scholarly journals The Influence of Neighborhood Characteristics on HIV Treatment Outcomes Among Adults: A Scoping Review Protocol

2021 ◽  
Author(s):  
Linda Jepkoech Kimaru ◽  
Magdiel Habila ◽  
Namoonga Mantina ◽  
Purnima Madhivanan ◽  
Elizabeth Connick ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Scoping Review ◽  
Hiv Treatment ◽  
Community Level ◽  
Hiv Care ◽  
Neighborhood Characteristics ◽  
Hiv Interventions ◽  
Individual Behaviors ◽  
Hiv Treatment Outcomes ◽  
Living With Hiv

Abstract BackgroundThe HIV pandemic has caused enormous suffering and loss of life in the last forty years. Currently more than 34 million people have died as a result of HIV infection and over 37 million people are currently living with HIV. There have been tremendous global efforts to address the HIV pandemic and although significant progress has been made in treatment and prevention of HIV, many people living with HIV still do not have appropriate access to treatment and care. Current HIV interventions have focused more on individual factors than on community level factors. Community level factors influence individual behavior by enhancing or limiting access to- and utilization of HIV care. The objective of this scoping review is to assess and critically examine the association between neighborhood characteristics and outcomes of HIV treatment.Methods The following databases will be searched for studies published on and prior to May 31, 2021: PubMed, PsycINFO, CINAHL, and EMBASE. We will include published full text studies with both experimental and observational study designs that discussed neighborhood characteristics and HIV treatment outcomes. We will exclude abstracts only publications and studies reporting opinion. Data generated from the search will be managed using Mendeley 1.19.8. The review will be conducted using Arskey and Levac’s methodological framework for scoping reviews. A narrative synthesis will be conducted on the included studies. Discussion Sustainability of HIV interventions that focus on individual behaviors rely on the community level factors that influence those individual behaviors. This review will enhance the understanding of the impact of neighborhood characteristics on HIV treatment outcomes among adults, and possibly shed a light on potential points of intervention that will aid in improving ART initiation, ART adherence, and HIV viral load suppression.Scoping Review Registration: OSF 10.17605/OSF.IO/MD89T

HIV treatment outcomes among newcomers living with HIV in Manitoba, Canada

2021 ◽  
pp. e20200042
Author(s):  
Charity Maritim ◽  
Leigh McClarty ◽  
Stella Leung ◽  
Sharon Bruce ◽  
Gayle Restall ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Clinical Characteristics ◽  
Cohort Analysis ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Similar Proportion ◽  
People Living With Hiv ◽  
Persons Living With Hiv ◽  
Hiv Treatment Outcomes ◽  
Living With Hiv

Background: Despite the overrepresentation of immigrants and refugees (newcomers) in the HIV epidemic in Canada, research on their HIV treatment outcomes is limited. This study addressed this knowledge gap by describing treatment outcomes of newcomers in comparison with Canadian-born persons living with HIV in Manitoba. Methods: Clinical data from 1986 to 2017 were obtained from a cohort of people living with HIV and receiving care from the Manitoba HIV Program. Retrospective cohort analysis of secondary data was completed using univariate and multivariate statistics to compare differences in socio-demographic and clinical characteristics and treatment outcomes among newcomers, Canadian-born Indigenous persons, and Canadian-born non-Indigenous persons on entry into HIV care. Results: By end of 2017, 86 newcomers, 259 Canadian-born Indigenous persons, and 356 Canadian-born non-Indigenous persons were enrolled in the cohort. Newcomers were more likely than Canadian-born Indigenous and non-Indigenous cohort participants to be younger and female and have self-reported HIV risk exposure as heterosexual contact. Average CD4 counts at entry into care did not differ significantly between groups. A higher proportion of newcomers was also diagnosed with tuberculosis within 6 months of entry into care (21%), compared with 6% and 0.6% of Canadian-born Indigenous non-Indigenous persons, respectively. Newcomers and Canadian-born non-Indigenous persons had achieved viral load suppression (< 200 copies/mL) at a similar proportion (93%), compared with 82% of Canadian-born Indigenous participants ( p < 0.05). Conclusions: The distinct demographic and clinical characteristics of newcomers living with HIV requires a focused approach to facilitate earlier diagnosis, engagement, and support in care.

Mapping Evidence Of Patient-centered Care For Persons Living With Hiv: A Protocol For A Systematic Scoping Review

2019 ◽  
Author(s):  
Delarise Mulqueeny ◽  
Manduleli Herald Pokiya ◽  
Praba Naidoo
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Hiv Treatment ◽  
World Health ◽  
Hiv Care ◽  
Future Research ◽  
Clinical Settings ◽  
Keywords Hiv ◽  
Persons Living With Hiv ◽  
Living With Hiv

Abstract Background: The Human Immunodeficiency virus (HIV) is a global, chronic health challenge that warrants a multidimensional approach to treatment and care. Notwithstanding the strides made in suppressing the virus, evidence illustrates challenges in persons living with HIV (PLHIV) experiences of treatment and care. Such experiences threaten HIV patients’ retention, adherence, mortality, comorbidities and the global community’s efforts to end the AIDS epidemic by 2030. A patient-centred approach (PCC) to HIV care and treatment could improve patients’ health care experiences, wellbeing, retention and adherence and strengthen patient-provider relationships, Hence, the aim of this scoping review is to comprehensively map existing evidence of PCC in HIV treatment and care. Additionally, the review will identify and describe gaps that could inform future research and interventional programmes or the need for systematic reviews. Methods and analysis: As HIV PCC is a broad topic, a systematic scoping review, that includes peer-reviewed journal articles and grey literature will be conducted. Online databases: (Google scholar, Scopus, EBSCOhost, PsycINFO via ProQuest, PsycARTICLES via ProQuest, International Bibliography of the Social Sciences (IBSS) via ProQuest, UNAIDS databases will be accessed. Humanitarian databases such as the World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO) will also be accessed to identify literature on PCC for PLHIV. Such literature will be published between 2009 and 2019. Two reviewers will independently extract data from relevant search engines, utilising specific inclusion and exclusion standards. Thereafter thematic content analysis will be performed, and a narrative account of the findings will be presented. Discussion: As this is a scoping review, no ethical approval is required. Once the review is completed all summarized data will be disseminated in peer-reviewed journals, at national and international conferences, clinical settings and to policy makers. This is aimed at improving PLHIV’s experiences in clinical settings, practice and care. Keywords: HIV, patient-centred care, patient experiences, ART programme; ARVS; patients

scholarly journals Socioeconomic and psychosocial factors are associated with poor treatment outcomes in Australian adults living with HIV: a case-control study

Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 548 ◽  
Author(s):  
Krista J. Siefried ◽  
Stephen Kerr ◽  
Robyn Richardson ◽  
Limin Mao ◽  
John Rule ◽  
...  
Keyword(s):  
Health Care ◽  
Treatment Outcomes ◽  
Psychosocial Factors ◽  
Hiv Treatment ◽  
Hiv Disclosure ◽  
Self Report ◽  
Hiv Care ◽  
Targeted Interventions ◽  
Poor Outcomes ◽  
Living With Hiv

Background A substantial minority of patients living with HIV refuse or cease antiretroviral therapy (ART), have virological failure (VF) or develop an AIDS-defining condition (ADC) or serious non-AIDS event (SNAE). It is not understood which socioeconomic and psychosocial factors may be associated with these poor outcomes. Methods: Thirty-nine patients with poor HIV treatment outcomes, defined as those who refused or ceased ART, had VF or were hospitalised with an ADC or SNAE (cases), were compared with 120 controls on suppressive ART. A self-report survey recorded demographics, physical health, life stressors, social supports, HIV disclosure, stigma or discrimination, health care access, treatment adherence, side effects, health and treatment perceptions and financial and employment status. Socioeconomic and psychosocial covariates significant in bivariate analyses were assessed with conditional multivariable logistic regression, adjusted for year of HIV diagnosis. Results: Cases and controls did not differ significantly with regard to sex (96.2% (n = 153) male) or age (mean (± s.d.) 51 ± 11 years). Twenty cases (51%) had refused or ceased ART, 35 (90%) had an HIV viral load &gt;50 copies mL–1, 12 (31%) were hospitalised with an ADC and five (13%) were hospitalised with a new SNAE. Three covariates were independently associated with poor outcomes: foregoing necessities for financial reasons (adjusted odds ratio (aOR) 3.1, 95% confidence interval (95% CI) 1.3–7.6, P = 0.014), cost barriers to accessing HIV care (aOR 3.1, 95% CI 1.0–9.6, P = 0.049) and lower quality of life (aOR 3.8, 95% CI 1.5–9.7, P = 0.004). Conclusions: Despite universal health care, socioeconomic and psychosocial factors are associated with poor HIV outcomes in adults in Australia. These factors should be addressed through targeted interventions to improve long-term successful treatment.

scholarly journals Association between Depression and HIV Treatment Outcomes in a US Military Population with HIV Infection

2020 ◽  
Author(s):  
Brandon Carney ◽  
Colton Daniel ◽  
Xiaohe Xu ◽  
Thankam Sunil ◽  
Anuradha Ganesan ◽  
...  
Keyword(s):  
Mental Health ◽  
Treatment Outcomes ◽  
Latent Class ◽  
Virologic Failure ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Lower Odds ◽  
Us Military ◽  
Hiv Treatment Outcomes

Abstract Background: Depression is common among HIV-infected individuals and may contribute to suboptimal adherence to antiretroviral therapy (ART) and subsequent inability to attain viral load (VL) suppression. We evaluated longitudinal HIV treatment outcomes in US Military HIV Natural History Study (NHS) participants with depression. Methods: Male NHS participants with available ICD-9 data for mental health diagnoses, Center for Epidemiological Studies Depression (CES-D) measures, and self-reported adherence (SRA) were included. ART use was defined as ART initiation between 2006-2010, with follow-up through 2015. SRA was defined as taking ³95% of ART doses and continuous ART was defined as longitudinal ART use with gaps <30 days. Continuous VL suppression was defined as maintaining VLs <200 c/mL on ART. To analyze the association between depression and HIV treatment outcomes, latent class analysis was used to create classes of depression trajectories: low depression (LD), recent onset depression (ROD) and high Depression (HD). Results: Participants had a mean age of 32 (±8.3) years at HIV diagnosis, and similar proportions were Caucasian (44.3%) or African American (40.8%). Overall, older participants at HIV diagnosis had greater odds of having 95% SRA (OR 1.06, 95% CI 1.02-1.12), and African Americans had lower odds (OR 0.41, 95% CI 0.22-0.76) compared to Caucasians (OR 1.49, 95% CI 0.52-4.28). However, there was no difference in SRA by depression trajectory. Participants with HD had a trend towards taking ART continuously (OR 1.75, 95% CI 0.99-3.09), and those with ROD had significantly higher odds of virologic failure (OR 0.58, 95% CI 0.38-0.91). Conclusions: Although there was no observed association between depression and SRA, participants with ROD had lower odds of attaining the HIV treatment goal of VL suppression. Continued efforts to identify and aggressively manage mental health disorders is important to success along the HIV care continuum.

scholarly journals Resilience and HIV Treatment Outcomes Among Women Living with HIV in the United States: A Mixed-Methods Analysis

2020 ◽  
Vol 34 (8) ◽  
pp. 356-366 ◽  
Author(s):  
Faith E. Fletcher ◽  
Nicholas R. Sherwood ◽  
Whitney S. Rice ◽  
Ibrahim Yigit ◽  
Shericia N. Ross ◽  
...  
Keyword(s):  
United States ◽  
Mixed Methods ◽  
Treatment Outcomes ◽  
The United States ◽  
Hiv Treatment ◽  
Women Living With Hiv ◽  
Hiv Treatment Outcomes ◽  
Living With Hiv

scholarly journals Association between depression and HIV treatment outcomes in a US military population with HIV infection

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Brandon Carney ◽  
Colton Daniels ◽  
Xiaohe Xu ◽  
Thankam Sunil ◽  
Anuradha Ganesan ◽  
...  
Keyword(s):  
Mental Health ◽  
Treatment Outcomes ◽  
Latent Class ◽  
Virologic Failure ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Lower Odds ◽  
Us Military ◽  
Hiv Treatment Outcomes

Abstract Background Depression is common among HIV-infected individuals and may contribute to suboptimal adherence to antiretroviral therapy (ART) and subsequent inability to attain viral load (VL) suppression. We evaluated associations between depression, self-reported adherence, and longitudinal HIV treatment outcomes in US Military HIV Natural History Study (NHS) participants with and without depression. Methods Male NHS participants with available ICD-9 data for mental health diagnoses, Center for Epidemiological Studies Depression (CES-D) measures, and self-reported adherence (SRA) were included. ART use was defined as ART initiation between 2006 and 2010, with follow-up through 2015. SRA was defined as taking 95% of ART doses and continuous ART was defined as longitudinal ART use with gaps  < 30 days. Continuous VL suppression was defined as maintaining VLs  < 200 c/mL on ART. To analyse the association between depression and HIV treatment outcomes, latent class analysis was used to create classes of depression trajectories: low depression (LD), recent onset depression (ROD) and high Depression (HD). Results Participants had a mean age of 32 (± 8.3) years at HIV diagnosis, and similar proportions were Caucasian (44.3%) or African American (40.8%). Overall, older participants at HIV diagnosis had greater odds of having 95% self-reported adherence (OR 1.06, 95% CI 1.02–1.12), and African Americans had lower odds (OR 0.41, 95% CI 0.22–0.76) compared to Caucasians (OR 1.49, 95% CI 0.52–4.28). However, there was no difference in SRA by depression trajectory. Participants with HD had an increased odds of taking ART continuously (OR 1.75, 95% CI 0.99–3.09), and those with ROD had significantly higher odds of virologic failure (OR 0.58, 95% CI 0.38–0.91). Conclusions Although there was no observed association between depression and SRA, participants with ROD had lower odds of attaining the HIV treatment goal of VL suppression. Continued efforts to identify and aggressively manage mental health disorders is important to success along the HIV care continuum.

scholarly journals Mechanisms from Food Insecurity to Worse HIV Treatment Outcomes in US Women Living with HIV

2020 ◽  
Vol 34 (10) ◽  
pp. 425-435
Author(s):  
Sheri D. Weiser ◽  
Lila A. Sheira ◽  
Kartika Palar ◽  
Margot Kushel ◽  
Tracey E. Wilson ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Treatment Outcomes ◽  
Hiv Treatment ◽  
Women Living With Hiv ◽  
Hiv Treatment Outcomes ◽  
Living With Hiv

scholarly journals 369. Association Between Depression and HIV Treatment Outcomes in a US Military Population with HIV Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S193-S194
Author(s):  
Brandon Carney ◽  
Colton Daniels ◽  
Xiaohe Xu ◽  
Thankam Sunil ◽  
Anuradha Ganesan ◽  
...  
Keyword(s):  
Mental Health ◽  
Treatment Outcomes ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Art Initiation ◽  
Us Military ◽  
History Of ◽  
Hiv Treatment Outcomes ◽  
History Of Depression

Abstract Background Depression is common among HIV-infected individuals and may contribute to suboptimal adherence to antiretroviral therapy (ART) and reduced rates of viral load (VL) suppression. We evaluated longitudinal HIV treatment outcomes in US Military HIV Natural History Study (NHS) participants with or without a diagnosis depression. Methods Male NHS participants with available ICD-9 data for mental health diagnoses and self-reported adherence (SRA) were included (n = 549). Groups were defined as having a history of depression (n = 188, 34.2%), classified as major depressive disorder and/or anxiety disorder, or no history of depression (n = 361, 65.8%). Delay in ART initiation was defined as the time from HIV diagnosis to ART start greater than the group mean (4.91 ± 4.69 years). SRA was defined as taking ≥95% of ART doses and continuous ART was defined as longitudinal ART use with gaps < 30 days. Continuous VL suppression was defined as maintaining VLs < 200 c/mL on ART. Logistic regression analysis was performed comparing variables for those with and without a coded diagnosis of depression. Results Participants had a mean age of 33 (±8.36) years at HIV diagnosis, and similar proportions were Caucasian (44.3%) or African American (40.8%). At ART initiation, the mean CD4 count was 370 (±154 cells/μL) and 362 (±163 cells/μL) for those with and without a history of depression, respectively. Overall, older participants at HIV diagnosis had greater odds of having high SRA (OR 1.07, 95% CI 1.03–1.11), and compared with Caucasians, African Americans had lower odds of having high SRA (OR 0.43, 95% CI 0.25–0.75; table). Participants with a history of depression had greater odds of experiencing delayed ART initiation (OR 2.12, 95% CI 1.11–4.05). However, they also had greater odds of remaining on continuous ART (OR 1.38, 95% CI 0.95–2.02) during follow-up compared with those without a history of depression. Conclusion Although HIV-infected individuals with depression were more likely to experience delays in ART initiation, there were no observed differences in SRA or VL suppression. Continued efforts to identify and aggressively manage mental health disorders are important to success along the HIV care continuum. Disclosures All authors: No reported disclosures.

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