scholarly journals Optimizing community linkage to care and antiretroviral therapy Initiation: Lessons from the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) and their adaptation in Nigeria ART Surge

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257476
Author(s):  
Ibrahim Jahun ◽  
Ishaq Said ◽  
Ibrahim El-Imam ◽  
Akipu Ehoche ◽  
Ibrahim Dalhatu ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Real Time ◽  
Treatment Initiation ◽  
Linkage To Care ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Art Initiation ◽  
Mobile Community ◽  
Mhealth Technology ◽  
Hiv Aids

Background Ineffective linkage to care (LTC) is a known challenge for community HIV testing. To overcome this challenge, a robust linkage to care strategy was adopted by the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). The NAIIS linkage to care strategy was further adapted to improve Nigeria’s programmatic efforts to achieve the 1st 90 as part of the Nigeria Antiretroviral Therapy (ART) Surge initiative, which also included targeted community testing. In this paper we provide an overview of the NAIIS LTC strategy and describe the impact of this strategy on both the NAIIS and the Surge initiatives. Methods The NAIIS collaborated with community-based organizations (CBOs) and deployed mobile health (mHealth) technology with real-time dashboards to manage and optimize community LTC for people living with HIV (PLHIV) diagnosed during the survey. In NAIIS, CBOs’ role was to facilitate linkage of identified PLHIV in community to facility of their choice. For the ART Surge, we modified the NAIIS LTC strategy by empowering both CBOs and mobile community teams as responsible for not only active LTC but also for community testing, ART initiation, and retention in care. Results Of the 2,739 PLHIV 15 years and above identified in NAIIS, 1,975 (72.1%) were either unaware of their HIV-positive status (N = 1890) or were aware of their HIV-positive status but not receiving treatment (N = 85). Of these, 1,342 (67.9%) were linked to care, of which 952 (70.9%) were initiated on ART. Among 1,890 newly diagnosed PLHIV, 1,278 (67.6%) were linked to care, 33.7% self-linked and 66.3% were linked by CBOs. Among 85 known PLHIV not on treatment, 64 (75.3%) were linked; 32.8% self-linked and 67.2% were linked by a CBO. In the ART Surge, LTC and treatment initiation rates were 98% and 100%, respectively. Three-month retention for monthly treatment initiation cohorts improved from 76% to 90% over 6 months. Conclusions Active LTC strategies by local CBOs and mobile community teams improved LTC and ART initiation in the ART Surge initiative. The use of mHealth technology resulted in timely and accurate documentation of results in NAIIS. By deploying mHealth in addition to active LTC, CBOs and mobile community teams could effectively scale up ART with real-time documentation of client-level outcomes.

scholarly journals A Systematic Review and Meta-Analysis on Depression and Associated Factors among Adult HIV/AIDS-Positive Patients Attending ART Clinics of Ethiopia: 2021

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Bitew Tefera Zewudie ◽  
Shegaw Geze ◽  
Yibeltal Mesfin ◽  
Muche Argaw ◽  
Haimanot Abebe ◽  
...  
Keyword(s):  
Mental Health ◽  
Antiretroviral Therapy ◽  
Random Effect ◽  
Hiv Care ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Aids Patients ◽  
Depression Prevalence ◽  
Hiv Aids

Introduction. Depression is the most common mental health problem in people living with the human immune virus. It ranges from 11% to 63% in low- and middle-income countries. Depression was high in people living with HIV/AIDS in developing countries, especially in the Ethiopian context. Even though depression has negative consequences on HIV-positive patients, the care given for depression in resource-limited countries like Ethiopia is below the standard in their HIV care programs. Method. International databases (Google Scholar, PubMed, Hinari, Embase, and Scopus) and Ethiopian university repository online have been covered in this review. Data were extracted using Microsoft Excel and analyzed by using the Stata version 14 software program. We detected the heterogeneity between studies using the I 2 test. We checked publication bias using a funnel plot test. Results. The overall pooled depression prevalence among adult HIV/AIDS patients attending antiretroviral therapy in Ethiopia was 36.3% (95% CI: 28.4%, 44.2%) based on the random effect analysis. Adult HIV/AIDS patients having CD4 count < 200 ( AOR = 5.1 ; 95% CI: 2.89, 8.99), widowed marital status ( AOR = 3.7 ; 95% CI: 2.394, 5.789), medication nonadherence ( AOR = 2.3 ; 95% CI: 1.63, 3.15), poor social support (2.986) (95% CI: 2.139, 4.169), perceived social stigma (2.938) (2.305, 3.743), opportunistic infections (3.010) (2.182, 4.151), and adverse drug reactions (4.013) (1.971, 8.167) were significantly associated with depression among adult HIV/AIDS patients on antiretroviral therapy, in Ethiopia. Conclusion and Recommendation. The pooled depression prevalence among adult HIV/AIDS patients attending antiretroviral therapy in Ethiopia was higher than the general population and is alarming for the government to take special consideration for HIV-positive patients. Depression assessment for all HIV-positive patients and integrating with mental health should be incorporated to ensure early detection, prevention, and treatment. Community-based and longitudinal study designs mainly focusing on the incidence and determinants of depression among adult HIV/AIDS patients should be done in the future.

scholarly journals Factors Associated With Virological Suppression of HIV Viral Load in Patients on Antiretroviral Therapy in Conakry, Guinea

2021 ◽  
Author(s):  
Alimou camara ◽  
Penda Maladho Diallo ◽  
Mamadou Bobo Diallo ◽  
Talla Nioké ◽  
Adama Cissé ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Detection Threshold ◽  
Virological Suppression ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Viral Load Data ◽  
Living With Hiv ◽  
Hiv Aids

Abstract BackgroundThe viral load has become an indispensable tool in evaluating antiretroviral therapy (ART) in people living with HIV / AIDS. This study aimed to assess virological suppression among in people living with HIV / AIDS on antiretroviral therapy in Guinea.MethodsThis was a descriptive cross-sectional study of more than three years that involved adult HIV-positive patients treated in different sites in Conakry. A total of 9815 viral load data were collected. The viral load was quantified by the Generic Biocentric technique and the detection threshold set at 350 copies/ml. Statistical analyses were performed by R software version R4.0.3..ResultsA total of 9815 viral load data collected at the national public health laboratory were analysed. The sample was dominated by women (72%), with an average age of 29 [29, 39]. Of these, 6,706 (68%) of HIV-positive people on ART had viral load suppression. The univaried analysis showed that women were 22% more likely to have VL suppression (p-value <0.001) moreover, the chance for all HIV-positive people on treatment to achieve viral load suppression was related to the length of treatment.Conclusionthe results of this study show viral load suppression greater than 68%. The length of antiretroviral therapy, female gender, and advancing age of PLHIV were all favourable to VL suppression.

Integrase strand transferase inhibitors: the preferred antiretroviral regimen in HIV-positive renal transplantation

2016 ◽  
Vol 28 (5) ◽  
pp. 447-458 ◽  
Author(s):  
Marwan M Azar ◽  
Maricar F Malinis ◽  
J Moss ◽  
Richard N Formica ◽  
Merceditas S Villanueva
Keyword(s):  
Renal Transplantation ◽  
Antiretroviral Therapy ◽  
Drug Interactions ◽  
Graft Survival ◽  
Hiv Positive ◽  
Published Data ◽  
People Living With Hiv ◽  
Renal Transplant Recipients ◽  
Living With Hiv ◽  
Hiv Aids

In the era of antiretroviral therapy, people living with HIV/AIDS live longer and are subject to co-morbidities that affect the general population, such as chronic kidney disease. An increasing number of people living with HIV/AIDS with end-stage renal disease are candidates for renal transplantation. Prior experience demonstrated that HIV-positive renal transplant recipients had acceptable survival but graft survival was decreased and rejection rates were increased, possibly due to suboptimal management of immunosuppressive medications in the face of drug interactions with antiretroviral therapy, particularly protease inhibitors and non-nucleoside reverse transcriptase inhibitors. Integrase strand transferase inhibitors are advantageous since they avoid drug–drug interactions with immunosuppressive drugs such as calcineurin inhibitors. We report clinical outcomes of 12 HIV-positive patients who underwent 13 kidney transplantations at our institution between 2000 and 2015. Cumulative survival was 75%, one-year and three-year survival were 100% and 63%. Integrase strand transferase inhibitor-based regimens were used in nine patients, of which eight survived. In patients on integrase strand transferase inhibitor, there was 100% graft survival and two had allograft rejection. In contrast, graft failure occurred in three patients on non-integrase strand transferase inhibitor-based regimens. Based on our study findings and on previously published data, we conclude that integrase strand transferase inhibitor-based therapy, preferably instituted prior to transplantation, is the preferred antiretroviral regimen in HIV-positive renal transplantation.

scholarly journals Predictors of antiretroviral therapy initiation in eThekwini (Durban), South Africa: Findings from a prospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246744
Author(s):  
Karla Therese L. Sy ◽  
Shema Tariq ◽  
Gita Ramjee ◽  
Kelly Blanchard ◽  
Cheng-Shiun Leu ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Prospective Cohort ◽  
Social Cognitive ◽  
Linkage To Care ◽  
Health Status Indicators ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Art Initiation ◽  
Using Data

Despite expanded antiretroviral therapy (ART) eligibility in South Africa, many people diagnosed with HIV do not initiate ART promptly, yet understanding of the reasons is limited. Using data from an 8-month prospective cohort interview study of women and men newly-diagnosed with HIV in three public-sector primary care clinics in the eThekwini (Durban) region, South Africa, 2010–2014, we examined if theoretically-relevant social-structural, social-cognitive, psychosocial, and health status indicators were associated with time to ART initiation. Of 459 diagnosed, 350 returned to the clinic for their CD4+ test results (linkage); 153 (33.3%) were ART-eligible according to treatment criteria at the time; 115 (75.2% of those eligible) initiated ART (median = 12.86 weeks [95% CI: 9.75, 15.97] after linkage). In adjusted Cox proportional hazard models, internalized stigma was associated with a 65% decrease in the rate of ART initiation (Adjusted hazard ratio [AHR] 0.35, 95% CI: 0.19–0.80) during the period less than four weeks after linkage to care, but not four or more weeks after linkage to care, suggesting that stigma-reduction interventions implemented shortly after diagnosis may accelerate ART uptake. As reported by others, older age was associated with more rapid ART initiation (AHR for 1-year age increase: 1.04, 95% CI: 1.01–1.07) and higher CD4+ cell count (≥300μL vs. <150μL) was associated with a lower rate of initiation (AHR 0.38, 95% CI: 0.19–0.80). Several other factors that were assessed prior to diagnosis, including stronger belief in traditional medicine, higher endorsement of stigma toward people living with HIV, food insecurity, and higher psychological distress, were found to be in the expected direction of association with ART initiation, but confidence intervals were wide and could not exclude a null finding.

Dukungan sosial dan kualitas hidup orang dengan HIV/AIDS

2017 ◽  
Vol 33 (3) ◽  
pp. 147
Author(s):  
Mardia Mardia ◽  
Riris Andono Ahmad ◽  
Bambang Sigit Riyanto
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Antiretroviral Therapy ◽  
Social Life ◽  
Opportunistic Infections ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Criteria For Diagnosis ◽  
Hiv Aids

Purpose: This study aimed to determine the quality of life among people living with HIV/AIDS based on the criteria for diagnosis and other factors.Methods: This study was conducted in the VCT clinic hospital of Dr. Moewardi. The population was HIV-positive patients with antiretroviral therapy. Data collection conducted through medical records and interview to patients. Results: Out of a total of 89 respondents, 66.29% were males and 71.91% were aged between 26-45 years. We found significant correlations for diagnosis of HIV/AIDS, opportunistic infections, time since HIV diagnosis, duration of ARV therapy, social support, modes of transport, sex, age, and marital status with the quality of life. Multivariate analysis obtained by each variable showed the strongest association with the quality of life was time since diagnosis, social support and duration of ARV therapy. Conclusion: The quality of life was better for those who have been diagnosed with HIV/AIDS ≥ 32 months, with social support, and who have been undergoing antiretroviral therapy ≥ 29 months. Improved counseling in the early days of ARV therapy is necessary to always maintain the treatment and provide support for their social life.

Assessing antiretroviral therapy success in HIV/AIDS morbidity and mortality trends in Brazil, 1990–2017: an interrupted time series study

2020 ◽  
pp. 095646242095298
Author(s):  
Augusto Cesar Lara de Sousa ◽  
Tatiana de Araujo Eleuterio ◽  
José Victor Afonso Coutinho ◽  
Raphael Mendonça Guimarães
Keyword(s):  
Time Series ◽  
Antiretroviral Therapy ◽  
Burden Of Disease ◽  
Interrupted Time Series ◽  
People Living With Hiv ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact ◽  
Hiv Aids

To describe the trends of HIV/AIDS metrics related to the burden of disease for Brazil between 1990 and 2017 we conducted a timeseries analysis for HIV/AIDS indicators by extracting data from the Global Burden of Disease study. We calculated traditional prevalence, incidence and mortality rates, the number of years lost by HIV-related deaths (YLL) and disability (YLD), and disability-adjusted life years (DALY). We estimated time series models and assessed the impact of highly active antiretroviral therapy (HAART) on the same indicators. In the set of disability-adjusted life years (DALY), the highest weight of its magnitude was due to YLL. There was a decline, especially after 1996, of DALY, mortality and YLL for HIV/AIDS. However, YLD, incidence, and prevalence increased over the same period. Also, the analysis of interrupted time series showed that the introduction of HAART into health policy had a significant impact on indicators, especially for DALY and YLL. We need to assess the quality of life of people living with HIV, especially among older adults. In addition, we need to focus on primary prevention, emphasizing methods to avoid infection and public policies should reflect this.

scholarly journals Food consumption and nutritional status of people living with HIV/AIDS (PLWHA): a case of Thika and Bungoma Districts, Kenya

2009 ◽  
Vol 13 (4) ◽  
pp. 475-479 ◽  
Author(s):  
Elizabeth Nafula Kuria
Keyword(s):  
Nutritional Status ◽  
Food Consumption ◽  
Dietary Habits ◽  
Well Being ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Significant Difference ◽  
Living With Hiv ◽  
Hiv Aids

AbstractObjectiveTo establish the food consumption, dietary habits and nutritional status of people living with HIV/AIDS (PLWHA) and adults whose HIV status is not established.DesignCross-sectional descriptive survey.SettingThika and Bungoma Districts, Kenya.SubjectsA random sample of 439 adults; 174 adults living with HIV/AIDS and 265 adults whose HIV/AIDS status was not established in Thika and Bungoma Districts.ResultsMajority of PLWHA consume foods that are low in nutrients to build up the immune system and help maintain adequate weight, and there is little variety in the foods they consume. More adults who are HIV-positive are undernourished than those whose status is not established. Of the HIV-positive adults, those with a BMI of ≤18·5 kg/m2 were 23·6 % (Thika 20·0 % and Bungoma 25·7 %) while of the adults whose status is not established those with BMI ≤ 18·5 kg/m2 were 13·9 % (Thika 9·3 % and Bungoma 16·7 %).ConclusionsAdults who are HIV-positive are more likely to be undernourished than those whose status is not established, as there is a significant difference (P = 0·000) between the nutritional status (BMI) of PLWHA and those whose HIV/AIDS status is not established. PLWHA consume foods that are low in nutrients to promote their nutritional well-being and health.

Sign in / Sign up

Export Citation Format

Share Document