Project SMART: Design and Delivery of an mHealth Intervention to Improve Treatment Outcomes among Cocaine Users with HIV (Preprint)

2021 ◽  
Author(s):  
Yerina Ranjit ◽  
Archana Krishnan ◽  
Debarchana Ghosh ◽  
Claire Cravero ◽  
Xin Zhou ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Hiv Treatment ◽  
Drop Out ◽  
Easy Access ◽  
Adherence Behavior ◽  
Mhealth Intervention ◽  
Project Smart ◽  
Study Population ◽  
Cocaine Users ◽  
Automated Feedback

BACKGROUND Antiretroviral therapy (ART) is effective in reducing HIV-related morbidity and mortality, and transmission among people with HIV (PWH). Adherence and persistence to ART, however, is crucial for successful HIV treatment outcomes. PWH who are cocaine users have poor access to HIV services and lower retention in care. OBJECTIVE The goal of this study was to examine the feasibility and acceptability of an mHealth intervention on ART adherence among cocaine using PWH. METHODS This project, titled Project SMART, used a wireless technology-based intervention, including cellular-enabled electronic pillboxes called TowerView Health® and smartphones to provide reminders and feedback on adherence behavior. This 12-week pilot (randomized control trial) with four arms provided three types of feedback: automated feedback, automated + clinician feedback, and automated feedback + social network feedback. RESULTS Between June 2017 to January 2020, this study screened 182 participants, out of which 80 successfully completed baseline, 71 enrolled to the intervention, and 57 completed the study. Study challenges included data loss due to untimely closure of the pillbox company, high drop-out rate (19.7%) likely due to the complexity of this study and burden of research components on the study population. CONCLUSIONS Implementing mHealth interventions for high-risk and marginalized populations is important in order to provide easy access to adherence services and scaling back the cost of personnel. Managing multi-component interventions come with certain challenges such as finding stable companies with adequate technology and financial support, and minimizing research-related burden for study population. The ability to adapt to these challenges posed by evolving technologies is important in conducting feasibility studies.

scholarly journals Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uganda

AIDS ◽  
2014 ◽  
Vol 28 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Sheri D. Weiser ◽  
Kartika Palar ◽  
Edward A. Frongillo ◽  
Alexander C. Tsai ◽  
Elias Kumbakumba ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Treatment Outcomes ◽  
Hiv Treatment ◽  
Longitudinal Assessment ◽  
Antiretroviral Adherence ◽  
Hiv Treatment Outcomes

scholarly journals “Our Tradition Our Enemy”: A Qualitative Study of Barriers to Women’s HIV Care in Jimma, Southwest Ethiopia

2020 ◽  
Vol 17 (3) ◽  
pp. 833
Author(s):  
Hailay Gesesew ◽  
Pamela Lyon ◽  
Paul Ward ◽  
Kifle Woldemichael ◽  
Lillian Mwanri
Keyword(s):  
Treatment Outcomes ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Negative Consequences ◽  
Framework Analysis ◽  
Southwest Ethiopia

Evidence exists that suggests that women are vulnerable to negative HIV treatment outcomes worldwide. This study explored barriers to treatment outcomes of women in Jimma, Southwest Ethiopia. We interviewed 11 HIV patients, 9 health workers, 10 community advocates and 5 HIV program managers from 10 institutions using an in-depth interview guide designed to probe barriers to HIV care at individual, community, healthcare provider, and government policy levels. To systematically analyze the data, we applied a thematic framework analysis using NVivo. In total, 35 participants were involved in the study and provided the following interrelated barriers: (i) Availability— most women living in rural areas who accessed HIV cared less often than men; (ii) free antiretroviral therapy (ART) is expensive—most women who have low income and who live in urban areas sold ART drugs illegally to cover ART associated costs; (iii) fear of being seen by others—negative consequences of HIV related stigma was higher in women than men; (iv) the role of tradition—the dominance of patriarchy was found to be the primary barrier to women’s HIV care and treatment outcomes. In conclusion, barriers related to culture or tradition constrain women’s access to HIV care. Therefore, policies and strategies should focus on these contextual constrains.

scholarly journals Ryan White HIV/AIDS Program Assistance and HIV Treatment Outcomes

2015 ◽  
Vol 62 (1) ◽  
pp. 90-98 ◽  
Author(s):  
Heather Bradley ◽  
Abigail H. Viall ◽  
Pascale M. Wortley ◽  
Antigone Dempsey ◽  
Heather Hauck ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Hiv Treatment ◽  
Ryan White ◽  
Aids Program ◽  
Hiv Treatment Outcomes ◽  
Hiv Aids

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 >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 Depression, sexual behavior, and HIV treatment outcomes among transgender women, cisgender women and men who have sex with men living with HIV in Brazil and Thailand: a short report

AIDS Care ◽  
2019 ◽  
Vol 32 (3) ◽  
pp. 310-315
Author(s):  
Tonia C. Poteat ◽  
David D. Celentano ◽  
Kenneth H. Mayer ◽  
Chris Beyrer ◽  
Matthew J. Mimiaga ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Treatment Outcomes ◽  
Transgender Women ◽  
Hiv Treatment ◽  
Short Report ◽  
Sex With Men ◽  
Hiv Treatment Outcomes ◽  
Living With Hiv

scholarly journals LBP-1.01 The interdiction project: an innovative program for HIV + persons to reduce HIV and STD co-infection and improve HIV treatment outcomes phase II

2011 ◽  
Vol 87 (Suppl 1) ◽  
pp. A352-A353
Author(s):  
S. Frimpong ◽  
M. Wilson ◽  
L. M. Mitchell-Samon ◽  
T. Azarian
Keyword(s):  
Treatment Outcomes ◽  
Phase Ii ◽  
Hiv Treatment ◽  
Innovative Program ◽  
Hiv Treatment Outcomes

Reconceptualizing Research on HIV Treatment Outcomes Among Criminalized Groups

2012 ◽  
Vol 59 (4) ◽  
pp. 329-330 ◽  
Author(s):  
Maria Patrizia Carrieri ◽  
Daniel Wolfe ◽  
Perrine Roux
Keyword(s):  
Treatment Outcomes ◽  
Hiv Treatment ◽  
Hiv Treatment Outcomes

Drug use and HIV treatment outcomes among HIV-infected men who have sex with men accessing Ryan White services in New York: a cross-sectional study

The Lancet ◽  
2013 ◽  
Vol 382 ◽  
pp. S4
Author(s):  
Jacinthe Thomas ◽  
Matthew Feldman ◽  
Mary Irvine ◽  
Emily Alexy
Keyword(s):  
New York ◽  
Drug Use ◽  
Treatment Outcomes ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ryan White ◽  
Sex With Men ◽  
Hiv Treatment Outcomes

scholarly journals Variation in HIV care and treatment outcomes by facility in South Africa, 2011–2015: A cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (3) ◽  
pp. e1003479
Author(s):  
Jacob Bor ◽  
Anna Gage ◽  
Dorina Onoya ◽  
Mhairi Maskew ◽  
Yorghos Tripodis ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Urban Areas ◽  
Viral Suppression ◽  
Laboratory Data ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
Hiv Care ◽  
Western Cape ◽  
Care And Treatment

Background Despite widespread availability of HIV treatment, patient outcomes differ across facilities. We propose and evaluate an approach to measure quality of HIV care at health facilities in South Africa’s national HIV program using routine laboratory data. Methods and findings Data were extracted from South Africa’s National Health Laboratory Service (NHLS) Corporate Data Warehouse. All CD4 counts, viral loads (VLs), and other laboratory tests used in HIV monitoring were linked, creating a validated patient identifier. We constructed longitudinal HIV care cascades for all patients in the national HIV program, excluding data from the Western Cape and very small facilities. We then estimated for each facility in each year (2011 to 2015) the following cascade measures identified a priori as reflecting quality of HIV care: median CD4 count among new patients; retention 12 months after presentation; 12-month retention among patients established in care; viral suppression; CD4 recovery; monitoring after an elevated VL. We used factor analysis to identify an underlying measure of quality of care, and we assessed the persistence of this quality measure over time. We then assessed spatiotemporal variation and facility and population predictors in a multivariable regression context. We analyzed data on 3,265 facilities with a median (IQR) annual size of 441 (189 to 988) lab-monitored HIV patients. Retention 12 months after presentation increased from 42% to 47% during the study period, and viral suppression increased from 66% to 79%, although there was substantial variability across facilities. We identified an underlying measure of quality of HIV care that correlated with all cascade measures except median CD4 count at presentation. Averaging across the 5 years of data, this quality score attained a reliability of 0.84. Quality was higher for clinics (versus hospitals), in rural (versus urban) areas, and for larger facilities. Quality was lower in high-poverty areas but was not independently associated with percent Black. Quality increased by 0.49 (95% CI 0.46 to 0.53) standard deviations from 2011 to 2015, and there was evidence of geospatial autocorrelation (p < 0.001). The study’s limitations include an inability to fully adjust for underlying patient risk, reliance on laboratory data which do not capture all relevant domains of quality, potential for errors in record linkage, and the omission of Western Cape. Conclusions We observed persistent differences in HIV care and treatment outcomes across South African facilities. Targeting low-performing facilities for additional support could reduce overall burden of disease.

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