scholarly journals Experiences of People Living With HIV in Community Based Exercise: A Qualitative Longitudinal Study

2021 ◽  
Vol 20 ◽  
pp. 232595822199534
Author(s):  
Patricia Solomon ◽  
Soo Chan Carusone ◽  
Aileen M. Davis ◽  
Rachel Aubry ◽  
Kelly K. O’Brien
Keyword(s):  
Longitudinal Study ◽  
Self Management ◽  
People Living With Hiv ◽  
Health Providers ◽  
Structured Interviews ◽  
Community Based ◽  
Weekly Session ◽  
Living With Hiv ◽  
Over Time

This qualitative longitudinal study examined the experiences of people living with HIV who engaged in a structured community-based exercise (CBE) program under the supervision of a fitness coach. Twenty people living with HIV were invited to participate in 3 semi-structured interviews over time. Participants engaged in exercise 3 times per week for 6 months with one weekly session supervised by a coach. Interviews were audio-recorded, transcribed verbatim and underwent longitudinal thematic analyses. Eleven participants were included representing a total of 30 interviews. Participants valued their experiences with the CBE program, particularly the motivation provided by the coach. Concerns about the environment, stigma and episodic health challenges affected their overall experience. To foster independence and promote self-management, health providers should consider these findings when encouraging CBE with people living with HIV. It is important to understand their goals and offer a variety of exercise options to meet their needs.

Counting, Coping, and Navigating the Flux: A Focused Ethnographic Study of HIV and Diabetes Self-Management

2021 ◽  
pp. 104973232110642
Author(s):  
Chelsi W Ohueri ◽  
Alexandra A. García ◽  
Julie A. Zuñiga
Keyword(s):  
Management Practices ◽  
Participant Observation ◽  
Ethnographic Study ◽  
Self Management ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Familial Support ◽  
Multiple Observations ◽  
Dual Diagnoses ◽  
Living With Hiv

Approximately 10–15% of people living with HIV are also diagnosed with diabetes. To manage their two chronic conditions, people must undertake certain activities and adopt behaviors. Due to overlapping symptoms, complex medication regimens, and heavy patient workloads, implementing these self-management practices can be difficult. In this focused ethnography, data were collected from semi-structured interviews and limited participant-observation with a selected subset of participants to gain insight into self-management challenges and facilitators. We conducted interviews and multiple observations with 22 participants with HIV+T2DM over the period of 9 months. Participants experienced numerous barriers to self-management in the areas of diet, medication adherence, and mental health. Social and familial support, as well as consistent access to care, were facilitators for optimal self-management. At the same time participants’ lives were in a unique flux shaped by the dual diagnoses, and therefore, required constant mental and physical adjustments, thus illustrating challenges of managing chronicity.

scholarly journals Evaluation of a Community-Based Self-Management Program to Increase Access to Rehabilitation for People Living with HIV

2019 ◽  
Vol 18 ◽  
pp. 232595821988333 ◽  
Author(s):  
Patricia Solomon ◽  
Nancy Margaret Salbach ◽  
Kelly Kathleen O’Brien ◽  
Stephanie Nixon ◽  
Larry Baxter ◽  
...  
Keyword(s):  
Peer Education ◽  
Management Program ◽  
Self Management ◽  
Rehabilitation Services ◽  
People Living With Hiv ◽  
Community Based ◽  
Centered Care ◽  
Living With Hiv ◽  
Future Work

We qualitatively evaluated a novel educational program to help people living with HIV understand the role of rehabilitation, facilitate access to rehabilitation, and promote self-management of chronic disease in Canada. The program incorporated components of self-efficacy, client-centered care, peer education, and problem-based learning. Delivery of the community-engaged program was viewed as feasible and acceptable; however, a flexible delivery model was deemed important. Perceived learning was related to rehabilitation, advocacy, and taking responsibility for one’s health. A co-leader model and access to online resources were strengths. Future work should assess the ability to apply advocacy knowledge and skills to access rehabilitation services.

scholarly journals Community-Based Exercise in the Context of HIV: Factors to Consider when Developing and Implementing Community-Based Exercise Programs for People Living with HIV

2017 ◽  
Vol 16 (3) ◽  
pp. 267-275 ◽  
Author(s):  
Anna Li ◽  
Taylor McCabe ◽  
Erin Silverstein ◽  
Stephanie Dragan ◽  
Nancy M. Salbach ◽  
...  
Keyword(s):  
Analytical Techniques ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Community Based ◽  
Exercise Participation ◽  
Rehabilitation Professionals ◽  
The United Kingdom ◽  
Qualitative Descriptive ◽  
Facilitators And Barriers ◽  
Living With Hiv

Objective: To identify factors to consider for developing and implementing a community-based exercise (CBE) program for people living with HIV (PLWH). Methods: We conducted a qualitative descriptive study using semi-structured interviews with PLWH, rehabilitation professionals, and recreation providers from Canada and the United Kingdom. We asked participants to describe their experience with exercise, facilitators, and barriers to accessing and participating in exercise, and factors to consider in developing a CBE program for PLWH. Interviews were analyzed using content analytical techniques. Results: We developed a Framework of CBE in the Context of HIV that describes (1) exercise experiences of PLWH (nature of exercise, motivators for initiating or sustaining exercise, perceived benefits, and barriers and facilitators to exercise) and (2) 11 factors to consider in developing and implementing a CBE program for PLWH. Conclusion: Recommendations for the development and implementation of an accessible and feasible CBE program may enhance exercise participation among PLWH.

scholarly journals Living strategies for disability in men ageing with HIV in Ontario, Canada: a longitudinal qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031262
Author(s):  
Patricia Solomon ◽  
Kelly K O'Brien ◽  
Rebecca McGuff ◽  
Michelle Sankey
Keyword(s):  
Social Support ◽  
Longitudinal Study ◽  
Problem Solving ◽  
Older Men ◽  
Self Management ◽  
Sense Of Control ◽  
Episodic Nature ◽  
Problem Solve ◽  
Living With Hiv ◽  
Over Time

ObjectivesTo examine the living strategies used by older men living with HIV to deal with the episodic nature of disability and associated uncertainty, over time.DesignQualitative longitudinal study in which men living with HIV were interviewed on four occasions over 20 months.SettingMen were recruited from HIV community organisations in Canada.Participants14 men with a median age of 57.5 years and median time since diagnosis of 21.5 years.ResultsFive themes depict the living strategies used to deal with the episodic nature of disability and uncertainty over time. Actively engaging in problem-solving by prioritising and modifying activities and avoiding stress, advocating for support, being positive and future oriented, engaging in healthy pursuits and providing social support to others helped men to mitigate their disability. By following participants over time, we were able to gather insights into triggers of episodes of disability, and perceptions of the success of implementing their living strategies and avoiding uncertainty.ConclusionsParticipants used living strategies to deal with uncertainty and mitigate episodes of disability over time. This study supports the importance of programmes that promote self-management for older men living with HIV through helping them identify triggers of disability, set realistic goals and problem-solve. These may help build self-efficacy, increase sense of control, and decrease feelings of uncertainty and episodes of disability.

scholarly journals Strengths and Challenges of Implementing Physiotherapy in an HIV Community-Based Care Setting: A Qualitative Study of Perspectives of People Living with HIV and Healthcare Providers

2021 ◽  
Vol 20 ◽  
pp. 232595822110056
Author(s):  
Kyle Vader ◽  
Soo Chan Carusone ◽  
Rachel Aubry ◽  
Puja Ahluwalia ◽  
Carolann Murray ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Unmet Need ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Community Based ◽  
Life Challenges ◽  
Qualitative Descriptive ◽  
Tailored Approach ◽  
Living With Hiv ◽  
Need For Rehabilitation

The needs of people living with HIV (PLWH) who have access to antiretroviral therapy have shifted from hospital to community care; however, little is known about physiotherapy within HIV community-based care. Our aim was to understand strengths and challenges of implementing physiotherapy within an interprofessional HIV day health program in Toronto, Ontario, Canada. We conducted a qualitative descriptive study using semi-structured interviews. Data were analyzed using inductive content analysis. Fifteen PLWH and 5 healthcare providers participated. Strengths included improved access to physiotherapy and fulfilling an unmet need for rehabilitation; a tailored approach to physiotherapy; co-location improved communication, coordination, and engagement in care; and improved health outcomes for PLWH (i.e. function, psychosocial outcomes, and quality of life). Challenges related to managing expectations; variable attendance at visits; and managing complex and diverse needs of PLWH. Results may be transferable to other community-based care settings that provide care for PLWH and complex multi-morbidity.

scholarly journals The Lived Experiences of Stigmatization in the Process of HIV Status Disclosure among People Living with HIV in Taiwan

2021 ◽  
Vol 18 (10) ◽  
pp. 5089
Author(s):  
Chia-Hui Yu ◽  
Chu-Yu Huang ◽  
Nai-Ying Ko ◽  
Heng-Hsin Tung ◽  
Hui-Man Huang ◽  
...  
Keyword(s):  
Lived Experiences ◽  
Healthcare Professionals ◽  
Social Stigma ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Structured Interviews ◽  
Two Phases ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure

People living with HIV (PLWH) face social stigma which makes disclosure of HIV status difficult. The purpose of this descriptive qualitative study was to understand the lived experiences of stigmatization in the process of disease disclosure among PLWH in Taiwan. Analysis of the semi-structured interviews from 19 PLWH in Taiwan revealed two phases and six themes. Phase one “experiences before disclosure” involved three themes: “Struggles under the pressure of concealing the HIV Status,” “Torn between fear of unemployment/isolation and desire to protect closed ones,” and “Being forced to disclose the HIV status.” Phase two “experiences after disclosure” included three themes: “Receiving special considerations and requirements from school or work,” “Receiving differential treatments in life and when seeking medical care,” and “Stress relief and restart.” Healthcare professionals need to assess stigmatization in PLWH and develop individualized approaches to assist with the disease disclosure process.

scholarly journals Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sovannary Tuot ◽  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Pheak Chhoun ◽  
Chamroen Pall ◽  
...  
Keyword(s):  
Experimental Study ◽  
Antiretroviral Therapy ◽  
Scale Up ◽  
Economic Evaluations ◽  
People Living With Hiv ◽  
Cad Model ◽  
Community Based ◽  
Quasi Experimental ◽  
Living With Hiv ◽  
Art Delivery

Abstract Background Multi-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every 3-6 months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities’ burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model’s effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia. Methods We will conduct this quasi-experimental study in 20 ART clinics across the capital city and nine provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and adherence to ART. The secondary endpoints will include health providers’ work burden, the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective. Discussion This study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response. Trial registration ClinicalTrials.gov, NCT04766710. Registered 23 February 2021, Version 1.

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