scholarly journals Opioid Use Disorders in People Living with HIV/AIDS: A Review of Implications for Patient Outcomes, Drug Interactions, and Neurocognitive Disorders

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 168
Author(s):  
Alina Cernasev ◽  
Michael P. Veve ◽  
Theodore J. Cory ◽  
Nathan A. Summers ◽  
Madison Miller ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Patient Outcomes ◽  
The United States ◽  
Neurocognitive Disorders ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Opioid Use ◽  
Addictive Disorders ◽  
Living With Hiv ◽  
Hiv Aids

The opioid epidemic has had a significant, negative impact in the United States, and people living with HIV/AIDS (PLWHA) represent a vulnerable sub-population that is at risk for negative sequela from prolonged opioid use or opioid use disorder (OUD). PLWHA are known to suffer from HIV-related pain and are commonly treated with opioids, leading to subsequent addictive disorders. PLWHA and OUD are at an increased risk for attrition in the HIV care continuum, including suboptimal HIV laboratory testing, delayed entry into HIV care, and initiation or adherence to antiretroviral therapy. Barriers to OUD treatment, such as medication-assisted therapy, are also apparent for PLWHA with OUD, particularly those living in rural areas. Additionally, PLWHA and OUD are at a high risk for serious drug–drug interactions through antiretroviral-opioid metabolic pathway-related inhibition/induction, or via the human ether-a-go-go-related gene potassium ion channel pathways. HIV-associated neurocognitive disorders can also be potentiated by the off-target inflammatory effects of opioid use. PLWHA and OUD might require more intensive, individualized protocols to sustain treatment for the underlying opioid addiction, as well as to provide proactive social support to aid in improving patient outcomes. Advancements in the understanding and management of PLWHA and OUD are needed to improve patient care. This review describes the effects of prescription and non-prescription opioid use in PLWHA.

scholarly journals Heterogeneity in the costs of medical care among people living with HIV/AIDS in the United States

AIDS ◽  
2019 ◽  
Vol 33 (9) ◽  
pp. 1491-1500 ◽  
Author(s):  
Benjamin Enns ◽  
Emanuel Krebs ◽  
William C. Mathews ◽  
Richard D. Moore ◽  
Kelly A. Gebo ◽  
...  
Keyword(s):  
United States ◽  
Medical Care ◽  
The United States ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

The Validity of the Substance Abuse and Mental Illness Symptom Screener (SAMISS) in People Living with HIV/AIDS in Primary HIV Care in Cape Town, South Africa

2014 ◽  
Vol 18 (6) ◽  
pp. 1133-1141 ◽  
Author(s):  
Erica Breuer ◽  
Kevin Stoloff ◽  
Landon Myer ◽  
Soraya Seedat ◽  
Dan J. Stein ◽  
...  
Keyword(s):  
South Africa ◽  
Substance Abuse ◽  
Mental Illness ◽  
Cape Town ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

Sociocultural Factors Influencing The Transmission of HIV/AIDS in The United States

2017 ◽  
Author(s):  
Robert E Fullilove
Keyword(s):  
United States ◽  
Criminal Justice ◽  
Correctional Facility ◽  
The United States ◽  
Hiv Care ◽  
Sociocultural Factors ◽  
Effective Interventions ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

This chapter discusses the unique impact that social disadvantage in general and the criminal justice systems in the United States in particular have on the conditions that drive the HIV/AIDS epidemic in this country. HIV/AIDS is classified as an important racial/ethnic health disparity because residents of marginalized black and Hispanic communities are overrepresented among persons living with HIV/AIDS in the United States. Members of black and Hispanic communities are also overrepresented in the criminal justice; in terms of the epidemic, approximately one out of seven persons living with HIV/AIDS will pass through a U.S. correctional facility in any given year. A history of incarceration is associated with poor treatment outcomes for HIV illness. Improving the quality of HIV care in correctional facilities and in the communities to which incarcerated persons will return is imperative, as is effective interventions in incarcerated populations and communities. Having AIDS activists, scientists, and healthcare workers join in efforts to reform incarceration policies and practices will improve efforts to prevent and treat HIV/AIDS, particularly in communities that confront high rates of HIV/AIDS and incarceration.

scholarly journals Adhering to antiretroviral therapy: A qualitative analysis of motivations for and obstacles to consistent use of antiretroviral therapy in people living with HIV

2020 ◽  
Vol 8 ◽  
pp. 205031212091540
Author(s):  
Lisa Fleischer ◽  
Ann Avery
Keyword(s):  
United States ◽  
Antiretroviral Therapy ◽  
Qualitative Analysis ◽  
The United States ◽  
Care Team ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Clinic ◽  
Main Motivation ◽  
Living With Hiv

Objectives: Based on the 2015 U.S. Centers for Disease Control and Prevention data, 40% of people living with HIV in the United States with an HIV diagnosis and 18.5% of people living with HIV in HIV care in the United States are not virally suppressed. Many HIV care clinics have implemented recommendations to improve the percentage of people living with HIV on antiretroviral therapy. To understand what more could be done, we examine patients’ motivations and obstacles to maintaining adherence to antiretroviral therapy. Methods: We conducted qualitative analysis using a qualitative description framework of in-depth interviews with people living with HIV receiving care at an urban HIV care clinic in the midwestern United States. Results: We found that while many traditional barriers to care have been addressed by existing programs, there are key differences between those consistent with antiretroviral therapy and those inconsistent with antiretroviral therapy. In particular, self-motivation, diagnosis acceptance, treatment for depression, spiritual beliefs, perceived value of the HIV care team, and prior experience with health care distinguish these two groups. Most significantly, we found that people living with HIV consistent with antiretroviral therapy describe their main motivation as coming from themselves, whereas people living with HIV inconsistent with antiretroviral therapy more often describe their main motivation as coming from the HIV care team. Conclusion: Our results highlight the importance of the HIV care team’s encouragement of maintaining antiretroviral adherence, as well as encouraging treatment for depression.

scholarly journals Reasons for Disclosure of HIV Status by People Living with HIV/AIDS and in HIV Care in Uganda: An Exploratory Study

2010 ◽  
Vol 24 (10) ◽  
pp. 675-681 ◽  
Author(s):  
Sarah N. Ssali ◽  
Lynn Atuyambe ◽  
Christopher Tumwine ◽  
Eric Segujja ◽  
Nicolate Nekesa ◽  
...  
Keyword(s):  
Exploratory Study ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Re-Validation of the Van Rie HIV/AIDS-Related Stigma Scale for Use with People Living with HIV in the United States

PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0118836 ◽  
Author(s):  
Aaron M. Kipp ◽  
Carolyn M. Audet ◽  
Valerie A. Earnshaw ◽  
Jared Owens ◽  
Catherine C. McGowan ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
People Living With Hiv ◽  
Stigma Scale ◽  
Related Stigma ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Social determinants of health and care outcomes among people living with HIV in the United States

2021 ◽  
Author(s):  
Timothy W Menza ◽  
Lindsay K Hixson ◽  
Lauren Lipira ◽  
Linda Drach
Keyword(s):  
United States ◽  
Social Determinants ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
Economic Disadvantage ◽  
People Living With Hiv ◽  
Care Outcomes ◽  
Durable Viral Suppression ◽  
Living With Hiv

Abstract Background Fewer than 70% of people living with HIV (PLHIV) in the United States have achieved durable viral suppression. To end the HIV epidemic in the United States, clinicians, researchers, and public health practitioners must devise ways to remove barriers to effective HIV treatment. To identify PLHIV who experience challenges to accessing healthcare, we created a simple assessment of social determinants of health (SDOH) among PLHIV and examined the impact of cumulative social and economic disadvantage on key HIV care outcomes. Methods We used data from the 2015-2019 Medical Monitoring Project, a yearly cross-sectional survey of PLHIV in the United States (N=15,964). We created a ten-item index of SDOH and assessed differences in HIV care outcomes of missed medical appointments, medication adherence, and durable viral suppression by SDOH using this index using prevalence ratios with predicted marginal means. Results Eighty-three percent of PLHIV reported at least one SDOH indicator. Compared to PLHIV who experienced none of the SDOH indicators, people who experienced one, two, three, and four or more SDOH indicators, were 1.6, 2.1, 2.6 and 3.6 as likely to miss a medical appointment in the prior year; 11%, 17%, 20% and 31% less likely to report excellent adherence in the prior 30 days; and, 2%, 4%, 10% and 20% less likely to achieve durable viral suppression in the prior year, respectively. Conclusions Among PLHIV, cumulative exposure to social and economic disadvantage impacts care outcomes in a dose-dependent fashion. A simple index may identify PLHIV experiencing barriers to HIV care, adherence, and durable viral suppression in need of critical supportive services.

scholarly journals Improving Engagement in the HIV Care Cascade: A Systematic Review of Interventions Involving People Living with HIV/AIDS as Peers

2016 ◽  
Vol 20 (10) ◽  
pp. 2452-2463 ◽  
Author(s):  
Becky L. Genberg ◽  
Sylvia Shangani ◽  
Kelly Sabatino ◽  
Beth Rachlis ◽  
Juddy Wachira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Living With Hiv ◽  
Hiv Aids
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