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Linfield RY, Nguyen NN, Laprade OH, Holodniy M, Chary A. An update on drug-drug interactions in older adults living with human immunodeficiency virus (HIV). Expert Rev Clin Pharmacol 2024; 17:589-614. [PMID: 38753455 PMCID: PMC11233252 DOI: 10.1080/17512433.2024.2350968] [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] [Received: 02/01/2024] [Accepted: 04/30/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION People with HIV are living longer due to advances in antiretroviral therapy. With improved life expectancy comes an increased lifetime risk of comorbid conditions - such as cardiovascular disease and cancer - and polypharmacy. Older adults, particularly those living with HIV, are more vulnerable to drug interactions and adverse effects, resulting in negative health outcomes. AREA COVERED Antiretrovirals are involved in many potential drug interactions with medications used to treat common comorbidities and geriatric conditions in an aging population of people with HIV. We review the mechanisms and management of significant drug-drug interactions involving antiretroviral medications and non-antiretroviral medications commonly used among older people living with HIV. The management of these interactions may require dose adjustments, medication switches to alternatives, enhanced monitoring, and considerations of patient- and disease-specific factors. EXPERT OPINION Clinicians managing comorbid conditions among older people with HIV must be particularly vigilant to side effect profiles, drug-drug interactions, pill burden, and cost when optimizing treatment. To support healthier aging among people living with HIV, there is a growing need for antiretroviral stewardship, multidisciplinary care models, and advances that promote insight into the correlations between an individual, their conditions, and their medications.
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Affiliation(s)
| | - Nancy N. Nguyen
- Department of Pharmacy, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy, University of the Pacific, Stockton, CA, USA
| | - Olivia H. Laprade
- Department of Pharmacy, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy, University of the Pacific, Stockton, CA, USA
| | - Mark Holodniy
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- National Public Health Program Office, Veterans Health Administration, Palo Alto, CA, USA
| | - Aarthi Chary
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- National Public Health Program Office, Veterans Health Administration, Palo Alto, CA, USA
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J Marwa K, Kadodo J, Iddi S, Kapesa A. Herbal medicines use among HIV/AIDS patients on antiretroviral therapy and its influence on viral suppression and CD4 count: A survey at a tertiary hospital in Tanzania. PUBLIC HEALTH IN PRACTICE 2024; 7:100492. [PMID: 38595639 PMCID: PMC11002646 DOI: 10.1016/j.puhip.2024.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/13/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Objectives This study aimed to determine the magnitude of concurrent use of herbal medicines with ART, its associated factors and effect on viral load suppression and CD4 count among people living with HIV. Study design This was a cross-sectional study involving 375 HIV positive patients on ART attending at care and treatment clinic (CTC). Methods Data were obtained through face-to-face interviews using pre-structured questionnaires and patient's files through a checklist. Adherence was assessed though pill count method while CD4 count and viral load suppression were assessed using the Tanzania National guidelines for the management of HIV and AIDS. Data were analysed using STATA version 15. Independent predictors for herbal medicine use or viral suppression were assessed using univariate and multivariate logistic regression. Results Out of 375 PLHIV, 37 (35%) reported to use herbal medicines concurrently with ART. Predictors for herbal medicines use were existence of chronic disease (OR = 4.53; CI = 1.87-10.95) (p = 0.001), male gender (OR = 0.57; CI = 0.35-0.93) (p = 0.02) and HIV clinical stage (OR = 1.71; CI = 0.99-2.94) (p = 005). PLHIV who used herbal medicines along with ART did not have a significantly higher chance of achieving viral suppression than PLHIV who did not use herbal medicines (OR = 1.42; CI = 0.71-2.82). There was no statistically significant difference on CD4 count (p = 0.8943) and viral load (p = 0.8612) between herbal medicines users and non-users. Conclusion The utilization of herbal medicine among PLHIV on ART remains notably prevalent. Nonetheless, it is worth noting that despite the prevailing herbal medicine usage, there is no substantial effect on viral suppression. The primary determinants of the adoption of herbal medicines use were having chronic medical conditions and the stage of progression of the HIV infection.
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Affiliation(s)
- Karol J Marwa
- Department of Pharmacology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Josephine Kadodo
- School of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Shabani Iddi
- Department of Physiology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Anthony Kapesa
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Colominas-González E, De Antonio M, Masip M, Martin Conde MT, Cardona G, Fresán Restituto D, Comas D, Roch MA, López B, Torres-Bondia FI, Retamero A, Knobel H, Luque S. Complementary and alternative medicine in HIV care: frequency of consumption, risks and interactions with antiretroviral therapy. Eur J Hosp Pharm 2024:ejhpharm-2024-004118. [PMID: 38802166 DOI: 10.1136/ejhpharm-2024-004118] [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: 01/26/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES People living with HIV (PLWH) are common users of complementary and alternative medicine (CAM). The main objective of this study was to study the frequency and patterns of CAM natural products use in a large cohort of PLWH and to identify potential drug-drug interactions (DDIs) and the impact on their antiretroviral treatment (ART) adherence and efficacy. METHODS This was a cross-sectional multicenter survey including 420 PLWH from different Spanish hospitals. Participants completed a face-to-face questionnaire on CAM consumption and different sociodemographic and clinical data were collected. DDIs between CAM and ART were identified and classified according to the Liverpool University Database and patient factors related to CAM consumption were assessed. RESULTS 420 participants were included (82.6% male, mean age 47 years); 209 patients (49.8%) were taking at least one CAM. The most consumed CAM were green, black and red tea (n=146, 25.4%), ginger (n=26, 4.5%), fish oil (n=25, 4.4%) and cannabis (n=24, 4.2%). An ART based on integrase inhibitors was the only factor independently associated with CAM consumption (OR 1.54, 95% CI 1.04 to 2.26). 50 potential CAM-ART interactions in 43 (20.6%) patients taking CAM were identified, being clinically significant in 80% of the cases. CAM products most frequently involved with a potential significant DDI were supplements containing divalent cations (n=11) and garlic (n=7). No differences in ART efficacy and adherence were observed between patients with and without CAM consumption. CONCLUSIONS Almost 50% of patients were taking at least one CAM product and its use was associated with an integrase inhibitor based ART. One out of every six patients was at risk of presenting with an interaction between a CAM and their ART, confirming the need to review continuously the use of CAM as part of the medication review process.
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Affiliation(s)
- Elena Colominas-González
- Pharmacy Department, Hospital del Mar, Barcelona, Spain
- Medicine Department, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Montserrat Masip
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Glòria Cardona
- Pharmacy Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Dolors Comas
- Pharmacy Department, Hospital Bellvitge Barcelona, Barcelona, Spain
| | | | - Belen López
- Pharmacy Department, Hospital Parc Tauli, Sabadell, Spain
| | | | | | - Hernando Knobel
- Infectious Diseases Department, Hospital del Mar, Barcelona, Spain
| | - Sonia Luque
- Pharmacy Department, Hospital del Mar, Barcelona, Spain
- Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
- CIBER of Infectious Diseases (CIBERINFEC CB21/13/0002), Institute of Health Carlos III, Madrid, Spain
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Mosavat SH, Pasalar M, Joulaei H, Ameli V, Heydari ST, Mirzazadeh A, Hashempur MH. Complementary and alternative medicine use among people living with HIV in Shiraz, Southern Iran. Front Public Health 2023; 11:1206665. [PMID: 37869188 PMCID: PMC10585019 DOI: 10.3389/fpubh.2023.1206665] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/05/2023] [Indexed: 10/24/2023] Open
Abstract
Background Living with HIV requires lifelong care to support engagement with and adherence to antiretroviral therapy. The Middle East and North Africa region provides access to ART, but research is lacking on the lived-experiences of people living with HIV. Globally, complementary and alternative medicine (CAM) is increasingly used by patients who need support alongside receiving medical treatment for chronic conditions. This study aims to examine the frequency and reasons behind the use of CAM, as well as identify its associated factors among people living with HIV in Shiraz, Iran. Methods In this cross-sectional study, a total of 320 patients (aged 18-70 years) with a confirmed diagnosis of HIV residing in Fars province and diagnosed between 1999 and 2019 were recruited randomly through their clinical record numbers from five HIV treatment centers. They were surveyed on their quality of life and CAM use via the Short-Form Health Survey questionnaire (SF-36) and a semi-structured survey of "CAM use." The data analysis for this study involved the use of Chi-squared test, independent t-test, and multiple logistic regression model. Results Of 287 patients, 89.22% reported using CAM in the previous year. CAM use was more prevalent among those with a family history of CAM use (94.3% vs. 81.8%, p = 0.023). Frequent reasons for using CAM were reported to be sexual dysfunction (32.4%), depression (28.3%), thirstiness (23.3%), and nausea (17.5%). Quality of life, as measured via the SF-36 questionnaire in all its 8 sub-domains, did not differ among those who used CAM versus those who did not (61.5 ± 27.6 vs. 58.1 ± 30.9, p = 0.626). Conclusion CAM was used among a majority of people living with HIV in Shiraz, Iran. People who used CAM appeared to experience a similar quality of life relative to those who did not use CAM. Future studies on the modalities of engagement with CAM can improve patient-physician shared decision-making and increase lifelong care options for people living with HIV.
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Affiliation(s)
- Seyed Hamdollah Mosavat
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Psychiatry and Behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vira Ameli
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Seyed Taghi Heydari
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Mohammad Hashem Hashempur
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Wan Yusuf, WN, Tang, SP, Mohd Ashari, and NS, Abd Aziz CB. Use of Honey in Immune Disorders and Human Immunodeficiency Virus. HONEY 2023:235-249. [DOI: 10.1002/9781119113324.ch18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Greenwald MK, Akcasu N, Baal P, Outlaw AY, Cohn JA, Lundahl LH. Cannabis and complementary/alternative self-treatment approaches for symptom management among African American persons living with HIV. AIDS Care 2023; 35:78-82. [PMID: 34743619 PMCID: PMC9076753 DOI: 10.1080/09540121.2021.1998311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 10/21/2021] [Indexed: 10/19/2022]
Abstract
Persons living with HIV (PLWH) experience symptoms from disease progression and side effects of antiretroviral treatment. This study examines in African American PLWH (N = 259) commonly-endorsed symptoms, types and self-rated efficacy of therapies for symptom alleviation. Analyses were stratified by gender (n = 178 males, n = 81 females) and cannabis use typology: non-users (n = 90), mostly recreational use (n = 46), mixed recreational/therapeutic use (n = 51), or mostly therapeutic use (n = 72). Females reported greater severity for pain, fatigue, depression, weight change and tingling in extremities, but there were no gender differences for ratings of poor sleep, anxiety, poor appetite, or headache. Both marijuana (used therapeutically by females more than males) and medication(s) were among the 3 top methods for managing pain, poor sleep, anxiety, and headache. Marijuana was most often used for poor appetite, and medications for depression. Perceived efficacy of self-treatment approaches was moderately good. Among African American PLWH, symptom severity was higher for females and for therapeutic users of cannabis. Marijuana and medicine were often used to self-treat symptoms, but many participants did nothing. These results highlight the need for careful evaluation and management of symptoms in this underserved population.
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Affiliation(s)
- Mark K. Greenwald
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
| | - Nora Akcasu
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
| | - Paige Baal
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
| | - Angulique Y. Outlaw
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI
| | - Jonathan A. Cohn
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI
| | - Leslie H. Lundahl
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
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Ahmed A, Tanveer M, Dujaili JA, Chuah LH, Hashmi FK, Awaisu A. Pharmacist-Involved Antiretroviral Stewardship Programs in People Living with HIV/AIDS: A Systematic Review. AIDS Patient Care STDS 2023; 37:31-52. [PMID: 36626156 DOI: 10.1089/apc.2022.0192] [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: 01/11/2023] Open
Abstract
People living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS; PLWHA) frequently encounter antiretroviral (ARV) therapy-related problems. Clinical pharmacists with specialized training in ARV stewardship play an important role in managing these problems. However, there is a paucity of evidence to clarify the impact of clinical pharmacists' interventions on managing ARV therapy-related problems in PLWHA. Therefore, we aim to systematically review the literature to determine the nature and impact of pharmacists' interventions on managing medication-related problems in PLWHA. The review protocol was registered on International Prospective Register of Systematic Reviews (PROSPERO; CRD42020173078). Relevant records were identified from six electronic bibliographic databases (PubMed, Embase, EBSCOhost, ProQuest, Scopus, and the Cochrane Central Register) from their inception until September 2022. We included all randomized and nonrandomized interventional studies that were published in English. After the abstract and full-text screening, data were extracted from the selected studies, and the quality of the studies was assessed. The electronic database search and citation tracking identified two thousand and three citations. The review included 21 of these studies, involving 2998 PLWHA, published between 2014 and 2022. Pharmacists' interventions, working alone or in a multi-disciplinary team, comprised ARV medication review, management of adverse drug reactions (ADRs), therapeutic drug monitoring, prevention of drug interactions, and provision of drug information to PLWHA or the health care team. The pharmacist-involved interventions significantly reduced incorrect/incomplete ARV regimens, drug interactions, incorrect dosages, duplicate therapy, polypharmacy, administration errors, missing medication, wrong formulation, ADRs, and prescribing errors. Most studies reported that physicians usually accept more than 90% of the pharmacists' recommendations. ARV medication-related problems remain highly prevalent in PLWHA. Pharmacist-led interventions and stewardship significantly reduce ARV therapy-related problems in PLWHA and are widely accepted by physicians. Dedicated pharmacists with specialized training and credentialing in infectious diseases or HIV/AIDS have a great potential to improve health outcomes in PLWHA.
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Affiliation(s)
- Ali Ahmed
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Malaysia
| | - Maria Tanveer
- Department of Pharmacy, Quaid I Azam University, Islamabad, Pakistan
| | - Juman Abdulelah Dujaili
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Malaysia.,Current affiliation: Swansea University Medical School, Singleton Campus, Swansea University, Wales, United Kingdom
| | - Lay Hong Chuah
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Malaysia
| | - Furqan Khurshid Hashmi
- University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, Pakistan
| | - Ahmed Awaisu
- Department of Clinical Pharmacy & Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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Terapias complementares para manejo de ansiedade em pessoas com HIV: revisão sistemática. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ar0002407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Ramirez Garcia MP, Leclerc-Loiselle J, Côté J, Brouillette MJ, Thomas R. The process of learning the autogenic training relaxation technique and its benefits on the wellness of people living with HIV. BMC Complement Med Ther 2022; 22:86. [PMID: 35331226 PMCID: PMC8953141 DOI: 10.1186/s12906-022-03557-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Various mind-body practices are used by people living with HIV to promote their general well-being. Among these is autogenic training (AT), a self-guided relaxation technique requiring regular practice for observable benefits. However, little has been written about the process of learning this technique, which is obviously a prerequisite to regular practice. This study therefore aims to describe the process by which people living with HIV learn AT. Methods The study is a descriptive qualitative study using semi-structured interviews and a thematic analysis with a mixed approach. Fourteen participants living with HIV completed sessions to learn autogenic training over a period of 3 months. Results The process of learning AT was approached through three themes: initiating the learning process, taking ownership of the technique, and observing its benefits on wellness. To initiate learning, participants had to express a need to take action on an aspect of their well-being and their openness to complementary approaches to care. Taking ownership of the technique was facilitated by guidance from the nurse researcher, the participants’ personal adaptations to overcome barriers to their practice, regular practice, and rapid observation of its benefits. Finally, the participants reported the observation of benefits on their wellness, including personal development, mainly in terms of the creative self, the essential self, and the coping self. This perception of the technique’s benefits was part of the learning process, as it contributed both to the participants’ ownership of the technique and to reinforcing their AT practice. Conclusions People living with HIV see learning AT as a progressive process, in which wellness is a major outcome and a contributing factor in developing a regular practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03557-6.
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Affiliation(s)
- Maria Pilar Ramirez Garcia
- Faculty of Nursing, Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Research Center of the Centre Hospitalier de l'Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Quebec Nursing Intervention Research Network (RRISIQ), Quebec, QC, Canada.
| | - Jérôme Leclerc-Loiselle
- Faculty of Nursing, Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada.,Quebec Nursing Intervention Research Network (RRISIQ), Quebec, QC, Canada
| | - Marie-Josée Brouillette
- Department of Psychiatry, McGill University, Montréal, QC, Canada.,AIDS and Infectious Disease Network (SIDA-MI), Quebec, Canada
| | - Réjean Thomas
- AIDS and Infectious Disease Network (SIDA-MI), Quebec, Canada.,Clinique médicale l'Actuel, Montréal, Québec, Canada
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Mazzitelli M, Sasset L, Trunfio M, di Meco E, Frater A, Leoni D, Cattelan A. Use of self-prescribed medications and complementary medicines in a cohort of women with HIV. AIDS 2022; 36:617-619. [PMID: 35197438 DOI: 10.1097/qad.0000000000003174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Azienda Ospedale Universita' di Padova, Padua
| | - Lolita Sasset
- Infectious and Tropical Diseases Unit, Azienda Ospedale Universita' di Padova, Padua
| | - Mattia Trunfio
- Unit of Infectious Diseases, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Eugenia di Meco
- Infectious and Tropical Diseases Unit, Azienda Ospedale Universita' di Padova, Padua
| | - Alessia Frater
- Infectious and Tropical Diseases Unit, Azienda Ospedale Universita' di Padova, Padua
| | - Davide Leoni
- Infectious and Tropical Diseases Unit, Azienda Ospedale Universita' di Padova, Padua
| | - Annamaria Cattelan
- Infectious and Tropical Diseases Unit, Azienda Ospedale Universita' di Padova, Padua
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Siritientong T, Thet D, Methaneethorn J, Leelakanok N. Pharmacokinetic Outcomes of the Interactions of Antiretroviral Agents with Food and Supplements: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:520. [PMID: 35276881 PMCID: PMC8840371 DOI: 10.3390/nu14030520] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 12/04/2022] Open
Abstract
Because pharmacokinetic changes in antiretroviral drugs (ARV), due to their concurrent administration with food or nutritional products, have become a clinical challenge, it is necessary to monitor the therapeutic efficacy of ARV in people living with the human immunodeficiency virus (PLWH). A systematic review and meta-analysis were conducted to clarify the pharmacokinetic outcomes of the interaction between supplements such as food, dietary supplements, and nutrients, and ARV. Twenty-four articles in both healthy subjects and PLWH were included in the qualitative analysis, of which five studies were included in the meta-analysis. Food−drug coadministration significantly increased the time to reach maximum concentration (tmax) (p < 0.00001) of ARV including abacavir, amprenavir, darunavir, emtricitabine, lamivudine, zidovudine, ritonavir, and tenofovir alafenamide. In addition, the increased maximum plasma concentration (Cmax) of ARV, such as darunavir, under fed conditions was observed. Area under the curve and terminal half-life were not significantly affected. Evaluating the pharmacokinetic aspects, it is vital to clinically investigate ARV and particular supplement interaction in PLWH. Educating patients about any potential interactions would be one of the effective recommendations during this HIV epidemic.
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Affiliation(s)
- Tippawan Siritientong
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
- Center of Excellence in Burn and Wound Care, Chulalongkorn University, Bangkok 10330, Thailand
| | - Daylia Thet
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Janthima Methaneethorn
- Pharmacokinetic Research Unit, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand;
- Center of Excellence for Environmental Health and Toxicology, Naresuan University, Phitsanulok 65000, Thailand
| | - Nattawut Leelakanok
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand;
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Youn I, Cheong MJ, Kim J, Kim SI, Kim HK, Kwon M, Seo J, Nam D, Leem J. Understanding the experiences and perception of people living with HIV on integrative traditional East Asian medicine management in Korea: an interview protocol for qualitative research. BMJ Open 2021; 11:e051880. [PMID: 34887276 PMCID: PMC8663099 DOI: 10.1136/bmjopen-2021-051880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 11/19/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Patients with HIV/AIDS have been able to experience the average life expectancy of the general population due to medical advancements. However, they face physical, emotional and social difficulties that worsen their quality of life. The pharmacological approach is often the first choice to address these issues, but it involves some limitations. Integrative traditional East Asian medicine (ITEAM) can compensate for the limitations of drugs and can be applied to treat physiological and psychiatric problems. In Korea, ITEAM interventions are easily accessible under the government insurance. However, the experiences, perceptions and barriers to the use of ITEAM in patients with HIV/AIDS are less studied. Therefore, we will interview them to explore their experiences and examine the strengths, limitations, barriers and improvements in the use of ITEAM. METHODS AND ANALYSIS This is a qualitative study using a phenomenological framework. We will conduct one-to-one interviews with 3-10 patients with HIV/AIDS who have been treated with ITEAM from March 2021 to January 2022. We will present semistructured open-ended questions and analyse them using experiential phenomenological research methods. The results will be reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies. ETHICS AND DISSEMINATION This research was approved by the Institutional Review Board of the National Medical Center (IRB number, NMC-2101-008). The results of this study will be disseminated through journal articles, newspapers and conference proceedings. TRIAL REGISTRATION NUMBER Clinical Research Information Service: KCT0005855; Pre-results.
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Affiliation(s)
- Inae Youn
- Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Acupuncture & Moxibustion, National Medical Center, Seoul, Republic of Korea
| | - Moon Joo Cheong
- Rare Disease Integrated Treatment Research Center, Wankwang University Jangheung Integrative Medical Hospital, Jangheung, Jeollanam-do, Republic of Korea
| | - Jinwon Kim
- Department of Internal Korean Medicine, National Medical Center, Seoul, Republic of Korea
| | - Soo Im Kim
- Department of Counseling, Dankook University, Yongin, Gyeonggi-do, Republic of Korea
| | - Hye Kyung Kim
- Psychological Counseling Office, LG Electronics Gasan Research and Development Campus, Geumcheon-gu, Seoul, Republic of Korea
| | - Miri Kwon
- Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Joohee Seo
- Department of Korean Neuropsychiatry, National Medical Center, Seoul, Republic of Korea
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jungtae Leem
- Research Center of Traditional Korean Medicine, Wonkwang University, Iksan, Jeollabuk-do, Republic of Korea
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13
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Zhang XL, Chen MH, Geng ST, Yu J, Kuang YQ, Luo HY, Wang KH. Effects of Probiotics on Diarrhea and CD4 Cell Count in People Living With HIV: A Systematic Review and Meta-Analysis. Front Pharmacol 2021; 12:570520. [PMID: 34349637 PMCID: PMC8326399 DOI: 10.3389/fphar.2021.570520] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/25/2021] [Indexed: 11/25/2022] Open
Abstract
Gastrointestinal probiotics play an important role in maintaining intestinal bacteria homeostasis. They might benefit people with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), which remains a global health challenge. However, there is a controversy regarding the efficacy of probiotics for the treatment of AIDS. This study systematically reviewed the evidence of the effects of existing probiotic interventions on AIDS and sought to provide information on the role of probiotics in the treatment of HIV/AIDS patients. A meta-analysis of studies identified by screening multiple databases was performed using a fixed-effects model in Review Manager 5.2 software. The meta-analysis showed that probiotics could reduce the incidence of AIDS-related diarrhea (RR = 0.60 (95% CI: 0.44–0.82), p = 0.001). The short-term use of probiotics (supplementation duration shorter than 30 days) did not reduce the incidence of diarrhea (RR = 0.76 (95% CI: 0.51–1.14), p = 0.19), while the long-term use of probiotics (supplementation duration longer than 30 days) reduced diarrhea (RR = 0.47 (95% CI: 0.29–0.76), p = 0.002). Probiotics had no effect on CD4 cell counts in HIV/AIDS patients (MD = 21.24 (95% CI: −12.95–55.39), p = 0.22). Our data support that probiotics were associated with an obvious reduction in AIDS-related diarrhea, which indicates the need for additional research on this potential preventive strategy for AIDS.
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Affiliation(s)
- Xiao-Li Zhang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China.,Scientific Research Laboratory Center, First Affiliated Hospital of Kunming Medical University, Kunming, China.,Yunnan Institute of Digestive Disease, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ming-Hui Chen
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China.,Scientific Research Laboratory Center, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shi-Tao Geng
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China.,Scientific Research Laboratory Center, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Juehua Yu
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China.,Scientific Research Laboratory Center, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yi-Qun Kuang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China.,Scientific Research Laboratory Center, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua-You Luo
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China.,Scientific Research Laboratory Center, First Affiliated Hospital of Kunming Medical University, Kunming, China.,Yunnan Institute of Digestive Disease, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kun-Hua Wang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China.,Scientific Research Laboratory Center, First Affiliated Hospital of Kunming Medical University, Kunming, China.,Yunnan Institute of Digestive Disease, First Affiliated Hospital of Kunming Medical University, Kunming, China
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14
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Greenwald MK, Sarvepalli SS, Cohn JA, Lundahl LH. Demand curve analysis of marijuana use among persons living with HIV. Drug Alcohol Depend 2021; 220:108524. [PMID: 33453502 PMCID: PMC7889735 DOI: 10.1016/j.drugalcdep.2021.108524] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/23/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Despite medicalization and legalization of marijuana use, factors influencing demand for marijuana among persons living with HIV (PLWH) are incompletely understood. This knowledge gap undermines effective clinical management and policies. This study used demand curve simulation methods to address these issues. METHODS Marijuana-using PLWH (N = 119) completed experimental tasks to simulate amount of marijuana purchasing/use across different costs (money or time), and likelihood of reselling marijuana or marijuana therapeutic-use registration card in relation to profits. Additional simulations assessed purchasing of marijuana relative to other drug and non-drug goods. RESULTS Simulated marijuana use decreased as money and time costs increased. Consumption was greater for participants with more severe Cannabis Use Disorder (CUD) and anxiety, intermediate pain levels, and past 90-day opioid use. Whereas few participants chose to sell their registration card, marijuana resale (diversion) steeply increased with profit. Likelihood of seeking marijuana therapeutic-use certification decreased in relation to registration card money cost, having to visit more physicians to get a signature, and delay to receiving the card, and increased with duration of certification. Participants who reported recent opioid use were more likely to seek certification. Consumption of several commodities assessed was independent of marijuana. CONCLUSIONS Simulated marijuana use was related to participants' clinical profile (CUD, anxiety and pain symptoms, recent opioid use), and unrelated to purchasing other goods. Likelihood of seeking marijuana therapeutic-use registration was affected by several types of costs and recent opioid use. Participants were unlikely to divert registration cards. We discuss clinical and policy implications of these findings.
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Affiliation(s)
- Mark K Greenwald
- Department of Psychiatry and Behavioral Neurosciences, USA; School of Medicine, Department of Internal Medicine Wayne State University, Detroit, MI 48201, USA.
| | - Siri S Sarvepalli
- School of Medicine, Department of Internal Medicine Wayne State University, Detroit, MI 48201, USA
| | - Jonathan A Cohn
- School of Medicine, Department of Internal Medicine Wayne State University, Detroit, MI 48201, USA; Department of Internal Medicine Wayne State University, Detroit, MI 48201, USA
| | - Leslie H Lundahl
- Department of Psychiatry and Behavioral Neurosciences, USA; School of Medicine, Department of Internal Medicine Wayne State University, Detroit, MI 48201, USA
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15
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Haron MH, Avula PhD B, Gurley PhD BJ, Chittiboyina PhD AG, Khan PhD IA, Khan PhD SI. Possible Herb-Drug Interaction Risk of Some Nutritional and Beauty Supplements on Antiretroviral Therapy in HIV Patients. J Diet Suppl 2020; 19:62-77. [PMID: 33200619 DOI: 10.1080/19390211.2020.1846658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study was carried out to assess the drug interaction potential of a variety of beauty and sports/nutritional supplements when co-administered with antiviral drug therapy, especially anti-HIV drugs. Ethanolic extracts of seven dietary supplements (two beauty products, three nutritional protein supplement products and two weight loss/body building products) were examined in human liver cells (HepG2 cells and primary hepatocytes) for their influence on the hepatic metabolism of five antiviral drugs (elvitegravir, rilpivirine, tenofovir, dolutegravir, and cobicistat), all of which are substrates for a key drug metabolizing enzyme CYP3A4. Our results showed that six of the seven supplements caused a 1.5 - 2 fold induction in PXR transcriptional activity in HepG2 cells. PXR regulates the expression of key drug metabolizing enzymes including CYP3A4. Follow up studies indicated a 1.5 - 3 fold induction in CYP3A4 enzyme activity in HepG2 cells treated with these supplements. We further investigated the effects of the supplement on the metabolism of above mentioned anti-viral drugs in HepG2 cells and primary hepatocytes. Of the five drugs, rilpivirine and dolutegravir metabolism was increased by up to 2-folds over the no supplement control by some of the supplements. Our findings indicate that concomitant consumption of these products with anti-HIV drugs may compromise the efficacy of antivirals therapy due to supplement-induced metabolism via induction of CYP3A4 activity.
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Affiliation(s)
- Mona H Haron
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Bharathi Avula PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Bill J Gurley PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Amar G Chittiboyina PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Ikhlas A Khan PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.,Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Shabana I Khan PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.,Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, University, MS, USA
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16
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Jiang T, Hou J, Sun R, Dai L, Wang W, Wu H, Zhang T, Su B. Immunological and Psychological Efficacy of Meditation/Yoga Intervention Among People Living With HIV (PLWH): A Systematic Review and Meta-analyses of 19 Randomized Controlled Trials. Ann Behav Med 2020; 55:505-519. [PMID: 33119732 DOI: 10.1093/abm/kaaa084] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An expanding number of mind-body therapies are being used to reduce the psychological burden of peoples living with human immunodeficiency virus (HIV). However, the effects on the immune system and mental health varied among studies. PURPOSE This meta-analysis was conducted to summarize the randomized controlled trials to draw comprehensive conclusions regarding the psycho-immunological efficacy. METHODS Random-effects models were used to assess the outcome of interest. Egger's tests were used to identify publication bias. Subgroup and meta-regression were used to explore potential moderators. This review was registered on the PROSPERO database (CRD42019148118). RESULTS Nineteen randomized controlled trials with a total sample size of 1,300 were included in this meta-analysis. Regarding immune system outcome, mind-body therapy significantly improved CD4 T-cell counts (Cohen's d = 0.214, p = .027) and maintained (0.427, p = .049). In addition, baseline CD4 T-cell counts and years since HIV diagnosis significantly moderated the efficacy of mind-body practices on CD4 improvement (all ps < .001). Regarding mental health outcome, mind-body therapy significantly reduced stress, depression, and anxiety symptoms (0.422, p < .001; 0.506, p < .001, and 0.709, p < .001, respectively) while improving quality of life (0.67, p < .001). CONCLUSIONS Meditation/yoga intervention could result in potential benefits with regard to improved CD4 T-cell counts immediately after the intervention and at long-term follow-up, while also improving their mental health. The cost-effective meditation/yoga intervention should be integrated into routine care for people living with HIV, especially for those with lower CD4 baseline and fewer years since diagnosis.
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Affiliation(s)
- Taiyi Jiang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Jianhua Hou
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Runsong Sun
- Department of Sociology and Social Work, School of Sociology, Beijing Normal University, Beijing, China
| | - Lili Dai
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wen Wang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
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17
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Positively Mindful: A Mixed Method Feasibility Study of Mindfulness Meditation for People Living with HIV in the UK. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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18
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Bordes C, Leguelinel-Blache G, Lavigne JP, Mauboussin JM, Laureillard D, Faure H, Rouanet I, Sotto A, Loubet P. Interactions between antiretroviral therapy and complementary and alternative medicine: a narrative review. Clin Microbiol Infect 2020; 26:1161-1170. [PMID: 32360208 DOI: 10.1016/j.cmi.2020.04.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/16/2020] [Accepted: 04/19/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND The use of complementary and alternative medicine including herbal medicine (phytotherapy), vitamins, minerals and food supplements is frequent among people living with HIV/AIDS (PLWHAs) who take antiretroviral (ARV) drugs, but is often not known by their prescribing physicians. Some drug-supplement combinations may result in clinically meaningful interactions. AIMS In this literature review, we aimed to investigate the evidence for complementary and alternative medicine interactions with ARVs. SOURCES A bibliographic search of all in vitro, human studies and case reports of the PubMed database was performed to assess the risk of interactions between complementary and alternative self-medication products and ARVs. The 'HIV drug interaction' (https://www.hiv-druginteractions.org) and 'Natural medicines comprehensive database' (https://naturalmedicines.therapeuticresearch.com) interaction checkers were also analysed. CONTENT St John's wort, some forms of garlic, grapefruit and red rice yeast are known to have significant interaction and thus should not be co-administered, or should be used with caution with certain ARV classes. Data on other plant-based supplements come from in vitro studies or very small size in vivo studies and are thus insufficient to conclude the real in vivo impact in case of concomitant administration with ARVs. Some polyvalent minerals such as calcium, magnesium, and iron salts can reduce the absorption of integrase inhibitors by chelation. Potential interactions with vitamin C and quercetin with some ARVs should be noted and efficacy and tolerance of the treatment should be monitored. IMPLICATIONS This review shows the importance of screening all PLWHAs for complementary and alternative medicine use to prevent treatment failure or adverse effects related to an interaction with ARVs. Further human studies are warranted to describe the clinical significance of in vitro interactions between numerous complementary and alternative medicine and ARVs.
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Affiliation(s)
- C Bordes
- Pharmacy Department, University of Montpellier, CHU Nimes, France
| | - G Leguelinel-Blache
- Pharmacy Department, University of Montpellier, CHU Nimes, France; UPRES EA2415, Laboratory of Biostatistics, Epidemiology, Clinical Research and Health Economics, Clinical Research University Institute, University of Montpellier, Montpellier, France
| | - J-P Lavigne
- VBMI, INSERM U1047, University of Montpellier, Department of Microbiology and Hospital Hygiene, CHU Nîmes, Nîmes, France
| | - J-M Mauboussin
- Department of Infectious and Tropical Diseases, CHU Nîmes, Nîmes, France
| | - D Laureillard
- Department of Infectious and Tropical Diseases, CHU Nîmes, Nîmes, France; Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français Du Sang, University of Montpellier, Montpellier, France
| | - H Faure
- Pharmacy Department, CH de Royan, Royan, France
| | - I Rouanet
- Department of Infectious and Tropical Diseases, CHU Nîmes, Nîmes, France
| | - A Sotto
- VBMI, INSERM U1047, University of Montpellier, Department of Infectious and Tropical Diseases, CHU Nîmes, Nîmes, France
| | - P Loubet
- VBMI, INSERM U1047, University of Montpellier, Department of Infectious and Tropical Diseases, CHU Nîmes, Nîmes, France.
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19
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Porter KE, Brennan-Ing M, Burr JA, Dugan E, Karpiak SE. HIV Stigma and Older Men's Psychological Well-Being: Do Coping Resources Differ for Gay/Bisexual and Straight Men? J Gerontol B Psychol Sci Soc Sci 2020; 74:685-693. [PMID: 28977625 DOI: 10.1093/geronb/gbx101] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 07/05/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study investigated whether sexual orientation moderated the mediation effects of coping resources (i.e., spirituality and complementary and integrative health [CIH] use) in the relationship between HIV stigma and psychological well-being (PWB) among older men with HIV (MWH). METHOD Data from the Research of Older Adults with HIV (ROAH) study was used (N = 640, Age 50+). Structural equation modeling (SEM) was employed to examine a coping resource mediation model. We used a multiple-group procedure to test moderation effects by sexual orientation. RESULTS HIV stigma was negatively associated with spirituality and PWB. HIV stigma accounted for a significant amount of variance in PWB, with significant indirect effects via spirituality, indicating a partial mediation. Chi-square difference tests supported the hypothesis that this mediation effect was moderated by sexual orientation. CIH use was not statistically significant. DISCUSSION HIV stigma's negative relationship with PWB was salient in both groups. Spirituality's buffer between HIV stigma and PWB was stronger in older gay/bisexual MWH compared to their heterosexual counterparts. With respect to HIV stigma, older gay/bisexual MWH exhibited a "crisis competence" in coping with stigma, perhaps through overcoming past homophobia related to their sexual minority status (i.e., homophobia).
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Affiliation(s)
| | - Mark Brennan-Ing
- Center on HIV & Aging, ACRIA, New York.,New York University Rory Meyers College of Nursing
| | - Jeffrey A Burr
- Department of Gerontology, University of Massachusetts, Boston
| | - Elizabeth Dugan
- Department of Gerontology, University of Massachusetts, Boston
| | - Stephen E Karpiak
- Center on HIV & Aging, ACRIA, New York.,New York University Rory Meyers College of Nursing
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20
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Quigley A, Brouillette MJ, Gahagan J, O’Brien KK, MacKay-Lyons M. Feasibility and Impact of a Yoga Intervention on Cognition, Physical Function, Physical Activity, and Affective Outcomes among People Living with HIV: A Randomized Controlled Pilot Trial. J Int Assoc Provid AIDS Care 2020; 19:2325958220935698. [PMID: 32583707 PMCID: PMC7318828 DOI: 10.1177/2325958220935698] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 04/07/2020] [Accepted: 05/26/2020] [Indexed: 12/30/2022] Open
Abstract
The purpose of this pilot randomized controlled trial is to assess the feasibility and impact of a triweekly 12-week yoga intervention among people living with HIV (PLWH). Additional objectives included evaluating cognition, physical function, medication adherence, health-related quality of life (HRQoL), and mental health among yoga participants versus controls using blinded assessors. We recruited 22 medically stable PLWH aged ≥35 years. A priori feasibility criteria were ≥70% yoga session attendance and ≥70% of participants satisfied with the intervention using a postparticipation questionnaire. Two participants withdrew from the yoga group. Mean yoga class attendance was 82%, with 100% satisfaction. Intention-to-treat analyses (yoga n = 11, control n = 11) showed no within- or between-group differences in cognitive and physical function. The yoga group improved over time in HRQoL cognition (P = .047) with trends toward improvements in HRQoL health transition (P =.063) and depression (P = .055). This pilot study provides preliminary evidence of feasibility and benefits of yoga for PLWH.
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Affiliation(s)
- Adria Quigley
- Department of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Jacqueline Gahagan
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kelly Kathleen O’Brien
- Department of Physiotherapy, University of Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Marilyn MacKay-Lyons
- Department of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Canada
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21
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Mey A, Plummer D, Rogers GD, O’Sullivan M, Domberelli A, Anoopkumar-Dukie S. Yes to Recreational Drugs and Complementary Medicines But No to Life-Saving Medications: Beliefs Underpinning Treatment Decisions Among PLHIV. AIDS Behav 2019; 23:3396-3410. [PMID: 31388852 DOI: 10.1007/s10461-019-02623-4] [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: 10/26/2022]
Abstract
Despite the life-preserving benefits of antiretroviral therapy (ART), some people living with HIV (PLHIV) delay, decline or diverge from recommended treatment while paradoxically being willing to use potentially dangerous substances, such as recreational drugs (RD) and complementary medicines (CM). During 2016 and 2017, interviews were conducted with 40 PLHIV, in Australia to understand drivers underpinning treatment decisions. While many believed ART to be effective, they expressed concerns about long-term effects, frustration over perceived lack of autonomy in treatment decisions and financial, emotional and physical burdens of HIV care. In contrast, they ascribed a sense of self-control over the use of RD and CM, along with multiple professed benefits. The perceived burden of ART emerged as a motivator for deviating from recommended treatment, while positive views towards RD and CM appear to justify use. This study may serve as guidance for the development of future strategies to address barriers to treatment uptake and adherence and subsequently health outcomes for PLHIV in Australia and elsewhere.
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22
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James PB, Wardle J, Steel A, Adams J. Pattern of health care utilization and traditional and complementary medicine use among Ebola survivors in Sierra Leone. PLoS One 2019; 14:e0223068. [PMID: 31560708 PMCID: PMC6764668 DOI: 10.1371/journal.pone.0223068] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 09/12/2019] [Indexed: 12/13/2022] Open
Abstract
Background It is well established that Ebola Survivors experience a myriad of physical and psychological sequelae. However, little is known about how they seek care to address their health needs. Our study determines the current healthcare seeking behaviour among Ebola survivors and determines the prevalence, pattern of use and correlates of traditional and complementary medicine (T&CM) use among Ebola survivors in Sierra Leone. Methods We conducted a nationwide questionnaire survey among a cross-sectional sample of Ebola Survivors in Sierra Leone between January and August 2018. We employed descriptive statistics, chi-square test, Fisher exact two-tailed test and backward stepwise binary regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant. Results Ebola Survivors who participated in our study (n = 358), visited a healthcare provider (n = 308, 86.0%), self-medicated with conventional medicines (n = 255, 71.2%) and visited a private pharmacy outlet (n = 141, 39.4%). Survivors also self-medicated with T&CM products (n = 107, 29.9%), concurrently self-medicated with conventional and T&CM products (n = 62, 17.3%), and visited a T&CM practitioner (n = 41, 11.5%). Almost half of (n = 163, 45.5%) Ebola survivors reported using T&CM treatments for post ebola related symptoms and non-Ebola related symptoms since their discharge from an Ebola treatment centre. Ebola survivors who considered their health to be fair or poor (AOR = 4.08; 95%CI: 2.22–7.50; p<0.01), presented with arthralgia (AOR = 2.52; 95%CI: 1.11–5.69, p = 0.026) and were discharged three years or less (AOR = 3.14; 95%CI: 1.13–8.73, p = 0.028) were more likely to use T&CM. Family (n = 101,62.0%) and friends (n = 38,23.3%) were the common sources of T&CM information. Abdominal pain (n = 49, 30.1%) followed by joint pain (n = 46, 28.2%) and back pain (n = 43, 26.4%) were the most cited post–Ebola indications for T&CM use. More than three-quarters of T&CM users (n = 135, 82.8%) failed to disclose their use of T&CM to their healthcare providers. Conclusion Ebola survivors in Sierra Leone employ a myriad of healthcare options including T&CM in addressing their healthcare needs. Researchers, health policy makers and healthcare providers should be aware of the substantial role of T&CM in the health seeking of survivors, and this topic that should be factored into future research, policy formulation and implementation as well as routine practice regarding Ebola survivors.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre inw Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Sydney, Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- * E-mail:
| | - Jon Wardle
- Australian Research Centre inw Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Sydney, Australia
| | - Amie Steel
- Australian Research Centre inw Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Sydney, Australia
| | - Jon Adams
- Australian Research Centre inw Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Sydney, Australia
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23
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Marks C, Zúñiga ML. CAM Practices and Treatment Adherence Among Key Subpopulations of HIV+ Latinos Receiving Care in the San Diego-Tijuana Border Region: A Latent Class Analysis. Front Public Health 2019; 7:179. [PMID: 31316963 PMCID: PMC6610997 DOI: 10.3389/fpubh.2019.00179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 06/13/2019] [Indexed: 11/13/2022] Open
Abstract
Latinos living in the United States-Mexico border region bear a disproportionate HIV/AIDS burden compared to individuals living in the interior of both nations and face a constellation of barriers that determine their ability to access and adhere to HIV care. Use of complementary and alternative medicine (CAM) may be associated with suboptimal treatment adherence. Sociodemographic factors, health practices, and social determinants of health unique to the border region may further contribute to health disparities that undermine care engagement and continuity. Improved understanding of HIV-positive Latino subgroups and their risk profiles can lead to more effective, targeted clinical and public health interventions. We undertook this study to identify and characterize distinct classes of HIV-positive Latinos in the San Diego-Tijuana border region, differentiated by HIV and border-related factors, utilizing latent class analysis. We investigated relationships between class membership and CAM utilization and self-reported antiretroviral therapy (ART) adherence. Five distinct classes were identified with unique demographic, HIV risk, and border mobility profiles. CAM was recently used by nearly half of each class, though there were significant differences in the proportion of CAM use by class ranging from 44.4 to 90.9%. As well, all classes were currently receiving ART at similarly high rates and ART adherence outcomes were not significantly different based on class. Findings highlight the significant use of CAM by all HIV-positive Latinos in the border region and imply the need for a research framework which appropriately acknowledges the heterogeneous nature of this population, such as intersectionality. Further research is recommended into understanding how patients integrate CAM into HIV treatment and the risks and benefits of incorporating CAM into HIV treatment.
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Affiliation(s)
- Charles Marks
- School of Social Work, San Diego State University, San Diego, CA, United States
- SDSU-UCSD Joint Doctoral Program in Interdisciplinary Research on Substance Use, San Diego, CA, United States
| | - María Luisa Zúñiga
- School of Social Work, San Diego State University, San Diego, CA, United States
- SDSU-UCSD Joint Doctoral Program in Interdisciplinary Research on Substance Use, San Diego, CA, United States
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24
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Ramirez-Garcia MP, Gagnon MP, Colson S, Côté J, Flores-Aranda J, Dupont M. Mind-body practices for people living with HIV: a systematic scoping review. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:125. [PMID: 31185970 PMCID: PMC6560810 DOI: 10.1186/s12906-019-2502-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/15/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Mind-body practices are frequently used by people living with HIV to reduce symptoms and improve wellbeing. These include Tai Chi, Qigong, yoga, meditation, and all types of relaxation. Although there is substantial research on the efficacy of mind-body practices in people living with HIV, there is no summary of the available evidence on these practices. The aim of this scoping review is to map available evidence of mind-body practices in people living with HIV. METHODS The Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005) methodological framework was used. A search of 16 peer-review and grey literature databases, websites, and relevant journals (1983-2015) was conducted. To identify relevant studies, two reviewers independently applied the inclusion criteria to all abstracts or full articles. Inclusion criteria were: participants were people living with HIV; the intervention was any mind-body practice; and the study design was any research study evaluating one or several of these practices. Data extraction and risk of bias assessment were performed by one reviewer and checked by a second, as needed, using the criteria that Cochrane Collaboration recommends for systematic reviews of interventions (Higgins and Green, Cochrane handbook for systematic reviews of intervention. 2011). A tabular and narrative synthesis was carried out for each mind-body practice. RESULTS One hundred thirty-six documents drawing on 84 studies met the inclusion criteria. The most widely studied mind-body practice was a combination of least three relaxation techniques (n = 20), followed in declining order by meditation (n = 17), progressive muscle relaxation (n = 10), yoga (n = 9) and hypnosis (n = 8). Slightly over half (47/84) of studies used a RCT design. The interventions were mainly (46/84) conducted in groups and most (51/84) included daily individual home practice. All but two studies were unblinded to participants. CONCLUSION The amount of available research on mind-body practices varies by practice. Almost half of the studies in this review were at high risk of bias. However, mindfulness, a combination of least three relaxation techniques and cognitive behavioral strategies, and yoga show encouraging results in decreasing physical and psychological symptoms and improving quality of life and health in people living with HIV. More rigorous studies are necessary to confirm the results of Tai Chi, Qigong, and some relaxation techniques.
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Affiliation(s)
- Maria Pilar Ramirez-Garcia
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Marie-Pier Gagnon
- Faculty of Nursing, Université Laval, Québec, Canada
- Research Center of the Centre Hospitalier Universitaire, Québec, Canada
| | - Sébastien Colson
- Faculty of Medicine, Aix Marseille Université, Marseille, France
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Jorge Flores-Aranda
- University Institute on Addiction, Montreal-Island-South-Center Integrated University Health and Social Services Centre, Montréal, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada
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Arego J, Ondenge K, Odero I, Awuonda E, Omoro T, Akelo V, Mudhune V, Gust DA. Medical pluralism and rationalities for HIV care utilization among discordant couples in Siaya County, rural western Kenya. Int J STD AIDS 2019; 30:868-874. [PMID: 31159708 DOI: 10.1177/0956462419843691] [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: 11/17/2022]
Abstract
Understanding healthcare seeking and utilization of members of discordant couples can help in implementing effective HIV treatment, care, and support. We conducted a qualitative study comprised of in-depth interviews (n = 26) and ten focus group discussions (n = 73) with community members including opinion leaders, healthcare workers, and members of discordant couples. A portion of the latter group had been participants in the HIV Prevention Trials Network (HPTN) 052 study. Themes that emerged from the data were pragmatism and the realities of hospital care, quest for a cure through traditional medicine, and religious dogma. Medical pluralism is practiced by members of discordant couples seeking HIV care through intersections of hospital facility services and traditional and religious therapeutic options. It would be prudent for healthcare policy makers and conventional medical providers to recognize the importance of traditional medicine and religion in the lives of members of HIV discordant couples and make efforts to integrate the positive concepts of both into the couples’ overall health plan.
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Affiliation(s)
- Judy Arego
- 1 Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Ken Ondenge
- 1 Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Isdorah Odero
- 1 Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Eucabeth Awuonda
- 1 Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Tereza Omoro
- 1 Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Victor Akelo
- 2 Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
| | - Victor Mudhune
- 1 Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Deborah A Gust
- 2 Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA
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Cattaneo D, Ridolfo A, Baldelli S, Gervasoni C. Effects of guggulsterones-containing thermogenic complex on elvitegravir plasma concentrations: a case report. Eur J Clin Pharmacol 2019; 75:1177-1178. [DOI: 10.1007/s00228-019-02677-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 04/01/2019] [Indexed: 12/14/2022]
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Assessing the literature of knowledge management (KM) in the field of library and information science. INFORMATION DISCOVERY AND DELIVERY 2019. [DOI: 10.1108/idd-06-2018-0021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to provide a bibliometric analysis of knowledge management (KM) literature published in the field of library and information science. KM is a systematic process of acquisition, extraction, organization and dissemination of knowledge in any organization. This study will help identify trends, emerging concepts and innovations in this particular field.
Design/methodology/approach
The data set of the study consists of 6,088 published documents the authors obtained from the ISI Web of Science database during 1900 and 2017. The analysis of literature about the library and information science consisted of five categories including productive institutions, prolific authors, annual publications, citations and highly cited articles. The documents included in this study include research papers, conference papers, reviews, book reviews and editorials.
Findings
The study found that the USA leads the world regarding the number of research publications in the area of KM in the field of library and information science. Considering the publication period, 2007, 2012 and 2016-2017 are the most productive years regarding publications in this particular field; the number of citations has been increasing over the years. The study also found that Nanyang Polytechnic University is the most productive research institution and Blanca Martins from the Polytechnic University of Catalonia is the most prolific researcher in this specific field.
Originality/value
This study provides a detailed bibliometric analysis of KM literature published in the field of library and information science. This study is an excellent example for researchers who are interested in conducting bibliometric studies.
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Mannes ZL, Ferguson EG, Burrell LE, Cook RL, Ennis N. Brief report: the association between recreational versus therapeutic marijuana use on hazardous alcohol consumption and alcohol-associated behavioral consequences among adults living with HIV in Florida. Harm Reduct J 2018; 15:61. [PMID: 30526597 PMCID: PMC6286547 DOI: 10.1186/s12954-018-0266-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/12/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Though marijuana use has previously been associated with risky alcohol use, studies often do not delineate between the effect of recreational versus therapeutic marijuana use, particularly among people living with HIV (PLWH). In this study, we examined the association between recreational versus therapeutic marijuana use to manage HIV symptoms (i.e., improve appetite/gain weight, induce sleep, relieve nausea/vomiting, relieve pain, relieve anxiety/depression/stress) on hazardous alcohol consumption and associated behavioral consequences among PLWH. METHODS PLWH (N = 703) recruited from community health centers in Florida completed questionnaires assessing sociodemographics, marijuana use motives (i.e., recreational versus therapeutic), alcohol use, and alcohol-associated behavioral consequences. Hazardous alcohol use was defined as consuming 5 or more drinks on one occasion at least monthly or > 14 drinks per week for men, or 4 drinks on one occasion at least monthly or > 7 drinks per week for women over the past 12 months, while alcohol-associated behavioral consequences were assessed via the Short Inventory of Problems Revised (SIP-R). A one-way analysis of covariance (ANCOVA) assessed differences in average number of alcohol-associated behavioral consequences between recreational and therapeutic marijuana users, and non-users, while multivariate logistic regression analysis evaluated the association between reason for marijuana use and hazardous alcohol consumption. RESULTS There was a significant effect of marijuana use group on SIP-R score after controlling for covariates [F (2, 579) = 3.04, p = 0.048], with post hoc analysis demonstrated significantly fewer alcohol-associated behavioral consequences among therapeutic marijuana users (1.27) compared to recreational users (3.35; p = 0.042). Compared to non-users, therapeutic marijuana users demonstrated significantly lower odds of hazardous drinking (AOR = 0.42, 95% CI = 0.18-0.96, p = 0.041), while recreational marijuana users were 64% more likely to report hazardous drinking (AOR = 1.64, 95% CI = 1.08-2.50, p = 0.019). CONCLUSIONS Findings from this study add to the literature by demonstrating how differing marijuana use motives are associated with hazardous alcohol consumption among PLWH. Given our findings showing greater risk of hazardous alcohol consumption among recreational marijuana users and lower risk among therapeutic marijuana users, results from this study may help inform interventions to reduce harmful alcohol consumption and associated adverse consequences among PLWH.
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Affiliation(s)
- Zachary L Mannes
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146, Gainesville, FL, 32610-0165, USA
| | - Erin G Ferguson
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146, Gainesville, FL, 32610-0165, USA
| | - Larry E Burrell
- Psychology Service, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA, 94121, USA
| | - Robert L Cook
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Nicole Ennis
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146, Gainesville, FL, 32610-0165, USA.
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Ahmad K, Jian Ming Z, Rafi M. Assessing the digital library research output: bibliometric analysis from 2002 to 2016. ELECTRONIC LIBRARY 2018. [DOI: 10.1108/el-02-2017-0036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this bibliometric analysis is to quantify the prominence and impact of published literature within the field. The research has been conducted with the intent of obtaining the expansion and characteristics of the literature on digital library.
Design/methodology/approach
More than 4,206 documents found in the period of 2002-2016 were collected from the ISI Web of Science and were analyzed to explore the annual productivity, yearly citation, most cited articles, prolific authors, eminent journals of the subject, productivity of institutes and contribution of countries. These results are based on the types of documents (articles, reviews, proceedings papers, book reviews, editorial materials and book chapters).
Findings
The core findings are that the most productive year of publication was 2016, and the growth of citation increased rapidly; the top source of title is electronic library. The result shows that the USA dominates in the research output, with Illinois University securing the first position; the most prolific author is Fourie I from South Africa. In the document types category, the most cited sources are research articles.
Originality/value
This research is useful for the researchers interested in the field of bibliometrics as it postulates an inclusive indication of provenance in the field of library and information science.
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Injeyan HS, Connell G, Foster K, Kopansky-Giles D, Sovak G, Tibbles T. The prevalence and characteristics of HIV/AIDS patients presenting at a chiropractic outpatient clinic in Toronto, Ontario. A retrospective, observational study. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2018; 62:77-84. [PMID: 30305763 PMCID: PMC6173221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine the prevalence and presenting complaints of HIV/AIDS patients attending a chiropractic outpatient teaching clinic in downtown Toronto, and explore their self-reported comorbidities, medications used, and consumption of other complementary health care. METHODS A random sample was drawn from the entire clinic file collection spanning the years 2007 to 2013. Files were anonymized and coded to ensure confidentiality. RESULTS A total of 264 files were radomly pulled from approxinately 3750 clinic files. The prevalence of HIV positive patients was 5.7% (15/264), predominantly males, with 3 patients having developed AIDS. Co-infection with Hepatitis B and/or C was identified in 5/15 patients. The most common presenting complaint was neck pain (80%), followed by low back pain (47%) compared to 20% and 43% respectively for the general cohort. Eleven of 15 patients were on antiretroviral treatment (ART); The frequency of comorbidities was 8/15 (53%) however, none were identified as being dominant. In addition to chiropractic, 7/15 patients reported receiving other complementary therapies. CONCLUSIONS A relatively small proportion of HIV/ AIDS patients were found to be receiving treatments in this downtown chiropractic clinic situated within a community health clinic setting. The principal presenting complaint was neck pain.
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Affiliation(s)
| | | | | | - Deborah Kopansky-Giles
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
- St. Michael's Hospital, Department of Family and Community Medicine, Toronto, ON, Canada
| | - Guy Sovak
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tony Tibbles
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
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Halpin SN, Carruth EC, Rai RP, Edelman EJ, Fiellin DA, Gibert C, Gordon KS, Huang W, Justice A, Marconi VC, Rimland D, Perkins MM. Complementary and Alternative Medicine Among Persons living with HIV in the Era of Combined Antiretroviral Treatment. AIDS Behav 2018; 22:848-852. [PMID: 28733920 DOI: 10.1007/s10461-017-1866-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Complementary and alternative medicine (CAM), often pursued independent of prescribing clinicians, may interact with traditional treatments, yet CAM use has not been well characterized among people living with HIV (PLWH) in the combined antiretroviral therapy (ART) era. We analyzed data from the Veterans Aging Cohort Study (October 2012-April 2015) to characterize CAM use in PLWH on ART. CAM users were more likely to have lived longer with HIV, report more bothersome symptoms, be prescribed more benzodiazepines and opioids, and consume less nicotine and alcohol. Given its high prevalence, clinicians should routinely assess for CAM use and its impact among PLWH.
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Affiliation(s)
- Sean N Halpin
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
| | | | - Ramona P Rai
- Veterans Affairs Medical Center, Decatur, GA, USA
| | | | | | | | | | - Wei Huang
- Veterans Affairs Medical Center, Decatur, GA, USA
| | - Amy Justice
- Veterans Affairs Medical Center, West Haven, CT, USA
| | - Vincent C Marconi
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - David Rimland
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Molly M Perkins
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
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Dahmer S, Kligler B. HIV Disease and AIDS. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00019-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hall VP. Common Gastrointestinal Complications Associated with Human Immunodeficiency Virus/AIDS: An Overview. Crit Care Nurs Clin North Am 2017; 30:101-107. [PMID: 29413205 DOI: 10.1016/j.cnc.2017.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Highly active antiretroviral therapy (HAART) has transformed human immunodeficiency virus (HIV)/AIDS into a manageable chronic illness. People living with HIV/AIDS (PLWHA) can experience multiple physical symptoms or problems related to HIV infection and treatment. A common problem for PLWHA continues to be diarrhea and nausea and vomiting (NV). Diarrhea and NV can negatively impact the quality of life and adherence to medication therapy among PLWHA and are common reasons to change or discontinue HAART regimens. Because diarrhea and NV can have substantial negative health outcomes for PLWHA, it is important to understand the causes of these conditions.
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Affiliation(s)
- Vincent P Hall
- School of Nursing, Walden University, 100 Washington Avenue, South Suite 900, Minneapolis, MN 55401, USA.
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Clinical Nurse Specialist Perceptions' of Spiritual Care: Nurses Need Support, Care Falls Short. J Christ Nurs 2017; 34:176-181. [PMID: 28604528 DOI: 10.1097/cnj.0000000000000394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The clinical nurse specialist (CNS) is positioned to influence spiritual care at three levels of practice: patient, nurse, and system. This study, the first to explore CNS spiritual care, reports on CNSs' perceptions in providing spiritual care. Four themes were extracted from interview data: 1) Providing direct spiritual support for patients, 2) Nurses need support in providing spiritual care, 3) Using existing resources, and 4) Spiritual care falls short. Not one CNS mentioned barriers to their direct provision of spiritual care. Results support that CNSs can improve spiritual care delivery.
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Chary A, Nguyen NN, Maiton K, Holodniy M. A review of drug-drug interactions in older HIV-infected patients. Expert Rev Clin Pharmacol 2017; 10:1329-1352. [PMID: 28922979 DOI: 10.1080/17512433.2017.1377610] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The number of older HIV-infected people is growing due to increasing life expectancies resulting from the use of antiretroviral therapy (ART). Both HIV and aging increase the risk of other comorbidities, such as cardiovascular disease, osteoporosis, and some malignancies, leading to greater challenges in managing HIV with other conditions. This results in complex medication regimens with the potential for significant drug-drug interactions and increased morbidity and mortality. Area covered: We review the metabolic pathways of ART and other medications used to treat medical co-morbidities, highlight potential areas of concern for drug-drug interactions, and where feasible, suggest alternative approaches for treating these conditions as suggested from national guidelines or articles published in the English language. Expert commentary: There is limited evidence-based data on ART drug interactions, pharmacokinetics and pharmacodynamics in the older HIV-infected population. Choosing and maintaining effective ART regimens for older adults requires consideration of side effect profile, individual comorbidities, interactions with concurrent prescriptions and non-prescription medications and supplements, dietary patterns with respect to dosing, pill burden and ease of dosing, cost and affordability, patient preferences, social situation, and ART resistance history. Practitioners must remain vigilant for potential drug interactions and intervene when there is a potential for harm.
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Affiliation(s)
- Aarthi Chary
- a Department of Medicine , Veterans Affairs Palo Alto Health Care System , Palo Alto , CA , USA.,b Division of Infectious Diseases and Geographic Medicine , Stanford University School of Medicine , Stanford , CA , USA
| | - Nancy N Nguyen
- c Department of Pharmacy , Veterans Affairs Palo Alto Health Care System , Palo Alto , CA , USA.,d Department of Pharmacy Practice, Thomas J. Long School of Pharmacy & Health Sciences , University of the Pacific , Stockton , CA , USA
| | - Kimberly Maiton
- d Department of Pharmacy Practice, Thomas J. Long School of Pharmacy & Health Sciences , University of the Pacific , Stockton , CA , USA
| | - Mark Holodniy
- a Department of Medicine , Veterans Affairs Palo Alto Health Care System , Palo Alto , CA , USA.,b Division of Infectious Diseases and Geographic Medicine , Stanford University School of Medicine , Stanford , CA , USA.,e Office of Public Health Surveillance & Research , Veterans Affairs Palo Alto Health Care System , Palo Alto , CA , USA
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Traditional herbal medicine use among people living with HIV/AIDS in Gondar, Ethiopia: Do their health care providers know? Complement Ther Med 2017; 35:14-19. [PMID: 29154059 DOI: 10.1016/j.ctim.2017.08.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/26/2017] [Accepted: 08/28/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND People living with HIV/AIDS (PLWHA) are increasingly using herbal remedies due to the chronic nature of the disease, the complexities of treatment modalities and the difficulty in adhering to the therapeutic regimens. Yet, research on herbal medicine use in this patient population is scarce in Ethiopia. The present study aimed at investigating the prevalence and factors associated with the use of traditional herbal medicine among PLWHA in Gondar, Ethiopia. METHODS A cross sectional survey was conducted on 360 PLWHA attending the outpatient clinic of University of Gondar referral and teaching hospital from September 1 to 30, 2016. A questionnaire about the socio-demographic, disease characteristics as well as traditional herbal medicine use was filled by the respondents. Descriptive statistics, univariate and multivariate logistic regression analyses were performed to determine prevalence and correlates of herbal medicine use. RESULTS Out of 360 respondents, 255 (70.8%) used traditional herbal medicine. The most common herbal preparations used by PLWHA were Ginger (Zingiber officinale) (47%), Garlic (Allium sativum L.) (40.8%) and Moringa (Moringa stenopetala) (31.4%). Majority of herbal medicine users rarely disclose their use of herbal medicines to their health care providers (61.2%). Only lower educational status was found to be strong predictors of herbal medicine use in the multivariate logistic regression. CONCLUSIONS The use of herbal medicine among PLWHA is a routine practice and associated with a lower educational status. Patients also rarely disclose their use of herbal medicines to their health care providers. From the stand point of high prevalence and low disclosure rate, health care providers should often consult patients regarding herbal medicine use.
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Bahall M. Prevalence, patterns, and perceived value of complementary and alternative medicine among HIV patients: a descriptive study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:422. [PMID: 28830419 PMCID: PMC5567497 DOI: 10.1186/s12906-017-1928-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 08/15/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND Use of complementary and alternative medicine (CAM) is widespread among different patient populations despite the availability of evidence-based conventional medicine and lack of supporting evidence for the claims of most CAM types. This study explored the prevalence, patterns, and perceived value of CAM among human immunodeficiency virus (HIV) patients. METHODS This quantitative descriptive study was conducted between November 1, 2014 and March 31, 2015 among a cross-sectional, convenience sample of attendees of the HIV clinic of a public tertiary health care institution. Face-to-face interviews using a 34-item questionnaire were conducted. Data analysis included descriptive statistics, chi-square tests, and binary logistic regression analysis. RESULTS CAM was used by 113 (32.8%) of a total of 343 HIV patients, but <1% informed their health care providers of CAM usage. Medicinal herbs were the most common type of CAM used (n = 110, 97.3%) followed by spiritual therapy (n = 56, 49.6%), including faith healing/prayer and meditation. The most used medicinal herbs were Aloe vera (n = 54, 49.1%), ginger (n = 33, 30.0%), and garlic (n = 23, 20.9%). The most used vitamins were complex B vitamins (n = 70, 61.9%), followed by vitamin A (n = 58, 51.3%), vitamin E (n = 51, 45.1%), and vitamin D (n = 42, 37.1%). Most CAM users continued using conventional medicine in addition to CAM and were willing to use CAM without supervision and without informing their health care provider. Patients were generally satisfied with CAM therapy (n = 91, 80.5%). The main reasons for CAM use were the desire to take control of their treatment (8.8%) or just trying anything that could help (18.8%). Main influences were the mass media (32.7%) and non-hospital health personnel (19.5%). Predictors of CAM use were being 30-50 years, married and having a secondary school education. CONCLUSION About one-third of HIV patients used CAM, but virtually none informed their healthcare provider. Medicinal herbs were the most common type of CAM, followed by spiritual therapy and vitamins. A patient's decision to use CAM was influenced for the most part by the mass media and non- hospital health care personnel.
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Affiliation(s)
- Mandreker Bahall
- School of Medicine and Arthur Lok Jack Graduate School of Business, University of the West Indies, St. Augustine, Trinidad and Tobago.
- Department of Medicine, San Fernando General Hospital, Chancery Lane, San Fernando, Trinidad and Tobago.
- , House #57 LP 62, Calcutta Road Number 3, McBean, Couva, Trinidad, Trinidad and Tobago.
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Oji VU, Hung LC, Abbasgholizadeh R, Terrell Hamilton F, Essien EJ, Nwulia E. Spiritual care may impact mental health and medication adherence in HIV+ populations. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2017; 9:101-109. [PMID: 28694708 PMCID: PMC5490435 DOI: 10.2147/hiv.s126309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To explore a potential role for spirituality in medication-related needs assessment for integrated care in chronically ill populations. METHOD A systematic literature review was conducted to explore the impact of faith beliefs on health and/or medication adherence in individuals with depression and/or HIV+/AIDS. Retrospective electronic medical record review of adult HIV+ patients of an urban primary care clinic with integrated mental health services was conducted, with Substance Abuse and Mental Illness Symptoms Screener (SAMISS), major depressive disorder (MDD) incidence over the preceding year, and history of contact with a spiritual advisor. A convenience sample was interviewed to qualitatively assess potential medication therapy management needs and medication-related problems. Another sample was examined utilizing the Daily Spiritual Experience Scale. RESULTS The literature reports positive influence on health behaviors, coping and outcomes; and poor medication adherence and treatment decisions due to patient passivity or resistance. Spiritual advisor contact (not limited to a specific religion) was significantly associated with MDD absence (1.7% vs. 15.3%, P<0.005) and inversely related to SAMISS, depression, and poor health behaviors. Patient interviews reflected significance of faith in terms of insight and acceptance of illness, the role or need for medications, coping, and medication adherence. An illustrative model was designed based on the literature and data collection. CONCLUSION Spiritual assessment may help identify positive or negative influence on health. Spiritual interventions could be beneficial in promoting adherence and positive health outcomes. Further research is recommended.
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Affiliation(s)
- Valerie U Oji
- Lifefountain Center Ministries Inc, Houston, TX, USA.,Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA.,University of Texas, College of Pharmacy, Austin, TX, USA
| | - Leslie C Hung
- University of Texas, College of Pharmacy, Austin, TX, USA
| | - Reza Abbasgholizadeh
- Lifefountain Center Ministries Inc, Houston, TX, USA.,University of Houston, Houston, TX, USA
| | | | - E James Essien
- University of Houston Institute for Community Health, Houston, TX, USA
| | - Evaristus Nwulia
- Psychiatry, Howard University Translational Neuroscience Laboratory, Washington, DC, USA
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Foley H, Steel A. The Nexus Between Patient-Centered Care and Complementary Medicine: Allies in the Era of Chronic Disease? J Altern Complement Med 2017; 23:158-163. [DOI: 10.1089/acm.2016.0386] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hope Foley
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
| | - Amie Steel
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia
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Monera-Penduka TG, Jani ZT, Maponga CC, Mudzengi J, Morse GD, Nhachi CFB. Quality and labeling information of Moringa oleifera products marketed for HIV-infected people in Zimbabwe. J Public Health Afr 2016; 7:84-88. [PMID: 28239441 PMCID: PMC5321099 DOI: 10.4081/jphia.2016.618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Labeling information and quality of marketed Moringa oleifera products were assessed. Personnel in 60 pharmacies and 11 herbal shops were interviewed about the sources, dosages, indications and counseling information of Moringa oleifera products. Content analysis of written information provided on Moringa oleifera products was also done. Three samples of Moringa from popular sources were acquired to determine heavy metal content and microbial contamination. The results were compared to specified limits in the European and Chinese pharmacopeia, World Health Organization guidelines and Bureau of Indian Standards. Moringa was available as capsules or powder in 73% of the premises. Moringa was recommended for seven different disease conditions. Four different dosage regimens were prescribed. The main references cited for the counseling information were unscientific literature (62%). The selected Moringa samples were contaminated with bacteria and fungi above the European Pharmacopeia specified limits. Escherichia coli and Salmonella species were present in all three samples. All three samples contained arsenic, nickel and cadmium above the permissible limits. Moringa oleifera with variable labeling information and poor microbial and heavy metal quality is widely available in Zimbabwe.
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Affiliation(s)
| | - Zvinji Tella Jani
- School of Pharmacy, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Charles Chiedza Maponga
- School of Pharmacy, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe; Pharmacy Practice, State University of New York at Buffalo, NY, USA
| | - Josephine Mudzengi
- Department of Clinical Pharmacology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Gene D Morse
- Pharmacy Practice, State University of New York at Buffalo, NY, USA
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Abou-Rizk J, Alameddine M, Naja F. Prevalence and Characteristics of CAM Use among People Living with HIV and AIDS in Lebanon: Implications for Patient Care. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:5013132. [PMID: 28050191 PMCID: PMC5168459 DOI: 10.1155/2016/5013132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/07/2016] [Indexed: 01/25/2023]
Abstract
This study aimed to assess the prevalence and determinants of Complementary and Alternative Medicine (CAM) use among People Living with HIV and AIDS (PLWHA) in Lebanon and to identify related issues that may affect patient care. A cross-sectional survey design was used to interview 116 PLWHA in Beirut. The questionnaire addressed sociodemographic and disease characteristics as well as CAM use. The main outcome of the study was CAM use since diagnosis. Data analysis included descriptive statistics and logistic regression analyses. Overall, 46.6% of participants reported using one or more CAM therapies, with herbs and herbal products being the most commonly used (63%). A higher education level was associated with a 3-fold increase in the odds of CAM use. Among users, 20% used CAM as alternative to conventional treatment, 48% were not aware of CAM-drug interactions, 89% relied on nonhealth care sources for their choice of CAM, and 44% did not disclose CAM use to their physician. CAM use is prevalent among Lebanese PLWHA. Findings of this study highlighted the need to educate health care practitioners to have an open communication and a patient-centered approach discussing CAM use during routine care and to enhance awareness of PLWHA on safe use of CAM.
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Affiliation(s)
- Joana Abou-Rizk
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
| | - Mohamad Alameddine
- Mohammed Bin Rashid University of Medicine and Health Sciences, Building 14, Dubai Healthcare City, P.O. Box 505055, Dubai, UAE
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
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Kelso-Chichetto NE, Okafor CN, Harman JS, Canidate SS, Cook CL, Cook RL. Complementary and Alternative Medicine Use for HIV Management in the State of Florida: Medical Monitoring Project. J Altern Complement Med 2016; 22:880-886. [PMID: 27631385 DOI: 10.1089/acm.2016.0190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The aims of this study were to describe complementary and alternative medicine (CAM) use and to assess the relationships between CAM use and antiretroviral therapy (ART) adherence and human immunodeficiency virus (HIV) RNA viral load suppression among a sample of persons living with HIV (PLWH) engaged in care in the state of Florida. DESIGN The Florida Medical Monitoring Project (n = 803) collected repeated cross-sectional data for surveillance of clinical outcomes among PLWH from 2009 to 2010. Past-year CAM use specifically for the management of HIV was measured via self-report. Logistic regression models were conducted to assess the effect of CAM use on ART adherence and viral load suppression, controlling for demographic and clinical factors using backwards stepwise deletion of factors with a p-value of >0.25. RESULTS CAM use was reported in 53.3% (n = 428). In bivariate analysis, CAM use was the highest among those 40-49 years of age (61%; p < 0.05), males (56%; p < 0.01), whites (61%; p = 0.001), and those educated beyond high school (59%; p < 0.05). Among those using CAM, 63% and 37% reported one and two or more CAM modalities, respectively. CAM modalities included biologically based therapies (89%), mind-body medicine/manipulative body-based therapies (30%), spiritual healing (23%), energy therapies (6%), and whole medical systems (6%). In multivariable analyses, any CAM use and number of CAM methods used were not associated with ART adherence. Any CAM use was not associated with detectable viral load (adjusted odds ratio [aOR] 0.81; 95% confidence interval [CI] 0.58-1.12; p = 0.20). Those using two or more methods had significantly decreased risk for detectable viral load (aOR 0.60; 95% CI 0.39-0.92; p < 0.02). CONCLUSIONS CAM use was not associated with negative effects on ART adherence. CAM users were less likely to have detectable viral load compared with non-users. Future research should focus on CAM use among PLWH not engaged in HIV care and the longitudinal patterns of CAM use and possible effects of long-term health outcomes.
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Affiliation(s)
- Natalie E Kelso-Chichetto
- 1 Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida , Gainesville, FL
| | - Chukwuemeka N Okafor
- 1 Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida , Gainesville, FL
| | - Jeffrey S Harman
- 2 Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University , Tallahassee, FL
| | - Shantrel S Canidate
- 3 Social and Behavioral Sciences Program, College of Public Health and Health Professions and College of Medicine, University of Florida , Gainesville, FL
| | - Christa L Cook
- 4 Department of Family, Community, and Health System Science, College of Nursing, University of Florida , Gainesville, FL
| | - Robert L Cook
- 1 Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida , Gainesville, FL
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Muramoto ML, Gordon JS, Bell ML, Nichter M, Floden L, Howerter A, Ritenbaugh CK. Tobacco Cessation Training for Complementary and Alternative Medicine Practitioners: Results of a Practice-Based Trial. Am J Prev Med 2016; 51:e35-e44. [PMID: 27061892 DOI: 10.1016/j.amepre.2016.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 01/19/2016] [Accepted: 02/09/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Brief behavioral intervention (BI) is a tobacco-cessation best practice well established among conventional healthcare practitioners. Complementary and alternative medicine (CAM) practitioners treat significant numbers of tobacco users, but do not systematically receive BI training. The CAM Reach study developed and evaluated a tobacco cessation BI training program/practice system intervention adapted specifically for CAM practitioners, and evaluated in real-world CAM practices. STUDY DESIGN Single-arm intervention. Data were collected in 2010-2014 and analyzed in 2015. SETTING/PARTICIPANTS Private practices of 30 chiropractors, 27 acupuncturists, 42 massage therapists (N=99), in metropolitan Tucson, Arizona. INTERVENTION Eight-hour tobacco cessation BI continuing education workshop, in-office BI skills practice/assessment, and system intervention. Training tailored to the CAM practice setting addressed tobacco cessation best practices from the U.S. Public Health Service Guidelines. MAIN OUTCOME MEASURES Seventeen items (assessing practitioner behavior, motivation, and self-efficacy with tobacco cessation) comprising three factors, Tobacco Cessation Activity, Tobacco Cessation Motivation, and Non-CAM Tobacco Cessation Comfort, were assessed at baseline and 3, 6, 9, and 12 months post-training by practitioner self-report. Research staff visited practices at approximately the same intervals to directly observe changes in clinical practice systems. RESULTS At 3 months, there were significant increases in practitioners' tobacco cessation activities, motivation and confidence in helping patients quit tobacco, and comfort with providing information and referrals for guideline-based tobacco cessation aids (p<0.0001). Practitioners significantly increased rates of discussing cessation medications with patients (AOR=3.76, 95% CI=1.84, 7.68), and routinely asking about tobacco use in clinical practice (AOR=2.62, 95% CI=1.11, 6.20). Increases occurred across all three practitioner types and were sustained at 12 months-despite heterogeneity in professional training, practice patterns/organization, and practice business models. CONCLUSIONS Results suggest CAM practitioners are willing and able to offer BIs, and are an important, yet overlooked channel for promoting tobacco cessation and use of evidence-based cessation aids.
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Affiliation(s)
- Myra L Muramoto
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona.
| | - Judith S Gordon
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Melanie L Bell
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Mark Nichter
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona; School of Anthropology, College of Social and Behavioral Sciences, University of Arizona, Tucson, Arizona
| | - Lysbeth Floden
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Amy Howerter
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Cheryl K Ritenbaugh
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona
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Carter GM, Esmaeili A, Shah H, Indyk D, Johnson M, Andreae M, Sacks HS. Probiotics in Human Immunodeficiency Virus Infection: A Systematic Review and Evidence Synthesis of Benefits and Risks. Open Forum Infect Dis 2016; 3:ofw164. [PMID: 27747250 PMCID: PMC5063545 DOI: 10.1093/ofid/ofw164] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/25/2016] [Indexed: 12/11/2022] Open
Abstract
The risk of sepsis is low. The best probiotic to optimize outcomes has not yet been identified. Potential benefit for CD4 count, recurrence or management of bacterial vaginosis and diarrhea. Uncertain effect on translocation, BV treatment. People living with human immunodeficiency virus frequently use dietary supplements, including probiotics, but concern exists about ingesting live organisms. We performed a systematic review of the benefits of probiotics and a meta-analysis of sepsis risk. We undertook a protocol-driven, comprehensive review to identify all relevant studies, assess their quality, and summarize the evidence. Of 2068 references, 27 were analyzed. The data suggest possible benefits for CD4 count, recurrence or management of bacterial vaginosis, and diarrhea management. We examined randomized, controlled studies explicitly assessing sepsis in any patient population, and we found zero cases of supplement-associated bacteremia or fungemia in 39 randomized controlled trials comprising 9402 subjects. The estimated number needed to harm is 7369 in Bayesian approach (95% credible interval: 1689, ∞), which should reassure clinicians. No or mild adverse effects were reported. Longer duration studies investigating different individual and mixed strains for plausible indications are needed to establish best practices.
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Affiliation(s)
| | | | | | - Debbie Indyk
- Department of Preventive Medicine , Icahn School of Medicine at Mount Sinai
| | | | - Michael Andreae
- Department of Anesthesiology , Albert Einstein College of Medicine , Bronx, New York
| | - Henry S Sacks
- Department of Preventive Medicine , Icahn School of Medicine at Mount Sinai
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Syed IA, Sulaiman SAS, Hassali MA, Thiruchelvam K, Syed SH, Lee CK. Beliefs and practices of complementary and alternative medicine (CAM) among HIV/AIDS patients: A qualitative exploration. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.09.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Danell JA. From Disappointment to Holistic Ideals: A Qualitative Study on Motives and Experiences of Using Complementary and Alternative Medicine in Sweden. J Public Health Res 2015; 4:538. [PMID: 26425496 PMCID: PMC4568425 DOI: 10.4081/jphr.2015.538] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/22/2015] [Accepted: 05/27/2015] [Indexed: 11/23/2022] Open
Abstract
Background Recent studies indicate increased use of complementary and alternative medicine (CAM) in western societies, to ameliorate health problems. Even if there is substantial research on general patterns of use, there is limited knowledge on individual motives. This study contributes to a qualitative understanding of experiences of choosing and using CAM. Design and methods This study consists of in-depth interviews with 10 CAM users in Sweden. The participants represent different backgrounds and experiences of using CAM. The interviews have been analysed in accordance with content analysis. Results In analysing experiences of choosing and using CAM four main themes were identified: frustration and critique, values and ideology, individual responsibility, and combining treatments. In general, the participants were highly reflexive on issues concerning their health. They highlighted their own role and responsibility, combined a variety of treatments, and continuously dealt with questions on risks, even if they had relatively different approaches to if and when to use CAM. The results also show that motives may change over time. Even if initial choices were closely related to frustration and critique of conventional treatments (for example, by perceiving conventional health care as limited, not receiving proper diagnoses, or being critical to conventional drugs) was long-term use motivated by ideological characteristics of CAM (such as holistic and individualized treatments, and extensive interaction with practitioners). Conclusions Four main themes, concerning experiences of choosing and using CAM were identified. This study also supports the idea that initial motives for choosing CAM may differ from those explaining long-term use. Significance for public health Recent studies indicate increased use of complementary and alternative medicine (CAM), both in general western populations and specific patient groups. Well-documented motives for choosing CAM are related to disappointment and failure of conventional health care. In addition, there are findings that demonstrate that certain basic values (such as individualism and holistic orientations) are related to the use of CAM. A better understanding of individual motives behind people’s choice of CAM, and how this is related to their perception of the health care system, is important for policy makers and health care professionals alike. This study contributes to a qualitative understanding of experiences of choosing and using CAM and how motives may change over time. It also contributes with knowledge on how users combine CAM with conventional health care and deal with risks.
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Carter GM, Indyk D, Johnson M, Andreae M, Suslov K, Busani S, Esmaeili A, Sacks HS. Micronutrients in HIV: a Bayesian meta-analysis. PLoS One 2015; 10:e0120113. [PMID: 25830916 PMCID: PMC4382132 DOI: 10.1371/journal.pone.0120113] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 02/04/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Approximately 28.5 million people living with HIV are eligible for treatment (CD4<500), but currently have no access to antiretroviral therapy. Reduced serum level of micronutrients is common in HIV disease. Micronutrient supplementation (MNS) may mitigate disease progression and mortality. OBJECTIVES We synthesized evidence on the effect of micronutrient supplementation on mortality and rate of disease progression in HIV disease. METHODS We searched MEDLINE, EMBASE, the Cochrane Central, AMED and CINAHL databases through December 2014, without language restriction, for studies of greater than 3 micronutrients versus any or no comparator. We built a hierarchical Bayesian random effects model to synthesize results. Inferences are based on the posterior distribution of the population effects; posterior distributions were approximated by Markov chain Monte Carlo in OpenBugs. PRINCIPAL FINDINGS From 2166 initial references, we selected 49 studies for full review and identified eight reporting on disease progression and/or mortality. Bayesian synthesis of data from 2,249 adults in three studies estimated the relative risk of disease progression in subjects on MNS vs. control as 0.62 (95% credible interval, 0.37, 0.96). Median number needed to treat is 8.4 (4.8, 29.9) and the Bayes Factor 53.4. Based on data reporting on 4,095 adults reporting mortality in 7 randomized controlled studies, the RR was 0.84 (0.38, 1.85), NNT is 25 (4.3, ∞). CONCLUSIONS MNS significantly and substantially slows disease progression in HIV+ adults not on ARV, and possibly reduces mortality. Micronutrient supplements are effective in reducing progression with a posterior probability of 97.9%. Considering MNS low cost and lack of adverse effects, MNS should be standard of care for HIV+ adults not yet on ARV.
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Affiliation(s)
- George M. Carter
- Foundation for Integrative AIDS Research, Brooklyn, NY, United States of America
| | - Debbie Indyk
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Matthew Johnson
- Teachers College, Columbia University, New York, NY, United States of America
| | - Michael Andreae
- Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Kathryn Suslov
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Sudharani Busani
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Aryan Esmaeili
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Henry S. Sacks
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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Ketema AK, Shewangizaw Weret Z. Assessment of adherence to highly active antiretroviral therapy and associated factors among people living with HIV at Debrebrihan Referral Hospital and Health Center, Northeast Ethiopia: a cross-sectional study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2015; 7:75-81. [PMID: 25792856 PMCID: PMC4362904 DOI: 10.2147/hiv.s79328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Patient adherence to antiretroviral combination therapy is a critical component to successful treatment outcome. Nonadherence to antiretroviral therapy (ART) is a major challenge to AIDS care, and the risks associated with it are extensive. The intention of this study was to determine prevalence and associated factors with adherence to highly active ART among people living with HIV/AIDS (PLWHA) at the Debrebrihan Referral Hospital and Health Center, Northeast Ethiopia. A cross-sectional study design with systematic random sampling conducted by the use of a structured, pretested self-rating adherence questionnaire was used to conduct the study among 422 respondents from the Debrebrihan Referral Hospital and Health Center. A single population proportion formula at 95% CI with 5% of marginal error at 50% of prevalence of occurrence was used to determine sample size. Adherence was defined as not missing a single ART dose during the 30-day period prior to filling out the self-report. Adherence was measured by self-reports by the patients. These results were then used in binary logistic regression analysis. Covariates were analyzed by bivariate and multivariate logistic regression with SPSS statistical software. The total number of respondents in this study was 422; their median age was 35 years. Among the participants, 95.5% were taking their medication without missing a dose. Factors such as having emotional or practical support positively encouraged ART adherence (adjusted odds ratio 0.16 [95% CI 0.05–0.49]). However, users of traditional, complementary, and alternative medicine (TCAM) (adjusted odds ratio 4.7 [95% CI 1.06–21.22]) had nearly a five times higher risk for ART nonadherence (P<0.05) than those not using TCAM. Adherence to ART among PLWA is imperative and standard. But, there is still a need to boost psychological support and practical support for the clients, and there is also a need to create a more integrative approach with TCAM in order to increase adherence to ART. Strengthening emotional and practical support for PLWHA and integrating TCAM with the proper use of ART are mandatory to enhance ART adherence.
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Affiliation(s)
- Abush Kebede Ketema
- Regional Monitoring and Evaluation Advisor, Management Sciences for Health, Addis Ababa, Ethiopia
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Agarwal RP, Kumar A, Lewis JE. A pilot feasibility and acceptability study of yoga/meditation on the quality of life and markers of stress in persons living with HIV who also use crack cocaine. J Altern Complement Med 2015; 21:152-8. [PMID: 25695849 DOI: 10.1089/acm.2014.0112] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Persons living with HIV (PLWH) who also use crack cocaine may have stressful, chaotic lives and typically do not engage in standard medical care that addresses a multitude of extenuating life circumstances. Yoga/meditation (YM) improves quality of life (QOL) and biomarkers of stress, but the effect of this intervention is almost unknown in PLWH, particularly those who use crack cocaine. OBJECTIVES This pilot study sought to compare the feasibility and acceptability of 60-minute, twice-per-week sessions of YM for 2 months with those of no-contact control and to evaluate the effects of the intervention on QOL (according to the Short Form-36, Perceived Stress Scale [PSS], and Impact of Events Scale [IES]) and salivary cortisol and dehydroepiandrosterone sulfate (DHEA-S) among PLWH who use crack cocaine. DESIGN Participants were randomly assigned to YM or no-contact control and were assessed at baseline, 2 months after the intervention, and 4 months' follow-up. RESULTS The YM program was acceptable and feasible, with high overall attendance (89%) and individual participation in yoga sessions (83%). YM participants showed modest improvements on QOL. The PSS total score and the IES intrusion score improved significantly 2 months after the intervention, but cortisol and DHEA-S did not change. CONCLUSIONS This pilot study showed a high level of feasibility and acceptability and modest effects on measures of QOL among PLWH who use crack cocaine. The results suggest utility of YM as a simple, safe, and inexpensive format to improve QOL in a population that has many medical difficulties and extenuating stressors.
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Affiliation(s)
- Ram P Agarwal
- 1 Department of Medicine, University of Miami Miller School of Medicine , Miami, FL
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Kaufman MR, Ioerger M, Harman JJ, Modarres N. Nature, extent and implications of belief in Kikombe cha babu and other herbal HIV cures in Tanzania. AIDS Care 2014; 26:1541-5. [PMID: 25024091 DOI: 10.1080/09540121.2014.936815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study's objective was to describe awareness of, access to, belief in, and utilization of the healing tea Kikombe cha babu and other alternative treatments for HIV in Tanzania. Associations with HIV testing, treatment, and prevention behaviors are also explored. A survey with questions about alternative medicine was administered to a sample in Tanzania using a stratified, multistage random selection method. Adults were interviewed face-to-face. Items concerning alternative HIV treatments addressed awareness, access, beliefs, and treatment-seeking behaviors. Questions about HIV prevention and treatment were also asked. Results showed participants indicated a high awareness of alternative treatments available in Tanzania, with 95.3% of 2313 adults having heard of these treatments. Of those, 6.0% had actually sought the treatment, and 46.8% had an acquaintance seek it. However, 81.0% indicated these treatments were not easily accessible. There is a high level of belief in the ability of these alternative treatments to cure HIV, with 44.0% of people who had heard of these treatments indicating they believe such treatments can cure HIV. Additionally, many people indicated having these alternative treatments available would result in decreased condom use (15.6%), no need to use condoms (94.9%), and no need to take antiretroviral therapy (81.7%). However, 57.4% indicated they would be more likely to get tested for HIV if alternative treatments were available. Belief in the ability of alternative treatments to cure HIV in Tanzania is high and should be further explored due to its implications for potentially sidelining HIV prevention and treatment initiatives.
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Affiliation(s)
- Michelle R Kaufman
- a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
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