scholarly journals Integrated care experiences and out-of-pocket expenditures: a cross-sectional survey of adults receiving treatment for HIV and hypertension in Malawi

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032652
Author(s):  
Corrina Moucheraud ◽  
Matthew Hing ◽  
Juliet Seleman ◽  
Khumbo Phiri ◽  
Florence Chibwana ◽  
...  
Keyword(s):  
Integrated Care ◽  
Antihypertensive Medication ◽  
Cost Of Care ◽  
Hiv Care ◽  
Hiv Positive ◽  
Care Seeking ◽  
Cross Sectional Survey ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Medication Costs

ObjectivesAs HIV-positive individuals’ life expectancy extends, there is an urgent need to manage other chronic conditions during HIV care. We assessed the care-seeking experiences and costs of adults receiving treatment for both HIV and hypertension in Malawi.Design, setting and participantsA cross-sectional survey was conducted with HIV-positive adults with hypertension at a health facility in Lilongwe that offers free HIV care and free hypertension screening, with antihypertensives available for purchase (n=199). Questions included locations and costs of all medication refills and preferences for these refill locations. Respondents were classified as using ‘integrated care’ if they refilled HIV and antihypertensive medications simultaneously. Data were collected between June and December 2017.ResultsOnly half of respondents reported using the integrated care offered at the study site. Among individuals using different locations for antihypertensive medication refills, the most frequent locations were drug stores and public sector health facilities which were commonly selected due to greater convenience and lower medication costs. Although the number of antihypertensive medications was equivalent between the integrated and non-integrated care groups, the annual total cost of care differed substantially (approximately US$21 in integrated care vs US$90 for non-integrated care)—mainly attributable to differences in other visit costs for non-integrated care (transportation, lost wages, childcare). One-third of those in the non-integrated care group reported no expenditure for antihypertensive medication, and six people in each group reported no annual hypertension care-seeking costs at all.ConclusionsIndividuals using integrated care saw efficiencies because, although they were more likely to pay for antihypertensive medications, they did not incur additional costs. These results suggest that preferences and experiences must be better understood to design effective policies and programmes for integrated care among adults on antiretroviral therapy.

scholarly journals Factors Associated with Delayed Enrollment in HIV Medical Care among HIV-Positive Individuals in Odessa Region, Ukraine

2016 ◽  
Vol 16 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Oleksandr Neduzhko ◽  
Oleksandr Postnov ◽  
Ihor Perehinets ◽  
Jack DeHovitz ◽  
Michael Joseph ◽  
...  
Keyword(s):  
Linkage To Care ◽  
Hiv Care ◽  
Hiv Positive ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Hiv Test ◽  
Delayed Enrollment ◽  
Specialized Care ◽  
History Of

In Ukraine, about one-third of identified HIV-positive individuals are not connected to care. We conducted a cross-sectional survey (n = 200) among patients registered at Odessa AIDS centers in October to December 2011. Factors associated with delayed enrollment in HIV care (>3 months since positive HIV test) were evaluated using logistic regression. Among study participants (mean age 35 ± 8.2 years, 47.5% female, 42.5% reported history of injecting drugs), 55% delayed HIV care enrollment. Odds of delayed enrollment were higher for those with lower educational attainment (adjusted odds ratio [aOR]: 2.65, 95% confidence interval [CI]: 1.04-6.76), not feeling ill (aOR: 2.98, 95% CI: 1.50-5.93), or not having time to go to the AIDS center (aOR: 3.89, 95% CI: 1.39-10.89); injection drug use was not associated with delayed enrollment. Programs linking HIV-positive individuals to specialized care should address enrollment barriers and include education on HIV care benefits and case management for direct linkage to care. HIV testing and treatment should be coupled to ensure a continuum of care.

scholarly journals HIV serodiscordant and nondisclosure rates among married women living with HIV in a Southern Nigerian region

2021 ◽  
Vol 5 ◽  
pp. 53-60
Author(s):  
Ubong Bassey Akpan ◽  
Kazeem Arogundade ◽  
Ezukwa Omoronyia ◽  
Atim Udo ◽  
Mabel Ekott ◽  
...  
Keyword(s):  
Married Women ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Hiv Status Disclosure ◽  
Status Disclosure

Objectives: Intimate sexual partners’ disclosure of HIV positive status is vital in the control of HIV/AIDS pandemic globally. The disclosure rates vary from region to region. The aim of this study was to document the prevalence of HIV serodiscordance and partners disclosure rate; and also determine the associated factors among HIV positive married women living in Calabar region of Nigeria. Material and Methods: A cross-sectional survey was conducted among 260 married women, 18 years and above, receiving HIV care at various health institutions in the region. Data were analyzed using SPSS VERSION 23. Their demographic and health profile were presented in simple proportion and percentages while Chi-square test and logistic regression were used to determine the factors influencing patient’s HIV status disclosure with the level of significance set at 0.05. Results: A total of 254 compiled questionnaires were included in the analysis (response rate-97.7%). The serodiscordant rate was 50%. HIV status disclosure to partner was high, 89.4%. The main determinants of HIV status disclosure were good level of education (AOR = 2.2, 95% CI: = 1.75–2.53, P = 0.007) and long duration of ART use (AOR = 3.23, 95% CI = 2.78–4.15, P = 0.001) while women with high discordant rate were more likely to be divorced/separated (P = 0.012, OR = 1.67). Conclusion: Female education is an important factor in HIV control. Disclosure of HIV status is beneficial to the partner as it promotes safe sex practices and increases adherence to ART.

scholarly journals HEALTH CARE-SEEKING BEHAVIOUR OF COASTAL COMMUNITIES IN BANYUWANGI, INDONESIA: RESULTS OF A CROSS-SECTIONAL SURVEY

Jurnal NERS ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 66
Author(s):  
Susy Katikana Sebayang ◽  
Erni Astutik ◽  
Desak Made Sintha Kurnia Dewi ◽  
Ayik Mirayanti Mandagi ◽  
Septa Indra Puspikawati
Keyword(s):  
Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Coastal Communities ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Seeking Behavior ◽  
Seeking Behavior

Introduction:  Improving health care-seeking behavior of the coastal communities is a pathway to improve their health. This analysis aims to explore the health care-seeking behavior of the coastal communities in Banyuwangi District to recommend the room for improvement for health promotion and health service improvement for these communities. Method: Data from a cross-sectional survey of metabolic syndrome and mental health conducted in coastal communities in Banyuwangi was used for analysis.  Randomly selected participants from a list of members of Family Welfare Development Group (Pembinaan Kesejahteraan Keluarga /PKK) were asked for an interview at corresponding village office in Ketapang, Bangsring, Bulu Agung, Grajagan and Kampung Mandar village.  Distribution of health care-seeking behaviors was analyzed individually and where possible were segregated by gender and age. Results: More than half of the coastal communities in Banyuwangi District went to health care service to seek health and 7 out of 10 turned to health care service to seek health for their family members.  Women more than men turned to health care service when they or their family members fell ill.  Private doctors rather than Puskesmas were more popular.  Private midwives were the most popular service for antenatal care (ANC) and delivery.  Although there was not a clear increase in health care service utilization over time, we found that contraceptive utilization increased with time. Conclusion: The utilization of health care service in Banyuwangi needs to be more promoted especially for men’s health.  

scholarly journals The reporting of the mode of transmission among HIV-positive men who have sex with men in Lviv oblast, Ukraine, 2014-2018

2020 ◽  
Vol 14 (11.1) ◽  
pp. 122S-127S
Author(s):  
Maryana Sluzhynska ◽  
Olga Denisiuk ◽  
Ruzanna Grigoryan ◽  
Yulia Sereda ◽  
Gennadiy Slabkiy ◽  
...  
Keyword(s):  
Urban Areas ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Medical Doctor ◽  
Hiv Care ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Aids Epidemic ◽  
Mode Of Transmission ◽  
Sex With Men

Introduction: Men who have sex with men (MSM) are one of the key populations driving HIV/AIDS epidemic globally. To date, MSM is the only population in Ukraine where the prevalence and incidence of HIV is increasing. As HIV-positive MSM might feel uncomfortable to report homosexual intercourses as a possible mode of transmission (MoT) of HIV, they prefer being registered as patients with heterosexual or non-defined MoT. This study aimed to calculate the proportion of misclassified MoT among HIV-positive MSM registered in Lviv oblast, Ukraine, during 2014-2018. Methodology: Cross-sectional study with 127 HIV-positive MSM patients from Lviv region for the period of 2014-2018. Results: Out of 127 HIV-positive MSM included in the study, 110 (86.6%) were from urban areas. In addition, 52 patients (40.9%) were diagnosed with stage 1 HIV, 16 (12.6%) – stage 2, 19 (15%) – stage 3, and 36 (28.3%) – stage 4. CD4 count < 200 cells/μL was found in 35 (27.6%) patients. Mean time from registration to antiretroviral therapy initiation was 80 days. During the first visit to medical doctor out of those 48 patients who had previously reported “other modes” of HIV transmission, 33 patients (68.7%) disclosed homosexual MoT of HIV. The remaining 15 (31.3%) patients disclosed their homosexual MoT of HIV later – during their regular follow-up visits to the doctor. Conclusion: Special measures are needed to improve the reporting of homosexual MoT which can potentially strengthen the HIV care among MSM.

scholarly journals Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Adedapo Olufemi Bashorun ◽  
Christopher Linda ◽  
Semeeh Omoleke ◽  
Lindsay Kendall ◽  
Simon D. Donkor ◽  
...  
Keyword(s):  
Care Seeking ◽  
Health Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tb Control ◽  
Care Cascade ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice ◽  
Selection Of ◽  
Structured Questionnaire

Abstract Background Early diagnosis and treatment of tuberculosis (TB) are the mainstay of global and national TB control efforts. However, the gap between expected and reported cases persists for various reasons attributable to the TB services and care-seeking sides of the TB care cascade. Understanding individual and collective perspectives of knowledge, attitudes, beliefs and other social circumstances around TB can inform an evidence-based approach in engaging communities and enhance their participation in TB case detection and treatment. Methods The study was conducted during the Gambian survey of TB prevalence. This was a nationwide cross-sectional multistage cluster survey with 43,100 participants aged ≥15 years in 80 clusters. The study sample, a random selection of 10% of the survey population within each cluster responded to a semi-structured questionnaire administered by trained fieldworkers to assess the knowledge, attitudes and practice of the participants towards TB. Overall knowledge, attitude and practice scores were dichotomised using the computed mean scores and analysed using descriptive, univariable and multivariable logistic regression. Results All targeted participants (4309) were interviewed. Majority were females 2553 (59.2%), married 2614 (60.7%), had some form of education 2457 (57%), and were unemployed 2368 (55%). Although 3617 (83.9%) of the participants had heard about TB, only 2883 (66.9%) were considered to have good knowledge of TB. Overall 3320 (77%) had unfavourable attitudes towards TB, including 1896 (44%) who indicated a preference for staying away from persons with TB rather than helping them. However, 3607(83.7%) appeared to have the appropriate health-seeking behaviours with regard to TB as 4157 (96.5%) of them were willing to go to the health facility if they had symptoms suggestive of TB. Conclusions About 3 in 10 Gambians had poor knowledge on TB, and significant stigma towards TB and persons with TB persists. Interventions to improve TB knowledge and address stigma are required as part of efforts to reduce the burden of undiagnosed TB in the country.

scholarly journals May Measurement Month 2018: an analysis of blood pressure screening results from Chile

2020 ◽  
Vol 22 (Supplement_H) ◽  
pp. H37-H39
Author(s):  
Fernando Lanas ◽  
Maria Soledad Garcia ◽  
Melanie Paccot ◽  
Jimena Peña ◽  
Pamela Torres ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Blood Pressure Measurement ◽  
National Health Survey ◽  
Uncontrolled Hypertension ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Systematic Screening ◽  
Temporary Solution ◽  
Global Initiative

Abstract Hypertension is highly prevalent in Chile. The National Health Survey 2016–17 reported a 27.6% prevalence, 68.7% awareness, and 33.3% of hypertensives had controlled blood pressure (BP). May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. A cross-sectional survey of volunteers aged ≥18 years old was carried out in May 2018. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the MMM protocol. Ninety-four sites participated, most of them from the Public Health System outpatient clinics distributed along the country. In addition, universities, clinical research sites, and private clinics participated. Hypertension was diagnosed as mean systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or receiving antihypertensive medication. Overall 9344 individuals were screened. After multiple imputation, hypertension prevalence was 29.2%, of which 64.0% were aware of their condition. Of those aware of their hypertension diagnosis, 87.7% were receiving antihypertensive medication and 56.1% of the total number of hypertensives were on antihypertensive medication. Moreover, 15.3% of the participants who were not receiving treatment were considered potential hypertensives identified in the MMM18. MMM18 was one of the largest BP screening campaigns performed in Chile. It demonstrated a high prevalence of hypertension with one-third of these individuals having controlled BP. The high percentage of persons untreated or with uncontrolled hypertension while on pharmacologic treatment suggests that systematic screening programmes may be a useful tool to improve hypertension control in Chile.

scholarly journals Associations between water-treatment methods and diarrhoea in HIV-positive individuals

2002 ◽  
Vol 129 (2) ◽  
pp. 315-323 ◽  
Author(s):  
J. N. S. EISENBERG ◽  
T. J. WADE ◽  
A. HUBBARD ◽  
D. I. ABRAMS ◽  
R. J. LEISER ◽  
...  
Keyword(s):  
Drinking Water ◽  
Water Treatment ◽  
San Francisco ◽  
Drinking Water Treatment ◽  
Diarrhoeal Disease ◽  
Treatment Modalities ◽  
Hiv Positive ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Boiled Water

This manuscript extends our previously published work (based on data from one clinic) on the association between three drinking water-treatment modalities (boiling, filtering, and bottling) and diarrhoeal disease in HIV-positive persons by incorporating data from two additional clinics collected in the following year. We conducted a cross-sectional survey of drinking water patterns, medication usage, and episodes of diarrhoea among HIV-positive persons attending clinics associated with the San Francisco Community Consortium. We present combined results from our previously published work in one clinic (n = 226) with data from these two additional clinics (n = 458). In this combined analysis we employed logistic regression and marginal structural modelling of the data. The relative risk of diarrhoea for ‘always’ vs. ‘never’ drinking boiled water was 0.68 (95% CI 0.45–1.04) and for ‘always’ vs. ‘never’ drinking bottled water was 1.22 (95% CI 0.82–1.82). Drinking filtered water was unrelated to diarrhoea [1.03 (95% CI 0.78, 1.35) for ‘always’ vs. ‘never’ drinking filtered water]. Adjustment for confounding did not have any notable effect on the point estimates (0.61, 1.35 and 0.98 for boiled, bottled, and filtered water respectively, as defined above). The risk of diarrhoea was lower among those consuming boiled water but this finding was not statistically significant. Because of these findings, the importance of diarrhoea in immunocompromised individuals, and the limitations of cross-sectional data further prospective investigations of water consumption and diarrhoea among HIV-positive individuals are needed.

scholarly journals May Measurement Month 2018: an analysis of blood pressure screening results from Ecuador

2020 ◽  
Vol 22 (Supplement_H) ◽  
pp. H53-H55
Author(s):  
Ernesto Peñaherrera ◽  
Thomas Beaney ◽  
Anca Chis Ster ◽  
Neil R Poulter ◽  
Jose Villalba ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Blood Pressure Measurement ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Raising Awareness ◽  
Health Centres ◽  
Temporary Solution ◽  
Global Initiative ◽  
Definition Of

Abstract Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative by the International Society of Hypertension (ISH) aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2018. A volunteer cross-sectional survey was carried out in May 2017 across 33 health centres. Blood pressure measurement, the definition of hypertension (HTN) (mean of the 2nd and 3rd BP measurement ≥ 140/90 mmHg or who were medicated for high BP), and statistical analysis followed the standard MMM protocol. In total, 11 922 individuals (53.7% female) were screened during MMM18. After multiple imputation, 4563 (38.3%) had HTN. Of individuals not receiving antihypertensive medication, 1302 (15.0%) were hypertensive. Of individuals receiving antihypertensive medication, 933 (28.6%) had uncontrolled BP. MMM18 was the largest BP screening campaign done in Ecuador. Hypertension was detected in 38.4% of those screened and almost 4 out of 10 were either not on treatment or were not controlled to the BP goal. These results suggest that appropriate screening can help to identify a significant number of people with high BP. These data should attract the attention of doctors and health care system in Ecuador.

scholarly journals Prevalence, Awareness, Treatment, and Control of Hypertension among Chinese First-Generation Migrants and Italians in Prato, Italy: The CHIP Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Pietro A. Modesti ◽  
Maria Calabrese ◽  
Ilaria Marzotti ◽  
Hushao Bing ◽  
Danilo Malandrino ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
First Generation ◽  
Primary Outcome Measure ◽  
Cross Sectional Survey ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Parental History ◽  
Chinese Migrants ◽  
First Generation Migrants

Data on health needs of Chinese living in the South of Europe are lacking. To compare prevalence, awareness, treatment, control, and risk factors for hypertension between Chinese migrants and Italian adults, a sample of 1200 first-generation Chinese migrants and 291 native Italians aged 35–59 years living in Prato (Italy) was recruited in a community-based participatory cross-sectional survey. Primary outcome measure was hypertension, diagnosed for blood pressure values ≥ 140/90 mmHg or current use of antihypertensive medications. Associations with exposures (including age, gender, body mass index, waist, education level, total cholesterol, and triglycerides) were examined using logistic regression. When compared with Italians, Chinese had higher hypertension prevalence (27.2% versus 21.3%,p<0.01), with comparable levels of awareness (57.4% and 48.4%) but lower treatment rates (70.6% and 90.0%, resp.). In both ethnic groups age and parental history of hypertension were predictors of awareness and treatment, body mass index being predictor of hypertension diagnosis. In Chinese participants, where the optimum cut-off point for body mass index was ≥23.9 kg/m2, the sensibility and specificity prediction for hypertension were 61.7% and 59.8%, respectively (area under the ROC curve = 0.629). Implementation of specific, culturally adapted health programs for the Chinese community is now needed.

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