Participantsʼ Reflections on a Home-Based Rehabilitation Intervention for People Living With HIV in KwaZulu-Natal, South Africa

Background Prescription drug diversion, and misuse has increased over the past decade and is notably in high-income-countries and significantly contributes to the opioid epidemic. People living with HIV (PLWH) are particularly vulnerable to prescription drug diversion, and misuse as most experience chronic pain, mental health problems and HIV-related illnesses. The researchers investigated the prevalence and correlates of prescription drug diversion, and misuse among PLWH in the eThekwini district, KwaZulu-Natal. Methods A cross-sectional study was conducted among 392 PLWH, conveniently recruited from the public healthcare facilities located in rural, semi-urban and urban areas of the eThekwini district. Participants answered questions about their background, prescription medications, substance use, and prescription drug diversion, and misuse. Descriptive analysis was performed to estimate the prevalence of prescription drug diversion, and misuse. Multivariable logistic regression was used to identify predictors of prescription drug diversion, and misuse. Findings Overall, 13% of the participants reported lifetime prescription drug diversion. The most common type of diversion was using prescription medication not prescribed by a healthcare provider (11%), followed by sharing of prescription medication (9%) and buying prescription medication without a medical script (5%). Twenty-three per cent of the participants reported prescription drug misuse in the past 90 days, with using prescription medication without a healthcare providers’ guidance (9%) and not following the scheduled time periods (8%) being the most common reported types of misuse. Self-medicating was identified as a risk factor for prescription drug misuse. There was no association between ART adherence and prescription drug diversion, and misuse. Conclusion The study findings contribute to improving the limited data available on prescription drug diversion, and misuse among PLWH in South Africa. The prevalence underscores a need for urgent interventions when prescribing medications with potential risks. Addressing the risk of self-medicating is imperative for HIV care outcomes and to avert death.

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MOTIVATIONAL FACTORS FOR CARING FOR PEOPLE LIVING WITH HIV IN SOUTH AFRICA: HOME-BASED CAREGIVERS’ EXPERIENCES

Social Work/Maatskaplike Werk ◽

10.15270/56-4-888 ◽

2020 ◽

Vol 56 (4) ◽

Author(s):

Robert Lekganyane

Keyword(s):

South Africa ◽

Motivational Factors ◽

People Living With Hiv ◽

Home Based ◽

Living With Hiv

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A pilot assessment of water, sanitation, hygiene and home-based care services for people living with HIV/AIDS in rural and peri-urban communities in South Africa

Water Science & Technology ◽

10.2166/wst.2007.564 ◽

2007 ◽

Vol 56 (5) ◽

pp. 125-131 ◽

Cited By ~ 6

Author(s):

N. Potgieter ◽

R. Koekemoer ◽

P. Jagals

Keyword(s):

South Africa ◽

Urban Communities ◽

Service Provision ◽

People Living With Hiv ◽

Short Term ◽

Care Services ◽

Home Based ◽

Living With Hiv ◽

Home Based Care ◽

Hiv Aids

A short-term assessment of water, sanitation, hygiene and home-based care services in two rural and two peri-urban communities in South Africa was made using specially designed questionnaires. The results from this assessment indicated the shortcomings of various sections in the service provision to people affected and living with HIV/AIDS in South Africa. This paper is a summarised version of the assessment and aims to give an indication of the inadequacies of some of these services.

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Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa

BMJ Global Health ◽

10.1136/bmjgh-2020-004089 ◽

2021 ◽

Vol 6 (4) ◽

pp. e004089

Author(s):

Hana Kim ◽

Frank Tanser ◽

Andrew Tomita ◽

Alain Vandormael ◽

Diego F Cuadros

Keyword(s):

South Africa ◽

High Resolution ◽

Optimal Allocation ◽

Healthcare Facility ◽

Hiv Prevalence ◽

People Living With Hiv ◽

Related Services ◽

Essential Information ◽

Kwazulu Natal ◽

Living With Hiv

IntroductionDespite progress towards the Joint United Nations Programme on HIV/AIDS 95-95-95 targets, South Africa is still suffering from one of the largest HIV epidemics globally. In this study, we generated high-resolution HIV prevalence maps and identified people living with HIV (PLHIV) in underserved areas to provide essential information for the optimal allocation of HIV-related services.MethodsThe data come from the South Africa Demographic and Health Survey conducted in 2016 and spatial variables from other published literature. We produced high-resolution maps of HIV prevalence and underserved areas, defined as a greater than 30 min travel time to the nearest healthcare facility. Using these maps and the population density, we mapped PLHIV and the PLHIV within underserved areas for 30, 60 and 120 min thresholds.ResultsThere was substantial geographic variation in HIV prevalence, ranging from 1.4% to 24.2%, with a median of 11.5% for men, and from 2.1% to 48.1%, with a median of 20.6% for women. Gauteng province showed the highest density for both HIV prevalence and PLHIV. 80% of all areas in the country were identified as underserved areas (30 min threshold), which contained more than 16% and 20% of the total men and women living with HIV, respectively. KwaZulu-Natal province had the largest number of PLHIV in underserved areas (30 min threshold) and showed less than one healthcare facility per 1000 PLHIV.ConclusionOur study showed extensive spatial variation of HIV prevalence and significant numbers of PLHIV in underserved areas in South Africa. Moreover, we identified locations where HIV-related services need to be intensified to reach the ~1.5 million PLHIV in underserved areas, particularly in KwaZulu-Natal province, with less than one healthcare facility per 1000 PLHIV.

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Counsellor-delivered HIV risk reduction intervention addresses safer sex barriers of people living with HIV in KwaZulu-Natal, South Africa

Psychology and Health ◽

10.1080/08870446.2011.552180 ◽

2011 ◽

Vol 26 (12) ◽

pp. 1623-1641 ◽

Cited By ~ 17

Author(s):

Deborah H. Cornman ◽

Sarah Christie ◽

Lindsay M. Shepherd ◽

Susan MacDonald ◽

K. Rivet Amico ◽

...

Keyword(s):

South Africa ◽

Risk Reduction ◽

Hiv Risk ◽

Safer Sex ◽

People Living With Hiv ◽

Hiv Risk Reduction ◽

Kwazulu Natal ◽

Risk Reduction Intervention ◽

Living With Hiv

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Assessing home-based rehabilitation within the development of an integrated model of care for people living with HIV in a resource-poor community

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v9i1.1374 ◽

2017 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Saul Cobbing ◽

Jill Hanass-Hancock ◽

Hellen Myezwa

Keyword(s):

Theoretical Model ◽

Policy Development ◽

Integrated Model ◽

Screening Tools ◽

People Living With Hiv ◽

Model Of Care ◽

Home Based ◽

Approach Training ◽

Kwazulu Natal ◽

Living With Hiv

Background: People living with HIV (PLHIV) are living longer lives but are at a greater risk of developing disability. South Africa has the largest antiretroviral therapy (ART) programme in the world, shifting HIV from a deadly to a chronic disease. The integration of rehabilitation into chronic care is therefore now crucial to ensure the highest quality of life of PLHIV.Aim: To describe how a home-based rehabilitation (HBR) programme adhered to the fundamental principles of a theoretical model of integrated care developed for the study setting in KwaZulu-Natal, South Africa.Method: The process and results from the HBR programme were assessed in relation to the model of care to ascertain which principles of the model were addressed with the HBR programme and which elements require further investigation.Results: The HBR programme was able to apply a number of principles such as evidence-based practice, task shifting to lay personnel, enabling patient-centred care and maximising function and independence of PLHIV. Other elements such as the adoption of a multidisciplinary approach, training on the use of disability screening tools and the use of evidence to influence policy development were more difficult to implement.Conclusion: It is possible to implement elements of the integrated model of care. Further research is needed to understand how principles that require further training and collaboration with other stakeholders can be implemented. The results of this study provide additional evidence towards understanding the feasibility of the theoretical model and what is required to adjust and test the full model.

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