Barriers to antiretroviral therapy adherence among prisoners in one prison in Iran

2019 ◽  
Vol 19 ◽  
Author(s):  
Behnam Farhoudi ◽  
Seyed Ahmad Seyedalinaghi ◽  
Masoud Jafarinasab ◽  
Seyed Mohammad Ghavam ◽  
Omid Dadras ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Patient Adherence ◽  
Social Stigma ◽  
Group Discussion ◽  
Life Quality ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Dramatic Improvement ◽  
Art Adherence ◽  
Opium Addiction

Background: Antiretroviral medications have improved the survival and life quality of people living with HIV and turned HIV into a chronic controllable disease. However, the success of HIV treatment depends on many factors; the patient adherence is one the most important indicators which. In this study, we explored the potential barriers to an effective adherence antiretroviral therapy (ART) among the HIV-positive prisoners of Ghezelhesar prison, Iran. Methods: To explore and identify the barriers toward ART adherence, a focus group discussion was held with six prisoners eligible for ART but rejected to be treated or did not retain on ART. The prisoners were recruited through purposive sampling method. All the words, behaviors and even body languages were precisely recorded and analyzed to reach the final results. Results: The most reported obstacles toward ART adherence were the lack of trust in effectiveness of medications and drug complications. Other reasons were inadequate nutrition, lack of amenities, social stigma, lack of economic and psychological support, misbehavior of prison staff and inadequate methadone prescription for those with opium addiction. Conclusion: Due to the results and the fact that adequate Methadone prescription for opium addiction, improving life quality and receiving emotional and medical support from staff could improve adherence to HIV medication in prisoners, comprehensive education of prisoners about their health condition along with staff education may improve the life condition of HIV infected prisoners and may cause dramatic improvement in ART adherence and prisoners health.

scholarly journals ASSESSING THE RATE OF ANTIRETRO VIRAL THERAPY ADHERENCE AMONG PEOPLE LIVING WITH HIV/AIDS IN THE ATWIMA NWABIAGYA MUNICIPAL - ASHANTI REGION

2021 ◽  
Vol 7 (7) ◽  
pp. 428-439
Author(s):  
Ernest Boateng ◽  
◽  
Dr. Emmanuel Kumah ◽  
Keyword(s):  
Antiretroviral Therapy ◽  
Quantitative Methods ◽  
Social Stigma ◽  
Medical Problem ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Cross Sectional ◽  
Behavioural Factors ◽  
Adherence Counselling

At the end of 2018, HIV remains a significant worldwide medical problem and has claimed over 32 million lives. Around 37.9 million individuals were living with the condition at the end of 2018. The pervasiveness of HIV among African adults (15–49 years) was 3–multiple times higher in 2018. When properly followed, ART has been shown to slow the progression of HIV and enable HIV-positive people to live longer, more productive lives. A treatment regimen of at least three antiretroviral (ARV) medications is typically used. Adherence to antiretroviral therapy (ART) is insufficient. Therefore, the study aimed to assess the ART adherence among PLHIV in the Atwima Nwabiagya Municipality to suggest efficient and effective strategies to maximize adherence. A cross-sectional study was employed using quantitative methods to assess the associations between ART adherence and socio-demographic and socioeconomic factors. The site for this study was the ART Clinic at Nkawie Government Hospital, with a study population of all AIDS patients at the ART Clinic. The 450 PLHIV sample included females (n = 323, or 71.8%), while the males were 127 (28.2). Of the 450 participants, 215 (47.8%) reported adherence of 95%. The mean adherence index was 91.3%. Again, the study showed that those who took a single (137; 30.4%) ART dose was more comfortable than those who took multiple doses (313; 69.6%). Discomfort with the ART regimen, financial restrictions, forgetting to take medicine, lack of family support, social stigma, and antiretroviral therapy side effects were all major barriers to adherence in this study. Adherence, as stated by the participants, appeared to be below. Non-adherence is linked to both medical and behavioural factors, such as pausing ART or feeling ART discomfort. Atwima Nwabiagya Municipality, adherence to antiretroviral therapy is low. Before starting antiretroviral treatment, all patients can receive intensive adherence counselling.

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 Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049824
Author(s):  
Andreas D Haas ◽  
Cordelia Kunzekwenyika ◽  
Stefanie Hossmann ◽  
Josphat Manzero ◽  
Janneke van Dijk ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv

ObjectivesTo examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).SettingSixteen government-funded health facilities in the rural Bikita district of Zimbabwe.DesignCross-sectional study.ParticipantsHIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months.Outcome measuresThe primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence.ResultsOut of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40–49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50–59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70).ConclusionsA substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe.Trial registration numberNCT03704805.

scholarly journals Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

2021 ◽  
Author(s):  
Andreas D Haas ◽  
Cordelia Kunzekwenyika ◽  
Stefanie Hossmann ◽  
Josphat Manzero ◽  
Janneke H van Dijk ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv

Objectives: To examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART). Setting: Sixteen government-funded health facilities in the rural Bikita district of Zimbabwe. Design: Cross-sectional study. Participants: HIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least six months. Outcome measures: The primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire (SSQ-14) score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms, and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms, and suboptimal ART adherence. Results: Out of 3,480 adults, 18.8% (95% confidence interval [CI] 14.8-23.7) screened positive for CMD, 2.7% (95% CI 1.5-4.7) reported suicidal ideations, and 1.5% (95% 0.9-2.6) reported perceptual symptoms. Positive CMD screens were more common in women (adjusted prevalence ratio [aPR] 1.67, 95% CI 1.19-2.35) than in men and were more common in adults aged 40-49 years (aPR 1.47 95% CI 1.16-1.85) or aged 50-59 years (20.3%; aPR 1.51 95% CI 1.05-2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37-1.70). Conclusions: A substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programs in rural Zimbabwe.

scholarly journals Assessing the Content Validity of a New Patient-Reported Measure of Barriers to Antiretroviral Therapy Adherence for Electronic Administration in Routine HIV Care: Proposal for a Web-Based Delphi Study (Preprint)

2018 ◽  
Author(s):  
Kim Engler ◽  
Sara Ahmed ◽  
David Lessard ◽  
Serge Vicente ◽  
Bertrand Lebouché
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Free Text ◽  
Art Adherence ◽  
Web Based ◽  
Specific Patient ◽  
Patient Reported ◽  
Electronic Administration ◽  
Oriented Research

BACKGROUND Adherence to lifesaving antiretroviral therapy (ART) for HIV infection remains a challenge for many patients. Routine screening for barriers to ART adherence could help make HIV care more patient-centered and prevent virologic rebound or failure. Our team is currently developing a new HIV-specific patient-reported outcome measure (PROM) of these barriers for use in Canada and France along with a digital app for its electronic administration. In our previous work, we developed the PROM’s multidimensional conceptual framework and generated 100 English items, which have been translated to French. OBJECTIVE This study aims to use a Web-based Delphi to help validate and select the content of this new HIV-specific PROM, based on the perspective of anglophone and francophone patients and providers in Canada and France. Here, we present the proposal for this Delphi. METHODS This modified Delphi will involve a diverse panel of patients (n=32) and providers (n=52) recruited especially from the 9 sites of the PROM development study (site locations in Canada: Montreal, Toronto, Vancouver; in France: Paris, Nantes, Clermont-Ferrand, Saint-Martin, Cayenne). Overall, 2 rounds of Web-based questionnaires will be conducted. The threshold for consensus is set at 60% and will determine which items are carried forward to the second round. Per item, 3 aspects will be rated: importance as a barrier to ART adherence, relevance for HIV care, and clarity. In both rounds, space will be available for free text comments. Overall comprehensiveness will be assessed in the second round. RESULTS This study has undergone a methodological review by experts in patient-oriented research. It has received approval from a research ethics board of the McGill University Health Centre. It is financially supported, in part, by the Canadian Institutes of Health Research’s Strategy for Patient-Oriented Research-Quebec Support Unit (M006). As of May 21, 2019, 15 people living with HIV and 25 providers completed the first round of the Delphi (24 from Canada and 16 from France). CONCLUSIONS To our knowledge, this is the first Delphi to seek consensus on the most relevant and clinically actionable barriers to ART adherence, collecting opinions on an extensive list of barriers. Drawing on a relatively large and diverse panel of HIV patients and providers, it essentially engages key stakeholders in decision making about the PROM’s final content, helping to ensure its utility and adoption. INTERNATIONAL REGISTERED REPOR PRR1-10.2196/12836

Self-esteem and motivation with adherence of people living with HIV/AIDS (PLWHA) in Indonesia with antiretroviral therapy: a cross-sectional study

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Purwaningsih Purwaningsih ◽  
Candra Panji Asmoro ◽  
Yenis Anggi Prastiwi
Keyword(s):  
Antiretroviral Therapy ◽  
Self Esteem ◽  
Cross Sectional Study ◽  
The Body ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Introduction Antiretroviral therapy (ART) helps reduce the amount of human immunodeficiency virus (HIV) that enters the body in order to avoid acquired immune deficiency syndrome (AIDS) and prevents the occurrence of opportunistic infections and complications. This study aims to describe the correlation between self-esteem and motivation with adherence of people living with HIV/AIDS (PLWHA) in ART. Methods This cross-sectional study involved 91 PLWHA who joined a non-government organization (NGO) support group, determined through a purposive sampling technique. The demography, and questionnaires about self-esteem, motivation and adherence to ART were employed to collect the raw data. The data were then analyzed using Spearman’s rho test with the degree of significance at p < 0.05. Results The result showed that self-esteem (p = 0.000, r = 0.445) and motivation (p = 0.019, r = 0.246) had correlation with adherence of PLWHA with ART. Conclusion PLWHA can increase self-esteem and motivation so that they can improve ART adherence. Further research is expected to use an instrument more objectively as a measurement tool for ART adherence in addition to a questionnaire so as to obtain more accurate and specific results.

scholarly journals Patient-Provider Communication and Information, Motivation, and Behavioral Skills in HIV-Positive Adults Initiating Antiretroviral Therapy in Haiti

2020 ◽  
Vol 19 ◽  
pp. 232595822095263
Author(s):  
Megan K. Ramaiya ◽  
Elizabeth Haight ◽  
Jane M. Simoni ◽  
Jean Marcxime Chéry ◽  
Witson Dervis ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Treatment ◽  
Provider Communication ◽  
Art Adherence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Behavioral Skills ◽  
Adherence Support ◽  
Hiv Positive Adults ◽  
Patient Provider Communication

While Haiti has scaled up use of antiretroviral therapy (ART), current studies suggest sub-optimal adherence threatens long-term viral suppression in this understudied setting. Patient-provider communication (PPC) and information, motivation, and behavioral skills (IMB) have been implicated in ART adherence globally. However, no studies have examined their relevance in Haiti. The present mixed-methods study utilized cross-sectional survey data from 128 ART-initiating patients at 2 large HIV treatment sites in Haiti, as well as observational data from 12 clinic visits, to document associations between adherence-related PPC and IMB. Multivariate regression analyses suggested that PPC is associated with IMB constructs. At the bivariate level, more effective PPC was associated with higher levels of adherence-related information and motivation, but not behavioral skills. Observational findings indicate infrequent and non-collaborative adherence support. Taken together, findings lay the groundwork for additional research in the area of PPC, IMB, and ART adherence in Haiti.

Undetected anogenital sexually transmitted infections among young adults living with HIV and receiving antiretroviral therapy: Implications for HIV treatment as prevention

2021 ◽  
pp. 095646242110465
Author(s):  
Seth C Kalichman ◽  
Lisa A Eaton ◽  
Moira O Kalichman
Keyword(s):  
Antiretroviral Therapy ◽  
Sexually Transmitted Infections ◽  
Sexual Behaviors ◽  
Hiv Transmission ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sexually Transmitted ◽  
Condomless Anal Intercourse ◽  
Living With Hiv

Undetected sexually transmitted infections (STIs) pose health threats to people living with HIV and when combined with uncontrolled HIV can amplify HIV transmission. The current study screened 174 self-identified men under age 36 living with HIV and receiving antiretroviral therapy (ART) for urethral and rectal incident chlamydia and gonorrhea infections. Participants were also screened for biomarkers indicating alcohol and other drug use, subclinical genital inflammation, and HIV viral load. ART adherence and sexual behaviors were also assessed prospectively over 1 month. Results detected an undiagnosed STI in 32 (18%) individuals. Participants with a previously undetected STI had significantly greater HIV viremia than those who did not have an STI after controlling for several confounding variables. Participants with an undetected STI also engaged in greater condomless anal intercourse with HIV negative and unknown status partners, including partners to whom they had not disclosed their HIV status. These findings show that undetected STI are associated with incomplete ART adherence and unsuppressed HIV, all of which are important for preventing HIV transmission.

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 Assessing the impact of HIV support groups on antiretroviral therapy adherence and viral suppression in the African cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Prudence Mbah ◽  
Michael Iroezindu ◽  
Allahna L. Esber ◽  
Nicole Dear ◽  
Domonique Reed ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Support Groups ◽  
Support Group ◽  
Viral Suppression ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Art Adherence ◽  
African Countries ◽  
The Impact

Abstract Background Support groups for people living with HIV (PLWH) may improve HIV care adherence and outcomes. We assessed the impact of support group attendance on antiretroviral therapy (ART) adherence and viral suppression in four African countries. Methods The ongoing African Cohort Study (AFRICOS) enrolls participants at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Self-reported attendance of any support group meetings, self-reported ART adherence, and HIV RNA are assessed every 6 months. Logistic regression models with generalized estimating equations were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for support group attendance and other factors potentially associated with ART adherence and viral suppression. Results From January 2013 to December 1, 2019, 1959 ART-experienced PLWH were enrolled and 320 (16.3%) reported any support group attendance prior to enrollment. Complete ART adherence, with no missed doses in the last 30 days, was reported by 87.8% while 92.4% had viral suppression <1000copies/mL across all available visits. There was no association between support group attendance and ART adherence in unadjusted (OR 1.01, 95% CI 0.99–1.03) or adjusted analyses (aOR 1.00, 95% CI 0.98–1.02). Compared to PLWH who did not report support group attendance, those who did had similar odds of viral suppression in unadjusted (OR 0.99, 95% CI 0.978–1.01) and adjusted analyses (aOR 0.99, 95% CI 0.97–1.01). Conclusion Support group attendance was not associated with significantly improved ART adherence or viral suppression, although low support group uptake may have limited our ability to detect a statistically significant impact.

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