scholarly journals Perspectives of Clients and Providers on Factors Influencing Medication Assisted Treatment Uptake Among People Who Use Drugs in Indonesia, Ukraine and Vietnam: HPTN 074 Study

2020 ◽  
Author(s):  
Tetiana Kiriazova ◽  
Vivian F. Go ◽  
Rebecca B. Hershow ◽  
Erica L. Hamilton ◽  
Riza Sarasvita ◽  
...  

Abstract Background: Medication-assisted treatment (MAT) is an effective method of addiction treatment and HIV prevention. However, globally, people who inject drugs (PWID) have insufficient MAT uptake. To expand MAT access and uptake, policy-makers, program-developers and health care providers should be aware of barriers to and facilitators of MAT uptake among PWID. Methods: As a part of the HPTN 074 study, which assessed the feasibility of an intervention to facilitate HIV treatment and MAT in PWID living with HIV in Indonesia, Ukraine, and Vietnam, we conducted in-depth interviews with 37 HIV-positive PWID and 25 health care providers to explore barriers to and facilitators of MAT uptake. All interviews were audio-recorded, transcribed, translated into English, and coded in NVivo for analysis. We developed matrices to identify emergent themes and patterns. Results: Despite some reported country-specific factors, PWID and health care providers at all geographic locations reported similar barriers to MAT initiation, such as complicated procedures to initiate MAT, problematic clinic access, lack of information on MAT, misconceptions about methadone, financial burden, and stigma towards PWID. However, while PWID reported fear of drug interaction (MAT and antiretroviral therapy), providers perceived that PWID prioritized drug use over caring for their health and hence were less motivated to take up ART and MAT. Motivation for a life change and social support were reported to be facilitators.Conclusion: These results highlight a need for support for PWID to initiate and retain in drug treatment. To expand MAT in all three countries, it is necessary to facilitate access and ensure low-threshold, financially affordable MAT programs for PWID, accompanied with supporting interventions. PWID attitudes and beliefs about MAT indicate the need for informational campaigns to counter misinformation and stigma associated with addiction and MAT (especially methadone).

2020 ◽  
Author(s):  
Tetiana Kiriazova ◽  
Vivian F. Go ◽  
Rebecca B. Hershow ◽  
Erica L. Hamilton ◽  
Riza Sarasvita ◽  
...  

Abstract Background: Opioid agonist treatment (OAT) is an effective method of addiction treatment and HIV prevention. However, globally, people who inject drugs (PWID) have insufficient OAT uptake. To expand OAT access and uptake, policy-makers, program-developers and health care providers should be aware of barriers to and facilitators of OAT uptake among PWID. Methods: As a part of the HPTN 074 study, which assessed the feasibility of an intervention to facilitate HIV treatment and OAT in PWID living with HIV in Indonesia, Ukraine, and Vietnam, we conducted in-depth interviews with 37 HIV-positive PWID and 25 health care providers to explore barriers to and facilitators of OAT uptake. All interviews were audio-recorded, transcribed, translated into English, and coded in NVivo for analysis. We developed matrices to identify emergent themes and patterns. Results: Despite some reported country-specific factors, PWID and health care providers at all geographic locations reported similar barriers to OAT initiation, such as complicated procedures to initiate OAT, problematic clinic access, lack of information on OAT, misconceptions about methadone, financial burden, and stigma towards PWID. However, while PWID reported fear of drug interaction (OAT and antiretroviral therapy), providers perceived that PWID prioritized drug use over caring for their health and hence were less motivated to take up ART and OAT. Motivation for a life change and social support were reported to be facilitators.Conclusion: These results highlight a need for support for PWID to initiate and retain in drug treatment. To expand OAT in all three countries, it is necessary to facilitate access and ensure low-threshold, financially affordable OAT programs for PWID, accompanied with supporting interventions. PWID attitudes and beliefs about OAT indicate the need for informational campaigns to counter misinformation and stigma associated with addiction and OAT (especially methadone).


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Tetiana Kiriazova ◽  
Vivian F. Go ◽  
Rebecca B. Hershow ◽  
Erica L. Hamilton ◽  
Riza Sarasvita ◽  
...  

Abstract Background Opioid agonist treatment (OAT) is an effective method of addiction treatment and HIV prevention. However, globally, people who inject drugs (PWID) have insufficient OAT uptake. To expand OAT access and uptake, policymakers, program developers and healthcare providers should be aware of barriers to and facilitators of OAT uptake among PWID. Methods As a part of the HPTN 074 study, which assessed the feasibility of an intervention to facilitate HIV treatment and OAT in PWID living with HIV in Indonesia, Ukraine, and Vietnam, we conducted in-depth interviews with 37 HIV-positive PWID and 25 healthcare providers to explore barriers to and facilitators of OAT uptake. All interviews were audio-recorded, transcribed, translated into English, and coded in NVivo for analysis. We developed matrices to identify emergent themes and patterns. Results Despite some reported country-specific factors, PWID and healthcare providers at all geographic locations reported similar barriers to OAT initiation, such as complicated procedures to initiate OAT, problematic clinic access, lack of information on OAT, misconceptions about methadone, financial burden, and stigma toward PWID. However, while PWID reported fear of drug interaction (OAT and antiretroviral therapy), providers perceived that PWID prioritized drug use over caring for their health and hence were less motivated to take up ART and OAT. Motivation for a life change and social support were reported to be facilitators. Conclusion These results highlight a need for support for PWID to initiate and retain in drug treatment. To expand OAT in all three countries, it is necessary to facilitate access and ensure low-threshold, financially affordable OAT programs for PWID, accompanied with supporting interventions. PWID attitudes and beliefs about OAT indicate the need for informational campaigns to counter misinformation and stigma associated with addiction and OAT (especially methadone).


2019 ◽  
Vol 7 ◽  
Author(s):  
Sherry Deren ◽  
Tara Cortes ◽  
Victoria Vaughan Dickson ◽  
Vincent Guilamo-Ramos ◽  
Benjamin H. Han ◽  
...  

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0186883 ◽  
Author(s):  
Melanie Plazy ◽  
Delphine Perriat ◽  
Dumile Gumede ◽  
Sylvie Boyer ◽  
Deenan Pillay ◽  
...  

2021 ◽  
Author(s):  
Anne C. Wagner

The current investigation seeks to examine the attitudes and beliefs of health care providers in Canada about people living with HIV. The line of research consists of three studies. Study 1 was a qualitative study conducted with a critical lens. The critical lens was used in a series of four focus groups when qualitatively soliciting opinions about the range of attitudes, behaviours and cognitions health care providers may have towards people living with HIV. Study 2 used the information gathered from Study 1 to develop a scale to assess HIV stigma in health care providers. Items were created from examples and themes found in the qualitative study, and were tested via exploratory factor analysis, confirmatory factor analysis, test-retest reliability analysis, and assessed for convergent and divergent validity. Study 3 examined the newly developed scale’s relationship to proposed overlapping stigmas and attitudes, and tested the adapted intersectional model of HIV-related stigma with health care trainees using the newly developed HIV stigma scale as an outcome measure. The line of research found that HIV stigma continues to be a significant problem in the health care system. The scale developed in Study 2 demonstrates that HIV stigma can be conceptualized and assessed as a tripartite model of discrimination, stereotyping and prejudice, and that this conceptualization of HIV stigma supports an intersectional model of overlapping stigmas with homophobia, racism, stigma against injection drug use and stigma against sex work.


2010 ◽  
Vol 5 (S1) ◽  
Author(s):  
Charles Adisa ◽  
Ugochukwu Onyeonoro ◽  
Aniele Agu ◽  
Ndukauba Eleweke ◽  
Umezurike Chisara

2021 ◽  
Vol 16 (1) ◽  
pp. 31-38
Author(s):  
Yuen Ching Chan ◽  
Maliza Mawardi ◽  
Adibah Hanim Ismail@Daud

Background: Stigmatizing attitudes expressed by health care providers prevent some members of at-risk populations from accessing human immunodeficiency virus (HIV) screening and care. This attitude contributes to the continuity of the infection dissemination within our community, which gives an impact on the healthcare service and the curtailment of the global HIV/acquired immunodeficiency syndrome (AIDS) pandemic. Objective: This study was conducted to identify stigmatizing attitudes toward people living with HIV/AIDS (PLWHA) and their determinants among primary health care providers in Kinta District, Perak. Methodology: A cross-sectional study was conducted in 36 primary care clinics in Kinta District, Perak. Using stratified random sampling, 365 primary health care providers were recruited into the study. A validated self-administered questionnaire was used to obtain sociodemographic data as well as information on the healthcare experiences of healthcare providers, their knowledge of HIV/AIDS, and attitudes toward PLWHA. Determinants were identified using multiple linear regression. Results: More than half of the respondents (54.1%) had never provided care to HIV/AIDS patients. A minority (29.9%) had received training on HIV/AIDS. This study shows that doctors (Coef.= -9.50, 95% CI: -18.93, -0.07, p= 0.048), respondents with HIV-positive relatives, (Coef.= -5.61, 95% CI: -10.57, -0.65, p= 0.027), those who had provided care to HIV/AIDS patients (Coef.= -2.38, 95% CI: -4.31, -0.45, p= 0.016), and those with a higher knowledge score on HIV/AIDS (Coef.= -0.86, 95% CI: -1.59, -0.13, p= 0.021) were less likely to show stigmatizing attitudes toward PLWHA. Conclusion: The issue of stigmatizing attitudes toward PLWHA among primary health care providers needs to be addressed. This study finds that knowledge, profession, experiences with caring for PLWHA, gender, and having HIV-positive relatives are significant predictors of stigmatizing attitudes toward PLWHA among primary health care providers in Kinta District, Perak. Interventional programs to improve knowledge and awareness, as well as decrease stigma toward PLWHA, should be implemented among all health care providers, especially those who have no opportunity to provide direct care.


2021 ◽  
Vol 9 (2) ◽  
pp. 358-367
Author(s):  
Ijaodola Aremu Olugbenga

Antiretroviral Therapy (ART) Has Decreased The Mortality And Morbidity Of HIV/AIDS, And High Adherence To ART (>95%) Is Necessary For A Good Therapeutic Outcome. Non-Adherence Can Lead To Drug-Resistant HIV Caused By Failure To Achieve Maximal Viral Suppression. Little Is Known About Adherence To ART And Its Determinants Among Ethnically Diverse And Economically Disadvantaged Patients. The Purpose Of The Study Was To Identify The Level Of Adherence And Describe Factors That Influence ART Adherence Among Ethnically Diverse And Economically Disadvantaged Patients. This Is With A View To Providing Information That Could Help Health Care Providers Understand Patient Motivations For Discontinuing Their Antiretroviral Treatment And Helping Patients Collaboratively Develop Treatment Regimens That Facilitate Adherence And Optimize The Outcomes Of HIV/AIDS Therapy. A Cross-Sectional Descriptive Survey Was Used. Data Were Collected Among 400 HIV-Infected Patients On ARV Who Received Pretreatment And Ongoing Adherence Counseling And Education Since 2010 Using A Self-Administered Questionnaire. The Data Were Analyzed Using Statistical Package For Social Sciences (SPSS). Findings Showed That The Self-Reported Adherence To The Specific Timing For Taking The Medications (Medication Schedule) Was Significantly Low (8.3%). The Major Factors For Non-Adherence To Medication Reported In This Study Were Being Busy At Work Or School, Forgetfulness, Fasting And Travelling Away From Home. Also, Employment Status Was Associated With Poor Adherence, Which May Be Corroborated By The Major Reason For Non-Adherence (Busy At Work Or School). This Study Is One Of The First Steps In The Exploration Of The Relationship Of Factors Responsible And Medication Adherence Among HIV Patients. This Study Used Three Different Measures Of Medication Adherence. These Are Patients’ Knowledge Of The Benefits Of Taking The Drugs, Adherence To A Medication Schedule, And The Number Of Prescribed Doses Of Medications Missed. Health Care Providers Must Identify Possible Barriers To Adherence At The Earliest And Provide Appropriate Solutions. These Factors Should Be Considered When Designing And Implementing Adherence Interventions.


2010 ◽  
Vol 21 (4) ◽  
pp. 159-172 ◽  
Author(s):  
Anita Rachlis ◽  
Marianne Harris ◽  
Richard Lalonde ◽  
Stephen D Shafran ◽  
Cécile Tremblay ◽  
...  

BACKGROUND AND OBJECTIVES: A Canadian group, consisting of six physicians and an HIV researcher with significant experience and knowledge in HIV management, reviewed the available data and developed guidelines for Canadian health care providers (who treat HIV infection) on the appropriate use of maraviroc (UK-427,857) in HIV-infected adults.METHODS: Evidence from the published literature and conference presentations, as well as the expert opinions of the group members were considered and evaluated to develop the recommendations. Feedback on the draft recommendations was obtained from this core group, as well as from four other physicians across Canada with expertise in HIV treatment and experience with the use of maraviroc. The final recommendations represent the core group’s consensus agreement once all feedback was considered.RESULTS/CONCLUSIONS: Recommendations were developed to guide physicians and other health care providers in the optimal use of maraviroc. The recommendations were considered in light of the fact that the decision to include maraviroc in an antiretroviral regimen depends not only on issues that concern all antiretroviral agents, such as efficacy, safety, resistance and drug interactions, but also on the issue of viral tropism, which is unique to maraviroc and other CCR5 inhibitors.


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