The Impact of Cumulative Depression Along the HIV Care Continuum in Women Living With HIV During the Era of Universal Antiretroviral Treatment

Abstract For people living with HIV, there are multiple barriers to engagement with care. This study qualitatively examines the role of use of alcohol and other drugs (AOD) on the health and management of Human Immunodeficiency Virus (HIV) disease among older African Americans (≥50 years). It draws on interviews conducted with twenty-seven older African Americans living with HIV in the Louisville, Kentucky area. Interviews were transcribed verbatim and then analyzed using constructivist grounded theory analytic techniques. Participants’ understandings of their AOD use fell on a continuum of problematic use to use for self-care. Regardless of where participants fell on this continuum, they faced a) environmental impacts of AOD use and b) current or historic discrimination from the health care system. The analysis focused on gaining a deeper understanding of the intersection of AOD use and engagement in the HIV care continuum. This revealed six major phases, which occurred at various stages of the continuum: (1) Linking AOD use as the cause of HIV diagnosis (2) Having AOD use facilitate denial of HIV, (3) Experiencing problematic use, (4) “Testing the Waters,” (5) Relying on AIDS Service Organizations (ASO) and medical providers and (6) Maintaining health and/or using AOD for self-care. We discuss the ways that stigma along the lines of race, gender, and age intersect with co-occurring conditions such as substance use disorders in complex and multifaceted ways. Recommendations include assessing a patients’ AOD use in relationship to the HIV care continuum to assess patients’ experiences and barriers within systems of care.

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Household Decision-Making and HIV Care Continuum Outcomes Among Women Living with HIV in Mozambique

AIDS Patient Care and STDs ◽

10.1089/apc.2019.0268 ◽

2020 ◽

Vol 34 (4) ◽

pp. 173-183

Author(s):

Angela M. Parcesepe ◽

Maria Lahuerta ◽

Matthew R. Lamb ◽

Laurence Ahoua ◽

Fatima Abacassamo ◽

...

Keyword(s):

Decision Making ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Household Decision ◽

Women Living With Hiv ◽

Household Decision Making ◽

Living With Hiv

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Barriers to HIV care among Francophone African, Caribbean and Black immigrant people living with HIV in Canada: a protocol for a scoping systematic review

BMJ Open ◽

10.1136/bmjopen-2018-027440 ◽

2019 ◽

Vol 9 (1) ◽

pp. e027440 ◽

Cited By ~ 2

Author(s):

Pascal Djiadeu ◽

Joseph Nguemo ◽

Chantal Mukandoli ◽

Apondi J Odhiambo ◽

David Lightfoot ◽

...

Keyword(s):

Systematic Review ◽

Social Determinant ◽

Hiv Care ◽

Published Data ◽

People Living With Hiv ◽

Hiv Care Continuum ◽

Care Continuum ◽

French Speaking ◽

Living With Hiv ◽

The Impact

IntroductionLanguage is a social determinant of health. Addressing social determinants of health is paramount to successful progression along the HIV-care continuum. Canada is a bilingual country with French and English as official languages. There are few studies to date that have focused on the impact of being a French-speaking linguistic minority on the HIV-care continuum. The primary objective of this scoping, systematic review of literature is to evaluate existing gaps in access to HIV- care among French-speaking people living with HIV in Canada. Our primary outcome is healthcare services availability and access for French- speaking people living with HIV.Methods and analysesOur scoping, systematic review will draw on a systematic search of published literature, both quantitative and qualitative studies published on French-speaking individuals' healthcare and HIV status in Canada, with particular emphasis on the province of Ontario. We will conduct our search in MEDLINE, the Excerpta Medica Database, the Cumulative Index to Nursing and Allied Health Literature, Web of Science, EBSCO and Google Scholar for work published between 1990 and 2018. Identified articles will be screened in duplicate and full-text articles of relevant studies will be retrieved. Data will also be extracted by two researchers working independently. Any discrepancies that arise will be resolved by consensus or by consulting a third author. Our findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationOur proposed research will not be conducted with human participants. We will only use secondary published data and therefore ethics approval is not required. Our findings will be disseminated as peer reviewed manuscripts at conferences and student rounds, and could be of interest to government health agencies and local HIV/AIDS service organisations.

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Text Messaging Improves HIV Care Continuum Outcomes Among Young Adult Trans Women Living with HIV: Text Me, Girl!

AIDS and Behavior ◽

10.1007/s10461-021-03352-3 ◽

2021 ◽

Author(s):

Cathy J. Reback ◽

Jesse B. Fletcher ◽

Kimberly A. Kisler

Keyword(s):

Young Adult ◽

Text Messaging ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Women Living With Hiv ◽

Trans Women ◽

Living With Hiv

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Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon

BMC Health Services Research ◽

10.1186/s12913-021-06331-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marwân-al-Qays Bousmah ◽

Marie Libérée Nishimwe ◽

Christopher Kuaban ◽

Sylvie Boyer

Keyword(s):

Socioeconomic Status ◽

Health Expenditure ◽

Antiretroviral Treatment ◽

Catastrophic Health Expenditure ◽

Hiv Care ◽

Free Access ◽

People Living With Hiv ◽

Art Policy ◽

Living With Hiv ◽

The Impact

Abstract Background To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon’s free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country’s treatment access program. Methods Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006–2007 and 2014 (i.e., before and after the policy’s implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy’s implementation. Conclusions Our findings suggest that Cameroon’s free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.

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Influence of Material Deprivation on Clinical Outcomes Among People Living with HIV in High-Income Countries: A Systematic Review and Meta-analysis

AIDS and Behavior ◽

10.1007/s10461-021-03551-y ◽

2021 ◽

Author(s):

Vasiliki Papageorgiou ◽

Bethan Davies ◽

Emily Cooper ◽

Ariana Singer ◽

Helen Ward

Keyword(s):

Systematic Review ◽

Social Determinants ◽

Meta Analysis ◽

Hiv Treatment ◽

Material Deprivation ◽

Hiv Care ◽

People Living With Hiv ◽

Hiv Care Continuum ◽

Care Continuum ◽

Living With Hiv

AbstractDespite developments in HIV treatment and care, disparities persist with some not fully benefiting from improvements in the HIV care continuum. We conducted a systematic review to explore associations between social determinants and HIV treatment outcomes (viral suppression and treatment adherence) in high-income countries. A random effects meta-analysis was performed where there were consistent measurements of exposures. We identified 83 observational studies eligible for inclusion. Social determinants linked to material deprivation were identified as education, employment, food security, housing, income, poverty/deprivation, socioeconomic status/position, and social class; however, their measurement and definition varied across studies. Our review suggests a social gradient of health persists in the HIV care continuum; people living with HIV who reported material deprivation were less likely to be virologically suppressed or adherent to antiretrovirals. Future research should use an ecosocial approach to explore these interactions across the lifecourse to help propose a causal pathway.

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Utility and acceptability of text messages for PMTCT: a qualitative assessment of user experiences (Preprint)

10.2196/preprints.32272 ◽

2021 ◽

Author(s):

Melinda Brown ◽

May Maloba ◽

Catherine Wexler ◽

Natabhona Mabachi ◽

Sharon Koech ◽

...

Keyword(s):

Medication Adherence ◽

Pilot Study ◽

Clinical Care ◽

Text Messages ◽

Hiv Care ◽

Qualitative Assessment ◽

Women Living With Hiv ◽

Pregnancy And Postpartum ◽

Living With Hiv ◽

The Impact

BACKGROUND Evidence that text messages can support patient adherence to HIV care is growing. We conducted a pilot study of the HIV Infant Tracking System (HITSystem 2.0), an intervention that includes SMS to patients to support maternal medication adherence, appointment attendance, and hospital-based deliveries during the antenatal period. OBJECTIVE The objective of this study was to qualitatively assess women’s experiences receiving SMS to understand message utility and acceptability with the goal of refining and strengthening the intervention. METHODS As part of an intervention development pilot study, we conducted semi-structured interviews with 33 women living with HIV who received SMS through the HITSystem 2.0 throughout their pregnancy and postpartum period. Interview questions assessed women’s feedback of the SMS, the impact of the SMS on their PMTCT care, and suggestions for improvement. RESULTS Participants described how SMS reinforced existing strategies for medication adherence and served as cues to action for antenatal appointments and hospital-based deliveries. SMS also provided encouragement and enhanced their sense of engagement with their clinical care team. Given the neutral content of the messages, most women reported no concerns about message confidentiality. Recommendations to enhance utility included greater customizability (timing and frequency of messages) and a few women suggested more comprehensive counseling regarding the SMS content to anticipate at the time of enrollment. CONCLUSIONS SMS content was deemed useful and acceptable by pregnant and postpartum women living with HIV and engaged in PMTCT services. Participant recommendations to increase message customization options have been adopted to enhance the intervention. CLINICALTRIAL Trial registration: clinicaltrials.gov, NCT02726607. Registered 01 April 2016. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02726607

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Motivational Interviewing and the Adolescent/Young Adult HIV Care Continuum

Motivational Interviewing in HIV Care ◽

10.1093/med/9780190619954.003.0005 ◽

2019 ◽

pp. 37-46

Author(s):

Sylvie Naar ◽

Maurice Bulls

Keyword(s):

Young Adult ◽

Motivational Interviewing ◽

Behavioral Therapy ◽

Hiv Care ◽

Behavior Changes ◽

Hiv Care Continuum ◽

Care Continuum ◽

Future Direction ◽

Youth Living With Hiv ◽

Living With Hiv

This chapter explores the HIV care continuum specifically with youth living with HIV (YLH). The authors review relevant HIV statistics, including the trends in YLH. The authors then examine the fit of motivational interviewing (MI) with adolescent development, arguing that it is an excellent strategy to include in promoting self-management of HIV. Multiple examples are also provided for programs and interventions using MI with youth. This chapter provides specific details on how MI can be leveraged in working with YLH, although many of these insights can generalize to adult populations. In the final section, the authors examine the future direction of MI in the care of YLH. They argue that once MI has helped to motivate YLH toward change, the substitution for or addition of cognitive-behavioral therapy (CBT) may be warranted. In this way, the more action-oriented strategies of CBT strengthen the behavior changes that MI has helped to put in motion.

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