scholarly journals Delivery of HIV Antiretroviral Therapy Adherence Support Services by HIV Care Providers in the United States, 2013 to 2014

2017 ◽  
Vol 16 (6) ◽  
pp. 624-631 ◽  
Author(s):  
John Weiser ◽  
Linda Beer ◽  
John T. Brooks ◽  
Kathleen Irwin ◽  
Brady T. West ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Nurse Practitioners ◽  
Support Services ◽  
International Association ◽  
The United States ◽  
Hiv Care ◽  
Art Adherence ◽  
Care Providers ◽  
Adherence Support ◽  
Hiv Antiretroviral Therapy

Background: Little is known about clinicians’ adoption of recommendations of the International Association of Providers of AIDS Care and others for supporting adherence to antiretroviral therapy (ART). Methods: We surveyed a probability sample of US HIV care providers to estimate the percentage offering 3 ART adherence support services to most or all patients and assessed the characteristics of providers offering all 3 services (comprehensive support) to most or all patients. Results: Almost all providers (95.5%) discussed ART adherence at every visit, 60.1% offered advice about tools to increase adherence, 53.5% referred nonadherent patients for supportive services, and 42.8% provided comprehensive support. Nurse practitioners were more likely to offer comprehensive support as were providers who practiced at Ryan White HIV/AIDS Program-funded facilities, provided primary care, or started caring for HIV-infected patients within 10 years. Conclusion: Less than half of HIV care providers offered comprehensive ART adherence support. Certain subgroups may benefit from interventions to increase delivery of adherence support.

scholarly journals Barriers to Universal Prescribing of Antiretroviral Therapy by HIV Care Providers in the United States, 2013–2014

2017 ◽  
Vol 74 (5) ◽  
pp. 479-487 ◽  
Author(s):  
John Weiser ◽  
John T. Brooks ◽  
Jacek Skarbinski ◽  
Brady T. West ◽  
Christopher C. Duke ◽  
...  
Keyword(s):  
United States ◽  
Antiretroviral Therapy ◽  
The United States ◽  
Hiv Care ◽  
Care Providers

scholarly journals School-level Barriers of Antiretroviral Therapy Adherence and Interventions to Overcome them Among Adolescents Living with HIV in Western Kenya: A Qualitative Study

2021 ◽  
Vol 15 (1) ◽  
pp. 93-107
Author(s):  
Monica A. Onyango ◽  
Houda Chergui ◽  
Lora L. Sabin ◽  
Lisa J. Messersmith ◽  
Natalya Sarkisova ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Health Care Providers ◽  
School Environment ◽  
Sexual Transmission ◽  
School Level ◽  
Art Adherence ◽  
Care Providers ◽  
School Settings ◽  
Adherence Support ◽  
Living With Hiv

Background: Adolescents in Kenya spend the majority of their time in a school environment. However, research to understand Antiretroviral Therapy (ART) adherence among adolescents living with HIV (ALWHIV) in school settings is sparse. Objective: To improve the design of appropriate interventions to better support this vulnerable population, the study aimed to explore school-related barriers to ART adherence experienced by ALWHIV. Methods: Qualitative data were utilized from a larger mixed-methods study on ALWHIV conducted at a major teaching and referral hospital in Kisumu, Kenya. Participants encompassed ALWHIV, their caregivers, teachers, and health care providers. Transcripts from a total of 24 in-depth interviews and five focus group discussions were analyzed in NVivo using a thematic approach. Results: Four themes emerged as key barriers in a school setting: negative experiences following HIV status self-disclosure, a strong desire for secrecy, restrictive school policies, and health education focused on sexual transmission of HIV. Participants suggested a range of potential interventions to better support ART adherence for ALWHIV, including coaching ALWHIV on disclosure strategies, promoting empathy among teachers and students, transition-preparing for ALWHIV, changing the narrative about HIV transmission in schools, providing water in schools, and introducing adherence support programs in schools, including the use of mobile technology. Conclusion: ALWHIV in Kenya experience numerous important challenges while trying to maintain optimal ART adherence in the school environment. Interventions that create supportive school settings are critical for better health outcomes among ALWHIV.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

scholarly journals Do HIV Care Providers Appropriately Manage Hepatitis B in Coinfected Patients Treated with Antiretroviral Therapy?

2007 ◽  
Vol 44 (7) ◽  
pp. 996-1000 ◽  
Author(s):  
M. K. Jain ◽  
C. K. Opio ◽  
C. C. Osuagwu ◽  
R. Pillai ◽  
P. Keiser ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hepatitis B ◽  
Hiv Care ◽  
Care Providers

scholarly journals HIV Antiretroviral Therapy Costs in the United States, 2012-2018

2020 ◽  
Vol 180 (4) ◽  
pp. 601 ◽  
Author(s):  
Nicole C. McCann ◽  
Tim H. Horn ◽  
Emily P. Hyle ◽  
Rochelle P. Walensky
Keyword(s):  
United States ◽  
Antiretroviral Therapy ◽  
The United States ◽  
Therapy Costs ◽  
Hiv Antiretroviral Therapy

scholarly journals Discontinuation of Antiretroviral Therapy Among Adults Receiving HIV Care in the United States

2014 ◽  
Vol 66 (1) ◽  
pp. 80-89 ◽  
Author(s):  
Alison J. Hughes ◽  
Christine L. Mattson ◽  
Susan Scheer ◽  
Linda Beer ◽  
Jacek Skarbinski
Keyword(s):  
United States ◽  
Antiretroviral Therapy ◽  
The United States ◽  
Hiv Care

scholarly journals HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abraham Aregay Desta ◽  
Tewolde Wubayehu Woldearegay ◽  
Nesredin Futwi ◽  
Gebrecherkos Teame Gebrehiwot ◽  
Goyitom Gebremedhn Gebru ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Antiretroviral Drugs ◽  
Resistance Pattern ◽  
Northern Ethiopia ◽  
Art Adherence ◽  
Adherence Level ◽  
Factors Associated ◽  
Number Of Patients ◽  
Adherence Support ◽  
Adolescents And Adults

Abstract Background Despite the benefits of Antiretroviral Therapy (ART), there is a growing concern of treatment failure. This study aimed to assess viral non suppression rate and factors associated with HIV viral non suppression among adolescents and adults on ART in Northern Ethiopia. Methods A retrospective cross sectional study was done on 19,525 study subjects. All the data in the database of Tigray Health Research Institute was exported to Microsoft excel 2010 and then data verification and filtration were done before exporting to STATA 14.0 for analysis. Generalized Estimating Equation (GEE) logistic regression was used for statistical modeling of viral non suppression. Results A total of 5153 (26.39%; 95%CI (25.77%, 27.02)) patients had no viral suppression despite being on ART. Being male (AOR = 1.27, 95% CI: 1.18, 1.37), 15–19 years of age (AOR = 4.86, 95%CI: 3.86, 6.12), patients from primary hospital (AOR = 1.26, 95%CI: 1.05, 1.52), WHO staging II (AOR = 1.31, 95%CI: 1.10, 1.54), poor ART adherence level (AOR = 2.56, 95%CI: 1.97, 3.33), fair ART adherence level (AOR = 1.61, 95%CI: 1.36, 1.90), baseline CD-4 count of < 200 cells/micro liter (AOR = 1.33, 95%CI: 1.14, 1.54), recent CD-4 count of < 200 cells/micro liter (AOR = 3.78, 95%CI: 3.34, 4.27), regimen types: 1c (AZT-3TC-NVP) (AOR = 1.32, 95%CI: 1.22, 1.44), 2 h (TDF-3TC-ATV/R) (AOR = 1.79, 95%CI: 1.27, 2.52) and declined immunological responses after ART initiation (AOR = 1.45, 95%CI: 1.30, 1.61) were significantly associated with viral non-suppression. Conclusions The virological non suppression was high which makes it less likely to achieve the third 90 UNAIDS target. Being male, patients with WHO staging II and poor ART adherence level were significantly associated with viral non suppression. Therefore, intensive adherence support and counseling should be provided. It is also a high time to determine the antiretroviral drugs resistance pattern given the fact that a large number of patients had virological non suppression.

scholarly journals Endoscopy by Nonphysicians

2007 ◽  
Vol 21 (1) ◽  
pp. 17-18 ◽  
Author(s):  
Elaine R Gossman
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
The United States ◽  
Current Status ◽  
Care Providers ◽  
Kaiser Permanente ◽  
Efficient System ◽  
Effective Manner

In 1945, Henry J Kaiser organized a group of physicians to provide health care for shipyard workers and their families. His foundation, Kaiser Permanente (USA), has developed into a prepaid health plan facility serving 8.4 million members in nine states and in Washington, DC, within the United States. It aspires to provide high quality, affordable, integrated health care within an organized, efficient system. A focus on preventive care in a cost-effective manner is a high priority. The Kaiser Permanente northwest region (covering northwest Oregon and southwest Washington) serves nearly one-half of a million members. Our region has utilized nurse practitioners (NPs) and physician assistants (PAs) (allied health care providers) in a variety of capacities for many years. The present paper reviews the background and current status of their role in endoscopy.

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