Randomized Clinical Trial of HIV Treatment Adherence Counseling Interventions for People Living With HIV and Limited Health Literacy

AbstractClinical outcomes among adolescents living with HIV (ALHIV) might be improved by interventions aimed at addressing limited health literacy. We developed a Spanish-language rap video on HIV concepts and examined its acceptability and feasibility as a learning tool among ALHIV in Lima, Peru. Twenty-eight ALHIV receiving care at an urban pediatric hospital and ten stakeholders engaged in the care of adolescents watched the video. Adolescents completed a pre- and post-video questionnaire. We conducted focus groups with ALHIV and in-depth interviews with stakeholders and analyzed transcripts to identify themes. ALHIV described concepts of CD4 cell count and viral load as they were portrayed. Participants reported the video was relatable, accessible, and provided hope that ALHIV could lead healthy lives and advocated for future videos to address topics such as transmission and sexual health. Questionnaires indicated some improvement in viral load knowledge. An HIV health literacy music video intervention was feasible to implement and accepted by ALHIV and their healthcare providers. Communicating HIV knowledge via music videos may be promising; further study is needed to optimize implementation.

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Race-based medical mistrust, medication beliefs and HIV treatment adherence: test of a mediation model in people living with HIV/AIDS

Journal of Behavioral Medicine ◽

10.1007/s10865-016-9767-1 ◽

2016 ◽

Vol 39 (6) ◽

pp. 1056-1064 ◽

Cited By ~ 26

Author(s):

Seth C. Kalichman ◽

Lisa Eaton ◽

Moira O. Kalichman ◽

Tama Grebler ◽

Cynthia Merely ◽

...

Keyword(s):

Treatment Adherence ◽

Hiv Treatment ◽

People Living With Hiv ◽

Medical Mistrust ◽

Mediation Model ◽

Medication Beliefs ◽

Adherence Test ◽

Living With Hiv ◽

Hiv Aids

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Associations between substance use, sexual risk taking and HIV treatment adherence among homeless people living with HIV

AIDS Care ◽

10.1080/09540120802513709 ◽

2009 ◽

Vol 21 (6) ◽

pp. 692-700 ◽

Cited By ~ 45

Author(s):

Mark S. Friedman ◽

Michael P. Marshal ◽

Ron Stall ◽

Daniel P. Kidder ◽

Kirk D. Henny ◽

...

Keyword(s):

Substance Use ◽

Sexual Risk ◽

Treatment Adherence ◽

Risk Taking ◽

Homeless People ◽

Hiv Treatment ◽

Sexual Risk Taking ◽

People Living With Hiv ◽

Living With Hiv

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Linguistic and Cultural Adaptation of a Computer-Based Counseling Program (CARE+ Spanish) to Support HIV Treatment Adherence and Risk Reduction for People Living With HIV/AIDS: A Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/jmir.5830 ◽

2016 ◽

Vol 18 (7) ◽

pp. e195 ◽

Cited By ~ 11

Author(s):

Ann E Kurth ◽

Nok Chhun ◽

Charles M Cleland ◽

Michele Crespo-Fierro ◽

José A Parés-Avila ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Treatment Adherence ◽

Cultural Adaptation ◽

Controlled Trial ◽

Hiv Treatment ◽

People Living With Hiv ◽

Counseling Program ◽

Randomized Controlled ◽

Computer Based ◽

Living With Hiv

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Comparative effects of telephone versus in-office behavioral counseling to improve HIV treatment outcomes among people living with HIV in a rural setting

Translational Behavioral Medicine ◽

10.1093/tbm/ibaa109 ◽

2020 ◽

Author(s):

Seth C Kalichman ◽

Harold Katner ◽

Lisa A Eaton ◽

Ellen Banas ◽

Marnie Hill ◽

...

Keyword(s):

Treatment Adherence ◽

Self Regulation ◽

Hiv Treatment ◽

People Living With Hiv ◽

Evidence Based ◽

Health Counseling ◽

Behavioral Health Counseling ◽

Hiv Treatment Outcomes ◽

Living With Hiv ◽

Delivery Formats

Abstract With the expansion of telehealth services, there is a need for evidence-based treatment adherence interventions that can be delivered remotely to people living with HIV. Evidence-based behavioral health counseling can be delivered via telephone, as well as in-office services. However, there is limited research on counseling delivery formats and their differential outcomes. The purpose of this study was to conduct a head-to-head comparison of behavioral self-regulation counseling delivered by telephone versus behavioral self-regulation counseling delivered by in-office sessions to improve HIV treatment outcomes. Patients (N = 251) deemed at risk for discontinuing care and treatment failure living in a rural area of the southeastern USA were referred by their care provider. The trial implemented a Wennberg Randomized Preferential Design to rigorously test: (a) patient preference and (b) comparative effects on patient retention in care and treatment adherence. There was a clear patient preference for telephone-delivered counseling (69%) over in-office-delivered counseling (31%) and participants who received telephone counseling completed a greater number of sessions. There were few differences between the two intervention delivery formats on clinical appointment attendance, antiretroviral adherence, and HIV viral load. Overall improvements in health outcomes were not observed across delivery formats. Telephone-delivered counseling did show somewhat greater benefit for improving depression symptoms, whereas in-office services demonstrated greater benefits for reducing alcohol use. These results encourage offering most patients the choice of telephone and in-office behavioral health counseling and suggest that more intensive interventions may be needed to improve clinical outcomes for people living with HIV who may be at risk for discontinuing care or experiencing HIV treatment failure.

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The Bio/Necropolitics of ACTG 076: Lessons from Pregnant Women of Colour Living with HIV for Treatment for Prevention in the Twenty-first Century

Somatechnics ◽

10.3366/soma.2020.0315 ◽

2020 ◽

Vol 10 (2) ◽

pp. 233-253

Author(s):

Eli Manning

Keyword(s):

Hiv Transmission ◽

Ethical Dilemmas ◽

Hiv Treatment ◽

First Century ◽

Hiv Positive ◽

Treatment As Prevention ◽

People Living With Hiv ◽

Hiv Positive Women ◽

Aids Clinical Trials ◽

Living With Hiv

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.

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Malaysian Health Literacy: Scorecard Performance from a National Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115813 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5813

Author(s):

Norrafizah Jaafar ◽

Komathi Perialathan ◽

Manimaran Krishnan ◽

Nurashma Juatan ◽

Masitah Ahmad ◽

...

Keyword(s):

Health Literacy ◽

Nationwide Survey ◽

Population Based ◽

Average Score ◽

Future Health ◽

Limited Health Literacy ◽

Health Literacy Level ◽

Prevention And Health Promotion ◽

Literacy Level ◽

Limited Health

Health literacy is an indicator of a society’s ability to make better health judgements for themselves and the people around them. This study investigated the prevalence of health literacy among Malaysian adults and provided an overall picture of the society’s current health literacy status, which has not been previously assessed. The study also highlighted socio-demographic markers of communities with limited health literacy that may warrant future intervention. A population-based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized a two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above, drawn from the living quarter list, participated in the study. The health literacy score was divided into three levels; limited, sufficient, and excellent. Findings showed a majority of the Malaysian population had a sufficient health literacy level in all three domains—healthcare, diseases prevention and health promotion (49.1%, 44.2%, and 47.5%, respectively)—albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups were prevalent among respondents with older age (68%), lower education level (64.8%), and lower household income (49.5%). The overall health literacy status for Malaysia was categorized at a lower sufficiency level. Future health literacy improvements should focus on communities with a limited health literacy level to improve the overall score.

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Health literacy level in a various nephrology population from Québec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study

BMC Nephrology ◽

10.1186/s12882-021-02464-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Annabel Boyer ◽

Yannick Begin ◽

Julie Dupont ◽

Mathieu Rousseau-Gagnon ◽

Nicolas Fernandez ◽

...

Keyword(s):

Health Literacy ◽

Observational Study ◽

Health Information ◽

Healthcare Providers ◽

Significant Proportion ◽

Good Health ◽

Sufficient Information ◽

Home Dialysis ◽

Limited Health Literacy ◽

Limited Health

Abstract Background Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD). Methods This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups. Results Patients on PD had a significantly higher BHLS’score than patients on ICHD (p = 0.04). HLQ’s scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001). Conclusion In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.

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