vulnerable populations, such as men who have sex with men (MSM). Web-based research has many advantages for participants and researchers, but fraud can present a significant threat to data integrity. OBJECTIVE The purpose of this analysis was to evaluate fraud detection strategies in a Web-based survey of young MSM and describe new protocols to improve fraud detection in Web-based survey research. METHODS This study involved a cross-sectional Web-based survey that examined individual- and network-level risk factors for HIV transmission and substance use among young MSM residing in 15 counties in Central Kentucky. Each survey entry, which was at least 50% complete, was evaluated by the study staff for fraud using an algorithm involving 8 criteria based on a combination of geolocation data, survey data, and personal information. Entries were classified as fraudulent, potentially fraudulent, or valid. Descriptive analyses were performed to describe each fraud detection criterion among entries. RESULTS Of the 414 survey entries, the final categorization resulted in 119 (28.7%) entries identified as fraud, 42 (10.1%) as potential fraud, and 253 (61.1%) as valid. Geolocation outside of the study area (164/414, 39.6%) was the most frequently violated criterion. However, 33.3% (82/246) of the entries that had ineligible geolocations belonged to participants who were in eligible locations (as verified by their request to mail payment to an address within the study area or participation at a local event). The second most frequently violated criterion was an invalid phone number (94/414, 22.7%), followed by mismatching names within an entry (43/414, 10.4%) and unusual email addresses (37/414, 8.9%). Less than 5% (18/414) of the entries had some combination of personal information items matching that of a previous entry. CONCLUSIONS This study suggests that researchers conducting Web-based surveys of MSM should be vigilant about the potential for fraud. Researchers should have a fraud detection algorithm in place prior to data collection and should not rely on the Internet Protocol (IP) address or geolocation alone, but should rather use a combination of indicators.

scholarly journals Bijou: Engaging Young MSM in HIV Care Using a Mobile Health Strategy

2021 ◽  
Vol 20 ◽  
pp. 232595822110308
Author(s):  
Tiffany Chenneville ◽  
Hunter Drake ◽  
Kemesha Gabbidon ◽  
Carina Rodriguez ◽  
Lisa Hightow-Weidman
Keyword(s):  
Health Literacy ◽  
Self Efficacy ◽  
Retention In Care ◽  
Knowledge Retention ◽  
Hiv Care ◽  
Ehealth Literacy ◽  
Literacy Engagement ◽  
Southeastern Us ◽  
Post Test ◽  
Living With Hiv

Young men who have sex with men (YMSM) living with HIV experience challenges with retention in care, which negatively affects viral suppression. To address this, researchers piloted Bijou, a program designed to provide health education through electronically delivered behavior and risk reduction modules. Participants were 29 YMSM aged 19-24 living with HIV from the southeastern US. Participants completed pre, post, and 3-month follow-up (3MFU) surveys assessing knowledge, intervention acceptability, satisfaction, self-efficacy, ehealth literacy, and usability. Findings revealed significant improvement in knowledge and e-health literacy from pre-test to post-test but lost significance at 3MFU. Self-efficacy scores did not show significant differences from pre-test to post-test or 3MFU. Participants who completed all modules considered Bijou usable and acceptable; however, many did not complete the program. Findings suggest a need for adaptations to promote knowledge retention, e-health literacy, engagement over time, and research with a larger, more representative sample.

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