scholarly journals Deconstructing Syndemics: The Many Layers of Clustering Multi-Comorbidities in People Living with HIV

2020 ◽  
Vol 17 (13) ◽  
pp. 4704
Author(s):  
Emmanuel Peprah ◽  
Elisabet Caler ◽  
Anya Snyder ◽  
Fassil Ketema
Keyword(s):  
Population Level ◽  
Communicable Diseases ◽  
People Living With Hiv ◽  
Infected People ◽  
Disease Clustering ◽  
Synergistic Interactions ◽  
Critical Knowledge ◽  
Hiv Epidemic ◽  
The Many ◽  
Living With Hiv

The HIV epidemic has dramatically changed over the past 30 years; there are now fewer newly infected people (especially children), fewer AIDS-related deaths, and more people with HIV (PWH) receiving treatment. However, the HIV epidemic is far from over. Despite the tremendous advances in anti-retroviral therapies (ART) and the implementation of ART regimens, HIV incidence (number of new infections over a defined period of time) and prevalence (the burden of HIV infection) in certain regions of the world and socio-economic groups are still on the rise. HIV continues to disproportionally affect highly marginalized populations that constitute higher-risk and stigmatized groups, underserved and/or neglected populations. In addition, it is not uncommon for PWH to suffer enhanced debilitating conditions resulting from the synergistic interactions of both communicable diseases (CDs) and non-communicable diseases (NCDs). While research utilizing only a comorbidities framework has advanced our understanding of the biological settings of the co-occurring conditions from a molecular and mechanistic view, harmful interactions between comorbidities are often overlooked, particularly under adverse socio-economical and behavioral circumstances, likely prompting disease clustering in PWH. Synergistic epidemics (syndemics) research aims to capture these understudied interactions: the mainly non-biological aspects that are central to interpret disease clustering in the comorbidities/multi-morbidities only framework. Connecting population-level clustering of social and health problems through syndemic interventions has proved to be a critical knowledge gap that will need to be addressed in order to improve prevention and care strategies and bring us a step closer to ending the HIV epidemic.

scholarly journals Psychological care for HIV-infected patientsat the St. Petersburg AIDS Center: history and the present time

2021 ◽  
Vol 13 (4) ◽  
pp. 121-126
Author(s):  
O. V. Koltsova
Keyword(s):  
Specific Treatment ◽  
Hiv Treatment ◽  
Psychological State ◽  
People Living With Hiv ◽  
Psychological Care ◽  
Infected People ◽  
Treatment Interruptions ◽  
The Moment ◽  
The Many ◽  
Living With Hiv

The psychological state of people living with HIV is suffering from the moment when the diagnosis of HIV infection is perceived to the onset of remission during treatment. To achieve real effectiveness of HIV treatment, it is important to use not only the potential of modern pharmacotherapy, it is equally important that all people living with HIV receive psychological support in overcoming the difficulties arising from daily regular intake of drugs throughout their lives. Psychologists who are working at the AIDS Center are ready and conduct crisis counseling, extended counseling on adherence to treatment, psychological diagnostics to identify disorders which prevent the initiation and continuation of drug therapy, psychological correction in case of treatment interruptions. The use of traditional psychological methods should be based on knowledge of the characteristics of the disease and the specific treatment of HIV-infected people, which is currently being acquired in real clinical conditions. The article summarizes the many years of experience of the team of psychologists at the St. Petersburg AIDS Center and presents a model of modern psychological care for HIV-infected people based on knowledge of the characteristics of the disease, its prevention and specific treatment. 

scholarly journals The essential role of physiotherapists in providing rehabilitation services to people living with HIV in South Africa

2013 ◽  
Vol 69 (1) ◽  
Author(s):  
S. Cobbing ◽  
V. Chetty ◽  
J. Hanass-Hancock ◽  
J. Jelsma ◽  
H. Myezwa ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Policy Formulation ◽  
People Living With Hiv ◽  
Highly Active ◽  
Hiv Epidemic ◽  
Wide Range ◽  
Living With Hiv ◽  
Education Courses

Despite increased access to highly active anti-retroviral therapy (HAART) in South Africa, there remains a high risk of people living with HIV (PLHIV) developing a wide range of disabilities. Physiotherapists are trained to rehabilitate individuals with the disabilities related to HIV. Not only can South African physiotherapists play a significant role in improving the lives of PLHIV, but by responding proactively to the HIV epidemic they can reinforce the relevance and value of the profession in this country at a time when many newly qualified therapists are unable to secure employment. This paper offers recommendations that may help to fuel this response. These ideas include enhancing HIV curricula at a tertiary level, designing and attending continuing education courses on HIV and researching Southern African rehabilitation interventions for HIV at all levels of practice. furthermore, it is vital that physiotherapists are at the forefront of directing multi-disciplinary responses to the rehabilitation of PLHIV in order to influence stakeholders who are responsible for health policy formulation. it is hoped that this paper stimulates discussion and further ideas amongst physiotherapists and other health professionals in order to improve the quality and access to care available to PLHIV in South Africa.

Emerging prevalence of fatty liver disease in HIV

2021 ◽  
Vol 16 (1) ◽  
pp. 59-73
Author(s):  
Amreen Dinani ◽  
Ali Khan ◽  
Douglas Dieterich
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Unmet Need ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Nonalcoholic Fatty Liver ◽  
Infected People ◽  
Direct Acting ◽  
Living With Hiv

Fatty liver disease is a growing concern in people living with HIV, the main drivers are alcoholic liver disease and nonalcoholic fatty liver disease. It has shown to negatively impact HIV care continuum and result in notable non-HIV related morbidity and mortality. With the advancement in antiretroviral therapy and effective direct acting antivirals, fatty liver disease is surfacing as the next big challenge in this population like that observed in the general population. This review article summarizes the gravity of these two common diseases in HIV-infected people and aims to sheds light on an unmet need to develop effective methods to identify, screen and manage fatty liver disease in this unique population.

Leveraging a Legacy of Activism: Black Lives Matter and the Future of HIV Prevention for Black MSM

2018 ◽  
Vol 30 (3) ◽  
pp. 208-212
Author(s):  
Derrick D. Matthews
Keyword(s):  
United States ◽  
The United States ◽  
Aids Education ◽  
Black Msm ◽  
People Living With Hiv ◽  
Black Lives Matter ◽  
Aids Epidemic ◽  
Hiv Epidemic ◽  
Sex With Men ◽  
Living With Hiv

This year marks the 30th anniversary of AIDS Education and Prevention. As we approach the United Nations goal of ending the AIDS epidemic by 2030, it is a useful time to reflect on and learn from history. In the United States, no such endeavor can be successful without addressing the specific context of Black men who have sex with men. In this commentary I highlight factors that led us to a state in which Black MSM represent approximately a quarter of all people living with HIV in the United States. I also look back at the power of activism during the beginning of the HIV epidemic. Using Black Lives Matter as a contemporary framework, I highlight natural linkages between activism 30 years ago, its incarnation and relationship to public health today, and its promise as the way forward in achieving the elimination of AIDS for Black MSM by 2030.

scholarly journals The Association between CD-4 Level, Stress and Depression Symptoms among People Living with HIV/AIDS

2019 ◽  
Vol 7 (20) ◽  
pp. 3459-3463
Author(s):  
Elmeida Effendy ◽  
Mustafa M. Amin ◽  
Lidya De Vega ◽  
Nurul Utami
Keyword(s):  
Hiv Infection ◽  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Self Report ◽  
Depression Symptoms ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Infected People ◽  
Living With Hiv ◽  
Hiv Aids

BACKGROUND: The lives of individuals diagnosed with HIV and the subsequent illness, AIDS, were often chaotic because these individuals deal with the physical, emotional, and interpersonal sequelae of this illness. Depressive symptoms and stress were common and impact on functioning, quality of life, and health status, highlighting the importance of diagnosis and treatment of patients with HIV infection. Psychiatric clinical practice and rating scales have come to play an ever-increasing role both in determining specific symptoms and diagnosing an individual condition. Descriptive reports of psychiatric morbidity among those with HIV infection, that relied primarily on self-report rating scales, described high rates of symptomatic depression and stress. AIM: This study aimed to determine the proportion of depression among people living with HIV/AIDS using the BDI-II and PSS to determine a relationship between symptoms of depression and stress with CD4 counts. METHODS: This study was a numerical correlative analytic study with a cross-sectional study approach that assessed the correlation between stress, depression and CD4 level in people with HIV/AIDS that were receiving ARV therapy in the Voluntary Counselling Test (VCT) Polyclinic of General Hospital Haji Medan by recruiting 46 subjects. CD4 level was examined in the Pramita Medan laboratory. RESULTS: When analysis of BDI-II level and CD4 scores were done, a significant correlation was found (P < 0.05). The strength of the relationship between the BDI score and the CD4 score was 0.548 revealing a positive correlation with moderate correlation strength CONCLUSION: We have shown a significant relationship between depression, stress and CD4 level among people with HIV/AIDS in Medan, Indonesia. Psychological distress may affect the immunity in infected people, leading to the disease progressivity.

scholarly journals Trends in proportion of older HIV-infected people in care in Latin America and the Caribbean: a growing challenge

2018 ◽  
Vol 146 (10) ◽  
pp. 1308-1311 ◽  
Author(s):  
Y. Caro-Vega ◽  
P. F. Belaunzarán-Zamudio ◽  
B. Crabtree-Ramírez ◽  
B. E. Shepherd ◽  
F. Mejia ◽  
...  
Keyword(s):  
Latin America ◽  
Regression Models ◽  
People Living With Hiv ◽  
South American ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Infected People ◽  
Logistic Regression Models ◽  
The Caribbean ◽  
Living With Hiv

AbstractWe aimed to quantify the proportion of people receiving care for HIV-infection that are 50 years or older (older HIV patients) in Latin America and the Caribbean between 2000 and 2015 and to estimate the contribution to the growth of this population of people enrolled before (<50yo) and after 50 years old (yo) (⩾50yo). We used a series of repeated, cross-sectional measurements over time in the Caribbean, Central and South American network (CCASAnet) cohort. We estimated the percentage of patients retained in care each year that were older HIV patients. For every calendar year, we divided patients into two groups: those who enrolled before age 50 and after age 50. We used logistic regression models to estimate the change in the proportion of older HIV patients between 2000 and 2015. The percentage of CCASAnet HIV patients over 50 years had a threefold increase (8% to 24%) between 2000 and 2015. Most of the growth of this population can be explained by the increasing proportion of people that enrolled before 50 years and aged in care. These changes will impact needs of care for people living with HIV, due to multiple comorbidities and high risk of disability associated with aging.

scholarly journals FACTORS ASSOCIATED WITH HEPATITIS B AND C CO-INFECTION AMONG PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS IN VIETNAM

2019 ◽  
Vol 5 (4) ◽  
pp. 147-154
Author(s):  
Le Hieu Thuy Anh ◽  
Suchada Thaweesit
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis B ◽  
Ecological Model ◽  
Theoretical Perspective ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Infected People ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
Living With Hiv

Background: Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) are the leading causes of death from infectious diseases. Because of sharing same transmission routes, the co-infection of HIV with HBV or HCV is common. And the co-infections make HIV infected persons have higher morbidity and mortality than those who infected only with HIV. This study aims to investigate factors that may have influence on the co-infections of HBV or HCV among HIV positive individuals.Objective: The goals of this study were to identify factors associated with the co-infection of HBV or HCV among people living with HIV. Methods: Quantitative research method was applied in this study to examine factors associated with HBV or HCV co-infection among HIV infected people. A total of 250 HIV infected individuals in Khanh Hoa province, Vietnam were the sample of this study. It employed the Social Ecological Model (SEM) as a theoretical perspective that focused on multiple levels of factors. Descriptive statistic was used to describe the general characteristics of the respondents. And Binary logistic regression was carried out to measure the influence of factors on the co-infection. Results: The multivariate analysis of this study showed that HIV-HBV co-infection was associated significantly with residents of Nha Trang (OR= 7.179). Regarding HIV-HCV co-infection, being men (OR= 7.617), unemployed (OR= 4.013), a resident of Nha Trang (OR=10.894) and an injecting drug user (OR= 16.688) were risk factors of the co-infection.Conclusions: This study recommended that intervention strategies to prevent HIV-positive individuals from co-infection with either HBV or HCV should focuses on altering individuals’ risk behaviors and their socio-economic environments. Also, specific preventing programs should be implemented and focus on unemployed populations, injecting drug users, men in general, as well as people living in particular areas, especially cities having a large number of people living with HIV.

scholarly journals Can we talk about price with patients when choosing antiretroviral therapy? A survey with people living with HIV and prescribers in France

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e046212
Author(s):  
Emmanuelle Papot ◽  
Nikos Kalampalikis ◽  
Marjolaine Doumergue ◽  
Fabrice Pilorgé ◽  
Guillemette Quatremère ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The North ◽  
Hiv Epidemic ◽  
Voluntary Response ◽  
History Of ◽  
Using Data ◽  
Living With Hiv

ObjectiveThe aim of this study was to evaluate people living with HIV (PLWH) and HIV specialist prescribers’ perception of discussing antiretroviral therapy (ART) price in PLWH’s care and the acceptability of choosing or switching to various types of less expensive ARTs.DesignCross-sectional surveys (one in a convenience sample of PLWH and one in a voluntary response sample of HIV specialist prescribers).Setting and participantsThe surveys were conducted among PLHW attending an HIV clinic in the North of Paris (cohort of 4922 PLWH in 2016), and HIV specialists working in French HIV clinics (210 across 12 districts/28), between January and June 2016.MethodSelf-administered questionnaires were constructed using data collected during focus groups with PLWH and prescribers. Pretests were carried out to select the questions and items. Descriptive analyses of the 129 complete questionnaires of PLWH and 79 of prescribers are presented.ResultsAmong PLWH, 128/129 were on ART and 54% (69/128) gave a fair estimation of the price of their current regimen. Among prescribers, 24% (19/79) thought that their patients knew this price. Taking into account the price of ART was not perceived as a negative step in the history of French response to HIV epidemic for 53% (68/129) of PLWH and 82% (65/79) of prescribers. Seventy-seven PLWH (60%) would agree to switch to less expensive antiretroviral regimens (as effective and with similar adverse events) if pills were bigger; 42 (33%) if there were more daily doses, and 37 (29%) if there were more pills per dose; prescribers were more circumspect.ConclusionA high proportion of PLWH gave a fair estimate of their ART price and this seemed unexpected by HIV specialists. Consideration of drug prices when choosing ART was perceived as conceivable by PLWH and prescribers if effectiveness and tolerance were also considered.

scholarly journals Determinants of AIDS and non-AIDS related mortality among people living with HIV in Shiraz, southern Iran: a 20-year retrospective follow-up study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zahra Gheibi ◽  
Zahra Shayan ◽  
Hassan Joulaei ◽  
Mohammad Fararouei ◽  
Shohreh Beheshti ◽  
...  
Keyword(s):  
Immune Deficiency Syndrome ◽  
Older Age ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Mena Region ◽  
Infected People ◽  
Clinical Stages ◽  
Living With Hiv ◽  
Related Mortality

Abstract Background Human Immunodeficiency Virus (HIV) infection has become a global concern. Determining the factors leading to death among HIV patients helps controlling Acquired Immune Deficiency Syndrome (AIDS) epidemic. Up to now, little is known about mortality and its determinants among people living with HIV in the Middle East and North Africa (MENA) region, including Iran. The purpose of this study was to assess the risk factors of AIDS-Related Mortality (ARM) and Non-AIDS-Related Mortality (NARM) among people with HIV in Iran. Methods This 20-year retrospective study was conducted on 1160 people with HIV whose data were collected from 1997 to 2017. The association of the study outcomes (ARM and NARM) with various study variables, including demographic status at the time of diagnosis and clinical indexes during the follow-up were examined to define the predictors of mortality among the patients. Regarding, Cox proportional hazard and competing risk models were fitted and Adjusted Hazard Ratios (AHR), Sub-distribution Hazard Ratio (SHR) and the 95% Confidence Intervals (CI) were reported. Results during the follow-up period, 391 individuals (33.7%) died with 86,375 person-years of follow-up. Of the total deaths, 251 (64.2%) and 140 (35.8%) were ARM and NARM, respectively. Rates of the mortality caused by AIDS and non-AIDS were 3.2 and 4.5 per 1000 person-months, respectively. Responding to combined Antiretroviral Treatment (cART) 6 months after initiation, receiving Pneumocystis Pneumonia (PCP) prophylaxis, and higher CD4 count at diagnosis, reduced the hazard of ARM and NARM. However, older age, late HIV diagnosis, and last HIV clinical stages increased the hazard of AIDS related to mortality. Additionally, male gender, older age, incarceration history, and last HIV clinical stages increased the non-AIDS mortality. Conclusions Mortality caused by AIDS and non-AIDS remains high among people with HIV in Iran, particularly among males and those with late diagnosis. It seems that applying effective strategies to identify infected individuals at earlier stage of the infection, and targeting individuals with higher risk of mortality can decrease the mortality rate among HIV infected people.

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