scholarly journals Factors for Low Uptake of Antiretroviral Therapy Among HIV Pregnant Women in Mbeya City Council, Tanzania

2019 ◽  
Vol 9 (1) ◽  
pp. 253
Author(s):  
Lawrencia Dominick Mushi ◽  
Eileen A Mhando
Keyword(s):  
Antiretroviral Therapy ◽  
Health Service ◽  
Pregnant Women ◽  
City Council ◽  
People Living With Hiv ◽  
Health Providers ◽  
Key Informants ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Depth Interviews

UNAIDS aimed to reach 90% antiretroviral therapy uptake among people living with HIV by 2015. Despite free provision of antiretroviral therapy to pregnant women living with HIV, the uptake remains low. This study describes views of pregnant women about low uptake of antiretroviral therapy among pregnant women living with HIV in Mbeya City Council.The study used a descriptive cross-sectional design and applied mixed research approaches. 44 pregnant women on antiretroviral therapy and 12 health providers were conveniently selected. Four key informants were purposively selected. In-depth interviews with pregnant women and key informants; exit interviews with pregnant women; and observation of health providers were conducted. Audio tape recording from in-depth interviews was transcribed into Swahili to English. Social ecological framework was used in data coding based on individual, social and health service aspects then analysed using Atlas. ti 7. Quantitative data was analyzed in Excel spreadsheet, and presented using tables.The findings from interviews and observations showed that the main individual factors (like treatment-related side effects and religious faith); social factors (like traditional medicine and lack of partner/husband support) and health service factors (like long waiting time and discrepancy in information given to clients during adherence counseling on antiretroviral therapy) were more likely to be associated with low uptake of antiretroviral therapy.This study indicates that various factors at individual, social and health service levels were more likely to cause low uptake of ART. Reasons for discrepant information during counseling by providers remain a question which needs further research.

Social Vulnerability among Foreign-Born Pregnant Women and Maternal Virologic Control of HIV

2020 ◽  
Author(s):  
Ashish Premkumar ◽  
Lynn M. Yee ◽  
Lia Benes ◽  
Emily S. Miller
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Median Time ◽  
Social Vulnerability ◽  
Viral Suppression ◽  
Foreign Born ◽  
Women Living With Hiv ◽  
Virologic Control ◽  
Clinical Records ◽  
Living With Hiv

Objective The aim of this study was to assess whether social vulnerability among foreign-born pregnant women living with HIV is associated with maternal viremia during pregnancy. Study Design This retrospective cohort study included all foreign-born pregnant women living with HIV who received prenatal care in a multidisciplinary prenatal clinic between 2009 and 2018. A licensed clinical social worker evaluated all women and kept detailed clinical records on immigration status and social support. Social vulnerability was defined as both living in the United States for less than 5 years and reporting no family or friends for support. The primary outcome was evidence of viral non-suppression after achievement of initial suppression. Secondary outcomes were the proportion of women who required > 12 weeks after starting antiretroviral therapy to achieve viral suppression, median time to first viral suppression (in weeks) after initiation of antiretroviral therapy, and the proportion who missed ≥ 5 doses of antiretroviral therapy. Bivariable analyses were performed. Results A total of 111 foreign-born women were eligible for analysis, of whom 25 (23%) were classified as socially vulnerable. Social and clinical characteristics of women diverged by social vulnerability categorization but no differences reached statistical significance. On bivariable analysis, socially-vulnerable women were at increased risk for needing > 12 weeks to achieve viral suppression (relative risk: 1.78, 95% confidence interval: 1.18–2.67), though there was no association with missing ≥ 5 doses of antiretroviral therapy or median time to viral suppression after initiation of antiretroviral therapy. Conclusion Among foreign-born, pregnant women living with HIV, markers of virologic control during pregnancy were noted to be worse among socially-vulnerable women. Insofar as maternal viremia is the predominant driver of perinatal transmission, closer clinical surveillance and support may be indicated in this population. Key Points

scholarly journals Feasibility and Acceptability of a Smartphone App for Daily Reports of Substance Use and Antiretroviral Therapy Adherence among HIV-Infected Adults

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Sarahmona M. Przybyla ◽  
Rebecca K. Eliseo-Arras ◽  
Gabriela Krawiec ◽  
Emily Gower ◽  
Kurt Dermen
Keyword(s):  
Substance Use ◽  
Antiretroviral Therapy ◽  
Smartphone Application ◽  
People Living With Hiv ◽  
Antiretroviral Therapy Adherence ◽  
High Satisfaction ◽  
Daily Report ◽  
Acceptable Method ◽  
Living With Hiv ◽  
Depth Interviews

While substance use is one of the most consistent predictors of poor adherence to antiretroviral therapy (ART), few studies among people living with HIV (PLH) have utilized mobile phone-based assessment of these health behaviors. PLH were recruited from primary care clinics to report ART and substance use using a smartphone application (app) for 14 consecutive days. The app’s feasibility as a data collection tool was evaluated quantitatively via surveys and qualitatively via in-depth interviews to assess daily report completion, compliance, and study satisfaction. Overall, 26 participants (M=49.5years, 76% male) completed 95.3% of time-based daily reports. Participants reported high satisfaction with the app and expressed future interest in using smartphones to report daily behaviors. High completion rates and participant acceptability suggest that smartphones are a feasible, acceptable method for collecting substance use and ART data among PLH. Potential areas of concern such as sufficient training and assistance for those with limited smartphone experience should be considered for future app-based research studies among PLH.

scholarly journals Antiretroviral therapy in pregnant women living with HIV: a clinical practice guideline

BMJ ◽  
2017 ◽  
pp. j3961 ◽  
Author(s):  
Reed A C Siemieniuk ◽  
Lyubov Lytvyn ◽  
Jinell Mah Ming ◽  
Rhonda Marama Mullen ◽  
Florence Anam ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Women Living With Hiv ◽  
Living With Hiv

scholarly journals The syndemic effects of mental ill health, household hunger, and intimate partner violence on adherence to antiretroviral therapy among pregnant women living with HIV in Yaoundé, Cameroon

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246467
Author(s):  
Evette Cordoba ◽  
Angela M. Parcesepe ◽  
John A. Gallis ◽  
Jennifer Headley ◽  
Claudian Soffo ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Partner Violence ◽  
Common Mental Disorders ◽  
Intimate Partner ◽  
Art Adherence ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
The Relationship

Background This research advances understanding of interrelationships among three barriers to adherence to antiretroviral therapy (ART) among pregnant women living with HIV (WLWH) in Cameroon: probable common mental disorders (CMD), intimate partner violence (IPV), and hunger. Methods The sample included 220 pregnant WLWH in Cameroon. Multivariable modified Poisson regression was conducted to assess the relationship between IPV, hunger, and CMD on ART adherence. Results Almost half (44%) of participants recently missed/mistimed an ART dose. Probable CMD was associated with greater risk of missed/mistimed ART dose (aRR 1.5 [95% CI 1.1, 1.9]). Hunger was associated with greater risk of missed/mistimed ART dose among those who reported IPV (aRR 1.9 [95% CI 1.2, 2.8]), but not among those who did not (aRR 0.8 [95% CI 0.2, 2.3]). Conclusion Suboptimal ART adherence, CMD, and IPV were common among pregnant WLWH in Cameroon. Pregnant WLWH experiencing IPV and hunger may be especially vulnerable to suboptimal ART adherence.

scholarly journals A qualitative study of barriers to employment experienced by people living with HIV in Toronto and Ottawa

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Melissa Perri ◽  
Amy-Craig Neil ◽  
Mark Gaspar ◽  
Charlotte Hunter ◽  
Claire Kendall ◽  
...  
Keyword(s):  
Unemployment Insurance ◽  
Employment Status ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Health Providers ◽  
Barriers To Employment ◽  
Working Age ◽  
Living With Hiv ◽  
Common Barriers ◽  
Depth Interviews

Abstract Background Effective treatment has extended the life expectancy and reduced disability in people living with HIV (PLWH). However, previous research has found 45–65% of working-age PLWH were unemployed compared to 5–10% in the general public of North America and Europe. We examined the barriers to gaining employment among PLWH. Methods Thirty-five in-depth interviews were conducted in person or over the phone with PLWH living in Toronto or Ottawa. This included PLWH who were unemployed but actively seeking employment, as well as PLWH who had successfully gained employment through an agency that specifically supported PLWH funded by the AIDS Committee of Toronto. Interviews were conducted between February 2019 and March 2020. All interviews were audio-recorded, transcribed and analyzed using thematic analysis. Results The majority of participants were between the ages of 40–55 and identified as male. Participants shared many common barriers when describing their attempts to attain or maintain employment. Although varying in employment status at the time of the study, consistent barriers included experiencing HIV stigma in workplaces, challenges overcoming mental health illnesses, and difficulties in navigating social assistance and unemployment insurance programs when pursuing a return to work. Conclusions PLWH face significant barriers when attempting to engage with employment opportunities. Health providers and organizations can do more to support campaigns to end HIV stigma, to support individuals in pursuing employment, and to advocate for policy change that supports reentry into the workforce for PLHA.

scholarly journals Childbearing Decision Making: A Qualitative Study of Women Living with HIV/AIDS in Southwest Nigeria

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Y. A. Sofolahan ◽  
C. O. Airhihenbuwa
Keyword(s):  
Decision Making ◽  
Antiretroviral Therapy ◽  
Qualitative Study ◽  
Partner Support ◽  
Women Living With Hiv ◽  
Sexual Reproductive Health ◽  
Southwest Nigeria ◽  
Living With Hiv ◽  
Depth Interviews ◽  
Hiv Aids

Using the PEN-3 model, the purpose of this qualitative study was to understand the factors responsible for the childbearing decisions of women living with HIV/AIDS (WLHA) in Lagos, Nigeria. Sixty WLHA who sought care at a teaching hospital in Lagos were recruited to participate in in-depth interviews. The average age of the participants was 30 years, and 48 participants were receiving antiretroviral therapy. Healthcare and spiritual practices, healthcare provider-patient communication about childbearing, and husband/partner support emerged as factors that contribute to the childbearing decisions of WLHA. The findings reveal the importance of discussing sexual reproductive health and childbearing issues with WLHA in the healthcare context prior to pregnancy.

scholarly journals Initiation of antiretroviral therapy or antiretroviral prophylaxis in pregnant women living with HIV registered in five townships of Mandalay, Myanmar: A cross sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Khine Wut Yee Kyaw ◽  
Aye Aye Mon ◽  
Khaing Hnin Phyo ◽  
Nang Thu Thu Kyaw ◽  
Ajay M. V. Kumar ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Antiretroviral Prophylaxis ◽  
Living With Hiv

Abstract Background A series of interventions are required to prevent mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) starting from HIV testing of pregnant women, initiating antiretroviral therapy (ART) or antiretroviral prophylaxis to HIV-positive pregnant women to providing HIV prophylaxis to newborn babies. Gaps in each step can significantly affect the effectiveness of PMTCT interventions. We aimed to determine the gap in initiation of ART/antiretroviral prophylaxis for pregnant women living with HIV, delay in initiation of ART/antiretroviral prophylaxis and factors associated with the delay. Methods This is a cross sectional study using routinely collected programme data from five health facilities providing PMTCT services located at Township Health Departments (THD) of Mandalay, Myanmar. Results There were 363 pregnant women living with HIV enrolled between January 2012 and December 2017. Sixty (16%) women were excluded from the study due to missing data on dates of HIV diagnosis. Of 303 (84%) women included in the study, 89/303 (29%) and 214/303 (71%) were diagnosed with HIV before and during current pregnancy respectively. Among 214 women, 180 (84%) women were started on ART by the censor date (31st March 2018). Among those who started ART, 109 (61%) women had a delay of starting ART > 2 weeks from diagnosis. Women residing in township 4 had a significantly higher risk of delay in initiation of ART/antiretroviral prophylaxis compared to women residing in township 1 [adjusted prevalence ratio 4.2 (95% confidence interval 1.2–14.8]. Conclusions We found that one in four women living with HIV knew their HIV status before current pregnancy. Although the rate of ART/antiretroviral prophylaxis initiation was high among pregnant women living with HIV, there was a delay. Early initiation of ART/antiretroviral prophylaxis among newly HIV diagnosed pregnant women needs to be strengthened.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

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