Patient-reported outcomes among people living with HIV on single- versus multi-tablet regimens: Data from a real-life setting

Background The use of single-tablet regimens (STRs) in HIV treatment is ubiquitous. However, reintroducing the (generic) components as multi-tablet regimens (MTRs) could be an interesting cost-reducing strategy. It is essential to involve patient-reported outcome measures (PROs) to examine the effects of such an approach. Hence, this study compared PROs of people living with HIV taking an STR versus a MTR in a real world setting. Materials and methods This longitudinal study included 188 people living with HIV. 132 remained on a MTR and 56 switched to an STR. At baseline, months 1-3-6-12-18 and 24, participants filled in questionnaires on health-related quality of life (HRQoL), depressive symptoms, HIV symptoms, neurocognitive complaints (NCC), treatment satisfaction and adherence. Generalized linear mixed models and generalized estimation equations mixed models were built. Results Clinical parameters and PROs of the two groups were comparable at baseline. Neurocognitive complaints and treatment satisfaction did differ over time among the groups. In the STR-group, the odds of having NCC increased monthly by 4,1% as compared to the MTR-group (p = 0.035). Moreover, people taking an STR were more satisfied with their treatment after 6 months: the median change score was high: 24 (IQR 7,5–29). Further, treatment satisfaction showed a contrary evolution in the groups: the estimated state score of the STR-group increased by 3,3 while it decreased by 0,2 in the MTR-group (p = 0.003). No differences over time between the groups were observed with regard to HRQoL, HIV symptoms, depressive symptoms and adherence. Conclusions Neurocognitive complaints were more frequently reported among people on an STR versus MTR. This finding contrasts with the higher treatment satisfaction in the STR-group over time. The long-term effects of both PROs should guide the decision-making on STRs vs. (generic) MTRs.

Exploring peer navigation and support in the quality of HIV care experiences of female sex workers in the Dominican Republic

Background Despite evidence on peer navigation’s association with positive HIV outcomes, such as engagement in HIV care and antiretroviral therapy (ART) initiation, the mechanisms through which peer navigation may influence these outcomes have been less explored. The purpose of this study is to describe the role of peer navigation and support on enhancing the quality of HIV treatment and care services experienced by female sex workers (FSWs). Methods Survey data was derived from a quantitative cohort (n = 211) of FSWs living with HIV in the Dominican Republic and complemented with data from two rounds of in-depth interviews (IDIs) from a qualitative subsample (n = 20 per round). Descriptive statistics and multivariable logistic regressions were used to explore the association between peer navigation and relational aspects of care and overall satisfaction of the quality of HIV treatment and care. Thematic analysis was employed to code and synthesize textual data from IDIs. Results 41.2% of the participants reported having had contact with a peer navigator in the last 6 months. Qualitative data revealed that peer navigation and support was instrumental in assisting FSWs linkage to HIV care after diagnosis, elevating FSWs’ ability to access more comprehensive clinical care facilities, and promoting agency by improving FSWs’ skills to more strategically and effectively engage with the clinic environment and health care providers. Peer navigation was positively associated with experiencing more respectful treatment by clinic staff (AOR: 6.65, 95% CI: 2.32–19.02), and greater satisfaction with overall HIV care services (AOR: 2.57, 95% CI: 1.77–3.74). Conclusion Promoting the full integration of peer navigation into healthcare structures is a strategic approach to enhance the quality of HIV care experienced by FSWs and improve their HIV-related outcomes.

Impact of Combined Antiretroviral Therapy on Metabolic Syndrome Components in Adult People Living with HIV: A Literature Review

The development of metabolic derangements as a result of HIV treatment has been an important area of research since the introduction of zidovudine in the 1980’s. Antiretroviral therapy has intensely evolved in the last three decades, with new drugs gradually incorporated into everyday clinical practice. With the life expectancy of people living with HIV rapidly approaching that of their HIV-negative counterparts, the influence of these antiretrovirals on the development of the components of the metabolic syndrome remains of major interest to clinicians and their patients. In this review, we aimed to discuss the impact of cART on components of the metabolic syndrome, i.e., weight, plasma lipid levels, plasma glucose levels, and blood pressure, describing the influence of cART classes and of individual antiretrovirals. We also aimed to outline the limitations of the research conducted to date and the remaining knowledge gaps in this area.

A quantitative analysis of the similarities and differences of the HIV/FIV gag genome

Among viruses, human immunodeficiency virus (HIV) presents the greatest challenge to humans. Here, we retrieved genome sequences from NCBI and were then run through LALIGN bioinformatics software to compute the E value, bit score, Waterman eggert score, and percent identity, which are four important indicators of how similar the sequences are. The E value was 3.1 x 10^-9, the percent identity was 54.4 percent, and the bit score was 51.9. It was also sensed that bases 1600 to 1990 in HIV and bases 800 to 910 in FIV have a higher than normal similarity. This reflects that while the DNA sequences of the gag region of both the HIV and FIV genomes are rather similar, it is unlikely that this similarity is due to random chance; therefore, there are a noticeable number of differences. A better understanding of the level of similarity and differences in the gag region of the genome sequence would facilitate our understanding of structural and cellular behavioral differences between FIV and HIV, and in the long term, it will provide new insights into the differences observed in previous studies or even facilitate the development of an effective HIV treatment.

Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe

As Zimbabwe expands tuberculosis preventive treatment (TPT) for people living with HIV (PLHIV), the Ministry of Health and Child Care is considering making TPT more accessible to PLHIV via less-intensive differentiated service delivery models such as Community ART Refill Groups (CARGs). We designed a study to assess the feasibility and acceptability of integrating TPT into CARGs among key stakeholders, including CARG members, in Zimbabwe. We conducted 45 key informant interviews (KII) with policy makers, implementers, and CARG leaders; 16 focus group discussions (FGD) with 136 PLHIV in CARGs; and structured observations of 8 CARG meetings. KII and FGD were conducted in English and Shona. CARG observations were conducted using a structured checklist and time-motion data capture. Ninety six percent of participants supported TPT integration into CARGs and preferred multi-month TPT dispensing aligned with ART dispensing schedules. Participants noted that the existing CARG support systems could be used for TB symptom screening and TPT adherence monitoring/support. Other perceived advantages included convenience for PLHIV and decreased health facility provider workloads. Participants expressed concerns about possible medication stockouts and limited knowledge about TPT among CARG leaders but were confident that CARGs could effectively provide community-based TPT education, adherence monitoring/support, and TB symptom screening provided that CARG leaders received appropriate training and supervision. These results are consistent with findings from pilot projects in other African countries that are scaling up both differentiated service delivery for HIV and TPT and suggest that designing contextually appropriate approaches to integrating TPT into less-intensive HIV treatment models is an effective way to reach people who are established on ART but who may have missed out on access to TPT.

A quantitative analysis of the FIV and HIV genome using bioinformatics software

Among viruses, the human immunodeficiency virus (HIV) presented the greatest challenge to human kinds. the HIV and FIV gag genome was sequenced using the Illumina MiSeq Benchtop next-generation sequencer.The DNA sequences obtained were then run through the LALIGN bioinformatics software to compute the E value, bit score, waterman eggert score, percent identity,which are four important indicators of how similar the sequences are. The E value was 3.1 x 10 ^-9, the percent identity was 54.4 percent and the bit score was 51.9. It was also sensed that base 1600 to 1990 in HIV and base 800 to 910 in FIV have a higher than normal similarity. This reflects that while the DNA sequences of the gag region of both the HIV and FIV genome are rather similar and it is unlikely that this similarity is due to random chance, there are a noticeable amount of differences. A better understanding of the level of similarity and differences in the gag region of the genome sequence would facilitate our understanding of structural and cellular behavioral differences between FIV and HIV, and in the long term it prevides new explanations to differences observed in previous studies, or even facilitate the development of an effective HIV treatment.

Client Satisfaction: Understanding its Predictors to improve HIV treatment and care in a tertiary facility southwestern state, Nigeria

Objective: Human Immunodeficiency Virus (HIV) infection is a major public health concern. Frequent hospital visits are needed on the part of the patient to achieve decreased prevalence, the efficacy of antiretroviral therapy (ART), and viral suppression. Patient satisfaction is needed to achieve the aforementioned outcomes of care. This study, therefore, was conducted to assess clients’ satisfaction and perception of the quality of HIV/AIDs services and to elicit factors associated with dissatisfaction. Method: A cross-sectional survey was done using a systematic sampling method to select the study population. Data were analyzed by descriptive statistics, chi-square test, and logistic regression at a p-value set at < 0.05. Results: Most of the respondents (34.4%) were within the age range of 36- 44years. The mean age was 42.1± 11.5years. The overall satisfaction was 85.6%. The majority of respondents (95.2%) affirmed that the quality of care received was good. Unavailability of HIV educational materials was shown to predict clients’ satisfaction more than other factors with 3.545; 95% CI: 1.519 - 8.275; p = 0.003. Likewise, clients who perceived health workers to be non-accepting and judgmental are 3.6 times more likely to be unsatisfied with HIV services provided compared to those who do not (3. 580; 95% CI: 1.264- 10.141; p = 0.016). Conclusion: The study demonstrated impressive overall clients’ satisfaction with services provided at the health facility and the quality of care. Attention must be paid to the availability of HIV materials and training and retraining of staff to reduce stigmatization and discrimination against patients.

HIV surveillance and research for migrant populations: a protocol integrating respondent-driven sampling, case finding, and medicolegal services for Venezuelans living in Colombia (Preprint)

BACKGROUND Epidemiologic research among migrant populations is limited by logistical, methodological, and ethical challenges, but necessary for informing public health and humanitarian programming. OBJECTIVE We describe a methodology to estimate HIV prevalence among Venezuelan migrants in Colombia. METHODS Respondent-driven sampling (RDS), a non-probability sampling method, was selected for attributes of reaching highly networked populations without sampling frames and analytic methods that permit estimation of population parameters. RDS was modified to permit electronic referral of peers via SMS and Whatsapp. Participants complete socio-behavioral surveys and rapid HIV and syphilis screening tests with confirmatory testing. HIV treatment is not available for migrants who have entered Colombia through irregular pathways; thus, medicolegal services integrated into post-test counseling provide staff lawyers and legal assistance to participants diagnosed with HIV or syphilis for sustained access to treatment through the national health system. Case finding is integrated into RDS to allow partner referral. The study is implemented by a local community-based organization providing HIV support services and related legal services for Venezuelans in Colombia. RESULTS Data collection launched in four cities in July and August 2021. As of November 2021, 3,105 of the target 6,100 participants were enrolled. CONCLUSIONS Tailored methods that combine community-led efforts with innovations in sampling and linkage to care can aid in advancing health research for migrant and displaced populations. Worldwide trends in displacement and migration underscore the value of improved methods for translation to humanitarian and public health programming.