‘What will it take’: addressing alcohol use among people living with HIV in South Africa

2019 ◽  
Vol 30 (11) ◽  
pp. 1049-1054 ◽  
Author(s):  
K Sorsdahl ◽  
NK Morojele ◽  
CD Parry ◽  
CT Kekwaletswe ◽  
N Kitleli ◽  
...  
Keyword(s):  
South Africa ◽  
Alcohol Use ◽  
Brief Intervention ◽  
Hiv Treatment ◽  
Hiv And Aids ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Screening And Brief Intervention ◽  
Treatment Services ◽  
Living With Hiv

Given that hazardous and harmful alcohol use has been identified as a significant barrier to adherence to antiretroviral therapy (ART) in South Africa, alcohol reduction interventions delivered within HIV treatment services are being investigated. Prior to designing and implementing an alcohol-focused screening and brief intervention (SBI), we explored patients’ perceptions of alcohol as a barrier to HIV treatment, the acceptability of providing SBIs for alcohol use within the context of HIV services and identifying potential barriers to patient uptake of this SBI. Four focus groups were conducted with 23 participants recruited from three HIV treatment sites in Tshwane, South Africa. Specific themes that emerged included: (1) barriers to ART adherence, (2) available services to address problematic alcohol use and (3) barriers and facilitators to delivering a brief intervention to address alcohol use within HIV care. Although all participants in the present study unanimously agreed that there was a great need for SBIs to address alcohol use among people living with HIV and AIDS, our study identified several areas that should be considered prior to implementing such a programme.

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

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.

The Validity of the Substance Abuse and Mental Illness Symptom Screener (SAMISS) in People Living with HIV/AIDS in Primary HIV Care in Cape Town, South Africa

2014 ◽  
Vol 18 (6) ◽  
pp. 1133-1141 ◽  
Author(s):  
Erica Breuer ◽  
Kevin Stoloff ◽  
Landon Myer ◽  
Soraya Seedat ◽  
Dan J. Stein ◽  
...  
Keyword(s):  
South Africa ◽  
Substance Abuse ◽  
Mental Illness ◽  
Cape Town ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals People living with HIV in Estonia: engagement in HIV care in 2013

2016 ◽  
Vol 21 (43) ◽  
Author(s):  
Kaja-Triin Laisaar ◽  
Mait Raag ◽  
Irja Lutsar ◽  
Anneli Uusküla
Keyword(s):  
Medical Care ◽  
Universal Access ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Administrative Databases ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
The European Union ◽  
Treatment Cascade ◽  
Living With Hiv

Estonia had the highest rate of newly diagnosed human immunodeficiency virus (HIV) cases in the European Union (24.6/100,000) and an estimated adult HIV prevalence of 1.3% in 2013. HIV medical care, including antiretroviral therapy (ART), is free of charge for people living with HIV (PLHIV). To maximise the health benefits of HIV treatment, universal access should be achieved. Using data from surveillance and administrative databases and the treatment cascade model, we assessed the number of people infected with HIV, diagnosed with HIV, linked to HIV care, retained in HIV care, on ART, and with suppressed viral load (HIV-RNA: < 200 copies/mL). We identified that about one quarter of the 8,628 HIV-positive people estimated to live in Estonia in 2013 had not been diagnosed with HIV, and another quarter, although aware of their HIV-positive serostatus, had not accessed HIV medical care. Although altogether only 12–15% of all PLHIV in Estonia had achieved viral suppression, the main gap in HIV care in Estonia were the 58% of PLHIV who had accessed HIV medical care at least once after diagnosis but were not retained in care in 2013.

scholarly journals 727. Predictors of Depressive Symptoms in Pregnant Partners in Seroconcordant Couples Living with HIV in Zambézia Province, Mozambique

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S462-S463
Author(s):  
Daniel Sack ◽  
Ariano Matino ◽  
Graves Erin ◽  
Almiro Emilio ◽  
Bryan Shepherd ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Male Partner ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Relationship Status ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Seroconcordant Couples

Abstract Background Depression contributes to HIV treatment outcomes in sub-Saharan Africa, where approximately 15% of people living with HIV have comorbid depression. HoPS+, a cluster randomized trial among seroconcordant couples living with HIV, assesses male partner involvement during antenatal HIV care and HIV outcomes. We describe predictors of depressive symptoms among pregnant partners living with HIV in Zambézia Province, Mozambique. Methods This baseline cross-sectional analysis includes 1079 female HoPS+ participants. We show demographic (age, enrollment date, relationship status, education, and occupation) and clinical (WHO HIV stage, body mass index [BMI], and antiretroviral therapy [ART] use history) factors. We model females’ depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]) using proportional odds models with continuous covariates as restricted cubic splines (enrollment date, age, BMI, partner’s PHQ-9 score), categorical covariates (district, relationship status, education, occupation, WHO stage), and ART use history. Missing covariates were imputed 20 times. Results Participants’ median age was 23 (interquartile range [IQR] 20-28). Most women reported no or &lt; 7 years of education (84.1%), were farmers (61.3%), and were WHO stage I (81.9%). They had a median PHQ-9 score of 3 (IQR 0-5) and 47 (43.6%) had moderately severe or severe depressive symptoms, with 19.6% missing PHQ-9 scores. Among 867 pregnant partners with PHQ-9s, demographic and clinical covariates were not meaningful predictors of PHQ-9 score. Male partner’s PHQ-9 score, however, was associated with (covariate-adjusted Spearman’s rho 0.58, 95% Confidence Interval [CI]: 0.51-0.65) and strongly predictive of a pregnant partner’s score (Figure). An increase in a male partner’s PHQ-9 score from 9 to 10 was associated with 1.47 times increased odds (95% CI: 1.37-1.58) of a ≥1-point increase in a woman’s PHQ-9 score Figure: Female Partner's Depressive Symptoms Conclusion Depressive symptoms are highly correlated among pregnant people and their partners, which may have implications for pregnancy care. Interventions aimed to reduce depressive symptoms and improve HIV-related outcomes during pregnancy may have greater success when focused on addressing both partners’ depressive symptoms. Disclosures All Authors: No reported disclosures

scholarly journals Determinants of Sputum Ordering for Tuberculosis Diagnosis in People Living with HIV in the Greater Accra Region, Ghana

2021 ◽  
Author(s):  
Daniel Kasozi ◽  
Philip Govule ◽  
Simon Peter Katongole ◽  
Bismark Sarfo
Keyword(s):  
Health Workers ◽  
Screen Test ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Presumptive Diagnosis ◽  
Treatment Services ◽  
Care And Treatment ◽  
Living With Hiv ◽  
Greater Accra Region ◽  
General Appearance

Abstract BackgroundTuberculosis (TB) remains a significant public health concern, and a leading cause of ill-health and death globally. More so, People living with HIV have been shown to carry an increased risk of developing TB with an estimated one-third of deaths in this population. The World Health Organization recommends systematic and routine screening of PLHIV for TB on every clinic visit and further testing using sputum for those with a positive TB screen test. Not all PLHIV with a positive TB screen test in Ghana are further tested for TB using sputum and the factors for this are not well understood. This study assessed factors associated with sputum ordering for TB diagnosis in PLHIV who were screened positive for TB in three hospitals providing HIV care and treatment services in the Greater Accra region of Ghana.MethodsMixed method study performed at three purposively selected hospitals providing HIV care and treatment services in the Greater Accra region. The study involved a cross sectional review of patients’ charts and in-depth interviews with health workers involved in the care and treatment of PLHIV. Quantitative data was analyzed using STATA version 15. Chi square test was used for bivariate analysis. Logistic regression was used for multivariate analysis. P≤ 0.05 was considered statistically significant. Inductive thematic analysis was used to determine emerging themes from the interviews. The major themes were represented with representative quotations.ResultsFour hundred (400) patient charts were reviewed of which 67.7% were female with median age of 39 (IQR 31-49). TB screening was recorded in 78% (95% CI 73.6, 82.0) of the patients of whom ninety-two (92) patients had a positive TB screen test. Only 53 (57.6%) who had a positive screen test had sputum ordered for further TB testing. In the multivariate analysis, patient general appearance described as abnormal (OR=3.05, p=0.036), having more than one TB symptom (OR=3.42, p=0.028) and presence of an alternative presumptive diagnosis (OR=0.34, p=0.023) were associated with having a sputum test ordered. High patient numbers, inability to produce sputum, unwillingness of the not so sick patients to provide sputum and the costs associated with chest X-ray were perceived as the challenges to further testing for TB.ConclusionTB screening in PLHIV is still lower than recommended and almost half of PLHIV with a positive TB screen test did not have a sputum test documented. Sputum testing was likely to be done in patients with an abnormal general appearance and more than one TB symptom and unlikely in those with an alternative presumptive diagnosis. High workload, costs of TB tests, lack of training for health workers and inability to produce sputum by patients were the barriers to sputum testing highlighted by the health workers.

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