scholarly journals Factors Associated with Adherence to Antiretroviral Drugs among HIV Positive Patients Attending Selected Comprehensive Care Centers in Semi-Urban, Kenya

2021 ◽  
Vol 11 (12) ◽  
pp. 134-151
Author(s):  
Martin Owuor Ochieng ◽  
Gideon Kikuvi ◽  
Daniel Mokaya
Keyword(s):  
Positive Attitude ◽  
Service Providers ◽  
Antiretroviral Drugs ◽  
Comprehensive Care ◽  
Poor Adherence ◽  
Hiv Positive ◽  
Factors Associated ◽  
Adequate Knowledge ◽  
Health Service Providers ◽  
And Gender

Management of Human Immunodeficiency Virus (HIV) is multipronged but its nerve centre is lifelong adequate and consistent use of antiretroviral drugs (ARVs). The overall objective of this study was to determine the factors associated with adherence to antiretroviral drugs among HIV positive patients attending selected Comprehensive Care Centres (CCC) in Kibwezi West Sub-county, Makueni County, Kenya. 385 respondents were recruited by systematic random sampling and interviewed. Three Focused Group Discussions (FGD) and two Key Informant Interviews (KII) were also conducted. Majority 364(94.5%) of the respondents were adherent to ARVs. There was a significant association between adherence to ARVs and gender {χ 2 (1) =4.636, p<0.05} with males likely to have poor adherence {OR 0.174 (95%CI 0.130, 0.233)}. Age was significantly associated with adherence {Likelihood Ratio G2 (4) =10.693, p<0.05} with older ages (above 65 years) likely to adhere. Living in the same house with someone on ARVs was significantly associated with adherence to ARVs {χ 2 (1) =3.997 p=<0.05} with respondents living in the same house with someone on ARVs likely to adhere {OR 0.144 (95%CI 0.103, 0.200)}. Majority of the respondents had adequate knowledge and positive attitude towards adherence to ARVs. FGDs and KIIs identified fear, stigma, not believing in oneself, participating in activities that hamper adherence such as drinking alcohol, ignorance, denial, lack of social support, busy work schedule poor attitude by health service providers, drug stock outs, distance and long waiting time as contributing to poor adherence to ARVs. In conclusion, constant education and awareness creation on importance of adherence to ARVs should be strengthened particularly during clinic appointments to maintain knowledge and enhance positive attitude towards adherence. Measures to improve adherence among the male and younger population should be strengthened. Key words: adherence, antiretrovirals age, gender, knowledge, attitude.

Addressing the Psychosexual Development of Teenagers on the Autism Spectrum Using the Tackling Teenage Training Program

2020 ◽  
pp. 115-127
Author(s):  
Kirsten Visser
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Service Providers ◽  
Gender Diversity ◽  
Autism Spectrum ◽  
Current Case ◽  
Health Service Providers ◽  
And Gender ◽  
Adults With Asd

People believe the combination of autism spectrum disorder (ASD) and gender dysphoria (GD) is a complicated one. In addition, clinicians can be reluctant to diagnose and treat this combination of problems. In scientific research, several researchers are currently debating the existence of a link between ASD and GD. Nevertheless, everyone agrees that there is more gender diversity among adolescents with ASD than previously thought. The current case study illustrates an example of a gender journey for an adolescent with ASD and the challenges faced by mental health service providers in guiding adolescents or young adults with ASD in this gender quest.

scholarly journals Factors associated with HPV-DNA clearance in a cohort of HIV-positive patients: role of cART and gender

2014 ◽  
Vol 17 ◽  
pp. 19717 ◽  
Author(s):  
Elisa Suardi ◽  
Francesca Bai ◽  
Laura Comi ◽  
Alessandro Pandolfo ◽  
Marco Rovati ◽  
...  
Keyword(s):  
Hiv Positive ◽  
Hpv Dna ◽  
Factors Associated ◽  
And Gender

scholarly journals The misuse of antiretrovirals to boost pig and poultry productivity in Uganda and potential implications for public health

2021 ◽  
Vol 7 (1) ◽  
pp. 88-95
Author(s):  
Dickson Ndoboli ◽  
Fredrick Nganga ◽  
Ben Lukuyu ◽  
Barbara Wieland ◽  
Delia Grace ◽  
...  
Keyword(s):  
Service Providers ◽  
Smallholder Farmers ◽  
Animal Health ◽  
Cross Sectional Study ◽  
Antiretroviral Drugs ◽  
Human Consumption ◽  
Cross Sectional ◽  
News Reports ◽  
Health Service Providers ◽  
Poultry Farmers

Background and Aim: Since 2015, local newspapers reported that pig and poultry farmers in Uganda use antiretroviral drugs (ARVs) to promote growth in animals and control diseases. This study was conducted to assess farmers' knowledge, attitude and perceptions about the use of antiretroviral drugs as boosters in pigs and poultry and the possibility of detecting the antiretroviral drugs in meat using available laboratory methods. Materials and Methods: In 2019, a cross-sectional study was conducted in ten districts in Uganda. In 20 focus group discussions with 100 pig and poultry farmers and 70 animal health service providers, we assessed the use of ARV in livestock enterprises. Subsequently, samples of chicken, pigs, and animal feeds were collected from volunteer participants, and screened for residues of saquinavir, lopinavir, nevirapine, and efavirenz using liquid chromatography-tandem mass spectrophotometer. Results: Participants in all ten districts were predominantly smallholder farmers supplying the local markets. All groups reported the use of ARVs in pigs and broiler birds but not in layer hens. In the absence of good quality feeds, the motivation for feeding ARVs was rapid animal weight gain, as well as the control of animal diseases, for which farmers have no alternative solutions. ARVs were obtained within the community for free, against cash, or in-kind payment. Residues of lopinavir were detected in four, and saquinavir in seven districts, and all three sample matrices. Conclusion: Our study findings confirm anecdotal news reports on ARV use in livestock. While our findings are not generalizable to the whole country, they call for a representative follow-up. As the drugs were detected in tissues destined for human consumption, the potential risk to human health warrants further investigation.

Describing the Nature and Correlates of Health Service Providers’ Competency Working With Sexual and Gender Minority Patients: A Systematic Review

2020 ◽  
pp. 152483992094321
Author(s):  
Corrine N. Wilsey ◽  
Robert J. Cramer ◽  
James M. Macchia ◽  
Frank D. Golom
Keyword(s):  
Systematic Review ◽  
Health Service ◽  
Health Services ◽  
Service Providers ◽  
Skill Sets ◽  
Gender Minority ◽  
Health Service Providers ◽  
Sexual And Gender Minority ◽  
And Gender ◽  
Meta Analyses

Disparities in the health services delivered to sexual and gender minority (SGM) individuals are widespread across health service disciplines. Many health service providers do not have the knowledge, comfort, or skills necessary to provide health services to SGM individuals. The objective of the current systematic review was to review the correlates of competency (defined as knowledge, attitude, and skill) that health service providers possess for working with SGM individuals. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was utilized to guide search and reporting strategies. PsycInfo/PsycArticles, PubMed/Medline, and Google Scholar databases were searched to find studies that addressed health service providers’ competency working with SGM individuals. There were 31 studies included in the review. Approximately half of the studies utilized the full definition of competency (knowledge, attitude, and skill). The most common competency assessed was knowledge, and the least common was skill. The majority of the studies addressed health service providers in the social sciences. Health service education needs to emphasize competency working with SGM individuals. Of particular importance is developing skill sets, as many providers reported that they did not have the skills necessary to provide culturally competent health services to SGM individuals.

scholarly journals Epidemiological investigation into the introduction and factors for spread of Peste des Petits Ruminants, southern Tanzania

2012 ◽  
Vol 79 (2) ◽  
Author(s):  
Epaphras A. Muse ◽  
Esron D. Karimuribo ◽  
George C. Gitao ◽  
Gerald Misinzo ◽  
Lesakit S.B. Mellau ◽  
...  
Keyword(s):  
Service Providers ◽  
Animal Health ◽  
Peste Des Petits Ruminants ◽  
Serum Samples ◽  
Administrative Authority ◽  
African Countries ◽  
Laboratory Findings ◽  
Factors Associated ◽  
Health Service Providers ◽  
And Control

A study was carried out to confirm and identify sources and elucidate factors associated with the introduction of Peste des Petits Ruminants (PPR) in southern Tanzania. This study was conducted in Tandahimba and Newala districts of Mtwara region following suspected outbreak of PPR in the area. Qualitative data were collected using semi-structured questionnaires and in-depth interviews of key informants who included goat and sheep owners with suspected cases of PPR and animal health service providers as well as local administrative authority. Additionally, 216 serum samples and 28 swabs were collected for serological and virological laboratory disease confirmation. The results show that PPR was first introduced in Likuna village of Newala district in February 2009 through newly purchased goats from the Pugu livestock market located about 700 km in the outskirts of Dar es Salaam city. Factors which contributed to spread of PPR included communal grazing and the cheap prices of sick animals bought by livestock keepers for slaughtering in other villages. Laboratory findings confirmed presence of PPR in the area by RT-PCR and serological analysis revealed that seroprevalence was 31%. These findings have confirmed, for the first time, introduction of PPR in southern Tanzania. The presence of PPR poses high risk of southward spread of the disease to other southern African countries in the SADC region thus calling for concerted and collaborative efforts in prevention and control of the disease to avoid losses. Further elaborate studies on the spread, prevalence and risk factors associated with the disease should urgently be investigated.

scholarly journals Factors associated with antiretroviral treatment failure among people living with HIV on antiretroviral therapy in resource-poor settings: a systematic review and metaanalysis

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Yishak Lailulo ◽  
Marcel Kitenge ◽  
Shahista Jaffer ◽  
Omololu Aluko ◽  
Peter Suwirakwenda Nyasulu
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Antiretroviral Treatment ◽  
Poor Adherence ◽  
Hiv Positive ◽  
Strength Of Evidence ◽  
Factors Associated ◽  
Resource Poor ◽  
Living With Hiv ◽  
Antiretroviral Treatment Failure

Abstract Background Despite the increase in the number of people accessing antiretroviral therapy (ART), there is limited data regarding treatment failure and its related factors among HIV-positive individuals enrolled in HIV care in resource-poor settings. This review aimed to identify factors associated with antiretroviral treatment failure among individuals living with HIV on ART in resource-poor settings. Methods We conducted a comprehensive search on MEDLINE (PubMed), Excerpta Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), World Health Organization’s (WHO’s) library database, and Latin American and Caribbean Health Sciences Literature (LILACS). We included observational studies (cohort, case-control, and cross-sectional studies) where adolescents and adults living with HIV were on antiretroviral treatment regardless of the ART regimen. The primary outcomes of interest were immunological, virological, and clinical failure. Some of the secondary outcomes were mm3 opportunistic infections, WHO clinical stage, and socio-demographic factors. We screened titles, abstracts, and the full texts of relevant articles in duplicate. Disagreements were resolved by consensus. We analyzed the data by doing a meta-analysis to pool the results for each outcome of interest. Results Antiretroviral failure was nearly 6 times higher among patients who had poor adherence to treatment as compared to patients with a good treatment adherence (OR = 5.90, 95% CI 3.50, 9.94, moderate strength of evidence). The likelihood of the treatment failure was almost 5 times higher among patients with CD4 < 200 cells/mm3 compared to those with CD4 ≥ 200 CD4 cells/mm3 (OR = 4.82, 95% CI 2.44, 9.52, low strength of evidence). This result shows that poor adherence and CD4 count below < 200 cells/mm3 are significantly associated with treatment failure among HIV-positive patients on ART in a resource-limited setting. Conclusion This review highlights that low CD4 counts and poor adherence to ART were associated to ART treatment failure. There is a need for healthcare workers and HIV program implementers to focus on patients who have these characteristics in order to prevent ART treatment failure. Systematic review registration The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number: 2019 CRD42019136538.

scholarly journals Knowledge, attitude and practice (KAP) of health providers towards safe abortion provision in Addis Ababa health centers

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Endalkachew Mekonnen Assefa
Keyword(s):  
Health Care Providers ◽  
Positive Attitude ◽  
Service Providers ◽  
Addis Ababa ◽  
Health Centers ◽  
Care Providers ◽  
Safe Abortion ◽  
Abortion Law ◽  
Abortion Care ◽  
Adequate Knowledge

Abstract Background Unsafe abortion remains a reality for many Ethiopian women and will remain so until safe abortion is more accessible across the country. The house of representatives of Federal Democratic Republic of Ethiopia (FDRE) revised the abortion law and Ministry of Health (MoH) of FDRE developed a revised technical and procedural guideline for safe abortion services in Ethiopia; emphasizing the need to increase knowledge and practice of health service providers on safe abortion care (SAC) and access to safe terminations of pregnancy at high standard and quality. Methods A facility based descriptive cross-sectional study using structured self-administered questionnaire was conducted between July and August 2015. A total of 405 mid-level providers (MLPs) including midwives, clinical nurses and health officers were included from 30 randomly selected health centers in Addis Ababa. SPSS version-21 was used for data entry, cleaning and analysis. The results were presented using frequency tables, percentages, means, Odds ratio and 95% confidence limits. Results Among 405 MLPs 71.9% knew the definition of abortion in the in Ethiopia context, 81.5% participants were familiar with the revised abortion law. 53.1% of respondents had adequate knowledge on safe abortion care and working for 3–5 years (AOR 3.1 with CI 1.6, 5.7) and midwives (AOR = 2.9 with CI 1.8, 4.7) had better knowledge on abortion. Only eighty-three (20.5%) of MLPs were trained on safe abortion and among them sixty-eight (81.9%) were practising/used to practice safe abortion services. Half of respondents gave post abortion family planning methods. 54.1% respondents had positive attitude towards safe abortion. MLPs’ who had adequate knowledge on safe abortion care (AOR 2.02, 95% CI 1.3–3.1) and male providers (AOR 1.6, 95% CI 1.04–2.4) were more likely to have positive attitude towards safe abortion. MLPs who had adequate knowledge on abortion 3.4 times (CI of 95% =1.1–10.6) were more likely to practise safe abortion care. Conclusion The majority claimed to know the current abortion law; however, many failed to understand the specific provisions of the law. Type of profession and years of experiences were important in explaining providers’ knowledge related to abortion. Being male and having the knowledge significantly influenced providers’ attitude toward safe abortion. Knowledge related to abortion also influenced the practice of SAC. Efforts to improve mid-level as well as other health care providers’ knowledge on abortion are necessary, for example, through pre−/on-service training.

Health service providers in psychology: Results of the 1978 APA Human Resources Survey.

1981 ◽  
Vol 36 (11) ◽  
pp. 1395-1418 ◽  
Author(s):  
Gary R. VandenBos ◽  
Joy Stapp ◽  
Richard R. Kilburg
Keyword(s):  
Health Service ◽  
Human Resources ◽  
Service Providers ◽  
Health Service Providers
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