scholarly journals Mental health and implications for antiretroviral adherence in a multiethnic Asian cohort

2021 ◽  
pp. sextrans-2021-055153
Author(s):  
Jaspal Singh Dhaliwal ◽  
Lai Gwen Chan ◽  
Justine Chay Boon Goh ◽  
Karis Hui En Koh ◽  
Chen Seong Wong
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Significant Risk ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Psychiatric History ◽  
Antiretroviral Medication ◽  
History Of ◽  
Mode Of Transmission ◽  
Living With Hiv

ObjectivesResearch suggests a high prevalence of depression and anxiety in people living with HIV, resulting in negative health outcomes and poorer help-seeking behaviours when undetected. Subsequent disease progression and non-adherence to treatment constitute a significant barrier to HIV treatment. This paper aims to identify the risk factors for the development of psychological distress and non-adherence to antiretroviral medication in people living with HIV.MethodsAn HIV outpatient clinical service screened for anxiety and depressive symptoms. As part of a retrospective analysis of the cohort, independent sample t-test and χ2 test were conducted to examine differences between symptomatic and asymptomatic patients in demographic variables such as mode of transmission and disclosure to family; clinical indicators such as psychiatric history and history of alcohol and substance use; and outcome variables such as current psychological distress and non-adherence. Binary logistic regression was conducted to determine predictors of psychological distress and non-adherence.ResultsAfter adjusting for age, no history of alcohol use and psychiatric history were found to be significant risk factors for psychological distress during the programme. Older patients were less likely to be symptomatic during the programme. After adjusting for age, having received intervention and psychiatric history, significant risk factors for non-adherence to antiretroviral medication were mode of transmission, history of smoking and being symptomatic during the programme.ConclusionSignificant psychological distress occurring early in HIV care predicts future non-adherence to antiretroviral treatment, highlighting the importance of early detection and intervention for psychological distress in people living with HIV. Mental health interventions should be intercalated with treatment adherence interventions to improve HIV treatment outcomes.

scholarly journals The Achilles’ Heel of HIV Treatment for Prevention

2011 ◽  
Vol 10 (6) ◽  
pp. 365-372 ◽  
Author(s):  
Seth C. Kalichman ◽  
Chauncey Cherry ◽  
Denise White ◽  
Mich'l Jones ◽  
Moira Kalichman
Keyword(s):  
Sexual Behaviors ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Sexually Transmitted ◽  
The Past ◽  
Younger Age ◽  
Transgender Persons ◽  
History Of ◽  
Living With Hiv

Background: Antiretroviral therapies (ARTs) offer promising new avenues for HIV prevention. Unfortunately, people infected with HIV who have co-occurring sexually transmitted infections (STIs) are more infectious than suggested by the amount of virus in their peripheral blood. We examined the history of sexually transmitted coinfections in people living with HIV. Methods: People living with HIV/AIDS completed confidential computerized interviews that assessed history of STI, sexual behaviors, and STI knowledge. Results: Among 414 men and 156 women currently receiving ART, 53% had been diagnosed with at least 1 STI since testing HIV positive; 24% women, 19% men, and 11% transgender persons had been diagnosed with an STI in the past year. History of STI was associated with younger age, greater STI knowledge, substance use, and ART nonadherence. Conclusions: Aggressive strategies for detecting and treating STI in people receiving ART will be necessary to achieve protective benefits.

scholarly journals Are you suppressed? Viral load test coverage for people living with HIV in Mutare District, Manicaland Province, Zimbabwe, 2015-2017 Investigators

2018 ◽  
Author(s):  
Charles Uzande ◽  
Jeffery Edwards ◽  
Philip Owiti ◽  
Admire Tatenda Maravanyika ◽  
Simba Mashizha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Electronic Monitoring ◽  
Significant Risk ◽  
Load Test ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Adjusted Relative Risk ◽  
Factors Associated ◽  
Living With Hiv

AbstractBackground:The third 90-90-90 UNAIDS goal require that 90% of people living with HIV (PLHIV) on antiretroviral treatment (ART) achieve viral load (VL) suppression. This study assessed the proportion of VL suppression and related factors among PLHIV on 1st and 2nd line ART in Mutare District, Manicaland Province, Zimbabwe between 2015-2017.Methods:A retrospective study using routine HIV programme data from the electronic monitoring system for nine health facilities in Mutare District. VL suppression was defined as < 1,000 copies/ml.Results:Of 16,590 registered patients, 15,566(94%) were on first-line and 1024(6%) on second-line ART. Of those on 1st-line ART, 2856(18%) had a VL test result documented, while 367(36%) of 2nd-line ART patients had VL results. VL suppression rates were 86% among those on 1st-line and 45% in 2nd-line ART. Independent risk factors associated with VL non-suppression for those on 1st-line ART were age 0-9 years (adjusted relative risk, aRR=2.9; 95% confidence interval, CI=1.7-4.8;P<0.001), 10-19 years (aRR=2.2;95%CI=1.4-3.2,P<0.001) compared to those 20-49 years, concurrent TB (aRR=9; CI=3.0-29.7,P<0.001) and male gender (aRR=1.5,95%CI=1.1-2.1;P=0.02). There were no significant risk factors associated with VL non-suppression for 2nd-line ART patients.Conclusion:For PLHIV on 1st-line ART in Mutare district, Manicaland, Zimbabwe, the frequency of reported VL results were only 18% among those on 1st-line ART, while the rate of VL suppression was near 90%. Viral Load testing coverage appears to be lagging behind current Zimbabwe goals and increased support is needed to improve the quality of HIV care and help reduce the threat of possible HIV drug resistance in the future.

Cardiovascular Risk Factors in Mexican People Living with HIV Under Cart with a High Prevalence of Overweight

2021 ◽  
Author(s):  
FRANCISCO CARLOS LOPEZ MARQUEZ ◽  
Alberto Alejandro Miranda Perez ◽  
Domingo Pere ◽  
Arguiñe Ivonne Urraza Robledo ◽  
Maria Elena Gutiérrez Perez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
People Living With Hiv ◽  
Anthropometric Measures ◽  
High Prevalence ◽  
History Of ◽  
Study Population ◽  
Living With Hiv

Abstract Objective: The aim of this study was to determine risk factors that increase cardiovascular risk and to estimate the cardiovascular risk at 5 and 10 years in overweight/obese in seropositive subjects undergoing cART from the of Northern Mexico Methods: This study included 186 PLWH under cART. The variables analyzed were were CD4+ count, viral load, lipid profile, glucose, insulin resistance, anthropometric measures, family history of hypertension and cardiovascular disease, years of treatment and cART scheme. In this study we analyzed the probable estimate of cardiovascular risk using the algorithmic models D: A: D (5-year period) and Framingham (10-year period). Results: In our study, 51.3% of the PLWH had arterial hypertension; most of the subjects were diagnosed with overweight, hypertriglyceridemia and metabolic syndrome, which are factors that increase the risk of cardiovascular disease. The evaluation of cardiovascular risk with the Framingham model, it is low and with the D model: A: D is moderate Conclusions: PLWH receiving cART present factors that potentiate the risk of early heart disease which are hypercholesterolemia, hypertriglyceridemia, smoking and age. The cardiovascular risk with the algorithmic models D: A:D and Framingham are low to moderate; however these latter results should be taken with caution since the study population is a young population, which will not allow us to establish an accurate cardiovascular risk. It is important to take into account other factors such as overweight or obesity, smoking or coinfections, in addition to years of exposure to cART, which could increase the rate of heart disease.

scholarly journals Psychological Distress and Its Correlates among Newly Diagnosed People Living with HIV in Northwest Ethiopia: Ordinal Logistic Regression Analyses

2021 ◽  
Vol 14 ◽  
pp. 117863372199459
Author(s):  
Nurilign Abebe Moges ◽  
Olubukola Adeponle Adesina ◽  
Micheal A Okunlola ◽  
Yemane Berhane ◽  
Joshua Odunayo Akinyemi
Keyword(s):  
Logistic Regression ◽  
Psychological Distress ◽  
Alcohol Use ◽  
Health Centers ◽  
People Living With Hiv ◽  
Newly Diagnosed ◽  
Regression Analyses ◽  
Sexually Transmitted ◽  
History Of ◽  
Living With Hiv

Background: Although there is a high burden of HIV in sub-Saharan Africa (SSA), studies on mental health issues among people living with HIV are scarce. The study addressed the transition to “test and treat” guidelines for HIV, which makes it unique regarding its evaluation of psychological distress amongst newly initiated people living with HIV in the test and treat era. Methods: We conducted a cross-sectional survey of 689 people newly diagnosed with HIV. Symptoms of psychological distress were measured using the Kessler-10 psychological distress assessment scale. Factors associated with psychological distress were captured using interviewer-administered questionnaires. Ordinal logistic regression analyses were employed to identify predictors of psychological distress. Results: The magnitude of psychological distress was 58.63% (95% CI = 55.2%-62.3%). The severity of the psychological distress of which, 17.42% had severe distress. Psychological distress was observed more among female patients (β = 0.47, AOR = 1.59, 95% CI = 1.12, 2.27), patients presented with opportunistic infections (β = 0.50, AOR = 1.65, 95% CI = 1.03, 2.66) and being non-working functional status (β = 0.99, AOR = 2.70, 95% CI = 1.64, 4.45). Moreover, patients who were malnourished (β = 0.46, AOR = 1.58, 95% CI = 1.09, 2.26), having good level of knowledge on HIV prevention (β = 0.59, 95% CI = 0.55, 0.39, 0.78), presented with sexually transmitted infection (β = 0.48, AOR = 1.61, 95% CI = 1.01, 2.58), history of alcohol use (β = 0.44, AOR = 1.55, 95% CI = 1.09, 2.21), perceived stigma (β = 0.08, AOR = 1.09 95% CI = 1.04, 1.15) and treated in health centers (β = 0.55, AOR = 1.74, 95% CI = 1.25, 2.41) had higher odds of psychological distress. Conclusion: The large majority of newly diagnosed HIV patients suffered from psychological distress. An increased vulnerability was observed among females, those with opportunistic and sexually transmitted infections, those having poor functional status and malnourished. Furthermore, HIV patients treated in health centers, those who had history of alcohol use and patients with high level of HIV related stigma are more negatively affected by the HIV diagnosis. Hence, all intervention strategies should target all the identified predictors.

An assessment of factors associated with neurocognitive decline in people living with HIV

2021 ◽  
pp. 095646242110433
Author(s):  
Zaeema Naveed ◽  
Howard S Fox ◽  
Christopher S Wichman ◽  
Pamela May ◽  
Christine M Arcari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Cox Proportional Hazards ◽  
Health Concern ◽  
People Living With Hiv ◽  
Hepatitis C Infection ◽  
Factors Associated ◽  
History Of ◽  
Living With Hiv ◽  
Neurocognitive Decline

Despite the widespread use of combination antiretroviral therapy (cART), HIV-associated neurocognitive impairment (NCI) remains a health concern. However, limited research has been done to identify factors associated with neurocognitive decline. We assessed risk factors associated with neurocognitive decline in people living with HIV using a definition of decline that is statistically easy to adopt, is based on a commonly used neuropsychological cut-off and may be clinically relevant. Cox proportional hazards modeling was performed using the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study database. 581 participants were followed for up to 12 years. Neurocognitive decline was defined as the first observed drop in global T-scores of at least 2.67. Lifetime methamphetamine use had the strongest association with neurocognitive decline (adjusted Hazard Ratio; aHR = 1.48; 95% CI = 0.92–2.39) followed by no current antiretroviral medication use (aHR = 1.32; 95% CI = 0.91–1.92). Other risk factors included Hispanic ethnicity, lifetime history of major depressive disorder, lifetime cannabis use, hepatitis-C infection, and difficulty eating, dressing, bathing, or using the toilet. Results indicate that consistent use of ART may be of high significance to preserving neurocognition. Furthermore, Hispanic patients, those with a history of depression and substance use, and those having difficulty in essential activities of daily living may require vigilant follow-up.

scholarly journals Global and Regional Prevalence and Burden of Latent and Acute Toxoplasmosis in People Living With HIV: an Updated Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Ali Rostami ◽  
Seyed Mohammad Riahi ◽  
Shayan Abdollahzadeh Sagha ◽  
Ali Taghipour ◽  
Mahdi Sepidarkish ◽  
...  
Keyword(s):  
Risk Factors ◽  
Meta Analysis ◽  
Significant Risk ◽  
World Health ◽  
People Living With Hiv ◽  
Prevalence Rates ◽  
Pooled Prevalence ◽  
Acute Toxoplasmosis ◽  
Health Organization ◽  
Living With Hiv

Abstract Background: Toxoplasma gondii infection is one of the most prevalent opportunistic and life-threatening infections in people living with HIV (PLWH). Here, we undertook a meta-analysis to estimate the global prevalence of latent (LT) and acute (AT) toxoplasmosis in PLWH.Methods: Eligible studies reporting the prevalence of LT or AT in PLWH were searched from January 1980 to July 2020, using PubMed/MEDLINE, Scopus, Web of Sciences, SciELO and Embase databases. We used a random effects model to calculate pooled prevalence estimates with 95% confidence intervals (CI) and evaluated overall burden of co-infection worldwide. Countries were categorised based on World Health Organization regions. Multiple subgroup and meta-regression analyses were performed.Results: From 4,024 studies identified, 150 (involving 44,473 PLWH) and 65 (involving 17,705 PLWH) studies met the inclusion criteria, for LT and AT in PLWH, respectively. The overall prevalence rates of LT and AT in PLWH were 37.4% (95% CI, 33.4–4.4) and 1.3% (95%CI, 0.9–1.8%), respectively. We estimated that, worldwide, approximately 14.2 and 0.5 million PLWH are affected by LT and AT, respectively. The highest and lowest burden of LT and AT were seen in the African and Western Pacific regions, respectively. Moreover prevalence rates were highest in countries with low levels of income and human development indexes. We indicated that eating raw/undercooked meat, frequent contact with soil, low numbers of CD4+ T lymphocytes and older age were significant risk factors of toxoplasmosis in PLWH.Conclusion: Our findings revealed that, a high number of PLWH are exposed to or infected with T. gondii. These findings suggest a need for more routine testing, care of, and treatment for T. gondii infection in all PLWH, and educating these patients about risk factors and preventive measures to reduce the burden of both latent and acute toxoplasmosis.

HIV and palliative care

2019 ◽  
pp. 561-578
Keyword(s):  
Opportunistic Infections ◽  
Advanced Disease ◽  
Late Presentation ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Antiretroviral Medication ◽  
Hiv Virus ◽  
The Uk ◽  
High Level ◽  
Living With Hiv

Since the discovery of HIV in 1983, there have been dramatic advances in the management of people living with the virus due to the availability of effective antiretroviral medication (ARV). Prior to this, acquisition of the virus would lead to the development of AIDS and eventual death within ten years for the majority. By 1996, a regime of triple therapy antiretroviral medication was developed which could sustainably suppress HIV viral replication and viral load in the blood. People living with HIV now have near-normal life expectancies, and opportunistic infection rates have reduced in the UK. Despite these advances, people living with HIV experience a high level of symptoms. Symptoms can be direct effects of the HIV virus, side effects of HIV treatment, or consequences of advanced disease. In the UK, advanced disease is still seen with late presentation of infection and poor adherence to ARV medication. Advanced HIV disease is associated with an impaired immune system, leading to high risk of developing opportunistic infections and HIV-associated malignancies. Painful peripheral neuropathy occurs at all stages of HIV infection and is resistant to many neuropathic pain treatments.

scholarly journals Risk factors of Toxoplasma encephalitis among people living with HIV/AIDS at Wangaya hospital in Denpasar, Bali, Indonesia: a case control study

2020 ◽  
Vol 7 (11) ◽  
pp. 1622
Author(s):  
Hamong Suharsono ◽  
Ketut Suryana ◽  
Mochamad P. Pujasakti
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Case Control Study ◽  
Case Control ◽  
People Living With Hiv ◽  
Toxoplasma Encephalitis ◽  
History Of ◽  
Living With Hiv ◽  
Control Study ◽  
Hiv Aids

Background: Toxoplasma encephalitis (TE) is the most frequent AIDS-related opportunistic infection. T. gondii infects the human population in both developed and developing countries. Toxoplasmosis among PLWHA manifests primarily as a life-threatening condition, TE, brain abscesses and death. Objective was to identify the risk factors of Toxoplasma encephalitis (TE) among people living with HIV/AIDS (PLWHA).  Methods: A case control study was conducted during May to November 2018. The study participants consisted of 90 PLWHA; 30 PLWHA with history of TE (cases) and 60 PLWHA without history of TE (controls). Data such as: socio-demographic, laboratory results, head CT scan findings were collected from the medical record and was analyzed using SPSS version 18.Results: A total of 90 participants PLWHA were enrolled, 30 participants as cases and 60 participants as a control. 49 (54.4%) participants were males and 41 (45.6%) participants were females. Among the risk factors evaluated; the lower lymphocyte level (p=0.016), the lower cluster differentiation (CD) 4 level (p=0.003), no taking highly active antiretroviral therapy (HAART) (p=0.000) were observed to be an independent associated risk factor of TE.Conclusions: Our findings suggest lower lymphocyte levels, lower CD4 count and no taking HAART may constitute a significant associated risk factor for TE in PLWHA.

Standardized comparison of cardiovascular risk factors prevalence in Spanish women and men living with HIV and in the general population

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Camps-Vilaro ◽  
S Perez-Fernandez ◽  
R Teira ◽  
V Estrada ◽  
P Domingo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
General Population ◽  
Density Lipoprotein ◽  
P Value ◽  
People Living With Hiv ◽  
General Population Cohort ◽  
History Of ◽  
Living With Hiv

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spain’s Ministry of Science and Innovation (Madrid, Spain), co-financed with European Union European Regional Development Funds –ERDF- [CIBERCV CB16/11/00229]; the Health Department of the Generalitat de Catalunya (Barcelona, Spain) through the Agència de Gestió d’Ajuts Universitaris de Recerca de Catalunya (AGAUR) (Barcelona, Spain) [2017SGR222]. OnBehalf DARIOS and VACH investigators Background People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared age-standardized prevalence and management of CV risk factors in PLWH to that of general population in Spain. Methods Blood pressure, lipid, glucose and anthropometric profile were cross-sectionally compared along with treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations by gender.  Results We included 39,598 individuals aged 35 to 74 years: 28,360 from the general population cohort and 11,238 from the PLWH cohort. Compared to general population, PLWH had a higher concentration of triglycerides (&gt;35mg/dL in women and &gt;26mg/dL in men), and a higher prevalence of metabolic syndrome (&gt;10% and &gt;7.8%) and diabetes (&gt;8.5% and &gt;5.3%) (Table). The proportion of treated diabetes, dyslipidemia, and hypertension were up to 3-fold lower in both women and men living with HIV than in general population (Table). Conclusions Lipid, gluco-metabolic profiles were significantly worse in PLWH compared to general population. In addition, PLWH were less often treated for diagnosed diabetes, dyslipidemia, and hypertension. CV risk factor standardized prevalence Cardiovascular risk factor WOMEN MEN General population People living with HIV p-Value General population People living with HIV p-Value N = 15,159 N = 2,171 N = 13,201 N = 9,067 Hypertension, % 27.4 (26.7 - 28.0) 24.8 (21.6 - 28.1) 0.136 29.0 (28.2 - 29.7) 22.9 (21.4 - 24.4) &lt;0.001 Treated hypertension, % a 62.7 (60.7 - 64.7) 18.9 (13.5 - 24.4) &lt;0.001 59.3 (57.5 - 61.1) 24.1 (21.0 - 27.1) &lt;0.001 Triglycerides, mg/dL b 99 (99 - 100) 134 (134 - 148) &lt;0.001 122 (121 - 122) 148 (148 - 164) &lt;0.001 Total cholesterol, mg/dL 214 (213 - 215) 207 (199 - 215) 0.111 214 (213 - 216) 195 (191 - 198) &lt;0.001 Treated dyslipidaemia, % c 14.0 (13.5 - 14.6) 7.80 (5.60 - 10.0) &lt;0.001 15.1 (14.5 - 15.7) 7.8 (6.8 - 8.7) &lt;0.001 Glucose, mg/dL 97 (96 - 97) 103 (98 - 107) 0.007 104 (103 - 105) 106 (104 - 109) 0.122 Diabetes, % 10.6 (10.1 - 11.1) 19.1 (16.0 - 22.1) &lt;0.001 15.4 (14.8 - 16.0) 20.7 (19.2 - 22.2) &lt;0.001 Treated diabetes, % d 34.4 (31.5 - 37.2) 12.8 (8.00 - 17.5) &lt;0.001 40.0 (37.1 - 42.9) 16.6 (13.9 - 19.3) &lt;0.001 Metabolic Syndrome, % 20.5 (19.8 - 21.1) 31.1 (25.8 - 36.4) &lt;0.001 27.9 (27.1 - 28.7) 35.7 (33.1 - 38.2) &lt;0.001 Values are expressed as mean (95% confidence interval). a Among patients with history of hypertension. b Mean (95% confidence interval) were obtained with log-transformed values. c Among all cohort participants. d Among patients with history of diabetes. HDL-c, high density lipoprotein cholesterol; LDL-c, low density lipoprotein cholesterol

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 ◽  
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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