scholarly journals Quality of antiretroviral therapy services in Ghana: Implications for the HIV response in resource-constrained settings

2021 ◽  
Vol 9 ◽  
pp. 205031212110361
Author(s):  
Robert Kaba Alhassan ◽  
Courage Edem Ketor ◽  
Anthony Ashinyo ◽  
Mary Eyram Ashinyo ◽  
Jerry John Nutor ◽  
...  
Keyword(s):  
Viral Load ◽  
Standard Deviation ◽  
Antiretroviral Therapy ◽  
National Health Insurance Scheme ◽  
People Living With Hiv ◽  
Input Process ◽  
Insurance Scheme ◽  
Therapy Services ◽  
Living With Hiv

Objective: Number of People Living with Human Immune-deficiency Virus in Ghana is over 300,000 and unmet need for antiretroviral therapy is approximately 60%. This study sought to determine the quality of antiretroviral therapy services in selected ART sites in Ghana using the input-process-outcome approach. Methods: This is a descriptive cross-sectional case study that employed modified normative evaluation to assess quality of antiretroviral therapy services in the Oti and Volta regions of Ghana among People Living with HIV (n = 384) and healthcare providers (n = 16). The study was conducted from 11 March to 9 May 2019. Results: Resources for managing HIV clients were largely available with the exception of viral load machines, reagents for CD4 counts, and antifungals such as Fluconazole and Cotrimoxazole. Patients enrolled on antiretroviral therapy within 2 weeks was 71% and clients retained in care within 2 weeks of enrolment was 90%. Approximately 26% of enrolled clients recorded viral load suppression; 33% of People Living with HIV who were not insured with the National Health Insurance Scheme paid for some antiretrovirals and cotrimoxazole. Adherence to ART and Cotrimoxazole were 95% and 88%, respectively, using pill count on their last three visits. Time spent with clinical team was among the worst rated (mean = 2.98, standard deviation = 0.54) quality indicators by patients contrary to interpersonal relationship with health provider which was among the best rated (mean = 3.25, standard deviation = 0.41) indicators. Conclusion: Observed quality care gaps could potentially reverse gains made in HIV prevention and control in Ghana if not addressed timely; an important value addition of this study is the novel application of input-process-outcome approach in the context of antiretroviral therapy services in Ghana. There is also the need for policy dialogue on inclusion of medications for prophylaxis in antiretroviral therapy on the National Health Insurance Scheme to promote adherence and retention.

scholarly journals Late Onset of Antiretroviral Therapy in Adults Living with HIV in an Urban Area in Brazil: Prevalence and Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Priscila Ribeiro Guimarães Pacheco ◽  
Ana Laura Sene Amâncio Zara ◽  
Luiz Carlos Silva e Souza ◽  
Marília Dalva Turchi
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Perceived Risk ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Late Initiation ◽  
Living With Hiv

Introduction. Highly active antiretroviral therapy has been available since 1996. Early initiation of antiretroviral therapy (ART) leads to improved therapeutic response and reduced HIV transmission. However, a significant number of people living with HIV (PLHIV) still start treatment late. Objective. This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods. This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count < 200 cells/mm3 or presence of AIDS-defining illness. Uni- and multivariate analysis were performed to evaluate associated factors for late ARV using SPSS®, version 21. The significance level was set at p<0.05. Results. 1,141 individuals were included, with a median age of 41 years, and 69.1% were male. The prevalence of late initiation of ART was 55.8% (95%CI: 52.9-58.7). The more common opportunistic infections at ART initiation were pneumocystosis, cerebral toxoplasmosis, tuberculosis, and histoplasmosis. Overall, 38.8% of patients had HIV viral load equal to or greater than 100,000 copies/mL. Late onset of ART was associated with higher mortality. After logistic regression, factors shown to be associated with late initiation of ARV were low education level, sexual orientation, high baseline viral load, place of residence outside metropolitan area, and concomitant infection with hepatitis B virus. Conclusion. These results revealed the need to increase early treatment of HIV infection, focusing especially on groups of people who are more socially vulnerable or have lower self-perceived risk.

scholarly journals Gender Differences in Health Related Quality of Life among People Living with HIV on Highly Active Antiretroviral Therapy in Mekelle Town, Northern Ethiopia

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Amanuel Tesfay ◽  
Abebe Gebremariam ◽  
Mulusew Gerbaba ◽  
Hailay Abrha
Keyword(s):  
Quality Of Life ◽  
Gender Differences ◽  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Health Related Quality ◽  
Highly Active ◽  
Related Quality ◽  
Health Related ◽  
Living With Hiv

Background. Health related quality of life (HRQOL) is an important outcome measure for highly active antiretroviral treatment program. In Ethiopia, studies revealed that there are improved qualities of life among adults living with the viruses taking antiretroviral therapy but there is no explicit data showing gender differences in health related quality of life.Aim. To assess gender differences in HRQOL and its associated factors among people living with HIV and on highly active antiretroviral therapy in public health institutions of Mekelle town, Northern Ethiopia.Methods. A comparative cross-sectional study was conducted among 494 adult people living with HIV taking ART services. Quality of life was measured using WHOQOL-HIV BREF.Result. There was a statistically significant gender difference (P<0.05) in HRQOL among PLHIV on HAART. Females had low score in all HRQOL domains. High perceived stigma was strongly associated with poor psychological quality of domain among both female and male groups with[AOR=2.89(1.69,4.96)]and[AOR=2.5(1.4,4.4)], respectively.Conclusion. There was statistically significant gender difference in all quality of life domains. Public health interventions to improve HRQOL of PLHIV should take in to account the physical, psychological, social, environmental, and spiritual health of PLHIV during treatment, care, and support.

scholarly journals Assessment of ART knowledge and adherence to ARVs among PLWHA accessing care in two Nigerian Military HIV/AIDS Treatment sites

2018 ◽  
Vol 4 (1) ◽  
pp. 43-52
Author(s):  
David Ufuoma Adje ◽  
Felicia Esemekiphorar Williams ◽  
Chukwuka Nicholas Bezugbe ◽  
Dauda Audi Dangiwa
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Systematic Random Sampling ◽  
Highly Active ◽  
Study Sites ◽  
Living With Hiv ◽  
Busy Schedule ◽  
Hiv Aids

Background:       Adherence to Highly Active Antiretroviral Therapy (HAART) is critical in achieving treatment goals, avoiding antimicrobial resistance, preventing treatment failure and improving the patient’s quality of life. Objectives: To assess the knowledge of antiretroviral therapy (ART) and adherence to antiretroviral (ARVs) medicines amongst People Living With HIV/AIDS (PLWHA) accessing care in two Nigerian Military HIV/AIDS Treatment sites. Methods: Four hundred patients on HAART who visited the study sites during the study period were recruited for the study using systematic random sampling method. A semi-structured, pretested, interviewer-administered questionnaire was used to obtain demographic details. Patients’ knowledge of HIV was assessed using an 8-item questionnaire while adherence was measured using the Simplified Medication Adherence Questionnaire (SMAQ). Results: The predominant age group was 31-40 years (46.4%). There were more females (69%) than males (31%). Only 45.5% answered knowledge questions correctly. The adherence level in this study was 64.0%. The major reasons cited for non-adherence included being away from home (23.6%), forgetfulness (17.1%), busy schedule (14%), need to conceal medication (12.7%) and feeling better (11.6%). Conclusion: Patients’ knowledge of ART and adherence to ARVs medicines were sub-optimal. Appropriate strategies to improve patients’ knowledge of ART and adherence to ARVs are recommended.

scholarly journals Quality of Life People Living with HIV-AIDS (PLWHA) with Antiretroviral therapy in Cendana Clinic Ngudi Waluyo Wlingi Hospital

2015 ◽  
Vol 2 (1) ◽  
pp. 006-014
Author(s):  
Erni Setiyorini
Keyword(s):  
Quality Of Life ◽  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Environment Problem ◽  
Immunodeficiency Virus ◽  
Long Time ◽  
Living With Hiv ◽  
Hiv Aids

Human Immunodeficiency Virus (HIV)is desease with high mortality and everyone have chancegot HIV. At Blitar HIV/AIDS prevalence increase since 2010. The incubation of HIV need long time tobecome AIDS. At this period PLWHA faced with physic, physichologic, sosial, environment problem andimpact to their quality of life. The purpose of this study was to describe quality of life PLWHA at physic,physichologic, sosial, environment dimension. Method: Research design was descriptive. Population ofthis study is PLWHA who receiving ARV at Cendana Clinic Ngudi Waluyo Wlingi Hospital. Samples 42respondent by using convenient sampling. Data collected at September 1st– 30, 2013 by questionaire.Result of this study in physic dimension much of them at good 16 peoples (38,1%), enough and less, eachof them 13 peoples (31%). Physhicology dimension at good and enough, each of them 20 peoples(47,6%) then at less 2 peoples (4,8%). Sosial dimension enough 25 peoples (59,5%), good 15 peoples(35,7%) and less 2 peoples (4,8%). Environment dimension enough 16 peoples (38,1%), good 15peoples (35,7%) dan kurang 11 orang (26,2%). It is suggested for nurse to implementation nursing careplan to PLWHA suitable with their quality of life dimension and enhance support to their sosial activity.

scholarly journals Protocol of a randomized controlled trial to test the effects of client-centered Representative Payee Services on antiretroviral therapy adherence among marginalized people living with HIV

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abisola Olaniyan ◽  
Stephanie L. Creasy ◽  
D. Scott Batey ◽  
Maria Mori Brooks ◽  
Catherine Maulsby ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Health Outcomes ◽  
Controlled Trial ◽  
People Living With Hiv ◽  
Randomized Controlled ◽  
Antiretroviral Therapy Adherence ◽  
Living With Hiv ◽  
Representative Payee

Abstract Background Client-Centered Representative Payee (CCRP) is an intervention modifying implementation of a current policy of the US Social Security Administration, which appoints organizations to serve as financial payees on behalf of vulnerable individuals receiving Social Security benefits. By ensuring beneficiaries’ bills are paid while supporting their self-determination, this structural intervention may mitigate the effects of economic disadvantage to improve housing and financial stability, enabling self-efficacy for health outcomes and improved antiretroviral therapy adherence. This randomized controlled trial will test the impact of CCRP on marginalized people living with HIV (PLWH). We hypothesize that helping participants to pay their rent and other bills on time will improve housing stability and decrease financial stress. Methods PLWH (n = 160) receiving services at community-based organizations will be randomly assigned to the CCRP intervention or the standard of care for 12 months. Fifty additional participants will be enrolled into a non-randomized (“choice”) study allowing participant selection of the CCRP intervention or control. The primary outcome is HIV medication adherence, assessed via the CASE adherence index, viral load, and CD4 counts. Self-assessment data for ART adherence, housing instability, self-efficacy for health behaviors, financial stress, and retention in care will be collected at baseline, 3, 6, and 12 months. Viral load, CD4, and appointment adherence data will be collected at baseline, 6, 12, 18, and 24 months from medical records. Outcomes will be compared by treatment group in the randomized trial, in the non-randomized cohort, and in the combined cohort. Qualitative data will be collected from study participants, eligible non-participants, and providers to explore underlying mechanisms of adherence, subjective responses to the intervention, and implementation barriers and facilitators. Discussion The aim of this study is to determine if CCRP improves health outcomes for vulnerable PLWH. Study outcomes may provide information about supports needed to help economically fragile PLWH improve health outcomes and ultimately improve HIV health disparities. In addition, findings may help to refine service delivery including the provision of representative payee to this often-marginalized population. This protocol was prospectively registered on May 22, 2018 with ClinicalTrials.gov (NCT03561103).

scholarly journals Factors Associated With Virological Suppression of HIV Viral Load in Patients on Antiretroviral Therapy in Conakry, Guinea

2021 ◽  
Author(s):  
Alimou camara ◽  
Penda Maladho Diallo ◽  
Mamadou Bobo Diallo ◽  
Talla Nioké ◽  
Adama Cissé ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Detection Threshold ◽  
Virological Suppression ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Viral Load Data ◽  
Living With Hiv ◽  
Hiv Aids

Abstract BackgroundThe viral load has become an indispensable tool in evaluating antiretroviral therapy (ART) in people living with HIV / AIDS. This study aimed to assess virological suppression among in people living with HIV / AIDS on antiretroviral therapy in Guinea.MethodsThis was a descriptive cross-sectional study of more than three years that involved adult HIV-positive patients treated in different sites in Conakry. A total of 9815 viral load data were collected. The viral load was quantified by the Generic Biocentric technique and the detection threshold set at 350 copies/ml. Statistical analyses were performed by R software version R4.0.3..ResultsA total of 9815 viral load data collected at the national public health laboratory were analysed. The sample was dominated by women (72%), with an average age of 29 [29, 39]. Of these, 6,706 (68%) of HIV-positive people on ART had viral load suppression. The univaried analysis showed that women were 22% more likely to have VL suppression (p-value <0.001) moreover, the chance for all HIV-positive people on treatment to achieve viral load suppression was related to the length of treatment.Conclusionthe results of this study show viral load suppression greater than 68%. The length of antiretroviral therapy, female gender, and advancing age of PLHIV were all favourable to VL suppression.

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