scholarly journals The perceptions of patients on antiretroviral therapy (ART) and treatment supporters with regard to their role towards ART adherence, at ART clinics in the intermediate hospital Oshakati, Namibia

2017 ◽  
Vol 5 (1) ◽  
pp. 17 ◽  
Author(s):  
Olivia Ningeninawa Tuhadeleni ◽  
Linda Ndeshipandula Lukolo
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Sampling Technique ◽  
Sub Saharan Africa ◽  
Treatment Programs ◽  
Clear Understanding ◽  
Art Adherence ◽  
Study Results ◽  
Sub Saharan

Background: The benefits of antiretroviral therapy (ART) are undeniable: decreased morbidity and mortality, improved clinical outcomes, and decreased HIV transmission. In recent years, there have been remarkable efforts to roll out HIV support and treatment programs, resulting in ART access to nearly 4 million people in sub-Saharan Africa. However, a decisive step in improving outcomes of these programs relies on ART adherence. This study was conducted by aiming at exploring and describing the perceptions of patients on ART and treatment supporters about their roles in ART adherence. It was carried out at Oshakati ART clinic in the Intermediate Hospital Oshakati in Oshana region, Northern Namibia.Methods: The qualitative investigation was carried out on patients on ART and treatment supporters by means of unstructured interviews through convenient sampling technique. The data were analysed by content analytical method.Results: The study results from all respondents were consolidated, which gave a clear understanding regarding adherence at the ART clinic in Intermediate Hospital Oshakati. The perceptions of patients on ART and treatment supporters with regard to their role towards ART adherence were classified based on participants’ experiences into two main themes and sub-themes, including: 1) ART patients’ perceptions around their current roles in ART adherence comprise of four sub-themes of ART patients’ perceptions about taking medication daily, perceptions about collection of medicine supply and follow-up visits, perceptions about food and medication and perceptions about support in ART treatment; 2) Treatment supporters’ perceptions about their role in ART adherence consist of four sub-themes of perceptions about follow-up visits and collection of medicine, perceptions about psychosocial and emotional support, perceptions about giving food and medication and perceptions about encouraging personal hygiene.Conclusion: Patients and treatment supporters perceived adherence as an important aspect in the success of antiretroviral treatment. Giving patients correct information, personal motivation, patients understanding of treatment, traditional and religious beliefs were among other factors perceived by treatment supporters to be impacting on ART adherence.

scholarly journals Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review

2021 ◽  
Vol 18 (5) ◽  
pp. 2477
Author(s):  
Panmial Priscilla Damulak ◽  
Suriani Ismail ◽  
Rosliza Abdul Manaf ◽  
Salmiah Mohd Said ◽  
Oche Agbaji
Keyword(s):  
Systematic Review ◽  
Antiretroviral Therapy ◽  
Behavioral Interventions ◽  
Controlled Trial ◽  
Self Report ◽  
Sub Saharan Africa ◽  
Art Adherence ◽  
Study Characteristics ◽  
Combination Study ◽  
Sub Saharan

Optimal adherence to antiretroviral therapy (ART) remains the bedrock of effective therapy and management of human immunodeficiency virus (HIV). This systematic review examines the effect of interventions in improving ART adherence in sub-Saharan Africa (SSA), which bears the largest global burden of HIV infection. In accordance with PRISMA guidelines, and based on our inclusion and exclusion criteria, PUBMED, MEDLINE, and Google Scholar databases were searched for published studies on ART adherence interventions from 2010 to 2019. Thirty-one eligible studies published between 2010 to 2019 were identified, the categories of interventions were structural, behavioral, biological, cognitive, and combination. Study characteristics varied across design, intervention type, intervention setting, country, and outcome measurements. Many of the studies were behavioral interventions conducted in hospitals with more studies being randomized controlled trial (RCT) interventions. Despite the study variations, twenty-four studies recorded improvements. Notwithstanding, more quality studies such as RCTs should be conducted, especially among key affected populations (KAPs) to control transmission of resistant strains of the virus. Reliable objective measures of adherence should replace the conventional subjective self-report. Furthermore, long-term interventions with longer duration should be considered when evaluating the effectiveness of interventions.

scholarly journals Feasibility and acceptability of financial incentives and peer-led life skills training for improving adherence to antiretroviral therapy among adolescents living with HIV in Rwanda: A pilot study

2020 ◽  
Author(s):  
Majdi Osman ◽  
Simon Pierre Niyonsenga ◽  
Manasi Sharma ◽  
Rebecca Hope ◽  
Shannon Milroy ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Pilot Study ◽  
Financial Incentives ◽  
Life Skills ◽  
Skills Training ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Art Adherence ◽  
Life Skills Training ◽  
Sub Saharan

Abstract Background The Human Immunodeficiency Virus (HIV) is the leading cause of death among adolescents in sub-Saharan Africa. Despite the long-term benefits of antiretroviral therapy (ART), adherence remains low among adolescents due to challenges related to cost, acquisition, and treatment regimen. Sub-optimal adherence to ART is associated with the development of viral resistance, treatment failure, and increased morbidity and mortality. Financial incentives and life skills training interventions have shown early promise in motivating protective behaviors, however, gaps still remain around effective and innovative ways to motivate adolescents to stay in HIV care. In partnership with youth, we developed an intervention to address their social and financial pressures in order to promote adherence. Methods A human-centered design approach was utilized to engage adolescents in the initial design of the intervention. Through random sampling, 72 adolescents ages 12–19 were then recruited from two clinics in Rwanda for the pilot study. Adolescents participated in three monthly peer-led life skills trainings at clinics and received financial incentives via mobile money upon clinic attendance and demonstration of suppressed viral load. Semi-structured interviews were then conducted with adolescents, healthcare workers, and caregivers to understand their experiences with the intervention. Results Participants responded favorably to the intervention because of the psychosocial, financial, and health benefits it provided. Caregivers felt that adolescents’ moods, attitudes, and overall well-being improved over time. Adolescents used funds to purchase school supplies and save for investments, thus mitigating their financial burdens. Additionally, we learned that logistical challenges such as SIM card registration and mobile phone access must be considered for scale-up of the intervention. Conclusions To our knowledge, this is the first intervention designed in partnership with youth in sub-Saharan Africa aimed at removing financial barriers to ART adherence. The findings suggest that involving youth in the design of programs, providing them with financial incentives, and training them to use and invest their money wisely has a positive effect on them and their families. Thus, to improve adherence to ART and retention in care among HIV-positive youth, it is critical to address their socioeconomic and psychosocial needs.

scholarly journals Barriers to and enablers of uptake of and adherence to antiretroviral therapy in the context of integrated HIV and tuberculosis treatment among adults in sub-Saharan Africa: a protocol for a systematic literature review

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031789
Author(s):  
Benjamin Momo Kadia ◽  
Noah Fongwen Takah ◽  
Christian Akem Dimala ◽  
Adrian Smith
Keyword(s):  
Antiretroviral Therapy ◽  
Meta Analysis ◽  
Scale Up ◽  
Integrated Treatment ◽  
Sub Saharan Africa ◽  
Treatment Programs ◽  
Quantitative Studies ◽  
Final Study ◽  
Registration Number ◽  
Sub Saharan

IntroductionThe scale-up of integrated Human Immunodeficiency Virus (HIV) and tuberculosis (TB) treatment has been an important intervention to curb the burden of HIV and TB co-infection worldwide. Uptake of and adherence to antiretroviral therapy (ART) are key determinants of the quality and therapeutic endpoints of this intervention. This study aims to conduct an up-to-date collection and synthesis of evidence on barriers to and facilitators of uptake of and adherence to ART in HIV/TB integrated treatment programs in sub-Saharan Africa (SSA).MethodA systematic review of peer-reviewed literature on the uptake of and adherence to ART in the context of integrated therapy for HIV and TB in SSA will be performed. We will review qualitative and quantitative studies reporting on the uptake of and adherence to ART during integrated treatment for TB and HIV among adults. These will include studies that involve HIV-infected TB patients initiating ART and studies involving PLWHA already on ART who are newly diagnosed with TB. Qualitative studies, quantitative studies, randomised trials and observational studies will be included. Six databases including Medline and Embase will be searched for relevant studies published from March 2004 to July 2019. Two authors will independently screen the search output and retrieve full texts of eligible studies. Disagreements between the two authors will be resolved by arbitration by a third author. Data will be abstracted from the eligible studies and synthesis will be done through descriptive synthesis for qualitative data and meta-analysis for quantitative data.Ethics and disseminationThis study will be a review of the literature and will not involve primary collection of individuals’ data. Amendments to the protocol will be documented in the final review. The final study will be published in a peer-reviewed journal and presented at conferences. The review is expected to contribute to improving strategies to enhance uptake of and adherence to ART in integrated care.PROSPERO registration numberCRD42019131933.

scholarly journals Global burden of active smoking among people living with HIV on antiretroviral therapy: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Boni Maxime Ale ◽  
Franck Amahowe ◽  
Motto Malea Nganda ◽  
Célestin Danwang ◽  
Nelly Njeri Wakaba ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Southern Africa ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Active Smoking ◽  
Suboptimal Adherence ◽  
Sub Saharan ◽  
Eastern And Southern Africa ◽  
Living With Hiv

Abstract Background Although the high burden of both active smoking and human immunodeficiency virus (HIV) is clearly known, the relationship between them is still not well characterized. Therefore, we estimated the global prevalence of active smoking in people living with HIV (PLHIV) on antiretroviral therapy (ART) and investigated the association between exposure to active smoking and risk for suboptimal adherence to ART. Main text: We searched PubMed, Embase, and Web of Science to identify articles published until September 19, 2019. Eligible studies reported the prevalence of active smoking in PLHIV on ART or investigated the association between active smoking and ART adherence; or enough data to compute these estimates. We used a random-effects model to pool data and quantified heterogeneity (I2). The global prevalence of active smoking was 36.1% (95% CI: 33.7–37.2; 329 prevalence data; 462 104 participants) with substantial heterogeneity. The prevalence increased with level of country income; from 10.1% (95% CI: 6.8–14.1) in low-income to 45.2% (95% CI: 42.7–47.7) in high-income countries; P < 0.0001. With regards to the Joint United Nations Programme on HIV/AIDS (UNAIDS) regions, the prevalence was higher in West and Central Europe and North America 45.4% (42.7–48.1) and lowest in the two UNAIDS regions of sub-Saharan Africa: Eastern and Southern Africa 10.7% (95% CI: 7.8–14.0) and West and Central Africa 4.4% (2.9–6.3); P < 0.0001. Globally, we estimated that there were 4 110 669 PLHIV on ART who were active smokers, among which the highest number was from Eastern and Southern Africa (35.9%) followed by Asia and the Pacific (25.9%). Active smoking was significantly associated with suboptimal ART adherence: pooled odds ratio 1.57 (95% CI: 1.37–1.80; I2 = 56.8%; 19 studies; 48 450 participants); even after considering adjusted estimates: 1.67 (95% CI: 1.39–2.01; I2 = 53.0%; 14 studies). Conclusions This study suggests a high prevalence of active smoking in PLHIV on ART and an association between active smoking and ART suboptimal adherence. As such, healthcare providers and policy makers should focus on adopting and implementing tobacco harm reduction strategies in HIV care, especially in sub-Saharan Africa known as epicenter of HIV pandemic with highest number of active tobacco smoking among PLHIV on ART.

scholarly journals Perinatal HIV Transmission Prevention: Challenges among Women Living with HIV in sub-Saharan Africa

2020 ◽  
Vol 9 (3) ◽  
pp. 354-359
Author(s):  
Elizabeth Armstrong-Mensah ◽  
Krystal Ruiz ◽  
Aminata Fofana ◽  
Victoria Hawley
Keyword(s):  
Antiretroviral Therapy ◽  
Sex Education ◽  
Hiv Transmission ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Creative Commons ◽  
Perinatal Hiv ◽  
Transmission Prevention ◽  
Sub Saharan ◽  
Hiv Transmission Prevention

About 86 percent of the estimated 160,000 children newly-infected with the human immunodeficiency virus (HIV) live in sub-Saharan Africa. Despite global efforts to reduce perinatal HIV transmission, this phenomenon continues to be a public health problem in sub-Saharan Africa. This paper discusses challenges associated with perinatal HIV transmission prevention in sub-Saharan Africa and offers strategies for the way forward. These strategies include safe sex education and behavioral change, increased access to integrated antenatal care, training of unskilled traditional birth attendants into formal delivery systems, access to antiretroviral therapy, and investing in virologic testing. Key words: • HIV • Perinatal • Antiretroviral Therapy • Mother to Child HIV Transmission • HIV Prevention • Sub-Saharan Africa   Copyright © 2020 Armstrong-Mensah, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Factors associated with the practice of exclusive breastfeeding for six months among mothers on antiretroviral therapy in the Eastern Cape, South Africa

2020 ◽  
Author(s):  
PROF DANIEL TER GOON ◽  
Anthony Idowu Ajayi ◽  
OLADELE VINCENT ADENIYI
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Factors Associated ◽  
Sub Saharan ◽  
Context Specific

Abstract Background: Exclusive breast feeding (EBF) is associated with reduction of post-natal HIV transmission and optimal infant growth. Given that the factors influencing EBF are multi-factorial and context-specific, we examined the prevalence and factors associated with EBF practice in the first six months among mothers on antiretroviral therapy (ART) in the Eastern Cape, South Africa. Methods: This was a prospective cross-sectional study conducted between January – May 2018 on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. EBF was defined as infant feeding with breast milk only. We collected relevant socio-demographic, lifestyle and maternal information by interview. Bivariate and multivariate logistic regression analyses were fitted to determine the factors associated with EBF practice.Results: EBF for six months was practised by a few women (32.0%). The prevalence of EBF was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%) and those who never drank alcohol (37.0%). Unemployed women (AOR = 1.66, 95% CI: 1.08-2.56) and those with grade 12 or less level of education (AOR =2.76, 95% CI: 1.02-7.49) had a higher likelihood of practising EBF for six months while mothers who consumed alcohol (AOR = 0.54, 95% CI: 0.34-0.85) were less likely to practice EBF for six months. Conclusions: Sub-optimal rate of EBF in this study is comparable with the national (31.6%), sub-Saharan Africa (36%) and WHO global (35%) rates. Advocacy campaign on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

scholarly journals Cohort profile: The International epidemiology Databases to Evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012-2019

2019 ◽  
Author(s):  
Frédérique Chammartin ◽  
Cam Ha Dao Ostinelli ◽  
Kathryn Anastos ◽  
Antoine Jaquet ◽  
Ellen Brazier ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Loss To Follow Up ◽  
Sub Saharan ◽  
Treat All ◽  
Living With Hiv ◽  
International Epidemiology

ABSTRACTPurposeThe objectives of the International epidemiology Databases to Evaluate AIDS (IeDEA) are to (i) evaluate the delivery of combination antiretroviral therapy (ART) in children, adolescents and adults in sub-Saharan Africa, (ii) to describe ART regimen effectiveness, durability and tolerability, (iii) to examine HIV-related comorbidities and co-infections, and (iv) to examine the pregnancy- and HIV-related outcomes of women on ART and their infants exposed to HIV or antiretroviral therapy in utero or via breastmilk.ParticipantsIeDEA is organized in four regions (Central, East, Southern and West Africa), with 240 treatment and care sites, six data centres at African, European and US universities, and almost 1.4 million children, adolescents and adult people living with HIV (PLWHIV) enrolled.Findings to dateThe data include socio-demographic characteristics, clinical outcomes, opportunistic events, treatment regimens, clinic visits and laboratory measurements. They have been used to analyse outcomes in people living with HIV-1 or HIV-2 who initiate ART, including determinants of mortality, of switching to second-line and third-line ART, drug resistance, loss to follow-up and the immunological and virological response to different ART regimens. Programme-level estimates of mortality have been corrected for loss to follow-up. We examined the impact of co-infection with hepatitis B and C, and the epidemiology of different cancers and of (multi-drug resistant) tuberculosis, renal disease and of mental illness. The adoption of “Treat All”, making ART available to all PLWHIV regardless of CD4+ cell count or clinical stage was another important research topic.Future plansIeDEA has formulated several research priorities for the “Treat All” era in sub-Saharan Africa. It recently obtained funding to set up sentinel sites where additional data are prospectively collected on cardiometabolic risks factors as well as mental health and liver diseases, and is planning to create a drug resistance database.

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