Optimizing switching strategies to simplify antiretroviral therapy: the future of second-line from a public health perspective

Multiple factors make adherence to antiretroviral therapy (ART) a complex process. This study aims to describe the barriers and facilitators to adherence for patients receiving first-line and second-line ART, identify different adherence strategies utilized and make recommendations for an improved adherence strategy. This mixed method parallel convergent study will be conducted in seven high volume public health facilities in Gauteng and one in Limpopo province in South Africa. The study consists of four phases; a retrospective secondary data analysis of a large cohort of patients on ART (using TIER.Net, an ART patient and data management system for recording and monitoring patients on ART and tuberculosis (TB)) from seven Johannesburg inner-city public health facilities (Gauteng province); a secondary data analysis of the Intensified Treatment Monitoring Accumulation (ITREMA) trial (a randomized control trial which ran from June 2015 to January 2019) conducted at the Ndlovu Medical Center (Limpopo province); in-depth interviews with people living with Human Immunodeficiency Virus (PLHIV) who are taking ART (in both urban and rural settings); and a systematic review of the impact of treatment adherence interventions for chronic conditions in sub-Saharan Africa. Data will be collected on demographics, socio-economic status, treatment support, retention in care status, disclosure, stigma, clinical markers (CD4 count and viral load (VL)), self-reported adherence information, intrapersonal, and interpersonal factors, community networks, and policy level factors. The systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting and Population, Interventions, Comparisons and Outcomes (PICO) criteria. Analyses will involve tests of association (Chi-square and t-test), thematic analysis (deductive and inductive approaches) and network meta-analysis. Using an integrated multilevel socio-ecological framework this study will describe the factors associated with adherence for PLHIV who are taking first-line or second-line ART. Implementing evidence-based adherence approaches, when taken up, will improve patient’s overall health outcomes. Our study results will provide guidance regarding context-specific intervention strategies to improve ART adherence.

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The Social Roots of Sexual Violence

Contexts ◽

10.1177/15365042211058131 ◽

2021 ◽

Vol 20 (4) ◽

pp. 72-73

Author(s):

Kelsey J. Drotning

Keyword(s):

Public Health ◽

Sexual Assault ◽

Sexual Violence ◽

Public Health Perspective ◽

Campus Sexual Assault ◽

The Social ◽

The Future ◽

Landmark Study ◽

Ecological Public Health

In their book, Sexual Citizens: A Landmark Study of Sex, Power, and Assault on Campus, Jennifer S. Hirsch and Shamus Khan seek to understand why campus sexual assault happens and what can be done to prevent it in the future by identifying its social roots. The book approaches sexual assault from an ecological public health perspective, but I think at its core, I think it is also an argument for dismantling power disparities within institutions.

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A Public Health Perspective on Paying for Dentistry, the Affordable Care Act, and Looking to the Future

Dental Clinics of North America ◽

10.1016/j.cden.2017.12.002 ◽

2018 ◽

Vol 62 (2) ◽

pp. 327-340 ◽

Cited By ~ 2

Author(s):

Burton L. Edelstein

Keyword(s):

Public Health ◽

Affordable Care Act ◽

Public Health Perspective ◽

The Future ◽

The Affordable Care Act

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PCN83 BUDGET IMPACT ANALYSIS OF OSIMERTINIB VERSUS PEMETREXED FOR THE SECOND-LINE TREATMENT OF ADVANCED LUNG CANCER WITH T790M POSITIVE FROM PUBLIC HEALTH PERSPECTIVE IN CHILE

Value in Health ◽

10.1016/j.jval.2019.04.207 ◽

2019 ◽

Vol 22 ◽

pp. S71 ◽

Cited By ~ 1

Author(s):

C. Balmaceda ◽

R. Rojas

Keyword(s):

Public Health ◽

Lung Cancer ◽

Impact Analysis ◽

Budget Impact ◽

Budget Impact Analysis ◽

Advanced Lung Cancer ◽

Line Treatment ◽

Second Line ◽

Public Health Perspective

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Study protocol: Strengthening understanding of effective adherence strategies for first-line and second-line antiretroviral therapy (ART) in selected rural and urban communities in South Africa

10.1101/2021.05.04.21256648 ◽

2021 ◽

Author(s):

Siphamandla Bonga Gumede ◽

John Benjamin Frank de Wit ◽

Willem Daniel Francois Venter ◽

Samanta Tresha Lalla-Edward

Keyword(s):

Public Health ◽

South Africa ◽

Systematic Review ◽

Data Analysis ◽

Antiretroviral Therapy ◽

Secondary Data ◽

Limpopo Province ◽

Second Line ◽

First Line ◽

Public Health Facilities

Multiple factors make adherence to antiretroviral therapy (ART) a complex process. This study aims to describe the barriers and facilitators to adherence for patients receiving first-line and second-line ART, identify different adherence strategies utilized and make recommendations for an improved adherence strategy. This mixed method parallel convergent study will be conducted in seven high volume public health facilities in Gauteng and one in Limpopo province in South Africa. The study consists of four phases; a retrospective secondary data analysis of a large cohort of patients on ART (using TIER.Net, an ART patient and data management system for recording and monitoring patients on ART and tuberculosis (TB) from seven Johannesburg inner-city public health facilities (Gauteng province); a secondary data analysis of the Intensified Treatment Monitoring Accumulation (ITREMA) trial (a randomized control trial which ran from June 2015 to January 2019) conducted at the Ndlovu Medical Center (Limpopo province); in-depth interviews with HIV infected patients on ART (in both urban and rural settings); and a systematic review of the impact of treatment adherence interventions for chronic conditions in sub-Saharan Africa. Data will be collected on demographics, socio-economic status, treatment support, retention in care status, disclosure, stigma, clinical markers (CD4 count and viral load), self-reported adherence information, intrapersonal, and interpersonal factors, community networks, and policy level factors. The systematic review will follow the PRISMA reporting and PICO criteria. Analyses will involve tests of association (Chi-square and t-test), thematic analysis (deductive and inductive approaches) and network meta-analysis. Using an integrated multilevel socio-ecological framework this study will describe the factors associated with adherence for HIV infected patients who are taking first-line or second-line ART. Implementing evidence-based adherence approaches, when taken up, will improve patients overall health outcomes. Our study results will provide guidance regarding context-specific intervention strategies to improve ART adherence.

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Future of keeping pet reptiles and amphibians: animal welfare and public health perspective

Veterinary Record ◽

10.1136/vr.j4640 ◽

2017 ◽

Vol 181 (17) ◽

pp. 454-455 ◽

Cited By ~ 5

Author(s):

C. Warwick ◽

M. Jessop ◽

P. Arena ◽

A. Pliny ◽

E. Nicholas ◽

...

Keyword(s):

Public Health ◽

Animal Welfare ◽

Public Health Perspective ◽

Health Implications ◽

The Future

In a review summary on page 450, Pasmans and others discuss the future of keeping reptiles and amphibians as pets. Here,Clifford Warwick and othersdiscuss the animal welfare and public health implications of exotic pet business.

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Global warming and Australian public health: reasons to be concerned

Australian Health Review ◽

10.1071/ah090611 ◽

2009 ◽

Vol 33 (4) ◽

pp. 611 ◽

Cited By ~ 11

Author(s):

Peng Bi ◽

Arthur Saniotis

Keyword(s):

Public Health ◽

Climate Change ◽

Global Warming ◽

Heat Stress ◽

Marked Effect ◽

Heat Waves ◽

Human Populations ◽

Public Health Perspective ◽

Future Studies ◽

The Future

Studies in global warming and climate change indicate that human populations will be deleteriously affected in the future. Studies forecast that Australia will experience increasing heat waves and droughts. Heat stress caused by frequent heat waves will have a marked effect on older Australians due to physiological and pharmacological factors. In this paper we present an overview of some of the foreseeable issues which older Australians will face from a public health perspective.

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