scholarly journals Facilitators and barriers to antiretroviral therapy adherence among HIV-positive adolescents living in Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cosette Audi ◽  
Ola Jahanpour ◽  
Gretchen Antelman ◽  
Laura Guay ◽  
Mastidia Rutaihwa ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Support Groups ◽  
Support Group ◽  
Psychosocial Support ◽  
Virologic Failure ◽  
Positive Influence ◽  
Hiv Positive ◽  
Art Adherence ◽  
Antiretroviral Therapy Adherence ◽  
Group Experiences

Abstract Background Adolescents living with HIV face substandard outcomes along the continuum of care, including higher rates of poor adherence and virologic failure. Support groups have been identified as a method to improve adherence, but there is insufficient evidence regarding their effectiveness. This study seeks to examine the protective influences for and barriers to antiretroviral therapy (ART) adherence in HIV-positive adolescents living in Tanzania. Methods This is a qualitative study conducted in Tanzania from January to March 2018. The sample of adolescents aged 10-19 (n = 33) was purposefully selected based on age, gender, and support group attendance to capture a broad range of experiences. Participants completed an in-depth interview, covering topics such as retention in HIV services, support group experiences, and joys and challenges of adolescent life. Interviews were coded and themes related to ART adherence were identified and summarized. Results Support groups helped promote adherence by improving adolescents’ knowledge and confidence. Participants associated joining support groups with an improvement in health. Almost every participant described the significant positive influence a treatment supporter had on adherence. Adolescents’ daily schedules and emotional state served as a barrier to adherence. Furthermore, adherence was negatively impacted by participants’ fear of accidental disclosure. Conclusion Logistical and psychosocial factors can hinder adherence. Interventions that provide both education and psychosocial support, such as peer support groups, have the potential to improve health outcomes for this population, but may not address more persistent barriers to adherence rooted in lack of treatment support from family members or friends who have not been disclosed to, or lack of transportation funds/food security.

scholarly journals Assessing the impact of HIV support groups on antiretroviral therapy adherence and viral suppression in the African cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Prudence Mbah ◽  
Michael Iroezindu ◽  
Allahna L. Esber ◽  
Nicole Dear ◽  
Domonique Reed ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Support Groups ◽  
Support Group ◽  
Viral Suppression ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Art Adherence ◽  
African Countries ◽  
The Impact

Abstract Background Support groups for people living with HIV (PLWH) may improve HIV care adherence and outcomes. We assessed the impact of support group attendance on antiretroviral therapy (ART) adherence and viral suppression in four African countries. Methods The ongoing African Cohort Study (AFRICOS) enrolls participants at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Self-reported attendance of any support group meetings, self-reported ART adherence, and HIV RNA are assessed every 6 months. Logistic regression models with generalized estimating equations were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for support group attendance and other factors potentially associated with ART adherence and viral suppression. Results From January 2013 to December 1, 2019, 1959 ART-experienced PLWH were enrolled and 320 (16.3%) reported any support group attendance prior to enrollment. Complete ART adherence, with no missed doses in the last 30 days, was reported by 87.8% while 92.4% had viral suppression <1000copies/mL across all available visits. There was no association between support group attendance and ART adherence in unadjusted (OR 1.01, 95% CI 0.99–1.03) or adjusted analyses (aOR 1.00, 95% CI 0.98–1.02). Compared to PLWH who did not report support group attendance, those who did had similar odds of viral suppression in unadjusted (OR 0.99, 95% CI 0.978–1.01) and adjusted analyses (aOR 0.99, 95% CI 0.97–1.01). Conclusion Support group attendance was not associated with significantly improved ART adherence or viral suppression, although low support group uptake may have limited our ability to detect a statistically significant impact.

Group Experiences and Individual Differences in Stuttering

2019 ◽  
Vol 62 (12) ◽  
pp. 4335-4350 ◽  
Author(s):  
Seth E. Tichenor ◽  
J. Scott Yaruss
Keyword(s):  
Individual Differences ◽  
Support Groups ◽  
Support Group ◽  
Affective States ◽  
Life Outcomes ◽  
Self Help ◽  
Wide Range ◽  
Group Experiences ◽  
History Of ◽  
Adults Who Stutter

Purpose This study explored group experiences and individual differences in the behaviors, thoughts, and feelings perceived by adults who stutter. Respondents' goals when speaking and prior participation in self-help/support groups were used to predict individual differences in reported behaviors, thoughts, and feelings. Method In this study, 502 adults who stutter completed a survey examining their behaviors, thoughts, and feelings in and around moments of stuttering. Data were analyzed to determine distributions of group and individual experiences. Results Speakers reported experiencing a wide range of both overt behaviors (e.g., repetitions) and covert behaviors (e.g., remaining silent, choosing not to speak). Having the goal of not stuttering when speaking was significantly associated with more covert behaviors and more negative cognitive and affective states, whereas a history of self-help/support group participation was significantly associated with a decreased probability of these behaviors and states. Conclusion Data from this survey suggest that participating in self-help/support groups and having a goal of communicating freely (as opposed to trying not to stutter) are associated with less negative life outcomes due to stuttering. Results further indicate that the behaviors, thoughts, and experiences most commonly reported by speakers may not be those that are most readily observed by listeners.

scholarly journals ANALYSIS OF ONLINE INFORMATION ON SUPPORT GROUP MEETINGS FOR CROHN’S DISEASE PATIENTS

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S52-S53
Author(s):  
Jooyoung Moon ◽  
Hanna Moon
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Support Groups ◽  
Support Group ◽  
Psychosocial Support ◽  
Online Information ◽  
Online Support Group ◽  
Significance Level ◽  
Group Meetings ◽  
Google Search

Abstract Background In 2018, the American College of Gastroenterology published guidelines for Crohn’s disease management that emphasized the importance of addressing the patient’s quality of life (QOL). Due to the unique challenges that they face, afflicted patients and their families benefit from support groups that provide psychosocial support. Hospitals have traditionally preferred in-person support group meetings, but there has recently been a great increase in the need for online meetings amidst the COVID-19 pandemic. With increasing usage of the Internet for health advice and assistance, it is important to assess the availability of information on support groups online. Methods Two independent investigators queried the terms “Crohn’s support group” using the Google search engine. The first 100 websites were analyzed and categorized into either informational websites (IW) or professional websites (PW) depending on their association. The mode of support group meetings was categorized as either online or in-person. Websites that included outdated events, were inaccessible, did not specify the mode of meeting, required additional contact, or were irrelevant were excluded. Statistical analyses were performed using the chi-squared test of independence with significance level at p&lt;0.05. Results A total of 56 websites (33 IW, 23 PW) met our inclusion criteria. IW offered online meetings more often than PW (60.6% and 39.1%, respectively; p=0.11). In contrast, PW offered in-person meetings more often than IW (73.9% and 69.7%, respectively; p=0.73). Excluded websites (30 IW, 14 PW) were further analyzed for their reason for elimination. For IW, the most frequent causes of exclusion in descending order were as follows: irrelevance (30.0%), outdated (26.7%), inaccessible (20.0%), did not specify the mode of meeting (13.3%), and redirected for further information (10.0%). Listing of outdated sessions was the most common reason for exclusion of PW from the study (57.1%), and the proportion was significantly higher than IW (26.7%) (p=0.01). Conclusion Crohn’s disease patients face unique challenges that require special attention. Support groups are an important means of alleviating stress, depression, and anxiety in order to improve their QOL. Yet, due to the COVID-19 social distancing policies, many are refrained from participating in in-person sessions. This study illustrates that more online support group meetings are needed and that professional websites should improve on making regular updates for future meeting sessions.

Intracranial hypertension and papilloedema as a complication to low antiretroviral therapy adherence in a man living with chronic HIV

2021 ◽  
Vol 14 (3) ◽  
pp. e237504
Author(s):  
Rosa Maja Møhring Gynthersen ◽  
Helene Mens ◽  
Marianne Wegener ◽  
Neval Ete Wareham
Keyword(s):  
Antiretroviral Therapy ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Ventricular Volume ◽  
Art Adherence ◽  
Hiv Viral Load ◽  
Blurred Vision ◽  
Antiretroviral Therapy Adherence ◽  
Acute Retroviral Syndrome

We describe a 61-year-old man living with HIV on antiretroviral therapy (ART), who presented with headache, dizziness and blurred vision. Latest CD4+ cell count 3 months prior to admission was 570×106 cells/mL and HIV viral load <20 copies/mL. The patient was diagnosed with cerebrospinal fluid (CSF) lymphocytic pleocytosis, raised intracranial pressure and papilloedema. Neuroimaging showed normal ventricular volume and no mass lesions, suggesting (1) neuroinfection (2) idiopathic intracranial hypertension or (3) retroviral rebound syndrome (RRS) as possible causes. Neuroinfection was ruled out and idiopathic intracranial hypertension seemed unlikely. Elevated plasma HIV RNA level was detected consistent with reduced ART adherence prior to admission. RRS is a virological rebound after ART interruption, which can mimic the acute retroviral syndrome of acute primary infection. To the best of our knowledge, we describe the second case of RRS presenting as CSF lymphocytic pleocytosis and elevated intracranial pressure after low ART adherence.

scholarly journals Association of Suboptimal Antiretroviral Therapy Adherence With Inflammation in Virologically Suppressed Individuals Enrolled in the SMART Study

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Jose R Castillo-Mancilla ◽  
Andrew N Phillips ◽  
James D Neaton ◽  
Jacqueline Neuhaus ◽  
Simon Collins ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Confidence Interval ◽  
Cohort Studies ◽  
Plasma Concentrations ◽  
Virologic Suppression ◽  
Art Adherence ◽  
Antiretroviral Therapy Adherence ◽  
Smart Study ◽  
Hiv 1 ◽  
D Dimer

Abstract Suboptimal (ie, &lt;100%) antiretroviral therapy (ART) adherence has been associated with heightened inflammation in cohort studies, even among people with virologic suppression. We aimed to evaluate this association among participants in the Strategies for Management of Antiretroviral Therapy (SMART) study who had virologic suppression (HIV-1 VL &lt; 200 copies/mL) at enrollment. Based on self-reported adherence (7-day recall), plasma concentrations of interleukin 6 and D-dimer were 9% (95% confidence interval [CI], 1%–18%; P = .02) and 11% (95% CI, 1%–22%; P = .03) higher in participants who reported suboptimal vs 100% adherence, respectively. These findings confirm previous observations and support the hypothesis that suboptimal ART adherence, even in the context of virologic suppression, may have significant biological consequences. ClinicalTrials.gov number NCT00027352

scholarly journals Option B plus antiretroviral therapy adherence and associated factors among HIV positive pregnant women in Southern Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Dawit Jember Tesfaye ◽  
Desalegn Tsegaw Hibistu ◽  
Teshome Abuka Abebo ◽  
Feleke Tafesse Asfaw ◽  
Kaleegziabher Lukas ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Associated Factors ◽  
Southern Ethiopia ◽  
Hiv Positive ◽  
Therapy Adherence ◽  
Antiretroviral Therapy Adherence

scholarly journals The Comparison of Teen Clubs vs. Standard Care on Treatment Outcomes for Adolescents on Antiretroviral Therapy in Windhoek, Namibia

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Farai K. Munyayi ◽  
Brian E. van Wyk
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Outcomes ◽  
Standard Care ◽  
Psychosocial Support ◽  
Peer Group ◽  
Cohort Analysis ◽  
Hiv Disclosure ◽  
Virologic Suppression ◽  
Art Adherence ◽  
Adherence Support

Background. Adolescents living with HIV (ALHIV) are challenged to adhere to antiretroviral therapy (ART) and achieve and maintain virologic suppression. Group-based adherence support interventions, such as adherence clubs, have been shown to improve long-term adherence in ART patients. The teen club intervention was introduced in 2010 in Namibia to improve treatment outcomes for ALHIV by providing adherence support in a peer-group environment. Adolescents who have completed the full HIV disclosure process can voluntarily join the teen clubs. The current study compared treatment outcomes of ALHIV receiving ART at a specialized paediatric HIV clinic between 1 July 2015 and 30 June 2017 in Windhoek, Namibia. Methods. A retrospective cohort analysis was conducted on routine patient data extracted from the electronic Patient Monitoring System, individual Patient Care Booklets, and teen club attendance registers. A sample of 385 adolescents were analysed: 78 in teen clubs and 307 in standard care. Virologic suppression was determined at 6, 12, and 18 months from study start date, and compared by model of care, age, sex, disclosure status, and ART regimen. Comparisons between adolescents in teen clubs and those receiving standard care were performed using the chi-square test, and risk ratios were calculated to analyze differences in ART adherence and virologic suppression. Results. The average clinician-measured ART adherence was 89% good, 6% fair, and 5% poor amongst all adolescents, with no difference between teen club members and adolescents in standard care ( p  = 0.277) at 3 months. Virologic suppression over the 2-year observation period was 87% (68% fully suppressed <40 copies/ml and 19% suppressed between 40–999 copies/ml), with no difference between teen club members and those in standard care. However, there were statistically significant differences in virologic suppression levels between the younger (10–14 years) adolescents and older (15–19 years) adolescents at 6 months ( p  = 0.015) and at 12 months ( p  = 0.021) and between adolescents on first-line and second-line ART regimen at 6 months ( p  = 0.012), 12 months ( p  = 0.004), and 18 months ( p  = 0.005). Conclusion. The teen club model delivering psychosocial support only did not improve adherence and virologic suppression levels for adolescents in a specialized paediatric ART clinic, neither were they inferior to standard care. Considering the limitations of this study, teen clubs may still hold potential for improving adherence and virologic suppression levels for older adolescents, and more robust research on adherence interventions for adolescents with higher methodological quality is required.

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