scholarly journals Improved HIV markers and decreased emergencyroom usage and hospital admission with initiation of a pilot specialty pharmacy at a southeastern Ryan –White –funded clinic over a three year period

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S419-S419
Author(s):  
Minh Ly Nguyen ◽  
Alton Condra ◽  
Della Corbin-Johnson ◽  
Kay Woodson ◽  
Manish Patel ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Emergency Room ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Assistance Program ◽  
Ryan White ◽  
Specialty Pharmacy ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background Specialty pharmacy (SP) provides timely medication delivery to patients and seeks to improve patient adherence through monthly pharmacist medication therapy management (MTM). Patients living with HIV/AIDS have both high cost medications and complex disease states and thus will benefit from SP. We report on the outcome of HIV therapy after 3 years of a pilot SP ina southern inner city RW funded clinic. Methods This is a single center retrospective chart review of patients at our clinic who were enrolled in the SP from 6/3/13–5/1/16 for at least 6 months. Baseline demographic characteristics and HIV markers (CD4, viral load) were collected. Outcomes of interest were: change in CD4 count, percent with viral suppression (VS), emergency room (ER) and hospital admission usage, as well as percent of scheduled providers’ appointment kept. Each individual had the same follow up time before and after SP initiation. Bivariate analysis compared outcomes preSP and during SP using Chi-square or Fisher exact tests for categorical and Wilcoxon rank-sum test for continuous variables. Results During the 3-year period, there were 212 individuals referred to SP, of which 170 participated in the program. There were 92(54%) men, 136(80%) black. The median age was 48.3 years (IQR: 28.5–56.3). The average duration of follow up pre and during SP was 22.1(IQR: 16.5–27) months. In terms of insurance, 69(40%) had Medicare, 22(13%) had Medicaid, 22(13%) had private insurance, 54(32%) received AIDS drug Assistance Program (ADAP), and 3(2%) had Ryan White. Patients resided an average distance from the clinic of 17.4(IQR: 8.8–25) miles. The respective outcomes before and during SP were: CD4: 350(IQR: 181–551) vs. 413(IQR: 263–611 cells/mL (P < 0.0001), VS in 78 ± 30% vs. 91 ± 20% (P < 0.0001). The proportion of patients with emergency room usage or hospital admissions was 68(40%) vs. 49(29%) (P = 0.036). There was no difference in the rate of kept providers’ appointment (66.6 %(IQR: 53.8–78.6%) vs. 63.8 %(50-77%) (P = 0.19). There was no reported death during the follow –up period. Conclusion This pilot SP program at the RW clinic showed statistically significant improvement of CD4 count and VS, as well as 40 % decrease in odds of using ER or hospital admission. Further studies are needed to determine whether SP is beneficial to people living with HIV/AIDS in other settings. Disclosures M. Patel, ViiV: Scientific Advisor, Consulting fee

scholarly journals Instant messaging application for the care of people living with HIV/aids

2019 ◽  
Vol 72 (5) ◽  
pp. 1161-1166
Author(s):  
Ivana Cristina Vieira de Lima ◽  
Marli Teresinha Gimeniz Galvão ◽  
Samyla Citó Pedrosa ◽  
Odaleia Oliveira Farias ◽  
Camila Aparecida Costa Silva ◽  
...  
Keyword(s):  
Physical Activity ◽  
Eating Habits ◽  
Instant Messaging ◽  
Signs And Symptoms ◽  
People Living With Hiv ◽  
Alcohol And Drugs ◽  
Living With Hiv ◽  
Anxiety Depression ◽  
Hiv Aids

ABSTRACT Objective: To assess a specific instant messaging application as a tool of care for people living with HIV/aids, based on analysis of the interactions between nurse and patients. Method: Descriptive, quantitative study with 102 patients from two outpatient infectious disease clinics of Fortaleza, Ceará. During four months, participants received a message every 15 days, totaling eight messages, regarding: adherence to antiretroviral therapy; physical activity; social support; self-esteem; anxiety/depression; eating habits; alcohol and drugs; and sexuality. Results: There were 816 interactions, especially for dialogs about performing physical activity (27.87%), sharing of signs and symptoms (18.03%), report of engagement with treatment (9.84%) and requests of information on the intake of medicine (9.84%). Most participants showed satisfaction with the follow-up, with willingness to continue receiving messages (90.58%). Conclusion: The use of this application is a viable strategy to improve care for people with HIV by promoting instant communication.

scholarly journals Food insecurity and associated factors among people living with HIV/AIDS on follow up receiving anti-retroviral therapy at public hospitals of Wollega zones, Oromia, Ethiopia, 2019

2019 ◽  
Author(s):  
Adugna Oluma ◽  
Muktar Abadiga ◽  
Getu Mosisa ◽  
Werku Etafa ◽  
Ginenus Fekadu
Keyword(s):  
Cigarette Smoking ◽  
Food Insecurity ◽  
Associated Factors ◽  
Dietary Diversity ◽  
Public Hospitals ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background : Food insecurity and HIV/AIDS are intertwined in a vicious cycle through nutritional, mental health, and behavioral pathways. Food insecurity is a potentially important barrier to the success of antiretroviral treatment, increased hospitalizations, and higher morbidity among HIV-infected individuals in resource-poor settings particularly in sub-Saharan Africa including Ethiopia. Therefore, the purpose of this study was to assess the prevalence of food insecurity and its associated factors among adult people living with HIV/AIDS on follow up receiving ART at public hospitals of wollega zone, west Ethiopia. Methods : An institutional-based cross-sectional study design was conducted on a sample of 428 among people living with HIV/AIDS on follow up receiving anti-retroviral therapy at public hospitals of wollega zones. Data was collected using the Household Food Insecurity Access Scale and dietary diversity scale by interviewer-administered questionnaires. The data was checked, cleaned and entered into Epi data version 3.1 and then exported into Statistical Package for the Social Sciences (SPSS) window version 21 for analysis. Descriptive statistics - cross-tabulation frequency table, mean, standard deviation, percentage, were employed. Bivariate and multiple logistic regression analyses were used with AOR at CI 95% and p<0.05 were used. Result: The overall prevalence of food insecurity among PLWHA receiving ART therapy was 68.8% which was partitioned as mild (23.32%), moderate (29.09%) and severe (16.35%) food in secured. Being single [AOR=3.507(1.377, 8.934)], illiterate [AOR=5.234(1.747, 15.686)], cigarette smoking [AOR=3.577(2.104, 6.081)], presence of anemia (AOR=2.650(1.563, 4.493)] and inadequate dietary diversity [AOR=2.870(1.088, 7.569)] were predictors of food insecurity. Conclusion : The prevalence of food insecurity was relatively high. Educational status, marital status, cigarette smoking, presence of anemia, opportunistic infection and inadequate dietary diversity were the major significant factors affecting food insecurity. We recommended Wollega Zonal Health Bureaus to effectively intervene in behavioral modification and health information dissemination (HID) which is the key strategies to improve food security.

scholarly journals Screening of Mental Disorders Related CD4 Count of People Living with HIV/AIDS with Anti-Retroviral Treatment in Medan, Indonesia

2019 ◽  
Vol 7 (16) ◽  
pp. 2647-2651
Author(s):  
Lidya De Vega ◽  
Elmeida Effendy ◽  
Vita Camellia
Keyword(s):  
Mental Disorders ◽  
General Health ◽  
General Health Questionnaire ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Health Questionnaire ◽  
Social Dysfunction ◽  
Cd4 Counts ◽  
Living With Hiv ◽  
Hiv Aids

BACKGROUND: Mental disorders are the most common problems in the life of People Living with HIV/AIDS (PLWHA). The frequency in which HIV/AIDS and mental health problems co-exist, and the complex bi-directional relationship between them. Several biological, distress psychological and social dysfunction factors are associated with mental disorders in PLWHA. AIM: To analyse the relationship between the screening of mental disorders using General Health Questionnaire-12 scores and CD4 counts of People Living with HIV/AIDS with Anti-Retroviral Treatment. METHODS: This was a correlative analytical study with a cross-sectional approach using the General Health Questionnaire-12 (GHQ-12) instrument to assess screening mental disorders and the CD4 count. This research was conducted in February 2019 – April 2019 at an HIV/AIDS outpatient clinic. As many 33 subjects were divided into inclusion criteria; participant confirmed HIV seropositivity in stage II or III were undergoing ARV treatment, ranged in age between 25-49 years. The duration of HIV disease was ≤ four years, and the duration of ARV treatment was ≥ six months and informed consent to participate in the study. The patient who had mental disorders and currently drugs user was excluded from this study. RESULTS: There was an association found between change in CD4 and screening mental disorders at univariate analysis among the study participants, whether on antiretroviral treatment. The correlation between the total GHQ-12 scores as a screening of mental disorders and CD4 counts indicated to result in a significant negative correlation, r = -0.670 with p = 0.001. CONCLUSION: Screening mental disorders using General Health Questionnaire-12 from the results of this study shows that it is important to do for PLWHA because with low CD4 levels as biomarkers the progression of HIV infection affects psychological distress and social dysfunction in people living with HIV who have the potential for symptoms of mental disorders.

scholarly journals Predictors of overall mortality among people living with HIV/AIDS in Brazil, 2007-2015

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M E Santos ◽  
R A Ribeiro ◽  
C Protopopescu ◽  
M Nishimwe ◽  
I Yaya ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Hiv Infection ◽  
Risk Group ◽  
National Database ◽  
People Living With Hiv ◽  
Factors Associated ◽  
Living With Hiv ◽  
Overall Mortality ◽  
Hiv Aids

Abstract Background In Brazil there are 926,742 people living with HIV/AIDS (PLWHA). Despite the introduction of antiretroviral therapy (ART) in 1996 and treatment for all in 2014, mortality has increased in some regions. This study aimed to estimate the factors associated with overall mortality in PLWHA to recommend public health actions. Methods We studied PLWHA aged ≥18 years old, followed-up from 2007 to 2015 in the universal health system in Brazil. We used a national database (disease reporting, laboratory tests, ART and death notifications). Kaplan-Meier method and Cox model were used in survival analysis. The outcome was all-cause deaths. The explanatory variables measured at baseline were sociodemographic characteristics, HIV transmission mode and coinfections by hepatitis B (HBV) and C (HCV). The time-varying variables were CD4 cell count, viral load (VL) and ART status. Results Study population (n = 411,281) was mainly male (61%), under 40 years old (61%), Caucasian (37%), with basic education (43%), heterosexual HIV-infection mode (41%), resident in Southeast region (48%). The co-infection rate was 2.5% for HCV, and 1.4% for HBV. Median time to ART initiation was 83 days. During the follow-up period (median: 4 years), 61,757 deaths occurred (6% HCV-coinfected and 2% HBV-coinfected). The global mortality rate was 3.44 [95% confidence interval: 3.42-3.47] per 100 person-years (PY) during 1,793,417 PY. The factors associated with increased mortality in multivariable analyses were male gender, age over 40, non-Caucasian race, HIV infection by drug use, resident in North, Northeast and South regions, HCV and HBV coinfection, VL ≥ 200 copies/mL and starting ART with CD4&lt;200 cells/mm3. Conclusions Although PLWHA start ART in less than 3 months after the beginning of follow-up, there is still late treatment (at CD4&lt;200 cells/mm3). Screening should target all populations regardless of risk group. Coinfected individuals should also be early treated for HCV and HBV infections. Key messages The results of our study show that all populations should be target for HIV screening regardless of risk group. PLWHA coinfected with hepatitis B and hepatitis C should be also early treated for hepatitis coinfections.

scholarly journals Psikoedukasi “Bidan Cerdas” untuk Menurunkan Stigma terhadap Orang dengan HIV/AIDS (ODHA)

2019 ◽  
Vol 3 (2) ◽  
pp. 93
Author(s):  
Adhesatya Ningsih Moodoeto ◽  
Esti Hayu Purnamaningsih
Keyword(s):  
Health Workers ◽  
Negative Impact ◽  
People Living With Hiv ◽  
Mixed Design ◽  
Post Test ◽  
Living With Hiv ◽  
Experimental Group ◽  
Hiv Aids

Lack of knowledge about HIV /AIDS makes people including health workers stigmatize people living with HIV (PLWHA). It has a negative impact on PLWHA because of the constraints of quality of service, lowering of health, reluctance of VCT, and non-compliance of ARVs. The aim of this research to reduce the stigma of midwives against PLWHA through psychoeducation program of "Bidan Cerdas". Subject of this research is midwife. This research uses the experiment design of Non Random Untreated Kontrol Group Design with Dependent Pretest and Posttest Samples. Stigma to PLWHA measurement uses stigma scale developed by Genberg, et., al (2009). The research hypothesis was tested with Mixed Design ANOVA. The results of the analysis in the experimental group showed p<0.05 in Pre Test to Post Test, and p<0.05 on Post Test data to Follow Up. It concluded that psychoeducation program of "Bidan Cerdas" can reduce stigma against PLWHA.

scholarly journals Burden of Fatigue among Adults Living with HIV/AIDS Attending Antiretroviral Therapy in Ethiopia

2020 ◽  
Author(s):  
Tsiwaye Gebreyesus ◽  
Addisalem Belay ◽  
Gebretsadik Berhe ◽  
Gebremedhin Haile
Keyword(s):  
Clinical Stage ◽  
Health Care Service ◽  
Cd4 Count ◽  
Stage Ii ◽  
People Living With Hiv ◽  
Aids Patients ◽  
Physically Active ◽  
Factors Associated ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background: Fatigue is one of the most common and devastating Human Immuno-deficiency Virus (HIV) - related symptoms, with a varying prevalence in different study areas. In Ethiopia, there is a paucity of information on the magnitude and factors associated with fatigue among HIV/Acquired Immune Deficiency Syndrome (AIDS) patients. This may lead to under-diagnosis and eventually under-management of the symptom. Methods: Institution based cross-sectional study design was conducted among 609 HIV/AIDS patients who were selected by using a systematic random sampling method. Data were collected by using interviewer administered structured questionnaire. Level of fatigue was measured by Fatigue Severity Scale. Results: The prevalence of fatigue was found to be 51.7%. The factors associated with fatigue were: Parity [AOR= 2.01; 95% CI: 1.09-3.71], CD4 count 200-499 cells/mm3 [AOR= 2.81; 95% CI: 1.58-4.99], anemia [AOR= 4.90 95% CI: 2.40-9.97], co-morbidities [AOR= 3.65; 95% CI: 1.71-7.78], depression [AOR= 3.68 95% CI: 1.99-6.79], not being physically active [AOR= 3.20 95% CI: 1.50-6.81], clinical stage II or IV HIV [AOR= 3.11; 95% CI: 1.51-6.40] and [AOR= 4.08; 95% CI: 1.37-12.14], respectively. Conclusion: The finding of this study revealed that fatigue is a common health problem among adult People Living with HIV (PLHIV). Factors associated with fatigue included: Parity, CD4 count 200-499 cells/mm3, Clinical Stage II or IV HIV, anemia, co-morbidities, depression, and not being physically active. The health care service needs to address the predisposing factors by provision integrated care including timely detection and treatment of comorbidities, mental health problems, and promote physical activity to slow down disease progression and then reduce exposure to fatigue.

scholarly journals Viral load as a risk factor of reverse transcriptase inhibitor drug resistance mutation in antiretroviral-treated people living with HIV/AIDS

2021 ◽  
Vol 40 (3) ◽  
pp. 243-253
Author(s):  
Hotma Martogi Lorensi Hutapea ◽  
Tri Nury Kridaningsih ◽  
Khoirul Huda Prasetyo ◽  
Milton Boaheng Antwi
Keyword(s):  
Drug Resistance ◽  
Logistic Regression ◽  
Viral Load ◽  
Reverse Transcriptase ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Multiple Logistic Regression ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Hiv Aids

Background The human immunodeficiency virus type 1 (HIV-1) is a major contagion faced by the population of Indonesia. The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). The aim of this study was to determine the association between CD4 count, CD4 count changes, viral load, adherence to therapy, and therapy history in the presence of DRM in people living with HIV/AIDS (PLWHA). MethodsThis was a cross-sectional study involving 269 adults who underwent antiretroviral (ARV) therapy for at least 6 months. The frequencies of DRM and polymorphisms were measured by partial amplification of the reverse transcriptase (RT) gene using RT-nested PCR on samples with viral loads of >1000 copies/mL. Sequencing was performed using the Sanger method, and edited by BioEdit. The edited sequences were submitted to http://hivdb.stanford.edu for DRM determination. Respondents’ medical data, CD4 count, viral load, and DRM were analyzed by simple and multiple logistic regression. ResultsThe multiple logistic regression analysis showed a significant association of CD4 count (aOR=12.47; 95% CI: 1.45 -107.39; p=0.023) and viral load at the time of study (aOR=29.56; 95% CI: 3.47-251.52; p=0.002) with the presence of DRM in respondents. ARV substitution history was not associated with the presence of DRM. There were 17 respondents (6.3%) carrying HIV-1 DRM, with M184V/I (11 sequences) as the most frequent pattern of NRTI resistance, and K103 (9 sequences) as that of NNRTI resistance. ConclusionThis study demonstrated that viral load at the time of the study was the most influential determinant factor for the presence of DRM in PLWHA.

scholarly journals Quality of life factors affecting quality of life in people living with HIV/AIDS in an urban area

2017 ◽  
Vol 4 (8) ◽  
pp. 3031 ◽  
Author(s):  
Pradnya S. Jadhav ◽  
Payal S. Laad ◽  
R. M. Chaturvedi
Keyword(s):  
Quality Of Life ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Age Group ◽  
Factors Affecting ◽  
Demographic Profile ◽  
Study Population ◽  
Living With Hiv ◽  
Hiv Aids

Background: The aims and objectives were to study socio-demographic profile of people living with HIV/ AIDS; to assess quality of life of people living with HIV/AIDS (PLHA); to study factors affecting Quality of life (QOL) in people living with HIV/AIDS. Methods: A cross-sectional study was conducted which included 319 study subjects. Data on socio-demographic profile was collected using questionnaire and quality of life was assessed using WHO - brief questionnaire. Data was analysed using SPSS software and MS–Excel. Results: Majority of study population 52% were female & 40.8%belonged to 35-45 yrs age group. Out of 319 study subjects, 80.88% were literate and 19.1% were illiterates, 75.9% were married. 65.83% of the study subjects belonged to socio-economic class- II, 27.9% of the study subjects belong to class–I. Majority 52.98% study population had CD4 less than 300 and 47.02% had CD4 count more than 300 cells/mm3. Female have better QOl in comparison to male. Subjects >55 age group, illiterate, unemployed and CD4 count <300cells/mm3 have lower QOL (p<0.05) in comparison to their respective group. Conclusions: The most factors significantly associated with decreased quality of life of people living with HIV/AIDS in the present study include gender, literacy status, age group, employment status and CD4 count (p<0.05).

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