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

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.

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Unique Circulating MicroRNA Associations with Dysglycemia in People Living with HIV and Alcohol Use

Physiological Genomics ◽

10.1152/physiolgenomics.00085.2021 ◽

2021 ◽

Author(s):

Brianna L Bourgeois ◽

Hui-Yi Lin ◽

Alice Y Yeh ◽

Danielle E. Levitt ◽

Stefany DePrato Primeaux ◽

...

Keyword(s):

Alcohol Use ◽

Tolerance Test ◽

Oral Glucose ◽

Circulating Microrna ◽

People Living With Hiv ◽

Regression Analyses ◽

Circulating Micrornas ◽

Altered Glucose ◽

Function Correlation ◽

Living With Hiv

People living with HIV (PLWH) have increased prevalence of comorbid conditions including insulin resistance and at-risk alcohol use. Circulating microRNAs (miRs) may serve as minimally invasive indicators of pathophysiological states. We aimed to identify whether alcohol modulates circulating miR associations with measures of glucose/insulin dynamics in PLWH. PLWH (N=96; 69.8% male) enrolled in the Alcohol & Metabolic Comorbidities in PLWH: Evidence-Driven Interventions (ALIVE-Ex) study were stratified into negative phosphatidylethanol (PEth<8ng/ml, N=42) and positive PEth (PEth≥8ng/ml, N=54) groups. An oral glucose tolerance test (OGTT) was administered, and total RNA was isolated from fasting plasma to determine absolute miR expression. Circulating miRs were selected based on their role in skeletal muscle (miR-133a, miR-206), pancreatic β-cell (miR-375), liver (miR-20a), and adipose tissue (miR-let-7b, miR-146a, miR-221) function. Correlation and multiple regression analyses between miR expression and adiponectin, 2h glucose, insulin, and C-peptide values were performed adjusting for BMI category, age, sex, and viral load. miR-133a was negatively associated with adiponectin (p=0.002) in the negative PEth group, and miR-20a was positively associated with 2h glucose (p=0.013) in the positive PEth group. Regression analyses combining miRs demonstrated that miR-133a (p<0.001) and miR-221 (p=0.010) together predicted adiponectin in the negative PEth group. miR-20a (p<0.001) and miR-375 (p=0.002) together predicted 2h glucose in the positive PEth group. Our results indicate that associations between miRs and measures of glucose/insulin dynamics differed between PEth groups suggesting that the pathophysiological mechanisms contributing to altered glucose homeostasis in PLWH are potentially modulated by alcohol use.

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The Achilles’ Heel of HIV Treatment for Prevention

Journal of the International Association of Physicians in AIDS Care ◽

10.1177/1545109711418120 ◽

2011 ◽

Vol 10 (6) ◽

pp. 365-372 ◽

Cited By ~ 4

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.

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A Chart Review Study of Sexually Transmitted Infections Among Persons Living with HIV Attending an STI Clinic in Trinidad

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/2325958219888463 ◽

2019 ◽

Vol 18 ◽

pp. 232595821988846

Author(s):

Jeffrey Edwards ◽

Avery Hinds ◽

Nyla Lyons ◽

Jonathan Edwards ◽

Shauntelle Quammie ◽

...

Keyword(s):

Hiv Infection ◽

Chart Review ◽

Health Interventions ◽

Newly Diagnosed ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Persons Living With Hiv ◽

History Of ◽

Review Study ◽

Living With Hiv

A chart review study of the sexually transmitted infection (STI) prevalence among persons living with HIV (PLHIV) was conducted among STI clinic attendees in Trinidad between January 2012 and December 2012. Data were abstracted from client records to obtain the clinical and the laboratory diagnoses of STIs. Descriptive and bivariate analyses were conducted, and factors significantly associated with the presence of a STI were assessed using multiple logistic regression. During this period, 385 PLHIV were seen; 104 (27.0%) were newly HIV diagnosed and 281 (73.0%) had a known history of HIV infection; 135 (35.1%) were diagnosed with a STI. Patients with known HIV infection were more likely to be diagnosed with a STI than those who were newly diagnosed (odds ratios: 6.99; 95% confidence interval: 3.79-12.89). The STI prevalence was high among PLHIV in Trinidad, identifying them as a critical target group for public health interventions to prevent the spread of HIV and STIs.

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

Sexually Transmitted Infections ◽

10.1136/sextrans-2021-055153 ◽

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.

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Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

Current HIV Research ◽

10.2174/1570162x18666200609115615 ◽

2020 ◽

Vol 18 (6) ◽

pp. 388-395

Author(s):

Daniel Vargas-Pacherrez ◽

Helma P. Cotrim ◽

Leonardo Pires ◽

Vitor Cunha ◽

Vitor Coelho ◽

...

Keyword(s):

Metabolic Syndrome ◽

Antiretroviral Therapy ◽

International Diabetes Federation ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Anthropometric Data ◽

Cross Sectional ◽

History Of ◽

Family History Of Hypertension ◽

Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

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Reducing time to differentiated service delivery for newly diagnosed people living with HIV in Kigali, Rwanda: study protocol for a pilot, unblinded, randomised controlled study

BMJ Open ◽

10.1136/bmjopen-2020-047443 ◽

2021 ◽

Vol 11 (4) ◽

pp. e047443

Author(s):

Jonathan Ross ◽

Gad Murenzi ◽

Sarah Hill ◽

Eric Remera ◽

Charles Ingabire ◽

...

Keyword(s):

Service Delivery ◽

Health Centre ◽

Albert Einstein College ◽

Secondary Outcome ◽

Controlled Study ◽

People Living With Hiv ◽

Newly Diagnosed ◽

Differentiated Service ◽

Viral Loads ◽

Living With Hiv

IntroductionCurrent HIV guidelines recommend differentiated service delivery (DSD) models that allow for fewer health centre visits for clinically stable people living with HIV (PLHIV). Newly diagnosed PLHIV may require more intensive care early in their treatment course, yet frequent appointments can be burdensome to patients and health systems. Determining the optimal parameters for defining clinical stability and transitioning to less frequent appointments could decrease patient burden and health system costs. The objectives of this pilot study are to explore the feasibility and acceptability of (1) reducing the time to DSD from 12 to 6 months after antiretroviral therapy (ART) initiation,and (2) reducing the number of suppressed viral loads required to enter DSD from two to one.Methods and analysesThe present study is a pilot, unblinded trial taking place in three health facilities in Kigali, Rwanda. Current Rwandan guidelines require PLHIV to be on ART for ≥12 months with two consecutive suppressed viral loads in order to transition to less frequent appointments. We will randomise 90 participants to one of three arms: entry into DSD at 6 months after one suppressed viral load (n=30), entry into DSD at 6 months after two suppressed viral loads (n=30) or current standard of care (n=30). We will measure feasibility and acceptability of this intervention; clinical outcomes include viral suppression at 12 months (primary outcome) and appointment attendance (secondary outcome).Ethics and disseminationThis clinical trial was approved by the institutional review board of Albert Einstein College of Medicine and by the Rwanda National Ethics Committee. Findings will be disseminated through conferences and peer-reviewed publications, as well as meetings with stakeholders.Trial registration numberNCT04567693.

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Cultural Adaptation of an Intervention to Reduce Hazardous Alcohol Use Among People Living with HIV in Southwestern Uganda

AIDS and Behavior ◽

10.1007/s10461-021-03186-z ◽

2021 ◽

Author(s):

Anna M. Leddy ◽

Judith A. Hahn ◽

Monica Getahun ◽

Nneka I. Emenyonu ◽

Sarah E. Woolf-King ◽

...

Keyword(s):

Alcohol Use ◽

Cultural Adaptation ◽

People Living With Hiv ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

Living With Hiv ◽

Southwestern Uganda

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Negative Consequences of Alcohol Use among People Living with HIV

Substance Use & Misuse ◽

10.1080/10826084.2021.1899232 ◽

2021 ◽

pp. 1-8

Author(s):

Rebecca J. Fisk ◽

Veronica L. Richards ◽

Robert F. Leeman ◽

Babette Brumback ◽

Christa Cook ◽

...

Keyword(s):

Alcohol Use ◽

People Living With Hiv ◽

Negative Consequences ◽

Living With Hiv

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Syphilis among men who have sex with men attending a large HIV clinic in Trinidad

International Journal of STD & AIDS ◽

10.1177/0956462421997193 ◽

2021 ◽

pp. 095646242199719

Author(s):

Robert Jeffrey Edwards ◽

Isshad John ◽

Selena Todd ◽

Leon-Omari Lavia ◽

David Musa ◽

...

Keyword(s):

Logistic Regression ◽

Chart Review ◽

Laboratory Data ◽

Previous History ◽

History Of ◽

Review Study ◽

Sex With Men ◽

Associated Risk Factors ◽

Living With Hiv ◽

Age Range

A chart review study was conducted to determine the prevalence of syphilis and explore the associated risk factors among men who have sex with men (MSM) who attended a large HIV clinic in Trinidad during the period January–December 2019. Patients were routinely screened for syphilis annually, and demographic, clinical, and laboratory data were extracted from the medical records. Descriptive and bivariate analyses were performed, and factors significantly associated with a syphilis diagnosis were assessed using multivariate logistic regression. During the period, 218 MSM were seen, age range 19–67 years, and median age 34.0 years. The prevalence of syphilis was 41.3% (90/218), and 71.1% (64//90) of these infections were asymptomatic. Multivariate analysis using logistic regression showed that MSM living with HIV in the 30–34 years old-age group (OR, 4.32; 95% CI, 1.04–18.02), and those with a previous history of treated syphilis (OR, 10.18; 95% CI, 4.60–22.53) were more likely to be diagnosed with syphilis. The prevalence of syphilis is high among MSM attending the HIV clinic in Trinidad, and most of these infections were asymptomatic; hence, targeted and sustained interventions to reduce syphilis transmission are urgently required. Repeat episodes of syphilis may play a role in the transmission dynamics of syphilis in MSM.

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