scholarly journals Does antiretroviral therapy packaging matter? Perceptions and preferences of antiretroviral therapy packaging for people living with HIV in Northern Tanzania.

2019 ◽  
Author(s):  
Charles Muiruri ◽  
Shelley A. Jazowski ◽  
Seleman K. Semvua ◽  
Francis P. Karia ◽  
Brandon A. Knettel ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Final Analysis ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Visual Identification ◽  
Northern Tanzania ◽  
Referral Hospitals ◽  
The Cost ◽  
Living With Hiv

Abstract Background: Despite improvements in treatment (e.g., reduction in pill intake), antiretroviral therapy (ART) is dispensed in socially inefficient and uneconomical packaging. To make pills less conspicuous and decrease the risk of being stigmatized, people living with HIV (PLWH) often engage in self-repackaging – the practice of transferring ART from original packaging to alternative containers. This behavior has been associated with ART nonadherence and failure to achieve viral load suppression. While much of the literature on ART packaging has centered around medication adherence, patients stated preferences for ART packaging and packaging attributes that influence the observed ART nonadherence are understudied. Methods: We conducted a qualitative study to elucidate perceptions of ART packaging among PLWH at two large referral hospitals in Northern Tanzania. Interviews were conducted until thematic saturation was reached. Interviews were audio recorded, transcribed and coded. Results: Of the sixteen participants whose data were used in the final analysis, a majority were between 36 and 55 years of age (Mean 45.5 years SD: 11.14), had primary-level education (n=11, 68.75%), were self-employed (n=9, 56.25%), and were taking ART for more than 6 years (n=11, 68.75%). Participants identified three attributes of ART packaging that increased anticipated HIV stigma and prompted self-repackaging, including visual identification, bulkiness, and the rattling noise produced by ART pill bottles. Conclusions: Given the drastic reduction in the number of pills required for HIV treatment, there is opportunity to not only assess the cost-effectiveness of innovative ART packaging, but also evaluate the acceptability of such packaging among PLWH in order to address stigma and improve ART adherence.

A model to predict adherence to antiretroviral therapy among people living with HIV

2021 ◽  
pp. sextrans-2021-055222
Author(s):  
Hui Chen ◽  
Rusi Long ◽  
Tian Hu ◽  
Yaqi Chen ◽  
Rongxi Wang ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Treatment ◽  
Poor Adherence ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Snowball Sampling ◽  
Hiv Viral Load ◽  
Temporal Validation ◽  
Suboptimal Adherence ◽  
Living With Hiv

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.

scholarly journals Does Antiretroviral Therapy Packaging Matter? Perceptions and Preferences of Antiretroviral Therapy Packaging for People Living with HIV in Northern Tanzania

2020 ◽  
Vol Volume 14 ◽  
pp. 153-161
Author(s):  
Charles Muiruri ◽  
Shelley A. Jazowski ◽  
Seleman K. Semvua ◽  
Francis P. Karia ◽  
Brandon A. Knettel ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Northern Tanzania ◽  
Living With Hiv

scholarly journals Time to Develop and Predictors for Incidence of Tuberculosis among Children Receiving Antiretroviral Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Fassikaw Kebede ◽  
Tsehay Kebede ◽  
Birhanu Kebede ◽  
Abebe Abate ◽  
Dube Jara ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cox Regression ◽  
Survival Curve ◽  
Final Analysis ◽  
Preventive Therapy ◽  
Public Hospitals ◽  
People Living With Hiv ◽  
Human Immune Deficiency Virus ◽  
North West ◽  
Living With Hiv

Infection by the human immune deficiency virus (HIV) is the strongest risk factor for latent or new infection of tuberculosis (TB) through reduction of CD4 T-lymphocytes and cellular immune function. Almost one-third of deaths among people living with HIV are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence of tuberculosis for children living with HIV. Thus, this study assessed time to develop and predictors for incidence of tuberculosis in children attending HIV/AIDS care in public hospitals: North West Ethiopia 2021. Methods. A facility-based retrospective cohort study was conducted among 421 seropositive children on antiretroviral therapy in two hospitals between January 1, 2011 and December 31, 2020. EPI-DATA version 3.2 and STATA/14 software were used for data entry and analysis, respectively. Tuberculosis-free survival time was estimated using the Kaplan-Meier survival curve. Bivariate and multivariable Cox regression model was fitted to identify predictors at a P value <0.05 within 95% CI. Results. In the final analysis, a total of 421 seropositive children were included, of whom, 64 (15.2%) developed tuberculosis at the time of follow-up. The mean (±SD) age of the children was 10.62 ± 3.32 years, with a median (IQR) time to develop TB that was 23.5 ( IQR = ± 19 ) months. This study found that the incidence of tuberculosis was 5.9 (95% CI: 4.7; 7.6) per 100 person-years (PY) risk of observation. Cases at baseline not taking cotrimoxazol preventive therapy (CPT) ( AHR = 2.5 ; 95% CI, 1.4-4.7, P < 0.021 ), being severely stunted ( AHR = 2.9 : 95% CI, 1.2-7.8, P < 0.03 ), and having low hemoglobin level ( AHR = 4.0 ; 95% CI, 2.1-8.1, P < 0.001 ) were found to be predictors of tuberculosis. Conclusion. A higher rate of tuberculosis incidence was reported in our study as compared with previous studies in Ethiopia. Cases at baseline not taking cotrimoxazol preventive therapy (CPT), being severely stunted, and having low hemoglobin (≤10 mg/dl) levels were found to be at higher risk to developed TB incidence.

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.

scholarly journals Disparities in Integrase Inhibitor Usage in the Modern HIV Treatment Era: a Population-Based Study in a U.S. City

2021 ◽  
Author(s):  
Matthew A Spinelli ◽  
Nancy A Hessol ◽  
Sandra K Schwarcz ◽  
Susan Scheer ◽  
Monica Gandhi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
San Francisco ◽  
Integrase Inhibitor ◽  
Population Based ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Population Based Study ◽  
Factors Associated ◽  
Living With Hiv

Abstract Integrase inhibitor-based (INSTI) antiretroviral therapy (ART) regimens are preferred for most people living with HIV (PLWH). We examined factors associated with INSTI use among PLWH in San Francisco who started ART in 2009-2016. PLWH who experienced homelessness were less likely, and older PLWH were more likely, to use an INSTI.

scholarly journals Impact of Combined Antiretroviral Therapy on Metabolic Syndrome Components in Adult People Living with HIV: A Literature Review

Viruses ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 122
Author(s):  
Mariusz Sapuła ◽  
Magdalena Suchacz ◽  
Andrzej Załęski ◽  
Alicja Wiercińska-Drapało
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
Plasma Lipid ◽  
Hiv Treatment ◽  
New Drugs ◽  
People Living With Hiv ◽  
The Metabolic Syndrome ◽  
Major Interest ◽  
Living With Hiv ◽  
The Impact

The development of metabolic derangements as a result of HIV treatment has been an important area of research since the introduction of zidovudine in the 1980’s. Antiretroviral therapy has intensely evolved in the last three decades, with new drugs gradually incorporated into everyday clinical practice. With the life expectancy of people living with HIV rapidly approaching that of their HIV-negative counterparts, the influence of these antiretrovirals on the development of the components of the metabolic syndrome remains of major interest to clinicians and their patients. In this review, we aimed to discuss the impact of cART on components of the metabolic syndrome, i.e., weight, plasma lipid levels, plasma glucose levels, and blood pressure, describing the influence of cART classes and of individual antiretrovirals. We also aimed to outline the limitations of the research conducted to date and the remaining knowledge gaps in this area.

scholarly journals Antiretroviral therapy among patients with HIV in Almaty, Kazakhstan: the implication for HIV-associated tuberculosis control

2020 ◽  
Vol 14 (11.1) ◽  
pp. 128S-132S
Author(s):  
Alfiya Denebayeva ◽  
Arpine Abrahamyan ◽  
Aelita Sargsyan ◽  
Karine Kentenyants ◽  
Ainur Zhandybayeva ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Guideline ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Preventive Strategy ◽  
Hiv Diagnosis ◽  
Art Initiation ◽  
Living With Hiv ◽  
And Control ◽  
The Impact

Introduction: Antiretroviral therapy (ART) is an effective preventive strategy against tuberculosis (TB) in people living with HIV (PLWH). In Kazakhstan, according to the revised HIV treatment guideline (2017), ART should be initiated immediately after HIV diagnosis established, regardless of CD4+ count. Aim: To evaluate the impact of early initiation of ART on TB infection in PLWH registered in the Center of Prevention and Control of AIDS, Almaty, Kazakhstan, between 2008 and 2018. Methodology: A retrospective cohort study was conducted using the data of 4,053 patients from electronic HIV case management system (2008-2018) (EHCMS). Results: The study revealed low rates (12.6%) of rapid ART (≤ 1 month after HIV diagnosis). Patients in the rapid ART initiation group were less likely to develop TB compared with those who started treatment >1 month after the HIV detection (odds ratio 1.6; 95% confidence interval [1.1, 2.2]; p = 0.00799). Interestingly, the risk for developing TB among patients receiving ART ≥ 1 month after HIV diagnosis was significantly higher compared with those not taking any treatment. The latter was explained by several confounding not addressed during the analysis, since ART was prescribed to patients with primarily deeper immunodeficiency, while the patients not receiving ART were less immunocompromised. Conclusion: Despite the recently changed HIV treatment guideline in Kazakhstan, ART is still initiated based on the disease severity. In 2018, the initiation of ART during the first month after HIV diagnosis increased by 50%. However, it is necessary to reduce the time to initiation of ART for all patients.

scholarly journals Changes in D-Dimer after initiation of antiretroviral therapy in adults living with HIV in Kenya

2020 ◽  
Author(s):  
Chloe A Teasdale ◽  
Cecilia Hernandez ◽  
Allison Zerbe ◽  
Duncan Chege ◽  
Mark Hawken ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Clinical History ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Median Viral Load ◽  
Art Initiation ◽  
Living With Hiv ◽  
D Dimer

Abstract Background: Increased coagulation biomarkers are associated with poor outcomes among people living with HIV(PLHIV). There are few data available from African cohorts demonstrating the effect of antiretroviral therapy (ART) on coagulation biomarkers. Methods: From March 2014 to October 2014, ART-naïve PLHIV initiating non-nucleoside reverse transcriptase inhibitor-based ART were recruited from seven clinics in western Kenya and followed for up to 12 months. Demographics, clinical history and blood specimens were collected. Logistic regression models adjusted for intrasite clustering examined associations between viral load and D-Dimer at baseline. Mixed linear effects models were used to estimate mean change from baseline to six months overall, and by baseline viral load, sex and TB status at enrollment. Mean change in D-dimer at six months is reported on the log10 scale and as percentage change from baseline. Results: Among 611 PLHIV enrolled, 66% were female, median age was 34 years (interquartile range (IQR) 29-43 years), 31 (5%) participants had tuberculosis and median viral load was 113,500 copies/mL (IQR: 23,600-399,000). At baseline, 311 (50.9%) PLHIV had elevated D-dimer (>500 ng/mL) and median D-dimer was 516.4 ng/mL (IQR: 302.7-926.6) (log baseline D-dimer: 2.7, IQR: 2.5-3.0). Higher baseline D-dimer was significantly associated with higher viral load (p<0.0001), female sex (p=0.02) and tuberculosis (p=-0.02). After six months on ART, 518 (84.8%) PLHIV had achieved viral load <1,000 copies/mL and median D-dimer was 390.0 (IQR: 236.6-656.9) (log D-dimer: 2.6, IQR: 2.4-2.8). Mean change in log D-dimer from baseline to six months was -0.12 (95%CI -0.15, - 0.09) (p<0.0001) indicating at 31.3% decline (95%CI -40.0, -23.0) in D-dimer levels over the first six months on ART. D-dimer decline after ART initiation was significantly greater among PLHIV with tuberculosis at treatment initiation (-172.1%, 95%CI -259.0, -106.3; p<0.0001) and those with log viral load >6.0 copies/mL (-91.1%, 95%CI -136.7, -54.2; p<0.01). Conclusions: In this large Kenyan cohort of PLHIV, women, those with tuberculosis and higher viral load had elevated baseline D-dimer. ART initiation and viral load suppression among ART-naïve PLHIV in Kenya were associated with significant decrease in D-dimer at six months in this large African cohort.

Foundations for Living: Evaluation of an Integrated Employment and Housing Program for People Living With HIV

2020 ◽  
pp. 003435522096217
Author(s):  
Yung-Chen Jen Chiu ◽  
Liza M. Conyers ◽  
SunHee J. Eissenstat ◽  
Mark Misrok
Keyword(s):  
Viral Load ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Structural Barriers ◽  
Viral Load Suppression ◽  
Housing Program ◽  
Complex Needs ◽  
Integrated Employment ◽  
Living With Hiv

Unstable housing and unemployment have been identified as major structural barriers to optimal HIV treatment outcomes among people living with HIV (PLWH). One solution is to provide integrated services that combine medical, employment, housing, and other psychosocial services to address the complex needs of PLWH. This program evaluation reports outcomes of the Foundations for Living program: an integrated employment and housing services program designed for PLWH. Employment and housing outcomes of participants who completed at least one 6-month reassessment were reported by frequency analysis. HIV immune health (CD4 count and viral load) are examined using a matched paired t test. HIV prevention outcomes were assessed by examining changes in the percent of participants with an undetectable viral load. Our findings indicate that among the participants who completed reassessments, 44.8% gained or maintained employment, 86.2% achieved viral load suppression, 75.9% achieved undetectable at the final reassessment. There was no statistical difference between the mean of CD4 count and viral load reported at intake and those reported during the final reassessment. Over half of the participants experienced unstable employment during the program, indicating that significant barriers to employment remain for this population. Implications for rehabilitation counseling practice and research are discussed.

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