scholarly journals The burden of anxiety among people living with HIV during the COVID-19 pandemic in Pune, India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ivan Marbaniang ◽  
Shashikala Sangle ◽  
Smita Nimkar ◽  
Kanta Zarekar ◽  
Sonali Salvi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Thematic Analysis ◽  
Family Income ◽  
Screening Tools ◽  
Prior History ◽  
Generalized Anxiety ◽  
People Living With Hiv ◽  
Health Related ◽  
History Of ◽  
Living With Hiv

Abstract Introduction Globally, India has the third largest population of people living with HIV (PLHIV) and the second highest number of COVID-19 cases. Anxiety is associated with antiretroviral therapy (ART) nonadherence. It is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during the COVID pandemic, but data are limited. Methods During the first month of government mandated lockdown, we administered an anxiety assessment via telephone among PLHIV registered for care at a publicly funded antiretroviral therapy (ART) center in Pune, India. Generalized anxiety was defined as GAD-7 score ≥ 10. Sociodemographic and clinical variables were compared by anxiety status (GAD-7 score ≥ 10 vs GAD-7 score < 10). Qualitative responses to an open-ended question about causes of concern were evaluated using thematic analysis. Results Among 167 PLHIV, median age was 44 years (IQR 40–50); the majority were cisgender women (60%) and had a monthly family income < 200 USD (81%). Prior history of tuberculosis and other comorbidities were observed in 38 and 27%, respectively. Overall, prevalence of generalized anxiety was 25% (n = 41). PLHIV with GAD-7 score ≥ 10 had fewer remaining doses of ART than those with lower GAD-7 scores (p = 0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions The burden of anxiety was high during COVID lockdown in our population of socioeconomically disadvantaged PLHIV in Pune and appeared to be influenced by concerns about ART availability. The burden of anxiety among PLHIV will likely increase with the worsening pandemic in India, as sources of anxiety are expected to persist. We recommend the regular use of short screening tools for anxiety to monitor and triage patients as an extension of current HIV services.

scholarly journals The burden of anxiety among people living with HIV during the COVID-19 pandemic in Pune, India

2020 ◽  
Author(s):  
Ivan Marbaniang ◽  
Shashikala Sangle ◽  
Smita Nimkar ◽  
Kanta Zarekar ◽  
Sonali Salvi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Thematic Analysis ◽  
Family Income ◽  
Screening Tools ◽  
Prior History ◽  
Generalized Anxiety ◽  
People Living With Hiv ◽  
Health Related ◽  
History Of ◽  
Living With Hiv

Abstract Introduction: Globally, India has the third largest population of people living with HIV (PLHIV) and the second highest number of COVID-19 cases. Anxiety is associated with antiretroviral therapy (ART) nonadherence. It is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during the COVID pandemic, but data are limited.Methods: During the first month of government mandated lockdown, we administered an anxiety assessment via telephone among PLHIV registered for care at a publicly funded antiretroviral therapy (ART) center in Pune, India. Generalized anxiety was defined as GAD-7 score ≥10. Sociodemographic and clinical variables were compared by anxiety status (GAD-7 score≥10 vs GAD-7 score<10). Qualitative responses to an open-ended question about causes of concern were evaluated using thematic analysis. Results: Among 167 PLHIV, median age was 44 years (IQR 40–50); the majority were cisgender women (60%) and had a monthly family income <200 USD (81%). Prior history of tuberculosis and other comorbidities were observed in 38% and 27%, respectively. Overall, prevalence of generalized anxiety was 25% (n=41). PLHIV with GAD-7 score ≥10 had fewer remaining doses of ART than those with lower GAD-7 scores (p=0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions: The burden of anxiety was high during COVID lockdown in our population of socioeconomically disadvantaged PLHIV in Pune and appeared to be influenced by concerns about ART availability. The burden of anxiety among PLHIV will likely increase with the worsening pandemic in India, as sources of anxiety are expected to persist. We recommend the regular use of short screening tools for anxiety to monitor and triage patients as an extension of current HIV services.

scholarly journals The Burden of Anxiety During the COVID-19 Pandemic Among People Living with HIV (PLHIV) in Pune, India

2020 ◽  
Author(s):  
Ivan Marbaniang ◽  
Shashikala Sangle ◽  
Smita Nimkar ◽  
Kanta Zarekar ◽  
Sonali Salvi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Thematic Analysis ◽  
Family Income ◽  
Screening Tools ◽  
Prior History ◽  
People Living With Hiv ◽  
Continuous Variables ◽  
Tertiary Healthcare ◽  
The Government ◽  
Living With Hiv

Abstract Introduction: There is a dearth of data on anxiety related to the COVID-19 pandemic from people living with HIV (PLHIV). This is a cause of concern as anxiety is associated with antiretroviral therapy (ART) nonadherence. Globally, India has the third largest population of PLHIV and third highest number of COVID-19 cases which are rapidly increasing. Therefore, it is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during this pandemic.Methods: We used data from a telephonically delivered assessment among PLHIV engaged in care at a tertiary healthcare associated antiretroviral therapy (ART) center in Pune, India. Assessments were conducted between April 21 and May 28, 2020, one month into the government mandated lockdown. GAD-7 was used to assess for anxiety over two-preceding weeks. Significant sociodemographic and clinical differences between groups (GAD-7<10 and GAD-7≥10) were assessed using Fisher’s exact and Wilcoxson rank sum tests, for categorical and continuous variables, respectively. Thematic analysis was employed to analyze an open-ended question that asked about the most pressing cause(s) of concern. Results: Of 167 PLHIV contacted, median age was 44 years (IQR:40 – 50), 60% (n=100) were cisgender women and 81% (n=135) had a monthly family income<200 USD. Thirty-eight percent (n=64) had prior history of tuberculosis and 27% (n=45) were living with another comorbidity. A fourth (25%, n=41) had GAD-7 scores indicative of generalized anxiety. PLHIV who had fewer remaining doses of ART had significantly higher GAD-7 scores compared to those that had more doses (p=0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions: In a group of socioeconomically disadvantaged PLHIV, a fourth were found to have anxiety, that appeared to be influenced by concerns about ART availability. Furthermore, the persistence of sources of anxiety and therefore an increase in anxiety for these PLHIV is anticipated as the pandemic worsens in India. We recommend the regular utilization of short screening tools for anxiety to monitor and triage PLHIV as an extension of current HIV-services.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

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.

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 Can we talk about price with patients when choosing antiretroviral therapy? A survey with people living with HIV and prescribers in France

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e046212
Author(s):  
Emmanuelle Papot ◽  
Nikos Kalampalikis ◽  
Marjolaine Doumergue ◽  
Fabrice Pilorgé ◽  
Guillemette Quatremère ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The North ◽  
Hiv Epidemic ◽  
Voluntary Response ◽  
History Of ◽  
Using Data ◽  
Living With Hiv

ObjectiveThe aim of this study was to evaluate people living with HIV (PLWH) and HIV specialist prescribers’ perception of discussing antiretroviral therapy (ART) price in PLWH’s care and the acceptability of choosing or switching to various types of less expensive ARTs.DesignCross-sectional surveys (one in a convenience sample of PLWH and one in a voluntary response sample of HIV specialist prescribers).Setting and participantsThe surveys were conducted among PLHW attending an HIV clinic in the North of Paris (cohort of 4922 PLWH in 2016), and HIV specialists working in French HIV clinics (210 across 12 districts/28), between January and June 2016.MethodSelf-administered questionnaires were constructed using data collected during focus groups with PLWH and prescribers. Pretests were carried out to select the questions and items. Descriptive analyses of the 129 complete questionnaires of PLWH and 79 of prescribers are presented.ResultsAmong PLWH, 128/129 were on ART and 54% (69/128) gave a fair estimation of the price of their current regimen. Among prescribers, 24% (19/79) thought that their patients knew this price. Taking into account the price of ART was not perceived as a negative step in the history of French response to HIV epidemic for 53% (68/129) of PLWH and 82% (65/79) of prescribers. Seventy-seven PLWH (60%) would agree to switch to less expensive antiretroviral regimens (as effective and with similar adverse events) if pills were bigger; 42 (33%) if there were more daily doses, and 37 (29%) if there were more pills per dose; prescribers were more circumspect.ConclusionA high proportion of PLWH gave a fair estimate of their ART price and this seemed unexpected by HIV specialists. Consideration of drug prices when choosing ART was perceived as conceivable by PLWH and prescribers if effectiveness and tolerance were also considered.

Nursing Considerations for Patients With HIV in Critical Care Settings

2020 ◽  
Vol 31 (3) ◽  
pp. 308-317
Author(s):  
Lucy Graham ◽  
Mary Beth Flynn Makic
Keyword(s):  
Critical Care ◽  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Secondary Complications ◽  
Qt Intervals ◽  
Appropriate Treatment ◽  
Increased Risk ◽  
History Of ◽  
Living With Hiv

Infection with HIV is a chronic condition that requires daily medication to suppress viral replication. With appropriate treatment, people living with HIV have a life expectancy approaching that of the general population. However, they are at increased risk for comorbidities including cardiovascular disease, renal disease, type 2 diabetes, neurologic conditions, and cancers, often with worse outcomes than in patients without HIV. When they are admitted to critical care settings, care considerations, particularly regarding antiretroviral therapy, must be addressed. Antiretroviral therapy is critical for successful management of HIV infection and should be continued when possible during intensive care unit stays. However, many antiretroviral regimens result in drug-drug interactions, adverse drug-related events, and secondary complications such as insulin resistance and prolonged QT intervals. Critical care nurses have unique opportunities to provide safe, unbiased, and compassionate care that promotes health for a population of people who have a history of being stigmatized.

An assessment of factors associated with neurocognitive decline in people living with HIV

2021 ◽  
pp. 095646242110433
Author(s):  
Zaeema Naveed ◽  
Howard S Fox ◽  
Christopher S Wichman ◽  
Pamela May ◽  
Christine M Arcari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Cox Proportional Hazards ◽  
Health Concern ◽  
People Living With Hiv ◽  
Hepatitis C Infection ◽  
Factors Associated ◽  
History Of ◽  
Living With Hiv ◽  
Neurocognitive Decline

Despite the widespread use of combination antiretroviral therapy (cART), HIV-associated neurocognitive impairment (NCI) remains a health concern. However, limited research has been done to identify factors associated with neurocognitive decline. We assessed risk factors associated with neurocognitive decline in people living with HIV using a definition of decline that is statistically easy to adopt, is based on a commonly used neuropsychological cut-off and may be clinically relevant. Cox proportional hazards modeling was performed using the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study database. 581 participants were followed for up to 12 years. Neurocognitive decline was defined as the first observed drop in global T-scores of at least 2.67. Lifetime methamphetamine use had the strongest association with neurocognitive decline (adjusted Hazard Ratio; aHR = 1.48; 95% CI = 0.92–2.39) followed by no current antiretroviral medication use (aHR = 1.32; 95% CI = 0.91–1.92). Other risk factors included Hispanic ethnicity, lifetime history of major depressive disorder, lifetime cannabis use, hepatitis-C infection, and difficulty eating, dressing, bathing, or using the toilet. Results indicate that consistent use of ART may be of high significance to preserving neurocognition. Furthermore, Hispanic patients, those with a history of depression and substance use, and those having difficulty in essential activities of daily living may require vigilant follow-up.

scholarly journals Chronic obstructive pulmonary disease prevalence and associated factors in an urban HIV clinic in a low income country

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256121
Author(s):  
Ahmed Ddungu ◽  
Fred C. Semitala ◽  
Barbara Castelnuovo ◽  
Christine Sekaggya-Wiltshire ◽  
William Worodria ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Low Income ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
Shortness Of Breath ◽  
Obstructive Pulmonary Disease ◽  
Low Income Country ◽  
Wide Availability ◽  
History Of ◽  
Living With Hiv

Introduction In the last decade, survival of people living with HIV (PLHIV) has dramatically increased due wide availability of effective antiretroviral therapy. However, PLHIV remain at a comparatively higher risk of non-communicable comorbidities. We sought to determine the burden of COPD and its associations in an urban tertiary HIV clinic in Uganda. Methods and findings HIV-infected adults attending the Makerere University Joint AIDS program; aged ≥30 years without acute ailments were screened for COPD using study questionnaires and spirometry (post-bronchodilator FEV1/FVC<0.7). We determined its prevalence and association with demographic characteristics, body mass index (BMI) and known risk factors. Of 288 participants enrolled, 177 (61%) were female; 253 (88%) were from urban residences, median age was 45 years (IQR: 39–51), 71(25%) were ‘ever’ smokers, 284(99%) reported biomass fuel use and 72(25%) had a history of tuberculosis. All except 1 participant were on antiretroviral therapy, median current CD4 (cells/mm3) was 558 (IQR 402–753) and 275(96%) were virologically suppressed. Nearly half (130/288, 45%) had recurrent respiratory symptoms. The prevalence of COPD was 3.1% (9/288) [95% CI: 1.63–5.92]. COPD was associated with: previous tuberculosis, (adjusted odds ratio (AOR): 6.36, [95% CI 1.64–35.84], P = 0.036), self-reported chronic shortness of breath (AOR: 9.06, [95% CI 1.34–61.10], P = 0.024) and a BMI <21 Kg/m2 (AOR: 10.42 [95% CI: 1.61–100.00], P = 0.013). Conclusion In this HIV population, COPD prevalence was low and was associated with previous tuberculosis, self-reported chronic shortness of breath and BMI <21 Kg/m2.

scholarly journals Antiretroviral therapy adherence and self-efficacy among people living with HIV and a history of drug use in Vietnam

2017 ◽  
Vol 28 (12) ◽  
pp. 1247-1254 ◽  
Author(s):  
Li Li ◽  
Chunqing Lin ◽  
Sung-Jae Lee ◽  
Le Anh Tuan ◽  
Nan Feng ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Drug Use ◽  
Treatment Adherence ◽  
Self Efficacy ◽  
Controlled Trial ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Heroin Use ◽  
History Of ◽  
Living With Hiv

People living with HIV with a history of drug use face additional psychosocial challenges that could compromise their adherence to antiretroviral therapy (ART). This study examined ART treatment adherence and adherence self-efficacy among people living with HIV with a history of drug use in Vietnam. We used cross-sectional baseline data collected between October 2014 and February 2015 from a randomized controlled trial in Vietnam. Of the 900 persons with a history of drug use in the trial, a sample of 109 people living with HIV currently on ART were included in the study. The vast majority (92%) of the participants reported not missing any medications in the past 30 days. Multiple regression results indicated that social support was positively associated with adherence self-efficacy (β = 0.420, P < 0.001) and general adherence to ART (β = 0.201, P = 0.0368). General adherence to ART was negatively associated with depressive symptoms (β = −0.188, P = 0.046) and current heroin use (β = −0.196, P = 0.042). These findings underscore the importance of addressing mental health and social challenges facing people living with HIV with a history of drug use to promote ART treatment adherence. Clinical management of HIV should identify and address concurrent substance use behaviors to maximize adherence and treatment outcomes.

scholarly journals High HIV Prevalence Among Low Income and Laborers in the District of Purba Medinipur, West Bengal, India

2013 ◽  
Vol 9 (2) ◽  
pp. 1-4
Author(s):  
DK Biswas ◽  
R Bhunia ◽  
A Mishra
Keyword(s):  
Hiv Infection ◽  
Low Income ◽  
Family Income ◽  
Economic Status ◽  
Heterosexual Transmission ◽  
People Living With Hiv ◽  
History Of ◽  
Social Amenities ◽  
Living With Hiv ◽  
Hiv Aids

Introduction: There were limited data of “People Living with HIV/AIDS” (PLHA). The data of PLHA were  analyzed in time, place and person and socio-economic status and recommended for prevention of HIV  infection. Objective of study were to describe the PLHAs in term of time, place and person distribution  and their socio-demographic status, to detect the mode of transmission of HIV and to recommend for  prevention of spread HIV infection and social security. Methodology: The information about socio-demographic status and exposure history of PLHAs since  2010 was collected. Data were analyzed by using Epi-info software. Results: Among 329 PLHAs, 165 (50%) were men and 42 (13%) were children <14 years and they  acquired HIV through blood transfusion 26 (62%). A maximum 276 (84%) PLHAs were age group 15 -  45 years. Out of 25 Community Block in district, maximum PLHAs were distributed at Tamluk Block 56  (17%) followed by Paskura 43 (13%). Of PLHAs, 246 (75%) had family income rupees <2000.00 per  month and 138 (38%) of them were laborer and 85 (26%) home maker (house-wife). Highest 289 (88%)  of PLHAs acquired HIV through heterosexual route. Conclusion: Heterosexual transmission of HIV showed among low income and laborer. The counseling  for safe sex practice, employment people and social amenities were recommended. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2012; IX(2) 1-4 DOI: http://dx.doi.org/10.3126/saarctb.v9i2.7970

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