scholarly journals “How am I going to live?”: exploring barriers to ART adherence among adolescents and young adults living with HIV in Uganda

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Sarah MacCarthy ◽  
Uzaib Saya ◽  
Clare Samba ◽  
Josephine Birungi ◽  
Stephen Okoboi ◽  
...  
Keyword(s):  
Young Adults ◽  
Adolescents And Young Adults ◽  
Art Adherence ◽  
Living With Hiv

scholarly journals Feasibility and Acceptability of Digital Gaming to Improve Adherence among Adolescents and Young Adults Living with HIV (Preprint)

2018 ◽  
Author(s):  
Amanda D. Castel ◽  
Saba Qasmieh ◽  
Daniel Greenberg ◽  
Nicole Ellenberger ◽  
Tyriesa Howard Howell ◽  
...  
Keyword(s):  
Young Adults ◽  
Healthcare Providers ◽  
Digital Games ◽  
Pediatric Hiv ◽  
Adolescents And Young Adults ◽  
Art Adherence ◽  
Digital Gaming ◽  
Adherence Support ◽  
Adherence Intervention ◽  
Living With Hiv

BACKGROUND An estimated 50% of adolescents and young adults (AYA) living with HIV are failing to adhere to prescribed antiretroviral treatment (ART). Digital games are effective in chronic disease management; however, research on gaming to improve ART adherence among AYA is limited. OBJECTIVE We assessed the feasibility and acceptability of videogaming to improve AYA ART adherence. METHODS Focus group discussions (FGDs) and surveys were administered to healthcare providers and AYA aged 13-24 years living with HIV at a pediatric HIV program in Washington, DC. During FGDs, AYA viewed demonstrations of three game prototypes linked to portable Wisepill medication dispensers. Content analysis strategies and thematic coding were used to identify adherence themes and gaming acceptance and feasibility. Likert scale and descriptive statistics were used to summarize response frequencies. RESULTS Providers (n=10) identified common adherence barriers and strategies, including use of gaming analogies to improve AYA ART adherence. Providers supported exploration of digital gaming as an adherence intervention. Six FGDs with 12 AYA identified disclosure of HIV status and irregular daily schedules as major barriers to ART and use of alarms and pillboxes as reminders. Most AYA were "very or somewhat likely" to use the demonstrated game prototypes to help with ART adherence and desired challenging, individually-tailored, user-friendly games with in-game incentives. Game prototypes were modified accordingly. CONCLUSIONS AYA and their providers supported the use of digital games for ART adherence support. Individualization and in-game incentives were preferable and informed the design of an interactive technology-based adherence intervention among AYA living with HIV.

scholarly journals Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e043941
Author(s):  
Tafadzwa Dhokotera ◽  
Julia Bohlius ◽  
Matthias Egger ◽  
Adrian Spoerri ◽  
Jabulani Ronnie Ncayiyana ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Cross Sectional Study ◽  
Adolescents And Young Adults ◽  
Hiv Positive ◽  
Sectional Study ◽  
Hiv Status ◽  
Cross Sectional ◽  
Laboratory Service ◽  
Living With Hiv

ObjectiveTo determine the spectrum of cancers in adolescents and young adults (AYAs) living with and without HIV in South Africa.DesignCross-sectional study with cancer records provided by the National Cancer Registry (NCR) and HIV records from the National Health Laboratory Service (NHLS).Setting and participantsThe NHLS is the largest provider of pathology services in the South African public sector. The NCR is a division of the NHLS. We included AYAs (aged 10–24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8479). HIV status was obtained through record linkages and text mining.Primary and secondary outcomesWe determined the spectrum of cancers by HIV status in AYAs. We used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex, ethnicity and calendar period. We imputed (post hoc) the HIV status for AYA with unknown HIV status.Results8479 AYAs were diagnosed with cancer, HIV status was known for 45% (n=3812). Of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi’s sarcoma (adjusted OR (aOR) 218, 95% CI 89.9 to 530), cervical cancer (aOR 2.18, 95% CI 1.23 to 3.89), non-Hodgkin’s lymphoma (aOR 2.12, 95% CI 1.69 to 2.66) and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27 to 5.86) than AYAs without HIV. About 44% (n=1062) of AYAs with HIV-related cancers had not been tested for HIV.ConclusionsTargeted HIV testing for AYAs diagnosed with cancer, followed by immediate start of antiretroviral therapy, screening for cervical precancer and vaccination against human papilloma virus is needed to decrease cancer burden in AYAs living with HIV in South Africa.

scholarly journals Call For Life, Uganda: Acceptability Of A Mobile Phone Support To Promote Adherence To Anti-Retroviral Therapy For Young Adults In A Randomised Control Trial: A Qualitative Review (Preprint)

2019 ◽  
Author(s):  
Agnes Bwanika Naggirinya
Keyword(s):  
Human Immunodeficiency Virus ◽  
Young Adults ◽  
Mobile Phone ◽  
Interactive Voice Response ◽  
Text Messages ◽  
Randomised Control Trial ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Immunodeficiency Virus ◽  
Living With Hiv

BACKGROUND : Adherence to treatment is critical to obtain successful treatment outcomes. While factors influencing antiretroviral therapy (ART) adherence vary, young adults are less likely to adhere because of psychosocial issues such as stigma, ART-related side effects as well as lack of access to treatment. Call for Life mHealth tool (C4LU), is a mobile phone- based technology that provides text messages or Interactive Voice Response (IVR) functionalities, through a web-interface and offers four modules including pill reminders, clinic visit reminders, health tips and symptom self-reporting support. Within a randomised control trial, we assessed perspectives and experiences of young adults living with human immunodeficiency virus towards the C4LU- system, with the objective to improve ART adherence among young people living with HIV with help of mHealth tool. OBJECTIVE To improve ART adherence among young people living with HIV through use of mHealth tool. METHODS This was an exploratory qualitative design at two study sites nested within an open label randomized controlled trial (RCT) entitled: “Improving outcomes in human immunodeficiency virus (HIV) patients using mobile phone based interactive software support “Call for Life study A total of 600 participants were randomly assigned 1:1 to either Standard of Care (SoC)- face-to-face counsellor adherence support or SoC plus mHealth call for life system (C4LU). C4LU uses Interactive voice response or text messages delivered via mobile phone. The qualitative study explored perspectives and experiences of young adults (18-24 years) towards the mHealth tool “C4LU”. A purposive sample of twenty-one vulnerable youth, seventeen from the intervention and four from the SoC arm were selected. We used semi-structured interviews to facilitate an in-depth exploration of experiences of young adults regarding C4LU-System. Thirteen in-depth interviews and one focus group discussion were conducted. The young adults were from four categories of population of interest that were targeted to be offered specialised care: young adults on PMTCT, switching to / or on second line ART, positive partners in a discordant relationship and initiating 1st line ART. Data was managed using Nvivo version 11 and analysed thematically. RESULTS C4LU-mHealth tool was perceived as an acceptable intervention for young adults. While on the system, participants reported: improvement in medication adherence, strengthened doctor /clinician -patient relationships, increased health knowledge through educative health tips. Appointment reminders and symptom reporting were singled out as beneficial because the system would address and manage the problems of forgetfulness, and stigma related issues. CONCLUSIONS The system was described as an acceptable and feasible strategy to improve ART adherence and retention among young adults in resource limited settings CLINICALTRIAL Trial Registration: ClinicalTrials.gov NCT 02953080

scholarly journals WYZ: Results of a pilot study of a mobile health application for engagement in care and antiretroviral therapy adherence among youth and young adults living with HIV (Preprint)

2020 ◽  
Author(s):  
Parya Saberi ◽  
Nadra E. Lisha ◽  
Xavier A. Erguera ◽  
Estie S. Hudes ◽  
Mallory O. Johnson ◽  
...  
Keyword(s):  
Young Adults ◽  
Antiretroviral Therapy ◽  
San Francisco ◽  
Mobile Health ◽  
Pilot Trial ◽  
Hiv Care ◽  
Art Adherence ◽  
Engagement In Care ◽  
Youth And Young Adults ◽  
Living With Hiv

BACKGROUND Youth are globally recognized as being vulnerable to HIV. Younger age has been correlated with worse health outcomes. Mobile health (mHealth) delivered interventions have the potential to meet youth where they are, using a device they already access. OBJECTIVE Using pre-defined benchmarks, we sought to evaluate the feasibility and acceptability of WYZ, an mHealth application, for improved engagement in care and antiretroviral therapy (ART) adherence among youth and young adults living with HIV (YLWH). WYZ was designed and developed with input from YLWH using a Human-Centered Design approach and based on the Information, Motivation, Behavioral Skills framework to address common barriers to care and ART adherence among YLWH. METHODS We recruited YLWH (18–29 years old) in the San Francisco Bay Area to take part in a six-month pilot trial. Their participation included completing a baseline and exit survey and participating in seven phone check-ins about their use of WYZ. RESULTS YLWH (N= 79) reported high levels of feasibility and acceptability with WYZ use. We met pre-defined benchmarks for recruitment, mean log-ins per week, tracking ART adherence, posting chat topics, and app crashes reported. Ease of app download, install, and set up, as well as comfort with security, privacy, and anonymity were highly rated. Additionally, participants reported high satisfaction for a research project that was remotely conducted. Participants used the app for shorter timeframes compared to the pre-defined benchmarks. CONCLUSIONS We noted high feasibility and acceptability with WYZ. Further research to examine the efficacy of WYZ will enable YLWH and their providers to make informed decisions when using, recommending, and prescribing it for improved engagement in HIV care and ART adherence. CLINICALTRIAL NCT03587857

scholarly journals Effectiveness of Peer Support Interventions for Adolescents and Young Adults Living with HIV Globally

2020 ◽  
Vol 3 ◽  
Author(s):  
Helen Hernandez ◽  
Hanna Craven ◽  
Judith Toromo ◽  
Leslie Enane
Keyword(s):  
Young Adults ◽  
Peer Support ◽  
Retention In Care ◽  
Small Sample ◽  
Adolescents And Young Adults ◽  
Favorable Effect ◽  
Current Evidence ◽  
Current Evidence Base ◽  
Living With Hiv ◽  
Peer Interventions

Background: Adolescents and young adults living with HIV (AYALHIV, ages 10-24) have poorer outcomes in care compared to other age groups. The global Treat All strategy aims to extend antiretroviral therapy (ART) to all individuals living with HIV. Efforts to improve outcomes in the AYALHIV population are essential to successfully achieving viral suppression and improving the long-term health outcomes of young people, and ultimately to ending the HIV pandemic. Peer support interventions are increasingly implemented by care programs, and are broadly favored by AYALHIV. This systematic review will evaluate the current evidence for quantitative effects of peer support interventions on AYALHIV treatment outcomes.   Methods:  We searched MEDLINE, Embase, Global Health, CINAHL Complete, Cochrane, and Scopus databases for papers published between 1994 and October 2019, in all languages and regions. Studies of the effect of peer support interventions for AYALHIV on measures of adherence or retention in care were included. Solely qualitative studies and those without a comparator or control were excluded. Three researchers screened the papers independently, and those meeting criteria were included. Abstracted variables included study characteristics, participant population, peer intervention characteristics, and outcomes.   Results: The current evidence base for the effect of peer interventions for AYALHIV is very limited. Included studies were of small sample size, and primarily consisted of observational cohort studies with imperfect comparators. In initial analyses we find that studies of peer interventions have had mixed findings regarding the effect of such interventions on adherence to ART. By contrast, studies have consistently reported a favorable effect of peer interventions on increased retention in care among AYALHIV.   Conclusion/Implications: Rigorous studies of interventions to improve outcomes among AYALHIV are urgently needed. Further analyses in this review will examine differences according to study population, design, or intervention characteristics, which may underlie variable effects identified. 

Associations Between Internalized HIV Stigma and Tobacco Smoking Among Adolescents and Young Adults Living with HIV: The Moderating Role of Future Orientations

2019 ◽  
Vol 24 (1) ◽  
pp. 165-172
Author(s):  
Kristi E. Gamarel ◽  
Zoe Finer ◽  
Kenneth Resnicow ◽  
Monique Green-Jones ◽  
Erica Kelley ◽  
...  
Keyword(s):  
Young Adults ◽  
Tobacco Smoking ◽  
Adolescents And Young Adults ◽  
Hiv Stigma ◽  
Future Orientations ◽  
Living With Hiv ◽  
Moderating Role

scholarly journals Predicting cognitive performance from physical activity and fitness in adolescents and young adults in Botswana relative to HIV status

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Leapetswe Malete ◽  
Jennifer L. Etnier ◽  
Dawn M. Tladi ◽  
Jarod C. Vance ◽  
Gabriel M. Anabwani
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Adolescents And Young Adults ◽  
Sorting Task ◽  
Card Sorting ◽  
Hiv Status ◽  
Card Sorting Task ◽  
Word Task ◽  
Living With Hiv ◽  
Hiv Negative

AbstractLittle is known about whether physical activity and fitness could enhance cognition in adolescents and young adults living with HIV. The purpose of this study was to examine this relationship in a group of 250 HIV+ (n = 88) and HIV negative (n = 162) participants from Botswana, aged 12–23 years (Mean = 17.87, SD = 2.24). Fitness was operationalized as muscular strength (push-ups) and aerobic endurance (PACER). PA was assessed using items from the Youth Risk Behavior Surveillance Survey. Cognition was measured using the Corsi Test, Berg Card Sorting Task (BCST), and Stroop Color Word Task (Stroop). Multiple regression analyses indicated that the HIV x push-ups interaction was a significant predictor of Corsi performance, and HIV status was a significant predictor of BCST performance (p < 0.05). For the Stroop portions, HIV status and HIV x push-ups were significant predictors (p < 0.01). HIV status is predictive of cognition and interacts with muscular fitness to predict cognition.

scholarly journals Psychosocial Support Interventions for Improved Adherence and Retention in ART care for Young People Living with HIV: A Scoping Review

2020 ◽  
Author(s):  
Emeka Francis Okonji ◽  
Ferdinand C. Mukumbang ◽  
Zaida Orth ◽  
Shelley A. Vickerman-Delport ◽  
Brian Van Wyk
Keyword(s):  
Young Adults ◽  
Medication Adherence ◽  
Young People ◽  
Scoping Review ◽  
Psychosocial Support ◽  
Retention In Care ◽  
Adolescents And Young Adults ◽  
People Living With Hiv ◽  
Living With Hiv

Abstract Background: Mental health disorders such as high levels of anxiety, isolation, depression and suicide ideation reported among young people living with HIV (10-24; YPLWH) contribute significantly to poor medication adherence and retention in care. While there is evidence supporting the role of psychosocial support interventions in promoting adherence and retention in antiretroviral treatment (ART) among adults living with HIV, there is little evidence on the role of psychosocial support on medication adherence among YPLWH . This scoping review was designed to identify and classify the types and effects of psychosocial support interventions designed to improve adherence and retention in ART among adolescents and young people living with HIV globally. Method: We searched six electronic databases (i.e., Scopus, Pubmed and EBSCOHost (Academic Search Premier, CINAHL, Psycarticles and Medline). Six relevant articles published between 2011 and 2019 met our inclusion criteria. We extracted information relevant to the nature and outcomes of the reported interventions using thematic content analysis informed by the Population, Intervention, comparison, outcome, and time (PICOT) framework. Results: Four distinctive treatment modalities that focused on improving ART adherence and retention in care were identified: individual counselling, support groups, family-centered services, and treatment supporters. Conclusion: There is a dearth of psychosocial support interventions to improve adherence and retention in ART amongst adolescents and young adults living with HIV. Future research and programming should seek to address psychosocial support interventions or approaches specifically designed to address the needs of adolescents and young adults living with HIV.PROSPERO: Registration CRD42018105057

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