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Kayiranga D, Mukamana D, Gishoma D, Relf MV. "Successful Living" Among Adolescents With HIV in Sub-Saharan Africa: An Evolutionary Concept Analysis. J Assoc Nurses AIDS Care 2024; 35:376-387. [PMID: 39196685 PMCID: PMC11356674 DOI: 10.1097/jnc.0000000000000485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
ABSTRACT The concept of successful living in the context of adolescents with HIV lacks clarity and is unexplored. Without a common understanding of successful living among adolescents with HIV (AWH) in Sub-Saharan Africa (SSA), health care interventions focusing on this population may continue to fall short, resulting in avoidable morbidity and mortality. Therefore, this analysis used Rodgers Evolutionary Concept Analysis method to identify attributes, antecedents, consequences, and related concepts of successful living among AWH in SSA. Health care interventions are encouraged to promote successful living among AWH to achieve behavioral and clinical outcomes.
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Affiliation(s)
- Dieudonne Kayiranga
- Dieudonne Kayiranga, MSN, RN, is an Assistant Lecturer and PhD Student, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda, and is a Visiting Scholar, Duke University School of Nursing, Durham, North Carolina, USA. Donatilla Mukamana, PhD, RMHN, FAAN, is a Professor of Mental Health Nursing, Department of Mental Health, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Darius Gishoma, PhD, RMHN, is an Associate Professor of Clinical Psychology, Department of Mental Health, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Michael V. Relf, PhD, RN, AACRN, ANEF, FAAN, is the Interim Dean and Mary T. Champagne Distinguished Professor, Duke University School of Nursing, Durham, North Carolina, USA
| | - Donatilla Mukamana
- Dieudonne Kayiranga, MSN, RN, is an Assistant Lecturer and PhD Student, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda, and is a Visiting Scholar, Duke University School of Nursing, Durham, North Carolina, USA. Donatilla Mukamana, PhD, RMHN, FAAN, is a Professor of Mental Health Nursing, Department of Mental Health, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Darius Gishoma, PhD, RMHN, is an Associate Professor of Clinical Psychology, Department of Mental Health, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Michael V. Relf, PhD, RN, AACRN, ANEF, FAAN, is the Interim Dean and Mary T. Champagne Distinguished Professor, Duke University School of Nursing, Durham, North Carolina, USA
| | - Darius Gishoma
- Dieudonne Kayiranga, MSN, RN, is an Assistant Lecturer and PhD Student, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda, and is a Visiting Scholar, Duke University School of Nursing, Durham, North Carolina, USA. Donatilla Mukamana, PhD, RMHN, FAAN, is a Professor of Mental Health Nursing, Department of Mental Health, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Darius Gishoma, PhD, RMHN, is an Associate Professor of Clinical Psychology, Department of Mental Health, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Michael V. Relf, PhD, RN, AACRN, ANEF, FAAN, is the Interim Dean and Mary T. Champagne Distinguished Professor, Duke University School of Nursing, Durham, North Carolina, USA
| | - Michael V. Relf
- Dieudonne Kayiranga, MSN, RN, is an Assistant Lecturer and PhD Student, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda, and is a Visiting Scholar, Duke University School of Nursing, Durham, North Carolina, USA. Donatilla Mukamana, PhD, RMHN, FAAN, is a Professor of Mental Health Nursing, Department of Mental Health, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Darius Gishoma, PhD, RMHN, is an Associate Professor of Clinical Psychology, Department of Mental Health, School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda. Michael V. Relf, PhD, RN, AACRN, ANEF, FAAN, is the Interim Dean and Mary T. Champagne Distinguished Professor, Duke University School of Nursing, Durham, North Carolina, USA
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Batte C, Semulimi AW, Mukisa J, Nakabuye M, Nidoi J, Mukunya D, Ratanshi RP, Castelnuovo B, Lamorde M, Meya D, Checkley W, Kalyesubula R, Siddharthan T, Babigumira JB. Health-related quality of life and hypertension in people with HIV on long-term antiretroviral therapy in Uganda. PLoS One 2024; 19:e0306928. [PMID: 39116145 PMCID: PMC11309503 DOI: 10.1371/journal.pone.0306928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 06/25/2024] [Indexed: 08/10/2024] Open
Abstract
INTRODUCTION The presence of hypertension could reduce the health-related quality of life (HRQoL) of people with HIV (PWH). Yet, literature describing the HRQoL of PWH who have hypertension in Uganda is scarce making the design of locally adapted interventions cumbersome. In our study, we compared HRQoL scores of people with HIV with and without hypertension on long term antiretroviral therapy (ART) in Uganda. METHODS We recruited 149 PWH with hypertension and 159 PWH without hypertension in the long-term ART cohort at an urban clinic in Kampala, Uganda. Data on socio-demographics were collected using an interviewer designed questionnaire while data on the World Health Organisation clinical stage viral load and CD4 count as well as ART duration were extracted from clinic electronic database and a generic EuroQol -5D- 5L (EQ-5D- 5L) and Medical Outcome Study (MOS-HIV) questionnaire used to collect HRQoL data. Data were summarized using descriptive statistics while inferential statistics were used to determine associations between key variables and HRQoL. Mann-Whitney U tests were used to compare HRQoL between groups of interest. RESULTS One hundred ninety (61.7%) participants were female. PWH who had hypertension were older (Mean ± SD: 53.7 ± 8.3 vs 49.9 ± 8.6, p value <0.001) than those without hypertension. Participants with hypertension had lower overall median health utility scores (0.71 (0.33-0.80) vs 0.80 (0.44-0.80), p value = 0.029) and mean physical health score (48.44 ± 10.17 vs 51.44 ± 9.65, p value < 0.001) as opposed to those without hypertension. Hypertension (p value = 0.023), high income status, >70,000 UGX, (p value = 0.044), disclosure of the HIV status of the participants to their partner (p value = 0.026), and current history of smoking (p value = 0.029) were associated with low HRQoL scores. CONCLUSION Among people with HIV, those with hypertension had lower HRQoL compared to those without. This calls for inclusion of quality-of-life assessment in the management of PWH who have been diagnosed with hypertension to identify those at risk and plan early interventions.
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Affiliation(s)
- Charles Batte
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Andrew Weil Semulimi
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - John Mukisa
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mariam Nakabuye
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jasper Nidoi
- Department of Medicine, Lung Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - David Mukunya
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Tororo, Uganda
| | - Rosalind Parkes Ratanshi
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | | | - Mohammed Lamorde
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - David Meya
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - William Checkley
- Center for Global Non-Communicable Diseases Research and Training, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Robert Kalyesubula
- Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Trishul Siddharthan
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Joseph B. Babigumira
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Diro H, Ataro Z. Health-related quality of life in reproductive-age women on antiretroviral therapy: a cross sectional study in Ethiopia. Qual Life Res 2024; 33:1961-1974. [PMID: 38727877 DOI: 10.1007/s11136-024-03668-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES While numerous studies have explored the impact of gender on Health-Related Quality of Life (HRQOL), there is a lack of evidence specifically among reproductive-age women undergoing Antiretroviral Therapy (ART). Therefore, this study aims to investigate HRQOL and its associated factors among reproductive-age women receiving ART at Hiwot Fana Comprehensive Specialized Hospital in Eastern Ethiopia. METHODS A cross-sectional study included 418 women of ART. The World Health Organization quality of Life Questionnaire (WHOQOL-HIV BREF) was used to assess HRQOL. Binary logistic regression was used to determine the factors that could predict HRQOL. RESULTS The study found that the median age of the participants was 37 years, and the overall percentage of women with good HRQOL was 40.7%. Women who stayed on ART for more than 6 years had higher odds of overall good HRQOL (AOR 6.73, 95% CI 3.31-13.71) compared to those with a duration of 6 years or less. Besides, women having no child (AOR 25.03, 95% CI 4.93-127.06), one child (AOR 18.60, 95% CI 3.95-87.65), two children (AOR 12.89, 95% CI 3.66-45.37) and three children (AOR 3.77, 95% CI 1.06-13.34) had higher odds of overall good HRQOL compared to those with four/more children. CONCLUSIONS The study found that the majority of women on ART had poor HRQOL. Factors such as longer duration of taking ART, higher CD4+ cell count, disclosure of HIV status, and receiving care from adherence support teams were associated with better quality of life. Thus, strengthening adherence support teams, promoting safe disclosure of HIV status, and providing comprehensive support for HIV-positive women are required to improve their overall HRQOL.
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Affiliation(s)
- Helen Diro
- Hiwot Fana Comprehensive Specialized Hospital, Haramaya University, P.O. Box 235, Harar, Ethiopia.
| | - Zerihun Ataro
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Foroozanfar Z, Hooshyar D, Joulaei H. Psychosocial predictors of quality of life among women living with HIV/AIDS: a cross-sectional study in a VCT centre in Shiraz, Iran. Qual Life Res 2024; 33:1063-1073. [PMID: 38231437 DOI: 10.1007/s11136-023-03586-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE We aimed to assess psychosocial predictors of quality of life (QOL) among women living with HIV/AIDS (WLHIV). QOL has been considered as an important indicator in evaluating the outcome of psychological and physical healthcare in people living with HIV (PLHIV). METHODS This cross-sectional study was carried out from October 2021 to April 2022 at the Voluntary, Counselling, and Testing (VCT) center in Shiraz, Iran. A total of 452 WLHIV were included in this study. Socio-demographic and clinical data, social support (MSPSS questionnaire), food insecurity (HFIAS questionnaire), resilience (CD-RISC questionnaire), mental health status (DASS questionnaire), and QOL (WHOQOL-BREF questionnaire) were collected through direct interviews and patients' files at Shiraz VCT. RESULTS Physical and social relationships domains of QOL had the highest (60.48 ± 18.00) and lowest (36.76 ± 23.88) scores, respectively. Higher clinical stage, psychotropic substances use, having a husband infected with HIV, history of hypertension, and higher socioeconomic status had a significant relationship with some domains of QOL. The score of social support, food insecurity, resilience, and mental health status had a significant relationship with all domains of QOL. CONCLUSION Social relationships domain of QOL had the lowest scores in WLHIV. Also, the mental health status of WLHIV was more related to their QOL than the physical status related to HIV/AIDS. Interventions such as improving the mental health care and resilience skills of WLHIV, including their social network in counseling services to promote their social support, could help them to improve their QOL.
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Affiliation(s)
- Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Scienses, Shiraz, Iran
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Dariush Hooshyar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Scienses, Shiraz, Iran
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Scienses, Shiraz, Iran.
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Wiginton JM, Murray S, Kall M, Maksut JL, Augustinavicius J, Delpech V, Baral SD. HIV-related Stigma and Discrimination in Health Care and Health-related Quality of Life among People Living with HIV in England and Wales: A Latent Class Analysis. STIGMA AND HEALTH 2023; 8:487-496. [PMID: 38292669 PMCID: PMC10824403 DOI: 10.1037/sah0000299] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Though life expectancy of people living with HIV (PLHIV) is now comparable to that of HIV-negative persons, their health-related quality of life (HRQoL) lags behind. Lower HRQoL among PLHIV may vary meaningfully, shaped in part by social factors, including stigma. Using data from Positive Voices, a national cross-sectional probability survey of adults ≥ 18 years living with HIV and accessing HIV care services in England and Wales (N = 4,422), we conducted latent class analysis on responses to a HRQoL measure (problems with mobility, usual activities, self-care, pain/discomfort, anxiety/depression) to identify HRQoL patterns, followed by multinomial logistic regression to examine relationships between HRQoL classes and a 4-item measure of HIV-related stigma and discrimination in health care. Four classes emerged: All Problems (18% prevalence); Pain and Distress (18%); Pain and Mobility (9%); No Problems (55%). Scale scores of HIV-related stigma and discrimination in health care were positively, significantly associated with membership in the All Problems (adjusted odds ratio [aOR] = 2.05; 95% confidence interval [CI] = 1.85, 2.28), Pain and Distress (aOR = 1.56; CI = 1.41, 1.73), and Pain and Mobility classes (aOR = 1.33; CI = 1.16, 1.52) compared to the No Problems class. A similar trend was observed for individual stigma and discrimination items. HRQoL among PLHIV in England and Wales varies and may be underpinned or exacerbated by HIV-related stigma and discrimination in health care. Ensuring stigma-mitigation interventions reach all health care systems/providers and emotional support services reach all PLHIV may improve HRQoL for PLHIV.
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Affiliation(s)
- John Mark Wiginton
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah Murray
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Meaghan Kall
- HIV/STI Department, National Infection Service, Public Health England, London, UK
| | - Jessica L Maksut
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jura Augustinavicius
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Valerie Delpech
- HIV/STI Department, National Infection Service, Public Health England, London, UK
| | - Stefan D Baral
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Milewska-Buzun M, Cybulski M, Baranowska A, Kózka M, Paradowska-Stankiewicz I. Quality of Life in HIV-Positive People in Poland Treated in the City of Bialystok: A Cross-Sectional Study. J Clin Med 2023; 12:5593. [PMID: 37685659 PMCID: PMC10488938 DOI: 10.3390/jcm12175593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
The quality of life is one of the key factors in assessing the health status of HIV-positive individuals, with its improvement considered an important goal of treatment. Assessment of the quality of life helps accurately evaluate the impact of diseases and treatment on the patient's life. The aim of this study was to assess the quality of life of HIV-positive people in Poland using the example of patients treated in the Observation and Infection Clinic with the Subunit for HIV/AIDS Patients of the University Clinical Hospital in Bialystok, based on the evaluation of HIV-positive status acceptance in HIV patients as well as sociometric variables such as age, gender and marital status. A total of 147 patients participated in this study, including 104 men (70.7%) and 43 women (29.3%). This study was conducted between May 2019 and January 2020 in the Observation and Infection Clinic with the Subunit for HIV/AIDS Patients with the Consultation and Diagnostic Centre at the Teaching Hospital of the Medical University of Bialystok. This study used a diagnostic survey method with a modified questionnaire "Psychosocial Situation of People Living with HIV/AIDS in Poland" by Dr. Magdalena Ankiersztejn-Bartczak and the following standardised psychometric tools: the World Health Organization Quality of Life (WHOQOL-BREF), Short-Form Health Survey (SF-36), Acceptance of Illness Scale (AIS) and Satisfaction with Life Scale (SWLS). The majority of respondents (60%) reported no significant changes in their lives as a result of HIV infection. Gender was not a differentiating factor in the quality of life of people living with HIV. The variation in psychometric measures within the female and male groups was far greater than the difference between them. Marital status clearly differentiated the quality of life. The following conclusions were drawn from this study: The surveyed HIV patients presented a moderate level of quality of life, which was mainly determined by marital status. Higher quality of life was presented by married persons. Duration of infection was not correlated with quality of life. The level of acceptance of HIV infection was relatively high among respondents. A higher level of HIV acceptance was associated with a higher quality of life. The respondents presented a relatively poor level of satisfaction with life. Changing jobs, going on disability, relationship breakdown, not having a family of their own and losing friends were the key HIV-related changes in the lives of the respondents.
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Affiliation(s)
- Marta Milewska-Buzun
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 15-096 Bialystok, Poland; (M.C.); (A.B.)
| | - Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 15-096 Bialystok, Poland; (M.C.); (A.B.)
| | - Anna Baranowska
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 15-096 Bialystok, Poland; (M.C.); (A.B.)
| | - Maria Kózka
- Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland;
| | - Iwona Paradowska-Stankiewicz
- Department of Epidemiology and Surveillance of Infectious Diseases, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland;
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Xing HY, Yan J. Quality of Life Assessment and Related Factors of HIV-Infected Patients in Hangzhou Using a Path Analysis Model: An Observational Study. Int J Gen Med 2022; 15:6325-6333. [PMID: 35924180 PMCID: PMC9342877 DOI: 10.2147/ijgm.s373796] [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: 05/07/2022] [Accepted: 07/21/2022] [Indexed: 12/01/2022] Open
Abstract
Objective This study aimed to examine which path among direct and indirect effects was more influential to the quality of life (QOL) for patients with human immunodeficiency virus (HIV). Methods An observational study among 951 individuals diagnosed with HIV was conducted in designated acquired immunodeficiency syndrome (AIDS) medical institutions in Hangzhou using simple random sampling technique. We collected the demographic data of patients and then evaluated their QOL by 12-Item Short-Form (SF-12) questionnaire survey. The two-stage least squares analysis was firstly performed to filter the independent influencing factors of Physical Component Summary (PCS) and Mental Component Summary (MCS). We then enrolled the PCS, MCS, and their influencing factors into the path analysis of QOL, and further revealed the direct and indirect effects of variables and examined the important path that was more influential on the patient’s QOL. Results The patient’s PCS, MCS, and quality of life showed a significant difference between groups in terms of education level and working condition (all P<0.05). Regression analysis showed that depression, age, education level, and treatment independently affected the PCS (all P<0.05), and depression and anxiety exerted an independent effect on the MCS (all P<0.05). Further path analysis integrating related variables showed that the main indexes of the goodness of fit implied the final model fit the data well. The path analysis showed that PCS and MCS exerted direct effects on the QOL (all P<0.001), especially the MCS (β=0.785), but other variables exerted no direct effects (all β=0, all P>0.05). It should be noted that anxiety presented an obvious indirect effect on the QOL (β=0.460), and its indirect effect was similar to the direct effect of PCS (β=0.471). Conclusion The MCS might exert a more important effect on the QOL of HIV patients. In addition, the indirect effect of anxiety on the QOL should not be ignored.
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Affiliation(s)
- Hao-yu Xing
- Medical Engineering Department, Hangzhou Seventh People’s Hospital, Hangzhou, 310013, People’s Republic of China
| | - Juan Yan
- Medical Affairs Department, Hangzhou Seventh People’s Hospital, Hangzhou, 310013, People’s Republic of China
- Correspondence: Juan Yan, Medical Affairs Department, Hangzhou Seventh People’s Hospital, No. 305, Tianmushan Road, Xihu District, Hangzhou, 310013, People’s Republic of China, Email
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Armoon B, Fleury MJ, Higgs P, Bayat AH, Bayani A, Mohammadi R, Ahounbar E. Prevalence, socio-demographics and service use determinants associated with disclosure of HIV/AIDS status to infected children: a systematic review and meta-analysis by 1985-2021. Arch Public Health 2022; 80:154. [PMID: 35681146 PMCID: PMC9178876 DOI: 10.1186/s13690-022-00910-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/03/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) is a public health issue of global importance. To our knowledge, no previous meta-analysis documenting the prevalence, socio-demographic, and service use determinants associated with HIV/AIDS disclosure to infected children has been conducted. The present study aimed to determine the prevalence, socio-demographics and service use determinants associated with the disclosure of HIV/AIDS status to infected children. METHODS Studies in English published between 01 January 1985 and 01 November 2021, and available on PubMed, Scopus, Web of Science, and Cochrane electronic databases were searched. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR), and 95% confidence intervals. RESULTS After article duplicates were excluded, assessments of abstracts were completed, and full-text papers evaluated, 37 studies were included in this meta-analysis. The prevalence of the disclosure of HIV status to children was measured to be 41% in this research. The odds that a child of 10 years and older is informed that they are HIV-positive is 3.01 time the odds that younger children are informed. Those children who had primary or lower schooling level were 2.41 times more likely to be informed of their HIV-positive status than children with higher levels of schooling. Children who had a non-biological parents were 3.17 times more likely to have been disclose being HIV-positive; social support (OR = 8.29, 95%CI = 2.34, 29.42), children who had higher levels of social supports were 8.29 times more likely to disclose HIV-positive; the primary educational level of caregivers (OR = 2.03, 95%CI = 1.43, 2.89), respondents who had caregivers with primary education level were 2.03 times more likely to disclose HIV-positive; antiretroviral treatment (ART) adherence (OR = 2.59, 95%CI = 1.96, 3.42), participants who adhered to ART were 2.59 times more likely to disclose HIV-positive and hospital follow-up (OR = 2.82, 95%CI = 1.85, 4.29), those who had hospital follow-up were 2.82 times more likely to disclose HIV-positive; were all significantly associated with the disclosure of HIV/AIDS status to infected children. CONCLUSION Such data are of importance for healthcare pediatrics HIV care professionals. Facilitating HIV diagnosis and disclosure to the infected children and ensuring access to HIV treatment will likely prevent secondary HIV transmission. Healthcare professionals are expected to provide age-appropriate counseling services to this population.
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Affiliation(s)
- Bahram Armoon
- Douglas Mental Health University Institute, Research Centre, 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, Research Centre, 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Peter Higgs
- Department of Public Health, La Trobe University, Melbourne, Australia
- Burnet Institute, Melbourne, VIC, Australia
| | - Amir-Hossien Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elaheh Ahounbar
- Orygen, The National Center of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Center for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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Mi T, Zhou G, Li X, Qiao S, Yang X, Shen Z, Zhou Y. The association between HIV disclosure to family members and quality of life among people living with HIV/AIDS: The indirect effects through social support. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01927-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mohammed SA, Yitafr MG, Workneh BD, Hailu AD. Health-related quality of life and associated factors among people living with human immunodeficiency virus on highly active antiretroviral therapy in North East Ethiopia: Cross-sectional study. PLoS One 2021; 16:e0247777. [PMID: 33667245 PMCID: PMC7935299 DOI: 10.1371/journal.pone.0247777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/14/2021] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION HIV/AIDS remains a public health concern affecting millions of people across the world. Although the health-related quality of life (HRQoL) of patients living with HIV has significantly improved after treatment, its chronicity makes the HRQoL uncertain. This study assessed factors associated with the health-related quality of life among people living with HIV/AIDS on HAART in North-East Ethiopia. METHODS An institutional-based cross-sectional study was conducted from March to April 2018, and systematic random sampling was used to select 235 participants who were on HAART. HRQoL was assessed using the Medical Outcomes Study HIV Health Survey. Descriptive and multiple linear regression analysis were computed using the statistical package for social sciences version 20. RESULTS The study revealed one-factor structure and had good overall internal consistency (78.5). Over one-third (42.6%; 95% CI; 36.2%, 48.9%) of participants had good HRQoL. The least HRQoL mean score was found for cognitive functioning 32.21(±19.78), followed by social functioning 40.58(±29.8). Factors associated with the overall HRQoL were 25-45 years of age (β = - 3.55, 95% CI;-6.54, -0.55), working in private sector (β = -5.66, 95% CI;-9.43, -1.88), government (β = -4.29, 95% CI;-7.83, -0.75) and self-employment (β = -8.86, 95% CI;-13.50, -4.21), 100-200 (β = - 4.84, 95% CI;-9.04, -0.63) and 201-350 CD4 at the time of diagnosis (β = - 7.45, 95% CI;-11.73, -3.16), 351-500 current CD4 level (β = 8.34, 95% CI;5.55, 11.41), 6-10 years of disease duration (β = -8.28, 95% CI;-12.51, -4.04), WHO stage II (β = -4.78, 95% CI;-8.52, -1.04) and III (β = 3.42, 95% CI;0.06, 6.79) during treatment initiation and not taking of Cotrimoxazole prophylaxis (β = -5.79, 95% CI;-8.34, -3.25). CONCLUSIONS High proportion of participants had a poor HRQoL. Routine assessment and appropriate interventions at each visit is recommended to improve HRQoL.
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Affiliation(s)
- Solomon Ahmed Mohammed
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Minilu Girma Yitafr
- Department of Pharmacy, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Birhanu Demeke Workneh
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Lygidakis C, Uwizihiwe JP, Bia M, Uwinkindi F, Kallestrup P, Vögele C. Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics. BMJ Open 2021; 11:e043997. [PMID: 33608403 PMCID: PMC7896598 DOI: 10.1136/bmjopen-2020-043997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To report on the disease-related quality of life of patients living with diabetes mellitus in Rwanda and identify its predictors. DESIGN Cross-sectional study, part of the baseline assessment of a cluster-randomised controlled trial. SETTING Outpatient clinics for non-communicable diseases of nine hospitals across Rwanda. PARTICIPANTS Between January and August 2019, 206 patients were recruited as part of the clinical trial. Eligible participants were those aged 21-80 years and with a diagnosis of diabetes mellitus for at least 6 months. Illiterate patients, those with severe hearing or visual impairments, those with severe mental health conditions, terminally ill, and those pregnant or in the postpartum period were excluded PRIMARY AND SECONDARY OUTCOME MEASURES: Disease-specific quality of life was measured with the Kinyarwanda version of the Diabetes-39 (D-39) questionnaire. A glycated haemoglobin (HbA1c) test was performed on all patients. Sociodemographic and clinical data were collected, including medical history, disease-related complications and comorbidities. RESULTS The worst affected dimensions of the D-39 were 'anxiety and worry' (mean=51.63, SD=25.51), 'sexual functioning' (mean=44.58, SD=37.02), and 'energy and mobility' (mean=42.71, SD=20.69). Duration of the disease and HbA1c values were not correlated with any of the D-39 dimensions. A moderating effect was identified between use of insulin and achieving a target HbA1c of 7% in the 'diabetes control' scale. The most frequent comorbidity was hypertension (49.0% of participants), which had a greater negative effect on the 'diabetes control' and 'social burden' scales in women. Higher education was a predictor of less impact on the 'social burden' and 'energy and mobility' scales. CONCLUSIONS Several variables were identified as predictors for the five dimensions of quality of life that were studied, providing opportunities for tailored preventive programmes. Further prospective studies are needed to determine causal relationships. TRIAL REGISTRATION NUMBER NCT03376607.
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Affiliation(s)
- Charilaos Lygidakis
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - Jean Paul Uwizihiwe
- College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Michela Bia
- Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - Francois Uwinkindi
- Division of Non Communicable Diseases, Rwanda Biomedical Center (RBC), Kigali, Rwanda
| | - Per Kallestrup
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Hema A, Poda A, Tougouma JB, Meda C, Kabore F, Zoungrana J, Kamoule E, Sore I, Bado G, Ouedraogo AS, Sawadogo AB, Millogo A. [Diabetes mellitus and high blood pressure over risk in HIV-infected people followed at Souro Sanou University Hospital Day Hospital, Bobo-Dioulasso 2018]. Rev Epidemiol Sante Publique 2021; 69:72-77. [PMID: 33563493 DOI: 10.1016/j.respe.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 11/24/2020] [Accepted: 12/10/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) represent the leading causes of death worldwide. HIV also increases the risk of developing NCDs including diabetes mellitus and hypertension. METHODS A cross-sectional study, based on an analysis of the cohort database of the day hospital of the Souro Sanou teaching hospital in Bobo-Dioulasso (Burkina Faso). Diabetes mellitus was defined by the undergoing of anti-diabetic treatment or two successive measurements of fasting blood sugar above 7mmol/l and high blood pressure by the undergoing of antihypertensive treatment or two successive measurements of blood pressure above 140/90mmHg. Comparison of the frequency of diabetes and hypertension in the people living with HIV/AIDS (PLWHA) population on antiretroviral therapy (ART) with that of the general population of Burkina Faso was made by indirect standardization according to age and gender. RESULTS A total of 4259 patients including 3148 women (73.9%) were included in this study. The median age of the patients was 45 years (IQR: 38-52); the median body mass index (BMI) was 19.6kg/m2 (IQR: 15.4 - 22.7) and 48.3% of patients had a BMI≥25kg/m2. The median CD4 count was 590 cells/mm3 (IQR: 417-785). The median ART duration was 8.2 years (IQR: 4.7-11.2). The majority of patients (82.9%) were on treatment combinations consisting in 2 INTI+1 NNRTI. Prevalence of hypertension was 39.8%; it was statistically higher in men than in women (45.8% versus 37.8%). Prevalence of hypertension was 87.0% higher in the PLWHA population than among same-sex and same-age subjects in the general population. Prevalence of diabetes mellitus was 7.3%. Diabetes mellitus was more common in men than in women (10.1% versus 6.3%; P<10-3). Prevalence of diabetes mellitus was 36.0% higher in the PLWHA population than among same-sex and same-age subjects in the general population. CONCLUSION Prevalence of diabetes mellitus and hypertension was higher among PLHWA undergoing ART than in the general population. Care for the PLHWA population should more widely include NCD treatment.
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Affiliation(s)
- A Hema
- Hôpital de jour du service de maladies infectieuses, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso.
| | - A Poda
- Hôpital de jour du service de maladies infectieuses, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso; Institut national des sciences de la santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - J-B Tougouma
- Service de cardiologie, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso; Institut national des sciences de la santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - C Meda
- Institut national des sciences de la santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - F Kabore
- Institut national de santé publique, Ouagadougou, Burkina Faso
| | - J Zoungrana
- Hôpital de jour du service de maladies infectieuses, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso; Institut national des sciences de la santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - E Kamoule
- Service d'hépato-gastroentérologie, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso
| | - I Sore
- Hôpital de jour du service de maladies infectieuses, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso
| | - G Bado
- Hôpital de jour du service de maladies infectieuses, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso
| | - A-S Ouedraogo
- Hôpital de jour du service de maladies infectieuses, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso
| | - A-B Sawadogo
- Hôpital de jour du service de maladies infectieuses, CHU Souro Sanou, 01 BP 676, Bobo-Dioulasso, Burkina Faso
| | - A Millogo
- UFR/Sciences de la santé, Université Joseph Ki Zerbo, Ouagadougou, Burkina Faso
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13
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Gebreyesus T, Belay A, Berhe G, Haile G. Burden of fatigue among adults living with HIV/AIDS attending antiretroviral therapy in Ethiopia. BMC Infect Dis 2020; 20:280. [PMID: 32295546 PMCID: PMC7161178 DOI: 10.1186/s12879-020-05008-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fatigue is one of the most common and devastating Human Immuno-deficiency Virus (HIV) - related symptoms, with a varying prevalence in different study areas. In Ethiopia, there is a paucity of information on the magnitude and factors associated with fatigue among HIV/Acquired Immune Deficiency Syndrome (AIDS) patients. This may lead to under-diagnosis and eventually under-management of the symptom. METHODS Institution based cross-sectional study design was conducted among 609 HIV/AIDS patients who were selected by using a systematic random sampling method. Data were collected by using interviewer administered structured questionnaire. Level of fatigue was measured by Fatigue Severity Scale. RESULTS The prevalence of fatigue was found to be 51.7%. The factors associated with fatigue were: Parity [AOR = 2.01; 95% CI: 1.09-3.71], CD4 count 200-499 cells/mm3 [AOR = 2.81; 95% CI: 1.58-4.99], anemia [AOR = 4.90 95% CI: 2.40-9.97], co-morbidities [AOR = 3.65; 95% CI: 1.71-7.78], depression [AOR = 3.68 95% CI: 1.99-6.79], not being physically active [AOR = 3.20 95% CI: 1.50-6.81], clinical stage II or IV HIV [AOR = 3.11; 95% CI: 1.51-6.40] and [AOR = 4.08; 95% CI: 1.37-12.14], respectively. CONCLUSION The finding of this study revealed that fatigue is a common health problem among adult People Living with HIV (PLHIV). Factors associated with fatigue included: Parity, CD4 count 200-499 cells/mm3, Clinical Stage II or IV HIV, anemia, co-morbidities, depression, and not being physically active. The health care service needs to address the predisposing factors by provision integrated care including timely detection and treatment of comorbidities, mental health problems, and promote physical activity to slow down disease progression and then reduce exposure to fatigue.
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Affiliation(s)
- Tsiwaye Gebreyesus
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia
| | - Addisalem Belay
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia
| | - Gebretsadik Berhe
- Department of Epidemiology, School of Public Health, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Gebremedhin Haile
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia
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Balayan T, Sudfeld CR. Health-related quality of life among adults living with HIV: a cross-sectional survey in Armenia. AIDS Care 2020; 33:20-30. [PMID: 31893936 DOI: 10.1080/09540121.2019.1709615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Few studies have examined health-related quality of life (HRQoL) among people living with HIV (PLWHIV) in Eastern Europe and Central Asia. We conducted a cross-sectional survey of 180 PLWHIV aged 18 years+ in Armenia who were on cART and used the 36-Item Short-Form Health Survey to assess HRQoL. The highest HRQoL domain score was 85.3 (SD 24.7) for physical functioning, followed by 82.1 (SD 25.0) for pain, 77.9 (SD 24.2) for social functioning, 76.4 (SD 39.6) for emotional role-functioning, 71.1 (SD 39.7) for physical role-functioning, and 64.0 (SD 20.3) for energy/fatigue, 63.7 (SD 22.7) for emotional well-being and 63.4 for general health 63.4 (SD 21.2). In the physical domain, chronic comorbidities and low emotional support were associated with worse physical functioning, physical role-functioning, general health and pain scores (p < 0.05). Unemployment and hepatitis C coinfection were associated with worse physical role functioning and pain scores (p < 0.01). As for mental HRQoL, we found that unemployment, chronic comorbidities, and lower emotional support were associated with poorer emotional well-being, energy, and emotional role-functioning scores (p < 0.05). These findings suggest that improved social support, employment opportunities, mental health services and integrated care for noncommunicable comorbidities may improve HRQoL in Armenia and similar settings.
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Affiliation(s)
- Tatevik Balayan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Legesse Tesemma A, Girma Abate M, Hailemariam Abebo Z, Estifanos Madebo W. Determinants of Poor Quality of Life Among Adults Living with HIV and Enrolled in Highly Active Anti-Retroviral Therapy at Public Health Facilities of Arba Minch Town Administration in Southern Ethiopia. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2019; 11:387-394. [PMID: 32021481 PMCID: PMC6948197 DOI: 10.2147/hiv.s227244] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/16/2019] [Indexed: 01/05/2023]
Abstract
Background The human immunodeficiency virus (HIV) continues to be a major global public health problem with more than 35 million people worldwide infected so far. Evidence shows that HIV has been compromising the quality of life of people living with HIV (PLWH) even in this era of highly active anti-retroviral therapy (HAART). There has been little research into the quality of life of PLWH receiving HAART in Ethiopia. Purpose The aim of this study was to assess the quality of life among PLWH attending anti-retroviral therapy at public health facilities of Arba Minch town, Southern Ethiopia, in 2019. Patients and methods We conducted a cross-sectional study design on 391 randomly selected PLWH who were attending HAART. We used a systematic random sampling technique to select participants in public health facilities of Arba Minch town from February 16 to April 26, 2019. The interviewers administered a structured questionnaire consisting of the WHOQOL-HIV BREF tool to measure the quality of life. Socio-demographic variables of study participants were collected, together with variables related to their clinical status extracted from their clinical records. Percentage mean scores were calculated and the mean of percentage mean scores was taken as the cutoff to categorize participants into two groups representing poor and good quality of life. Simple binary logistic regression and multivariable logistic regression analyses were used to determine significant variables. All variables with p-value ≤ 0.25 in simple binary logistic regression were considered as eligible variables for multivariable logistic regression. Variables with p-value ≤ 0.05 in multivariable logistic regression were considered as predictor variables. Results Out of the 391 enrolled adult PLWH, 184 of them (47.1%) had poor of overall quality of life status, as estimated by the WHOQOL-HIV BREF tool. Good quality of life was positively associated with recent CD4 count greater than or equal to 500 cell/mm3 (AOR=1.96, 95% CI; 1.18-3.27), absence of depression (AOR=10.59, 95% CI; 6.16-18.21), normal body mass index (AOR=2.66, 95% CI; 1.18-3.27), social support (AOR= 6.18, 95% CI; 3.56-10.75) and no perceived stigma (AOR=2.75, 95% CI; 1.62-4.67). Conclusion Nearly half of the adult PLWH receiving HAART at Arba Minch town had poor quality of life. High CD4 count, lack of social support, depression, and perceived stigma were associated with poor quality of life of PLWH. PLWH should be encouraged to be part of structured social support systems, such as associations of people living with HIV and mother support groups, in order to improve their social and psychological health. The health system should give attention to counseling on chronic care adherence and nutritional support to improve the quality of life of PLWH receiving HAART.
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Affiliation(s)
| | - Meseret Girma Abate
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Zeleke Hailemariam Abebo
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Wubshet Estifanos Madebo
- Department of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Biraguma J, Mutimura E, Frantz JM. Knowledge about modifiable risk factors for non-communicable diseases adults living with HIV in Rwanda. Afr Health Sci 2019; 19:3181-3189. [PMID: 32127895 PMCID: PMC7040312 DOI: 10.4314/ahs.v19i4.41] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes. Research has revealed that there is a relationship between knowledge of NCD risk factors and risk perceptions in the general population. Therefore, an assessment of PLHIV's NCD risk factors knowledge is quite critical, to design effective NCD prevention programmes. OBJECTIVE To assess the level of knowledge of modifiable risk factors for NCDs and its associated factors among adults living with HIV in Rwanda. METHODS A cross-sectional quantitative design was used to collect the data. The study targeted PLHIV who visited the out-patients' public health centres in three purposively selected provinces of Rwanda. The knowledge assessment questionnaire relating to risk factors for chronic diseases of lifestyle was used to collect the data. Data were analysed using SPSS version 23. RESULTS Of the 794 respondents, 64.6% were women, and the mean age was 37.9 (±10.8) years. The results revealed that the majority of the respondents (65.0%) had low levels of knowledge about NCD risk factors, while some (35.6%) were of the opinion that they had a low risk of contracting NCDs. Good knowledge was significantly associated with high educational status, a low CD4+ cell count (< 350 cells/mm3) and normotension. CONCLUSION The current study findings highlight the need for comprehensive health education, to raise awareness of non-communicable diseases' risk factors for adults living with HIV in Rwanda.
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Affiliation(s)
- Juvenal Biraguma
- University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
- University of the Western Cape, Faculty of Community and Health Sciences, Cape Town, South Africa
| | - Eugene Mutimura
- University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
- Regional Alliance for Sustainable Development (RASD), Kigali, Rwanda
| | - José M Frantz
- University of the Western Cape, Faculty of Community and Health Sciences, Cape Town, South Africa
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Pierre S, Seo G, Rivera VR, Walsh KF, Victor JJ, Charles B, Julmiste G, Dumont E, Apollon A, Cadet M, Saint‐Vil A, Marcelin A, Severe P, Lee MH, Kingery J, Koenig S, Fitzgerald D, Pape J, McNairy ML. Prevalence of hypertension and cardiovascular risk factors among long-term AIDS survivors: A report from the field. J Clin Hypertens (Greenwich) 2019; 21:1558-1566. [PMID: 31448551 PMCID: PMC6896990 DOI: 10.1111/jch.13663] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 05/14/2019] [Accepted: 06/18/2019] [Indexed: 12/23/2022]
Abstract
HIV infection is associated with increased risk and progression of cardiovascular disease (CVD), yet little is known about the prevalence of CVD risk factors among long-term AIDS survivors in resource-limited settings. Using routinely collected data, we conducted a retrospective study to describe the prevalence of CVD risk factors among a cohort of HIV-infected patients followed for over 10 years in Port-au Prince, Haiti. This cohort includes 910 adults who initiated antiretroviral therapy (ART) between 2003 and 2004 and remained in care between 2014 and 2016 when routine screening for CVD risk factors was implemented at a large clinic in Haiti. A total of 397 remained in care ≥10 years and received screening. At ART initiation, 59% were female, median age was 38 years (IQR 33-44), and median CD4 count was 117 cells/mm3 (IQR 34-201). Median follow-up time from ART initiation was 12.1 years (IQR 11.7-12.7). At screening, median CD4 count was 574 cells/mm3 (IQR 378-771), and 84% (282 of 336 screened) had HIV-1 RNA < 1000 copies/mL. Seventy-four percent of patients had at least 1 risk factor including 58% (224/385) with hypertension, 8% (24/297) diabetes, 43% (119/275) hypercholesterolemia, 8% (20/248) active smoking, and 10% (25/245) obesity. Factors associated with hypertension were age (adjusted OR 1.06, P < .001) and weight at screening (adjusted OR 1.02, P = .019). Long-term AIDS survivors have a high prevalence of CVD risk factors, primarily hypertension. Integration of cardiovascular screening and management into routine HIV care is needed to maximize health outcomes among aging HIV patients in resource-limited settings.
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Affiliation(s)
- Samuel Pierre
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Grace Seo
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
- Department of Medicine, Center for Global HealthWeill Cornell MedicineNew YorkNYUSA
| | - Vanessa R. Rivera
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
- Department of Medicine, Center for Global HealthWeill Cornell MedicineNew YorkNYUSA
| | - Kathleen F. Walsh
- Department of Medicine, Center for Global HealthWeill Cornell MedicineNew YorkNYUSA
- Division of General Internal MedicineWeill Cornell MedicineNew YorkNYUSA
| | - Jean Joscar Victor
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Benedict Charles
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Gaetane Julmiste
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Emelyne Dumont
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Alexandra Apollon
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Molene Cadet
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Alix Saint‐Vil
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Adias Marcelin
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Patrice Severe
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
| | - Myung Hee Lee
- Department of Medicine, Center for Global HealthWeill Cornell MedicineNew YorkNYUSA
| | - Justin Kingery
- Department of Medicine, Center for Global HealthWeill Cornell MedicineNew YorkNYUSA
- Division of General Internal MedicineWeill Cornell MedicineNew YorkNYUSA
| | - Serena Koenig
- Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - Daniel Fitzgerald
- Department of Medicine, Center for Global HealthWeill Cornell MedicineNew YorkNYUSA
| | - Jean Pape
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO)Port‐au‐PrinceHaiti
- Department of Medicine, Center for Global HealthWeill Cornell MedicineNew YorkNYUSA
| | - Margaret L. McNairy
- Department of Medicine, Center for Global HealthWeill Cornell MedicineNew YorkNYUSA
- Division of General Internal MedicineWeill Cornell MedicineNew YorkNYUSA
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