1
|
Nguyen TT, Nguyen HT, Do HP, Ho CSH, Ho RCM. Characterizing the Development of Research Landscapes in Substance Use and HIV/AIDS During 1990 to 2021. Subst Abuse 2023; 17:11782218231177515. [PMID: 37304210 PMCID: PMC10251474 DOI: 10.1177/11782218231177515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/07/2023] [Indexed: 06/13/2023]
Abstract
Mitigating the impacts of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and substance use requires comprehensive and systematic thinking in designing interventions and developing policies. This study describes the growth of research publications from 1991 to 2021 in the Web of Science database and points out current research landscapes in the fields of HIV/AIDS and substance use. Latent Dirichlet Allocation was used for classifying 21 359 papers into corresponding topics. The most common topics were HIV transmission, HIV infection, quality of life and mental health of substance users, and the biomedical effect of substance use. Emerging research landscapes include vulnerabilities of people who inject drugs to HIV transmission and related health problems. This study found a lack of research on health services, interdisciplinary and inter-sectoral in combination with clinical evaluation and treatment services. Future investment and implementation of HIV/AIDS and substance use programs should focus on research of health services and clinical evaluation, especially context-specific interventions.
Collapse
Affiliation(s)
- Tham Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Huyen Phuc Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Cyrus SH Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Roger CM Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| |
Collapse
|
2
|
Ozga JE, Shuter J, Chander G, Graham AL, Kim RS, Stanton CA. Co-use of cigarettes and cannabis among people with HIV: Results from a randomized controlled smoking cessation trial. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100172. [PMID: 37342512 PMCID: PMC10277428 DOI: 10.1016/j.dadr.2023.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
Significance People with HIV (PWH) who smoke cigarettes have lower cessation rates than the general population. This study investigated whether changes in cannabis use frequency impedes cigarette cessation among PWH who are motivated to quit. Methods Between 2016-2020, PWH who smoked cigarettes were enrolled in a randomized controlled trial for cigarette cessation. Analyses were limited to PWH who reported on their past 30-day (P30D) cannabis use during four study visits (baseline, 1-month, 3-month, and 6-month) (N=374). Descriptive statistics and multivariable logistic regression were used to evaluate changes in cannabis use frequency from baseline to 6 months and associations with cigarette abstinence at 6 months among PWH who reported no use during all four visits (n=176), as well as those who reported use during at least one visit and who increased (n=39), decreased (n=78), or had no change (n=81) in use frequency. Results Among those who reported cannabis use during at least one visit (n=198), at baseline, 18.2% reported no use. At 6 months, 34.3% reported no use. Controlling for covariates, increased cannabis use frequency from baseline was associated with reduced odds of cigarette abstinence at 6 months versus decreased use frequency (aOR=0.22, 95% CI=0.03, 0.90) or no use at either time-point (aOR=0.25, 95% CI=0.04, 0.93). Conclusions Increased cannabis use over 6 months was associated with reduced odds of cigarette smoking abstinence among PWH who were motivated to quit. Additional factors that influence cannabis use and cigarette cessation simultaneously are in need of further study.
Collapse
Affiliation(s)
- Jenny E. Ozga
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Jonathan Shuter
- Department of Medicine, Division of Infectious Diseases, Albert Einstein College of Medicine, The Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, The Bronx, NY, USA
| | | | - Amanda L. Graham
- Innovations Center, Truth Initiative, Washington, DC, USA
- Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Ryung S. Kim
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Cassandra A. Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| |
Collapse
|
3
|
Woode E, Boakye‐Gyasi E, Obirikorang Y, Adu EA, Obirikorang C, Acheampong E, Odame‐Anto E. Predictors of medication nonadherence among hypertensive clients in a Ghanaian population: Application of the Hill‐Bone and Perceived Barriers to Treatment Compliance Scale. Health Sci Rep 2022; 5:e584. [PMID: 35509411 PMCID: PMC9059218 DOI: 10.1002/hsr2.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022] Open
Abstract
Background and Aim Nonadherence to antihypertensive medication impairs optimal blood pressure and is influenced by multiple interrelating factors. Knowing the complexity of medication nonadherence and its associated factors is essential for intervention strategies. This study evaluated the predictors of medication nonadherence among hypertensive clients in a Ghanaian population. Methods This was a hospital‐based cross‐sectional study conducted at the Hypertensive Clinic of the Kwame Nkrumah University of Science and Technology (KNUST) Hospital, Kumasi, Ghana. A self‐designed questionnaire, the Hill‐Bone Compliance to High Blood Pressure Therapy and Perceived Barriers to Treatment Compliance Scales, were used for data collection from 246 hypertensives. Data were analyzed using Statistical Package for Social Sciences, version 25. Results Medication nonadherence was observed among 8.5% of the study participants. In a multivariate regression model perceived noneffectiveness of medication (odds ratio [OR] = 1.76, 95% confidence interval [CI]: 1.34–2.31, p < 0.001) and barriers to alcohol and smoking cessation (OR = 2.83, 95% CI: 1.31–6.13, p = 0.008) were associated increased odds of antihypertensive medication nonadherence. Also, patients who do not know their total prescription (OR = 8.81, 95% CI: 2.28–34.0, p = 0.002) were more likely to be nonadherent to their antihypertensive medications. Moreover, clients who associate signs/symptoms of palpitations (OR = 5.82, 95% CI: 1.31–25.80, p = 0.021), poor sleep (OR = 3.92, 95% CI: 1.09–14.12, p = 0.036) and decreased sexual drive (OR = 4.74, 95% CI: 0.96–23.28, p = 0.055), were more likely to be nonadherent to antihypertensive medication. Conclusion In conclusion, we observed a lower nonadherence rate among hypertensive clients in a Ghanaian population with correlates being medication‐related factors. Most importantly, perceived noneffectiveness of medication, barriers to smoking and alcohol cessation, palpitations, poor sleep, and decreased sexual drive significantly predicted lower adherence and could serve as indicators for high risk of nonadherence to antihypertensive medications.
Collapse
Affiliation(s)
- Eric Woode
- Department of Pharmacology and Toxicology, School Of Pharmacy University of Health and Allied Sciences Ho Ghana
| | - Eric Boakye‐Gyasi
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Yaa Obirikorang
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana
- Department of Nursing, Faculty of Health Sciences Garden City University College Kumasi Ghana
| | - Evans A. Adu
- Department of Molecular Medicine, School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana
- Department of Medical Diagnostics, Faculty of Allied Health Science, College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi West Africa Ghana
| | - Enoch Odame‐Anto
- Department of Medical Diagnostics, Faculty of Allied Health Science, College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi West Africa Ghana
- School of Medical and Health Science, Centre for Precision Health Edith Cowan University Perth Australia
| |
Collapse
|
4
|
SantaBarbara NJ, Nosrat S, Arnold EM, Swendeman D, Comulada WS. Intersection of COVID-19, HIV and exercise: a commentary with home-based exercise recommendations for practice. AIDS Care 2022; 34:188-192. [PMID: 34743617 PMCID: PMC8857034 DOI: 10.1080/09540121.2021.1998312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The worldwide spread of COVID-19 has led to closures or reduced capacity of non-essential businesses and recreational areas and stay-at-home orders to promote social distancing. Although effective to reduce transmission, these policies may negatively impact exercise behaviors. Exercise is effective at mitigating the risk of developing or exacerbating several of underlining risk factors for a more severe COVID-19 disease course and may be particularly important for people with HIV (PWH). In this commentary, we discuss the intersection of COVID-19 and exercise with a specific focus on people living with HIV. We then provide a pragmatic, home-based exercise routine that can be performed with little to no equipment or supervision. It is important for PWH (and others) to start or maintain at least some level of exercise to reduce the risk of a severe COVID-19 disease course and to improve other health outcomes in this unfamiliar climate.
Collapse
Affiliation(s)
- Nicholas J. SantaBarbara
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024
| | - Sanaz Nosrat
- Department of Health Sciences, Lehman College/CUNY 250 Bedford Park Boulevard Bronx, NY 10468, USA
| | - Elizabeth Mayfield Arnold
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd #303, Dallas, TX, 75390
| | - Dallas Swendeman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024
| | - Warren Scott Comulada
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024
| |
Collapse
|
5
|
Santos WND, Silva RSD, Souza FMDLC, Santos RSDC, Oliveira ICD, Silva RARD. Ineffective health control: concept analysis. Rev Bras Enferm 2021; 74:e20190158. [PMID: 33787772 DOI: 10.1590/0034-7167-2019-0158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/05/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to identify and synthesize the concept of Ineffective Health Control. METHODS Concept Analysis from the perspective of Walker and Avant, operationalized by an integrative review in the databases Scopus, LILACS, PubMed, CINAHL, Web of Science, Science Direct e Cochrane, using the descriptors: Adhesion to Medication; Cooperation and Adherence to Treatment and Acquired Immunodeficiency Syndrome. RESULTS five critical attributes were identified for the concept, namely: patient's refusal to follow the therapeutic plan; abandoning treatment and worsening signs and symptoms; difficulty in reaching agreed goals; difficulty following health professionals' guidelines; multifactorial and dynamic process. CONCLUSIONS the concept of Ineffective Health Control is characterized by a multifactorial and dynamic process evidenced by the patient's refusal to follow a therapeutic plan, favouring the abandonment of treatment and resulting in the worsening of signs and symptoms and failure to reach goals.
Collapse
|
6
|
Ale BM, Amahowe F, Nganda MM, Danwang C, Wakaba NN, Almuwallad A, Ale FBG, Sanoussi A, Abdullahi SH, Bigna JJ. Global burden of active smoking among people living with HIV on antiretroviral therapy: a systematic review and meta-analysis. Infect Dis Poverty 2021; 10:12. [PMID: 33579391 PMCID: PMC7881452 DOI: 10.1186/s40249-021-00799-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/21/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although the high burden of both active smoking and human immunodeficiency virus (HIV) is clearly known, the relationship between them is still not well characterized. Therefore, we estimated the global prevalence of active smoking in people living with HIV (PLHIV) on antiretroviral therapy (ART) and investigated the association between exposure to active smoking and risk for suboptimal adherence to ART. Main text: We searched PubMed, Embase, and Web of Science to identify articles published until September 19, 2019. Eligible studies reported the prevalence of active smoking in PLHIV on ART or investigated the association between active smoking and ART adherence; or enough data to compute these estimates. We used a random-effects model to pool data and quantified heterogeneity (I2). The global prevalence of active smoking was 36.1% (95% CI: 33.7-37.2; 329 prevalence data; 462 104 participants) with substantial heterogeneity. The prevalence increased with level of country income; from 10.1% (95% CI: 6.8-14.1) in low-income to 45.2% (95% CI: 42.7-47.7) in high-income countries; P < 0.0001. With regards to the Joint United Nations Programme on HIV/AIDS (UNAIDS) regions, the prevalence was higher in West and Central Europe and North America 45.4% (42.7-48.1) and lowest in the two UNAIDS regions of sub-Saharan Africa: Eastern and Southern Africa 10.7% (95% CI: 7.8-14.0) and West and Central Africa 4.4% (2.9-6.3); P < 0.0001. Globally, we estimated that there were 4 110 669 PLHIV on ART who were active smokers, among which the highest number was from Eastern and Southern Africa (35.9%) followed by Asia and the Pacific (25.9%). Active smoking was significantly associated with suboptimal ART adherence: pooled odds ratio 1.57 (95% CI: 1.37-1.80; I2 = 56.8%; 19 studies; 48 450 participants); even after considering adjusted estimates: 1.67 (95% CI: 1.39-2.01; I2 = 53.0%; 14 studies). CONCLUSIONS This study suggests a high prevalence of active smoking in PLHIV on ART and an association between active smoking and ART suboptimal adherence. As such, healthcare providers and policy makers should focus on adopting and implementing tobacco harm reduction strategies in HIV care, especially in sub-Saharan Africa known as epicenter of HIV pandemic with highest number of active tobacco smoking among PLHIV on ART.
Collapse
Affiliation(s)
| | | | - Motto Malea Nganda
- Department of Clinical Science and International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Célestin Danwang
- Epidemiology and Biostatistics Unit, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
| | | | - Ateeq Almuwallad
- Applied Medical Sciences College, Jazan University, Jazan, Saudi Arabia
- Center for Trauma Science, Queen Mary University of London, London, UK
| | | | - Alamou Sanoussi
- Transition Support Program Department, Advocate Good Samaritan Hospital, Downers Grove, IL USA
| | | | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| |
Collapse
|
7
|
Satre DD, Levine-Hall T, Sterling SA, Young-Wolff K, Lam JO, Alexeeff S, Hojilla JC, Williams A, Justice AC, Sterne J, Cavassini M, Bryant KJ, Williams EC, Horberg MA, Volberding P, Weisner C, Silverberg MJ. The relationship of smoking and unhealthy alcohol use to the HIV care continuum among people with HIV in an integrated health care system. Drug Alcohol Depend 2021; 219:108481. [PMID: 33429295 PMCID: PMC7869693 DOI: 10.1016/j.drugalcdep.2020.108481] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/12/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Smoking tobacco and unhealthy alcohol use may negatively influence HIV care continuum outcomes but have not been examined in combination. METHODS Participants were people with HIV (PWH) in Kaiser Permanente Northern California. Predictors included smoking status and unhealthy alcohol use (exceeding daily and/or weekly limits) reported by patients during primary care screening (index date). Outcomes were based on not achieving the following steps in the care continuum: linkage to HIV care (≥1 visit within 90 days of newly identified HIV diagnosis), retention (2+ in-person visits, 60+ days apart) and HIV RNA control (<75 copies/mL). Adjusted odds ratios (ORs) were obtained from separate logistic regression models for each outcome associated with smoking and unhealthy alcohol use independently and combined. RESULTS The overall sample (N = 8958) had a mean age of 48.0 years; was 91.3 % male; 54.0 % white, 17.6 % Latino, 15.1 % black, and 9.6 % other race/ethnicity. Smoking was associated with higher odds of not being linked to HIV care (OR = 1.60 [95 % CI 1.03-2.48]), not retained (OR = 1.30 [95 % CI 1.13-1.50]), and HIV RNA not in control (OR = 1.91 [95 % CI 1.60-2.27]). Alcohol measures were not independently associated with outcomes. The combination of unhealthy alcohol use and smoking (versus neither) was associated with higher odds of not being linked to care (OR = 2.83 [95 % CI 1.40-5.71]), although the interaction did not reach significance (p = 0.18). CONCLUSIONS In this large sample of PWH in an integrated health care system, smoking, both independently and in combination with unhealthy alcohol use, was associated with worse HIV care continuum outcomes.
Collapse
Affiliation(s)
- Derek D. Satre
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA,Kaiser Permanente Northern California, Oakland, CA, USA,Corresponding author: Derek D. Satre, Ph.D., Department of Psychiatry and Behavioral Sciences Weill Institute for Neurosciences University of California, San Francisco 401 Parnassus Avenue, Box 0984 San Francisco, CA 94143, , Phone: (415) 476-7382
| | | | | | - Kelly Young-Wolff
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA,Kaiser Permanente Northern California, Oakland, CA, USA
| | | | | | | | | | | | | | | | - Kendall J. Bryant
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Emily C. Williams
- Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven Care, Veteran Affairs (VA) Puget Sound Health Care System, Seattle, WA,Department of Health Services, University of Washington, Seattle, WA
| | - Michael A. Horberg
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA
| | - Paul Volberding
- AIDS Research Institute, University of California, San Francisco, USA
| | - Constance Weisner
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA,Kaiser Permanente Northern California, Oakland, CA, USA
| | | |
Collapse
|
8
|
Nguyen AL, Lake JE, Preciado D, Liao D, Moore AA, Del Pino HE. A Modified Alcohol SBI for Use among Older Adults Living with HIV. West J Nurs Res 2020; 42:1155-1162. [PMID: 32238110 DOI: 10.1177/0193945920912946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Older adults living with HIV may have health conditions that amplify the potentially negative health effects of alcohol use. We adapted the Comorbidity Alcohol Risk Evaluation Tool (CARET) screening tool for at-risk drinking to reflect HIV/AIDS and related conditions, medications, and behaviors. The adapted CARET-HIV along with a brief intervention was administered to 27 older men living with HIV. The CARET-HIV identified the same number of at-risk drinkers as the original CARET (n = 24) but identified more risk domains. Most participants welcomed receiving information about risks associated with their drinking, but some felt "embarrassed" or "guilty" discussing their drinking. This is particularly salient within the context of HIV discourse, which has historically assigned blame of HIV infection on personal choices. The SBI was generally acceptable to participants. The modified CARET can help providers integrate discussion of alcohol use into the context of HIV care for personalized feedback.
Collapse
Affiliation(s)
- Annie L Nguyen
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Alhambra, CA, USA
| | - Jordan E Lake
- Division of Infectious Diseases, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA.,Division of Infectious Diseases, McGovern Medical School at the University of Texas, Houston, TX
| | - Diane Preciado
- Division of Geriatrics, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Diana Liao
- Division of Geriatrics, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Alison A Moore
- Division of Geriatrics, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA.,Division of Geriatrics, Departments of Medicine and Psychiatry, University of California, San Diego, La Jolla, CA
| | - Homero E Del Pino
- Division of Geriatrics, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA.,Department of Psychiatry and Human Behavior at Charles R. Drew University of Medicine and Science, Los Angeles, CA
| |
Collapse
|
9
|
HIV-Related Stigma, Motivation to Adhere to Antiretroviral Therapy, and Medication Adherence Among HIV-Positive Methadone-Maintained Patients. J Acquir Immune Defic Syndr 2019; 80:166-173. [PMID: 30383588 DOI: 10.1097/qai.0000000000001891] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Opioid agonist therapies with methadone are associated with higher levels of adherence to antiretroviral therapy (ART); yet, no studies have explored factors associated with optimal ART levels in HIV-positive patients on methadone maintenance treatment, including explanatory pathways using mediation analysis. SETTING Participants included 121 HIV-positive, methadone-maintained patients who reported HIV-risk behaviors and were taking ART. METHODS Participants were assessed using an audio computer-assisted self-interview. Multivariable logistic regression was used to identify significant correlates and PROCESS macro to test the explanatory pathway (ie, mediational effect) for optimal ART adherence. RESULTS Among 121 participants, almost 40% reported suboptimal adherence to ART. Optimal ART adherence was significantly associated with being virally suppressed [adjusted odds ratio (aOR) = 6.470, P = 0.038], higher motivation to adhere to ART (aOR = 1.171, P = 0.011), and lower anticipated HIV-related stigma (aOR = 0.384, P = 0.015). Furthermore, results revealed an indirect effect of motivation on the relationship between HIV stigma and ART adherence (effect = -0.121, P = 0.043), thus supporting the mediation effect. CONCLUSIONS Our findings underscore the complexities surrounding ART adherence, even in patients on methadone maintenance treatment. These findings provide insights on how to more effectively intervene to optimize HIV treatment outcomes, including HIV treatment-as-prevention initiatives, in methadone-maintained patients.
Collapse
|
10
|
Camargo CC, Cavassan NRV, Tasca KI, Meneguin S, Miot HA, Souza LR. Depression and Coping Are Associated with Failure of Adherence to Antiretroviral Therapy Among People Living with HIV/AIDS. AIDS Res Hum Retroviruses 2019; 35:1181-1188. [PMID: 31592722 DOI: 10.1089/aid.2019.0050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Sustained adherence to antiretroviral therapy (ART) is critical in the prevention of drug resistance, disease progression, and death. We aimed to assess the level of ART adherence among 112 people living with HIV/AIDS (PLWHA) and to determine associated factors with that. The socioeconomic aspects were evaluated by medical records; the adherence, depression, and coping by specific questionnaires. Although most patients have undetectable viral load (79%) and CD4+ T count >500 cells/mm3 (65%), two-third (66%) of them exhibited a lower adherence, which was directly associated with some signs of depression (p = .006) presented by 65% of them. Some risk factors to presence of depression were female gender (p = .008) and low income (p = .013). In addition, most participants who reported tobacco (33%) and alcohol (29%) consumption had a low or intermediate adherence score. Among the coping strategies, self-control (p = .029), social support (p = .006), problem solving (p = .013), and positive reappraisal (p = .049) led to an improvement in adherence.
Collapse
Affiliation(s)
- Caio C. Camargo
- Department of Tropical Diseases, Botucatu Medical School (FMB), Univ Estadual Paulista (UNESP), Botucatu, Brazil
| | - Nayara R. V. Cavassan
- Department of Tropical Diseases, Botucatu Medical School (FMB), Univ Estadual Paulista (UNESP), Botucatu, Brazil
| | - Karen I. Tasca
- Department of Tropical Diseases, Botucatu Medical School (FMB), Univ Estadual Paulista (UNESP), Botucatu, Brazil
| | - Silmara Meneguin
- Department of Nursing, Botucatu Medical School (FMB), Univ Estadual Paulista (UNESP), Botucatu, Brazil
| | - Hélio A. Miot
- Department of Dermatology, Botucatu Medical School (FMB), Univ Estadual Paulista (UNESP), Botucatu, Brazil
| | - Lenice R. Souza
- Department of Tropical Diseases, Botucatu Medical School (FMB), Univ Estadual Paulista (UNESP), Botucatu, Brazil
| |
Collapse
|
11
|
Jiang Y, Li X, Cho H, Brown MJ, Qiao S, Haider MR. Effects of individual and neighborhood socioeconomic status on antiretroviral therapy adherence: The role of adherence self-efficacy. J Health Psychol 2019; 26:1143-1153. [PMID: 31419916 DOI: 10.1177/1359105319869809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the potential mediation effect of adherence self-efficacy on the associations between individual and neighborhood socioeconomic status and antiretroviral therapy adherence in a sample of 337 people living with HIV in South Carolina, United States. Results showed that there were no direct effects of individual or neighborhood socioeconomic status on antiretroviral therapy adherence, whereas both individual socioeconomic status and neighborhood socioeconomic status were associated with adherence self-efficacy, which in turn were related to antiretroviral therapy adherence. These findings suggest that interventions targeting adherence self-efficacy may improve antiretroviral therapy adherence among people living with HIV with low socioeconomic status or those living in socioeconomically disadvantaged neighborhoods.
Collapse
|
12
|
Lindayani L, Yeh CY, Ko WC, Ko NY. High smoking prevalence among HIV-positive individuals: a systematic review and meta-analysis. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1652364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Linlin Lindayani
- Department of Nursing, Sekolah Tinggi Ilmu Keperawatan PPNI Jawa Barat, Bandung, Indonesia
| | - Chun-Yin Yeh
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
13
|
The Potential Impact of a Low Nicotine Product Standard for Cigarettes in Smokers Living With HIV. J Assoc Nurses AIDS Care 2019; 30:137-141. [PMID: 30822286 PMCID: PMC7014914 DOI: 10.1097/jnc.0000000000000027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
14
|
Silverberg MJ, Leyden WA, Leibowitz A, Hare CB, Jang HJ, Sterling S, Catz SL, Parthasarathy S, Horberg MA, Satre DD. Factors associated with hazardous alcohol use and motivation to reduce drinking among HIV primary care patients: Baseline findings from the Health & Motivation study. Addict Behav 2018; 84:110-117. [PMID: 29660593 DOI: 10.1016/j.addbeh.2018.03.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/29/2018] [Accepted: 03/29/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Limited primary care-based research has examined hazardous drinking risk factors and motivation to reduce use in persons with HIV (PWH). METHODS We computed prevalence ratios (PR) for factors associated with recent (<30 days) hazardous alcohol use (i.e., 4+/5+ drinks in a single day for women/men), elevated Alcohol Use Disorders Identification Test (AUDIT) scores, and importance and confidence (1-10 Likert scales) to reduce drinking among PWH in primary care. RESULTS Of 614 participants, 48% reported recent hazardous drinking and 12% reported high alcohol use severity (i.e., AUDIT zone 3 or higher). Factors associated with greater alcohol severity included moderate/severe anxiety (PR: 2.07; 95% CI: 1.18, 3.63), tobacco use (PR: 1.79; 1.11, 2.88), and other substance use (PR: 1.72; 1.04, 2.83). Factors associated with lower alcohol severity included age 50-59 years (PR: 0.46; 0.22, 2.00) compared with age 20-39 years, and having some college/college degree (PR: 0.61; 0.38, 0.97) compared with ≤high school. Factors associated with greater importance to reduce drinking (scores >5) included: moderate/severe depression (PR: 1.43; 1.03, 2.00) and other substance use (PR: 1.49; 1.11, 2.01). Lower importance was associated with incomes above $50,000 (PR: 0.65; 0.46, 0.91) and marijuana use (PR: 0.65; 0.49, 0.87). HIV-specific factors (e.g., CD4 and HIV RNA levels) were not associated with alcohol outcomes. CONCLUSIONS This study identified modifiable participant characteristics associated with alcohol outcomes in PWH, including anxiety and depression severity, tobacco use, and other substance use.
Collapse
Affiliation(s)
- Michael J Silverberg
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States.
| | - Wendy A Leyden
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Amy Leibowitz
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - C Bradley Hare
- Department of Adult and Family Medicine, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, United States
| | - Hannah J Jang
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States; UCSF Medical Center Institute for Nursing Excellence, United States
| | - Stacy Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Sheryl L Catz
- Betty Irene Moore School of Nursing, University of California at Davis, Sacramento, CA, United States
| | - Sujaya Parthasarathy
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Michael A Horberg
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, United States
| | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States; UCSF Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, CA, United States
| |
Collapse
|
15
|
Gamarel KE, Westfall AO, Lally MA, Hosek S, Wilson CM. Tobacco Use and Sustained Viral Suppression in Youth Living with HIV. AIDS Behav 2018; 22:2018-2025. [PMID: 28951979 PMCID: PMC5869110 DOI: 10.1007/s10461-017-1915-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Tobacco has been associated with worse HIV disease progression in adult samples of people living with HIV; however, studies have yet to examine these effects in youth living with HIV (YLWH). This study examined the association between tobacco smoking behaviors and sustained viral suppression among a sample of 820 YLWH who were recruited through the Adolescent Medicine Trials Network for HIV Interventions. Participants completed a cross-sectional survey and then staff abstracted viral suppression data from medical records for up to 26 weeks prior to enrollment. Overall, 20.4% of youth reported daily or almost daily tobacco use. In multivariable analyses, older age and daily or almost daily tobacco smoking, and ART adherence remained statistically significant in predicting sustained viral suppression over the study period. These findings underscore the need for tobacco screening and interventions in HIV care settings in order to identify youth in need of additional smoking cessation services.
Collapse
Affiliation(s)
- Kristi E Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.
| | - Andrew O Westfall
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michelle A Lally
- Lifespan Hospital System, Providence, RI, USA
- Alpert Medical School, Brown University, Providence, RI, USA
| | - Sybil Hosek
- John Stroger Hospital of Cook County, Chicago, IL, USA
| | - Craig M Wilson
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
16
|
Gamarel KE, Neilands TB, Conroy AA, Dilworth SE, Lisha N, Taylor JM, Darbes LA, Johnson MO. A longitudinal study of persistent smoking among HIV-positive gay and bisexual men in primary relationships. Addict Behav 2017; 66:118-124. [PMID: 27930901 PMCID: PMC5525143 DOI: 10.1016/j.addbeh.2016.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION We examined the stability of smoking behaviors, and factors associated with persistent smoking in a longitudinal study of HIV-positive gay and bisexual men in primary relationships. METHODS A sample of 377 HIV-positive men on antiretroviral therapy and their same-sex partners completed five assessments over two years. Participants completed semi-structured interviews which assessed smoking status, sociodemographic factors, relationship dynamics, and HIV-related disease characteristics. Latent transition analysis estimated the amount of transition in smoking over time. Latent class analysis examined factors associated with smoking status across the study period. RESULTS At baseline, 28.1% (n=106) of participants reported current smoking. Over 90% of the HIV-positive men remained in the same smoking category over time (68.4% persistent non-smokers; 24.1% persistent smokers). Men whose partners smoked and men with lower income had higher odds of being persistent smokers, whereas older men and men who identified as Latino race/ethnicity had lower odds of being persistent smokers compared to non-smokers. CONCLUSIONS Despite efforts to reduce smoking among people living with HIV (PLWH), a substantial subset of men continued to smoke during their two years in the study. Findings suggest that primary partners who also smoke and low income were the strongest predictors of sustained smoking behaviors among HIV-positive men. Additional research is needed to better understand how to increase motivation and support for smoking cessation among PLWH and their primary partners, while attending to how socioeconomic status may inhibit access to and the sustained impact of existing smoking cessation programs.
Collapse
Affiliation(s)
- Kristi E Gamarel
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, USA; Department of Behavioral and Social Sciences, Brown University School of Public Health, USA.
| | | | - Amy A Conroy
- Department of Medicine, University of California, San Francisco, USA
| | | | - Nadra Lisha
- Department of Medicine, University of California, San Francisco, USA
| | - Jonelle M Taylor
- Department of Medicine, University of California, San Francisco, USA
| | - Lynae A Darbes
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, USA
| | - Mallory O Johnson
- Department of Medicine, University of California, San Francisco, USA
| |
Collapse
|