scholarly journals Building HIV Workforce Capacity Through a Residency Pathway: Outcomes and Challenges

2018 ◽  
Vol 5 (12) ◽  
Author(s):  
Jehan Z Budak ◽  
Kathleen Volkman ◽  
Brian R Wood ◽  
Shireesha Dhanireddy
Keyword(s):  
Primary Care ◽  
Training Programs ◽  
People Living With Hiv ◽  
Physician Shortage ◽  
Long Term Outcomes ◽  
Primary Care Career ◽  
Hiv Primary Care ◽  
Workforce Capacity ◽  
Living With Hiv

Abstract To help address the impending HIV physician shortage, we launched an HIV Medicine Pathway within our Internal Medicine Residency in 2008. Between 2015 and 2017, surveys showed a decrease in the number of graduates providing primary care for people living with HIV. We suggest evaluation of long-term outcomes from similar training programs and stronger support for HIV primary care career development.

scholarly journals HIV Care Continuum among Postpartum Women Living with HIV in Atlanta

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Christina M. Meade ◽  
Martina Badell ◽  
Stephanie Hackett ◽  
C. Christina Mehta ◽  
Lisa B. Haddad ◽  
...  
Keyword(s):  
Primary Care ◽  
Viral Suppression ◽  
Retention In Care ◽  
Hiv Care ◽  
Women Living With Hiv ◽  
Care Visit ◽  
Retention In Hiv Care ◽  
Hiv Primary Care ◽  
Living With Hiv

Introduction. While increased healthcare engagement and antiretroviral therapy (ART) adherence occurs during pregnancy, women living with HIV (WLWH) are often lost to follow-up after delivery. We sought to evaluate postpartum retention in care and viral suppression and to identify associated factors among WLWH in a large public hospital in Atlanta, Georgia. Methods. Data from the time of entry into prenatal care until 24 months postpartum were collected by chart review from WLWH who delivered with ≥20 weeks gestational age from 2011 to 2016. Primary outcomes were retention in HIV care (two HIV care visits or viral load measurements >90 days apart) and viral suppression (<200 copies/mL) at 12 and 24 months postpartum. Obstetric and contraception data were also collected. Results. Among 207 women, 80% attended an HIV primary care visit in a mean 124 days after delivery. At 12 and 24 months, respectively, 47% and 34% of women were retained in care and 41% and 30% of women were virally suppressed. Attending an HIV care visit within 90 days postpartum was associated with retention in care at 12 months (aOR 3.66, 95%CI 1.72-7.77) and 24 months (aOR 4.71, 95%CI 2.00-11.10) postpartum. Receiving ART at pregnancy diagnosis (aOR 2.29, 95%CI 1.11-4.74), viral suppression at delivery (aOR 3.44, 95%CI 1.39-8.50), and attending an HIV care visit within 90 days postpartum (aOR 2.40, 95%CI 1.12-5.16) were associated with 12-month viral suppression, and older age (aOR 1.09, 95% CI 1.01-1.18) was associated with 24-month viral suppression. Conclusions. Long-term retention in HIV care and viral suppression are low in this population of postpartum WLWH. Prompt transition to HIV care in the postpartum period was the strongest predictor of optimal HIV outcomes. Efforts supporting women during the postpartum transition from obstetric to HIV primary care may improve long-term HIV outcomes in women.

Risk of Anal Cancer in People Living with HIV: Addressing Anal Health in the HIV Primary Care Setting

2016 ◽  
Vol 27 (5) ◽  
pp. 563-573 ◽  
Author(s):  
Crystal Martin Walker ◽  
Wendy Likes ◽  
Marye Bernard ◽  
Satish Kedia ◽  
Elizabeth Tolley
Keyword(s):  
Primary Care ◽  
Anal Cancer ◽  
Care Setting ◽  
Primary Care Setting ◽  
People Living With Hiv ◽  
Hiv Primary Care ◽  
Living With Hiv

scholarly journals Substance use, Unlike Dolutegravir, is Associated with Mood Symptoms in People Living with HIV

2021 ◽  
Author(s):  
Lisa Van de Wijer ◽  
Wouter van der Heijden ◽  
Mike van Verseveld ◽  
Mihai Netea ◽  
Quirijn de Mast ◽  
...  
Keyword(s):  
Substance Use ◽  
Term Treatment ◽  
Assessment Tools ◽  
Self Report ◽  
People Living With Hiv ◽  
Antiretroviral Drug ◽  
Long Term Treatment ◽  
Living With Hiv ◽  
Neuropsychiatric Side Effects

AbstractContradictory data have been reported concerning neuropsychiatric side effects of the first-line antiretroviral drug dolutegravir, which may be partly due to lack of control groups or psychiatric assessment tools. Using validated self-report questionnaires, we compared mood and anxiety (DASS-42), impulsivity (BIS-11), and substance use (MATE-Q) between dolutegravir-treated and dolutegravir-naive people living with HIV (PLHIV). We analyzed 194, mostly male, PLHIV on long-term treatment of whom 82/194 (42.3%) used dolutegravir for a median (IQR) of 280 (258) days. Overall, 51/194 (26.3%) participants reported DASS-42 scores above the normal cut-off, 27/194 (13.5%) were classified as highly impulsive, and 58/194 (29.9%) regularly used recreational drugs. Regular substance use was positively associated with depression (p = 0.012) and stress scores (p = 0.045). We observed no differences between dolutegravir-treated and dolutegravir-naive PLHIV. Our data show that depressed and anxious moods and impulsivity are common in PLHIV and associate with substance use and not with dolutegravir use.

scholarly journals Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework

2017 ◽  
Vol 31 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mark J. Siedner
Keyword(s):  
Quality Of Life ◽  
Conceptual Framework ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Impact

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.

scholarly journals Trans cohort metabolic reprogramming towards glutaminolysis in long-term successfully treated HIV-infection

2022 ◽  
Vol 5 (1) ◽  
Author(s):  
Flora Mikaeloff ◽  
Sara Svensson Akusjärvi ◽  
George Mondinde Ikomey ◽  
Shuba Krishnan ◽  
Maike Sperk ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Cell Model ◽  
Antiretroviral Drugs ◽  
Metabolic Reprogramming ◽  
System Level ◽  
People Living With Hiv ◽  
Low Grade ◽  
Middle Income ◽  
Living With Hiv

AbstractDespite successful combination antiretroviral therapy (cART), persistent low-grade immune activation together with inflammation and toxic antiretroviral drugs can lead to long-lasting metabolic flexibility and adaptation in people living with HIV (PLWH). Our study investigated alterations in the plasma metabolic profiles by comparing PLWH on long-term cART(>5 years) and matched HIV-negative controls (HC) in two cohorts from low- and middle-income countries (LMIC), Cameroon, and India, respectively, to understand the system-level dysregulation in HIV-infection. Using untargeted and targeted LC-MS/MS-based metabolic profiling and applying advanced system biology methods, an altered amino acid metabolism, more specifically to glutaminolysis in PLWH than HC were reported. A significantly lower level of neurosteroids was observed in both cohorts and could potentiate neurological impairments in PLWH. Further, modulation of cellular glutaminolysis promoted increased cell death and latency reversal in pre-monocytic HIV-1 latent cell model U1, which may be essential for the clearance of the inducible reservoir in HIV-integrated cells.

scholarly journals STUDI RETROSPEKTIF KETAHANAN HIDUP ORANG DENGAN INFEKSI HIV/AIDS (ODHA) DI RSUD DR. ACHMAD MOCHTAR BUKITTINGGI

2019 ◽  
Vol 3 (3) ◽  
pp. 175
Author(s):  
Sukarsi Rusti
Keyword(s):  
Opportunistic Infection ◽  
Opportunistic Infections ◽  
Analysis Data ◽  
P Value ◽  
People Living With Hiv ◽  
Chi Square ◽  
The People ◽  
Living With Hiv ◽  
Hiv Aids

<p><em>H</em><em>I</em><em>V/AIDS disease is a health problem in indonesia. The problem cause of</em><em> </em><em>the number of morbility and mortality that still hight. It is cause of long term</em><em> </em><em>infection, adherance consuming the drungs and opportunistic that can deastroy the</em><em> </em><em>imun system </em><em>of People Living With HIV/AIDS (PLHIV)</em><em>.  The purpose of this research is to identify the factors</em><em> </em><em>related to the people living with </em><em>PLHIV</em><em> </em><em>in Achmad Muchtar Hospital Bukittinggi</em></p><p><em>2016.</em><em></em></p><p><em>This research was conducted by a retrospective cohort design approach, doing  research  of the death of people who living with HIV by observing the patient’s  medical  record  from  2014-2015.  The  research  of  study  were  215 patient’s  who  is  criteria  inclusion.  Analysis  data  using  test  chi-square.  who became the independent  variable is  long  infection,  adherance  comsuming the </em><em>Anti Retroviral (ARV)</em><em> </em><em>, and opportunistic infection and dependent variable that survive the HIV people life.</em><em></em></p><p><em>The research showed that among  215 patients with the number of deaths 39 people ( 18,% ), stages 3 and 4 (&gt;5 th) is 89 people ( 41.4% ), not adherence is  77 people ( 35.8% ), and who suffered an opportunistic infection were 61 people (28.4% ). The statistical test relationships survival of people  living with</em><em> </em><em>H</em><em>I</em><em>V with long-term  infection obtained p value </em><em>=</em><em> </em><em>0,000</em><em> and </em><em>RR = 0,019 ( confidence interfal 95 % with alpha = 0.05 )</em><em>, </em><em>a</em><em>dherance comsuming the </em><em>ARV </em><em>obtained p value  </em><em>= </em><em>0,000 </em><em>and</em><em>  </em><em>RR = 0,494 ( confidence interfal  95 % with alpha = 0.05 ), infection opportunistic</em><em> obtained</em><em> </em><em>p value </em><em>= </em><em>0,000 </em><em>and</em><em> </em><em>RR = 0,361 ( confidence interfal 95 % with αlpha = 0.05 ).</em></p><p><em>From these findings, it can be concluded that  the  long-term  infection,  adherence  ARV  and opportunistic infections associated with survival of people living with HIV. Of the three variables obtained interrelated and value the highest association is long-term  infection</em><em>.</em></p>

scholarly journals Screening for language and speech delay in children under five years

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Sophie Jullien
Keyword(s):  
Primary Care ◽  
Universal Screening ◽  
Screening Tools ◽  
Supporting Evidence ◽  
Speech Delay ◽  
Speech And Language ◽  
Long Term Outcomes ◽  
Targeted Interventions ◽  
Short And Long Term

AbstractWe looked at existing recommendations and supporting evidence on the effectiveness of universal screening for language and speech delay in children under 5 years of age for short- and long-term outcomes.We conducted a literature search up to the 20th of November 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported on the accuracy of the screening tests for detecting language and speech delay, the efficacy of existing interventions for children with language and speech delay, and the potential harms associated with screening and the associated interventions.Several screening tools are used to assess language and speech delay with a wide variation in their accuracy. Targeted interventions improve some measures of speech and language delay and disorders. However, there is no evidence on the effectiveness of such interventions in children detected by screening with no specific concerns about their speech or language before screening. There is no evidence assessing whether universal screening for language and speech delay in a primary care setting improves short and long-term outcomes (including speech and language outcomes and other outcomes). Finally, there is no evidence on the harms of screening for language and speech delay in primary care settings, and there is limited evidence assessing the potential harms of interventions.

Sign in / Sign up

Export Citation Format

Share Document