scholarly journals The effect on survival of a multidimensional intervention project (SEAD) in HIV/AIDS patients with follow-up and adherence (FUP/ADH) barriers

2012 ◽  
Vol 15 (6(Suppl 4)) ◽  
Author(s):  
M Pérez Elías ◽  
L Elías Casado ◽  
M Pumares ◽  
A Moreno ◽  
F Dronda ◽  
...  
Keyword(s):  
Aids Patients ◽  
Hiv Aids

scholarly journals The role of SEAD project intervention in viral suppression of HIV/AIDS patients with follow-up and adherence barriers

2012 ◽  
Vol 15 (6(Suppl 4)) ◽  
Author(s):  
L Elías Casado ◽  
M Pérez Elías ◽  
D López Pérez ◽  
M Pumares Álvarez ◽  
M Martinez-Colubi ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Aids Patients ◽  
Project Intervention ◽  
Hiv Aids

scholarly journals Eliminating Perceived Stigma and Burnout among Nurses Treating HIV/AIDS Patients Implementing Integrated Intervention

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Ilakkiya. L ◽  
Dr S. Subramanian
Keyword(s):  
Burnout Syndrome ◽  
Perceived Stigma ◽  
Aids Patients ◽  
Government Hospitals ◽  
Integrated Intervention ◽  
Post Test ◽  
Experimental Group ◽  
Three Phases ◽  
Hiv Aids

Stigma is essentially one of the most important barriers to public action, disease disclosure and treatment adherence, worse even it gets exacerbated when those who provide treatment hold stigmatizing attitudes or at the receiving end of stigma. Stigma is of global concern and it requires an intensive integrated approach across all levels to eliminate it from healthcare settings for the betterment of patients and nurses. Objective: The present study intended to explore whether there were significant association between Perceived Stigma and Burnout Syndrome among nurses treating cancer patients and nurses treating HIV/AIDS patients and the extent to which the Integrated Intervention facilitates eliminating Perceived Stigma and Burnout. Methods: Around 120 nurses treating HIV/AIDS patients were selected from a sample of 240 nurses working in government hospitals in Chennai. Later, the Nurses were classified into two groups – as Experimental Group (N=30) and Control Group (N=30) treating HIV/AIDS patients in Government Hospitals. Their level of Perceived Stigma was measured using the HASI-N developed by Uys and others and burnout level was assessed using questionnaire developed by Maslach. The comprehensive Integrated Intervention covering cognitive restructuring, Jacobson’s Progressive Muscle Relaxation, yoga and mindfulness meditation, etc was administered exclusively to the Experimental Group of Nurses for the duration of three months. The required data on Perceived Stigma and Burnout levels were measure at three phases of time period – pre and post period of the administration of Integrated Intervention. Results: In this study, these two categories of nurses were tested at three points of time (pre-test, post-test and follow-up). The within-subjects factor was the three phases of testing (pre-test, post-test, and follow-up) of the variables under investigation or time and the between-subjects factor was the two Category of nurses. Therefore, a mixed model factorial ANOVA was used to analyse differences over time and between the two categories of nurses Conclusions: There were significant differences among nurses treating HIV/AIDS patients with regard to stigma and burnout.

scholarly journals Predicting the loss to follow-up of HIV-infected patients on ART in a rural area in South Africa using generalized gamma distributions

2021 ◽  
Author(s):  
Pepukai Bengura
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Viral Load ◽  
Marital Status ◽  
Art Adherence ◽  
Aids Patients ◽  
Loss To Follow Up ◽  
Generalized Gamma ◽  
Hiv Aids

Abstract Background - Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa.Methods— This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as ‘dead’ or ‘transferred-out’ patient. Patient information was obtained from the routine hospitals’ records, and the data were analysed using Generalized gamma distribution to identify the predictors of loss to follow up among HIV/AIDS patients while Kaplan-Meier model was used to estimate and compare the LTFU survival probabilities of heterogenous groups among the patients.Results— Of the 357 patients, 60.5% were female. The mean (SD) age of the cohort was 36.2 (14.1), 15.4 (3.5), and 5.1 (3.5) years for adults, adolescents, and children, respectively. From 357 HIV/AIDS patients, 93 (26.05%) were lost to follow-up. Empirical results show that the Weibull distribution gives the best fit to the data. The Weibull model determined the Factors associated with significant risk factors to patient loss to follow up as: regimen EFV+D4T+3TC [HR: 2.0 CI;(1.3–3.1)], regimen EFV+AZT+3TC [HR: 2.9 CI;(1.3–6.4)], regimen EFV+3TC+TDF [HR: 10.0 CI;(3.9–25.9)], regimen NVP+3TC+TDF [HR: 10.6 CI;(1.8–62.4)], follow up CD4 [HR: 1.0 CI;(1.0–1.0)], log(follow up viral load) [HR: 0.8 CI;(0.7–0.9)], marital status (married) [HR: 0.4 CI;(0.3–0.8)], marital status (cohabitation) [HR: 0.6 CI;(0.3–0.9)], ART adherence (fair) [HR: 2.4 CI;(1.3–3.4)], ART adherence (good) [HR: 4.6 CI;(2.2–9.5)] and age [HR: 1.02 CI;(1.0–1.04)]. Discussion— Effective control and tracing measures in the at-risk population and in defaulters need to be stepped up especially during this COVID-19 period, to improve retention in hospitals. There is also need for careful adherence counseling and assessment of medication supplies.Conclusion— LTFU is more pronounced among females and is highest among adolescents. Patients with increased risk for LTFU were consistent with ART regimens, viral load, age, CD4 count, adherence and marital status.

scholarly journals Rate of Initial Anti-retroviral Treatment Modification and Its Predictors Among Adult Hiv/aids Patients at Pawe General Hospital, Benishangul Gumuz Region, Northwest Ethiopia

2020 ◽  
Author(s):  
Tsehay Matso ◽  
Habtamu Jarso ◽  
Girma Mamo Ijigu
Keyword(s):  
General Hospital ◽  
Cox Regression ◽  
Disease Stage ◽  
Aids Patients ◽  
Treatment Modification ◽  
Increased Risk ◽  
Regimen Modification ◽  
Baseline Hemoglobin ◽  
Hiv Aids

Abstract Background: Combination antiretroviral therapy (cART) is the cornerstone of managing patients with HIV infection. Once cART is initiated, patients generally remain on medications indefinitely. However, antiretroviral regimens commonly require changes which often involve switches of multiple medications simultaneously. The maximal regimen durability with regard to safety and efficacy is a critical factor for long-term success of ART since modification to cART has a number of challenges.Objectives: To assess the rate, time to change, reasons and predictors of treatment modification among HIV/AIDS patients at Pawe General Hospital.Method: Hospital based retrospective cohort study was conducted among adult HIV/AIDS patients on follow-up in Pawe Hospital from 01 April 2017 to 30 April 2017. Patients who started cART at Pawe General Hospital from January 2012 to December 2016 were included. Data abstraction tool was used to collect data from patient chart. Data were analyzed using SPSS version 21. Descriptive statistics were used to summarize patient socio-demographics characteristics and rate of regimen modification. Bivariate and multivariate Cox proportional hazard were performed to identify the predictors. Result: Over a median follow-up period of 21 months (IQR 6 - 38), 62 (14.5%) patients modified their initial regimens (incidence rate (IR); 7.66 per 100 person years [95% CI: 5.84 – 9.50]). Toxicity was the most common reason (72.6%). In multivariate Cox regression model, WHO stage III/IV at initiation(AHR;2.39, 95% CI: 1.23 – 4.66), AZT based initial NRTI backbone (AHR; 8.19, 95% CI: 4.55 - 14.73), low baseline hemoglobin ((< 7 g/dl [AHR; 6.32, 95% CI: 1.40 – 28.58] and 7-9.9 g/dl [AHR 4.21, 95% CI: 1.92 - 9.22]) and co-medication with cART (AHR 1.73, 95% CI: 1.03 - 2.89) were associated with increased risk of treatment modification.Conclusion: Initial regimen modification rate was lower in this population than cohorts in resource-rich settings. Special attention should be given for patients who are at advanced disease stage, AZT based regimen, low baseline hemoglobin and taking additional medications other than cART.

Predicting the loss to follow-up of HIV-infected patients on ART in a rural area in South Africa using generalized gamma distributions

2021 ◽  
Author(s):  
Pepukai Bengura
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Viral Load ◽  
Marital Status ◽  
Art Adherence ◽  
Aids Patients ◽  
Loss To Follow Up ◽  
Generalized Gamma ◽  
Hiv Aids

Abstract Background - Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa.Methods— This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as ‘dead’ or ‘transferred-out’ patient. Patient information was obtained from the routine hospitals’ records, and the data were analysed using Generalized gamma distribution to identify the predictors of loss to follow up among HIV/AIDS patients while Kaplan-Meier model was used to estimate and compare the LTFU survival probabilities of heterogenous groups among the patients.Results— Of the 357 patients, 60.5% were female. The mean (SD) age of the cohort was 36.2 (14.1), 15.4 (3.5), and 5.1 (3.5) years for adults, adolescents, and children, respectively. From 357 HIV/AIDS patients, 93 (26.05%) were lost to follow-up. Empirical results show that the Weibull distribution gives the best fit to the data. The Weibull model determined the Factors associated with significant risk factors to patient loss to follow up as: regimen EFV+D4T+3TC [HR: 2.0 CI;(1.3–3.1)], regimen EFV+AZT+3TC [HR: 2.9 CI;(1.3–6.4)], regimen EFV+3TC+TDF [HR: 10.0 CI;(3.9–25.9)], regimen NVP+3TC+TDF [HR: 10.6 CI;(1.8–62.4)], follow up CD4 [HR: 1.0 CI;(1.0–1.0)], log(follow up viral load) [HR: 0.8 CI;(0.7–0.9)], marital status (married) [HR: 0.4 CI;(0.3–0.8)], marital status (cohabitation) [HR: 0.6 CI;(0.3–0.9)], ART adherence (fair) [HR: 2.4 CI;(1.3–3.4)], ART adherence (good) [HR: 4.6 CI;(2.2–9.5)] and age [HR: 1.02 CI;(1.0–1.04)]. Discussion— Effective control and tracing measures in the at-risk population and in defaulters need to be stepped up especially during this COVID-19 period, to improve retention in hospitals. There is also need for careful adherence counseling and assessment of medication supplies.Conclusion— LTFU is more pronounced among females and is highest among adolescents. Patients with increased risk for LTFU were consistent with ART regimens, viral load, age, CD4 count, adherence and marital status.

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