scholarly journals Determinants of adherence to antiretroviral therapy among people living with HIV/AIDS in Chhattisgarh, India

Author(s):  
Mayank Kumar Khede ◽  
Pragyan Paramita Parija ◽  
Manisha Ruikar Madhukar ◽  
Shiv Kumar Bhinjwar

Background: Achieving the WHO 2020 treatment goals will not only depend on access to HIV treatment, but also on good adherence. Chhattisgarh SACS under guidance of CST division NACO and community and family medicine department AIIMS, Raipur undertook this study to investigate the major factors that influence the adherence of PLHIV visiting ART centres of Chhattisgarh.Methods: From five ART centres, 415 participants were interviewed through simple random sampling method through a semi structured interview schedule. Results: We found that 346 of the 415 (83.3%) patients had ≤95% adherence to ART on the basis of pill count method. Major proportion (90.0%) of patients were on TLE regimen, among them (74.4%) were non-adherent. An association was found between health condition of patient, poor life style and adherence rate. Three-month drug dispensation was recommended by most of the participants to improve adherence.Conclusions: Multiple months drug dispension along with other innovative approaches should be tailored made to improve the adherence and compliance among PLHIV individuals.

Somatechnics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 233-253
Author(s):  
Eli Manning

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.


Author(s):  
Shanthi Edward ◽  
Praveena Periasamy

Background: Advocates, being stressed out and depressed in the law profession due to unstable work pattern, work overload and lack in coping up skills. They thrive a lot to survive in the profession. In such circumstances, lawyers may lean on alcohol or tobacco. In view of above issues, one of the main objectives of the study is to evaluate the association between use of alcohol, tobacco, smoking and hypertension among practising advocates.Methods: A cross-sectional study was conducted in a sample of 300 practising advocates at Madurai district court for a period of 1 year by simple random sampling method. Data was collected using structured interview schedule and analysed using SPSS.Results: Around 263 (87.66%) study participants were non-smokers and 37 (12.33%) were tobacco smokers. Among the tobacco smokers, a majority of 24 (64.86%) were found to be hypertensives (p=0.002). In the current study among the alcohol consumers, a majority of 26 (55.32%) were hypertensives and among the non-consumers of alcohol, only 38.34% were hypertensives (p=0.044).Conclusions: Advocates being professionals are well educated, informative and aware of complications. Adoption of healthy life style practices, the prevalence of hypertension may be reduced among the advocate community. Life style modifications such as cessation of smoking, alcohol and tobacco should be adopted. Promotive activities like arrangement of health camps in the court, health education, counselling on self-care, stress bursting leisure time activities would reduce the dependency on tobacco and alcohol.


2021 ◽  
Author(s):  
Vasiliki Papageorgiou ◽  
Bethan Davies ◽  
Emily Cooper ◽  
Ariana Singer ◽  
Helen Ward

AbstractDespite developments in HIV treatment and care, disparities persist with some not fully benefiting from improvements in the HIV care continuum. We conducted a systematic review to explore associations between social determinants and HIV treatment outcomes (viral suppression and treatment adherence) in high-income countries. A random effects meta-analysis was performed where there were consistent measurements of exposures. We identified 83 observational studies eligible for inclusion. Social determinants linked to material deprivation were identified as education, employment, food security, housing, income, poverty/deprivation, socioeconomic status/position, and social class; however, their measurement and definition varied across studies. Our review suggests a social gradient of health persists in the HIV care continuum; people living with HIV who reported material deprivation were less likely to be virologically suppressed or adherent to antiretrovirals. Future research should use an ecosocial approach to explore these interactions across the lifecourse to help propose a causal pathway.


2021 ◽  
pp. sextrans-2021-055222
Author(s):  
Hui Chen ◽  
Rusi Long ◽  
Tian Hu ◽  
Yaqi Chen ◽  
Rongxi Wang ◽  
...  

ObjectivesSuboptimal adherence to antiretroviral therapy (ART) dramatically hampers the achievement of the UNAIDS HIV treatment targets. This study aimed to develop a theory-informed predictive model for ART adherence based on data from Chinese.MethodsA cross-sectional study was conducted in Shenzhen, China, in December 2020. Participants were recruited through snowball sampling, completing a survey that included sociodemographic characteristics, HIV clinical information, Information-Motivation-Behavioural Skills (IMB) constructs and adherence to ART. CD4 counts and HIV viral load were extracted from medical records. A model to predict ART adherence was developed from a multivariable logistic regression with significant predictors selected by Least Absolute Shrinkage and Selection Operator (LASSO) regression. To evaluate the performance of the model, we tested the discriminatory capacity using the concordance index (C-index) and calibration accuracy using the Hosmer and Lemeshow test.ResultsThe average age of the 651 people living with HIV (PLHIV) in the training group was 34.1±8.4 years, with 20.1% reporting suboptimal adherence. The mean age of the 276 PLHIV in the validation group was 33.9±8.2 years, and the prevalence of poor adherence was 22.1%. The suboptimal adherence model incorporates five predictors: education level, alcohol use, side effects, objective abilities and self-efficacy. Constructed by those predictors, the model showed a C-index of 0.739 (95% CI 0.703 to 0.772) in internal validation, which was confirmed be 0.717 via bootstrapping validation and remained modest in temporal validation (C-index 0.676). The calibration capacity was acceptable both in the training and in the validation groups (p>0.05).ConclusionsOur model accurately estimates ART adherence behaviours. The prediction tool can help identify individuals at greater risk for poor adherence and guide tailored interventions to optimise adherence.


2021 ◽  
Vol 33 (1) ◽  
pp. 1-15
Author(s):  
Marcie Berman ◽  
Lisa A. Eaton ◽  
Ryan J. Watson ◽  
Jessica L. Maksut ◽  
Katherine B. Rucinski ◽  
...  

HIV discrimination has served as a barrier to addressing the HIV epidemic and providing effective HIV treatment and care. Measuring HIV discrimination, particularly covert HIV discrimination, has proven to be complex. Adapted from a previous scale, we developed a perpetuated HIV micro-aggressions scale to assess covert forms of discriminatory beliefs among HIV-negative/unknown HIV status individuals. Factor analysis resulted in three subscales, explaining 73.58% of the scale's variance. The new scale demonstrated both convergent validity (HIV prejudice, HIV stereotypes) and discriminant validity (alcohol use, depressive symptomology). Perpetuated HIV microaggressions were significantly associated with HIV conspiracy beliefs, HIV prejudice, and HIV stereotypes. This new scale can serve as an important tool in evaluating perpetuated HIV microaggressions among HIV-negative individuals.


2021 ◽  
pp. sextrans-2020-054648
Author(s):  
Babatunde Akinwunmi ◽  
Daniel Buchenberger ◽  
Jenny Scherzer ◽  
Martina Bode ◽  
Paolo Rizzini ◽  
...  

ObjectivesA novel long-acting regimen (LAR) of cabotegravir and rilpivirine for HIV treatment requires dosing every 2 months instead of daily. We assessed what proportion of people living with HIV and physicians would be interested in trying and offering LAR respectively and why.Methods688 people living with HIV on treatment, and 120 HIV physicians completed web-based surveys in Germany, Italy, the UK and France during 2019. Balanced description of a hypothetical LAR regarding efficacy, administration and possible side effects were provided. The hypothetical long-acting injections were assumed to be cost-neutral to current daily oral antiretrovirals. Interest of people living with HIV in trying (‘very’/’highly’) and physicians’ willingness to offer (‘definitely’/’probably’) this LAR in different situations, with perceived benefits/concerns was measured.ResultsOf people living with HIV, 65.8% were interested in trying LAR. The majority (~80%–90%) of those with unmet needs felt LAR would help, including those with strong medical needs (malabsorption and interfering gastrointestinal conditions), suboptimal adherence, confidentiality/privacy concerns and emotional burden of daily dosing. Of physicians, percentage willing to offer LAR varied situationally: strong medical need (dysphagia, 93.3%; malabsorption, 91.6%; interfering gastrointestinal issues, 90.0%; central nervous system disorders, 87.5%); suboptimal adherence (84.2%); confidentiality/privacy concerns (hiding medications, 86.6%) and convenience/lifestyle (84.2%). People living with HIV liked LAR for not having to carry pills when travelling (56.3%); physicians liked the increased patient contact (54.2%). Furthermore, 50.0% of people living with HIV perceived LAR would minimise transmission risk and improve their sexual health. The most disliked attribute was scheduling appointments (37.2%) and resource constraints (57.5%) for people living with HIV and physicians, respectively. Physicians estimated 25.7% of their patients would actually switch.ConclusionProviders and people living with HIV viewed the described LAR as addressing several unmet needs. Alternative treatment routes and especially LAR may improve adherence and quality of life.


2021 ◽  
Author(s):  
Lelisa Worku Belcha

Abstract Background: Globally 38 million people were living with HIV in 2019. In Africa, 25 million people are living with HIV/AIDS undernutrition and food insecurity is endemic. Hence the study aimed to assess the magnitude of undernutrition and associated factors among HIV-infected adults receiving ART. Methods: Institutional based cross-sectional study was conducted among HIV/AIDS patients who following the ART service was selected by a simple random sampling method. The data were collected by direct interview, using a structured questionnaire. Descriptive statistics and a Logistic regression model were employed. Result: The study revealed that the magnitude of under-nutrition was 18.8%. The history of opportunistic infection (AOR=4.518:95% CI: 2.304-8.857), Patients taking ART for less than one year (AOR=3.675:95% CI: 1.831-7.377) household food insecure (AOR= 3.113:95% CI: 1.628-5.950) and dietary diversity score (AOR=2.340:95% CI: 1.221-4.485) were found to have a statistically significant association with undernutrition. Conclusion: The magnitude of undernutrition among people living with HIV/AIDS was found to be high. Having an opportunistic infection, duration of taking ART treatment, household food security status, and dietary diversity status were found to statistically significant association with undernutrition.


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