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Yuan GF, Qiao S, Li X, Shen Z, Zhou Y. How Does Anticipated HIV Stigma Affect Medication Adherence? A Longitudinal Path Analysis Model. AIDS Behav 2024; 28:1684-1693. [PMID: 38340222 DOI: 10.1007/s10461-024-04293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
Prior research has documented that anticipated HIV stigma may play an important predictive role in medication adherence among people living with HIV (PLWH). However, longitudinal data on the mechanisms underlying this linkage are scarce. The current study aimed to explore the longitudinal mediation association among anticipated HIV stigma, medication adherence support, HIV self-management, and medication adherence. A four-wave sample consisting of 1,098 Chinese PLWH (Mage = 38.63, SD = 9.20; 63.9% male) with a six-month interval was used in the current study. Participants were asked to complete self-report questionnaires. A path analysis model was analyzed. Results indicate that anticipated HIV stigma at baseline was positively related to medication adherence at Time 4 (T4). Medication adherence support at Time 2 (T2) and HIV self-management at Time 3 (T3) serially mediated the anticipated HIV stigma at Time 1 (T1) and medication adherence at T4. These findings provide critical insights into the mediating roles of medication adherence support and HIV self-management in the relationship between anticipated HIV stigma and medication adherence over time. Such an understanding has important implications for the development of tailored interventions and public health strategies aimed at improving medication adherence among PLWH in the context of HIV-related stigma.
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Affiliation(s)
- Guangzhe Frank Yuan
- School of Education Science, Leshan Normal University, Leshan, Sichuan, China.
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Shan Qiao
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
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Yona S, Edison C, Nursasi AY, Ismail R. Self-awareness as the key to successful adherence to antiretroviral therapy among people living with HIV in Indonesia: A grounded theory study. BELITUNG NURSING JOURNAL 2023; 9:176-183. [PMID: 37469582 PMCID: PMC10353585 DOI: 10.33546/bnj.2480] [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: 12/10/2022] [Revised: 01/05/2023] [Accepted: 02/17/2023] [Indexed: 07/21/2023] Open
Abstract
Background Adherence to antiretroviral therapy (ART) continues to pose a significant challenge for people living with HIV (PLWH). Non-adherence to ART can have far-reaching implications for patient well-being, particularly in increasing the risk of opportunistic infections when medication is not taken as prescribed. Objective This study aimed to develop a theoretical model that explains how PLWH in Indonesia adhere to their ART regimen and the strategies they follow to maintain adherence. Methods The study used a grounded theory approach. Data were collected through face-to-face in-depth interviews with 21 PLWH who had been taking ART for six months or more at a non-governmental organization (NGO) in Jakarta, Indonesia, between July 2019 and November 2019. Theoretical sampling was used, and the data analysis method of Corbin and Strauss was utilized, including open coding, axis coding, and selective coding. Results Three stages were identified as a process of adherence to the ART regimen: 1) initiating ART, 2) missing the connection, and 3) taking control. Self-awareness was identified as the central core theme describing the ART adherence process. Conclusion Having adequate self-awareness to take ART regularly is crucial to improving adherence to ART. Moreover, social support from one's spouse and family members can help patients maintain adherence. Therefore, self-awareness and support systems should be included as components in nursing interventions when starting ART therapy. In addition, nurses can help identify potential support persons and provide information related to ART therapy.
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Affiliation(s)
- Sri Yona
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
| | - Chiyar Edison
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
| | - Astuti Yuni Nursasi
- Department of Community Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
| | - Rita Ismail
- Ministry of Health Republic of Indonesia, Poltekkes Kemenkes Jakarta III, Bekasi, West Java, Indonesia
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Abu-Sharkia S, Taubman - Ben-Ari O, Mofareh A. Personal Growth and Life Satisfaction during Fertility Treatment-A Comparison between Arab and Jewish Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2187. [PMID: 36767553 PMCID: PMC9915886 DOI: 10.3390/ijerph20032187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Coping with difficulty conceiving and the ensuing fertility treatments is a stressful experience that impacts many aspects of women's lives. On the basis of Lazarus and Folkman's model of stress and coping and Schaefer and Moos's model of personal growth, and in view of the sparse literature on cultural aspects of infertility and personal growth, this study examined the relationship between stress on the one hand and personal growth and life satisfaction on the other among Arab and Jewish Israeli women. Furthermore, it investigated the moderating role played by perceived stigma, coping flexibility, cultural orientation (individualism and collectivism), and ethnicity. Two hundred five Arab and Jewish Israeli women undergoing fertility treatment completed self-report questionnaires. The results show that Arab women reported higher levels of personal growth and individualism than Jewish women. In the whole sample, a linear negative relationship was found between stress and life satisfaction, and a curvilinear relationship was found between stress and personal growth. In addition, perceived stigma, collectivism, individualism, and coping flexibility were found to moderate the association between perceived stress and personal growth. The findings provide further understanding of personal growth in the context of infertility, showing that personal resources and perceptions are more important than cultural differences in this regard.
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Affiliation(s)
- Salam Abu-Sharkia
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Orit Taubman - Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Ali Mofareh
- Clalit Health Services (Kupat Holim Clalit), Jerusalem 9112102, Israel
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Saleem HT, Knight D, Yang C, Kidorf M, Latkin C, Nkya IH. HIV Stigma, HIV status disclosure, and ART adherence in the context of an integrated opioid use disorder and HIV treatment setting in Dar es Salaam, Tanzania. AIDS Care 2023; 35:91-94. [PMID: 35109727 PMCID: PMC9343474 DOI: 10.1080/09540121.2022.2032575] [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] [Indexed: 10/19/2022]
Abstract
Little is known about social factors, including stigma, that affect antiretroviral therapy (ART) adherence among people enrolled in opioid use disorder treatment (OUDT) in the context of integrated OUDT and HIV treatment models. We qualitatively examined the relationship between HIV stigma, HIV status disclosure, and ART adherence among clients living with HIV at an OUDT clinic with integrated HIV services in Tanzania. We conducted in-depth interviews with 25 clients receiving HIV care at an OUDT clinic in Dar es Salaam, Tanzania between January and April 2020. HIV stigma, particularly anticipated stigma, and HIV status disclosure were key factors that affected ART adherence. Participants feared non-voluntary HIV status disclosure to and HIV stigma from their peers enrolled in OUDT. Most participants reported concealing their HIV status from peers at the OUDT clinic and not associating with other clients living with HIV at the clinic. Reducing HIV stigma and enhancing clinic structures and procedures to maintain privacy and confidentiality are essential to mitigating the effects of stigma on ART adherence.
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Affiliation(s)
- Haneefa T Saleem
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Deja Knight
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Cui Yang
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michael Kidorf
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Carl Latkin
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Iddi Haruna Nkya
- Department of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Elgalib A, Shah S, Al-Wahaibi A, Al-Habsi Z, Al-Fouri M, Lau R, Al-Kindi H, Al-Rawahi B, Al-Abri S. Treatment outcomes 12 months after antiretroviral therapy initiation in Oman: a nationwide study from the Middle East. AIDS Care 2023; 35:63-70. [PMID: 34702098 DOI: 10.1080/09540121.2021.1991880] [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: 10/20/2022]
Abstract
ABSTRACTWe used routinely collected programme data on people living with HIV in Oman who started ART in 2014-2018 to assess retention on ART, viral suppression, attrition (mortality or loss to follow-up [LTFU]) and treatment failure (attrition or HIV viral load of > 1000 copies/mL) 12 months after antiretroviral therapy (ART) initiation. We identified 726 patients; 72% were male. Overall, 12 months retention on ART and viral suppression (intention-to-treat [ITT] analysis) were 85.7% and 74.5%, respectively. Attrition occurred in 14.3% (mortality of 7% and LTFU of 7.3%). Retention increased from 78.8% (93/118) to 90.6% (144/159) among patients who started ART in 2014 and 2018, respectively. Similarly, ITT and on-treatment analyses revealed that viral suppression 12 months after ART initiation increased from 57.6% (68/118) and 73.1% (68/93) among patients who initiated therapy in 2014-80.5% (128/159) and 88.8% (128/144) among patients started treatment in 2018, respectively. On multivariate analysis, older age, having "Other" as an HIV risk factor (compared to heterosexual) and receiving HIV care outside the capital Muscat independently predicted both attrition and treatment failure. Our findings have been useful in identifying factors at the individual and programme level that influenced the risk of attrition and treatment failure.
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Affiliation(s)
- A Elgalib
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - S Shah
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - A Al-Wahaibi
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Z Al-Habsi
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - M Al-Fouri
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - R Lau
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - H Al-Kindi
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - B Al-Rawahi
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - S Al-Abri
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
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Jia W, Jiao K, Ma J, Liao M, Wang C, Kang D, Lin Y, Yan Y, Li Y, Cheng C, Meng J, Wang L, Yang X, Cao Y, Zhao Z, Wang X, Ma W. HIV infection disclosure, treatment self-efficacy and quality of life in HIV-infected MSM receiving antiretroviral therapy. BMC Infect Dis 2022; 22:937. [PMID: 36514071 PMCID: PMC9749163 DOI: 10.1186/s12879-022-07932-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Research on the relationship between disclosure of HIV status to male sexual partners (HIV disclosure) and quality of life (QOL) revealed complex and even contradictory results. The impact of HIV disclosure on various domains of QOL and the mediation effect between them are unclear. The purposes of this study were to explore the impact of HIV disclosure on QOL among men who have sex with men (MSM), and whether HIV treatment self-efficacy mediated these relationships. METHODS The data came from a baseline survey on the design of a randomized control trial conducted in Shandong, China. A total of 579 MSM patients were included. SPSS 24.0 was used to conduct independent samples t test, one-way analysis of variance and nonparametric tests and the PROCESS macro was used to conduct mediation analysis. RESULTS Among 579 participants, 16.06% disclosed their HIV infection status to their male sexual partners. The effect of HIV disclosure on QOL was mediated by treatment self-efficacy. Self-efficacy played partial mediating role in social relationships, meaning that HIV disclosure had both direct and indirect effects on this factor. In the overall QOL and domains of physical, psychological, independence, and environment, HIV disclosure had an indirect effect only through self-efficacy and no significant effect on the spirituality domain. CONCLUSIONS The results emphasize the importance of HIV disclosure and self-efficacy on the QOL of MSM patients and suggest that health care providers should assist MSM patients in deciding whether to disclose their HIV status during daily medical services.
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Affiliation(s)
- Wenwen Jia
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Kedi Jiao
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Jing Ma
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Meizhen Liao
- grid.512751.50000 0004 1791 5397Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, 16992 Jingshi Road, Jinan, 250014 Shandong People’s Republic of China
| | - Chunmei Wang
- Shandong Public Health Clinical Center, 12 East Martyrs Mountain Road, Jinan, 250132 Shandong People’s Republic of China
| | - Dianmin Kang
- grid.512751.50000 0004 1791 5397Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, 16992 Jingshi Road, Jinan, 250014 Shandong People’s Republic of China
| | - Yuxi Lin
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Yu Yan
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Yijun Li
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Chunxiao Cheng
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Jing Meng
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Lina Wang
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Xuan Yang
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Yanwen Cao
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Zhonghui Zhao
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Xinting Wang
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
| | - Wei Ma
- grid.27255.370000 0004 1761 1174Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong People’s Republic of China
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Nkenu NG, Nsoh M, Paul AJ, Nkondjock A. Characterizing factors influencing adherence to surgery and chemotherapy amongst women suffering from breast cancer in Mbingo Baptist Hospital Cameroon. Pan Afr Med J 2022; 43:102. [PMID: 36699974 PMCID: PMC9834800 DOI: 10.11604/pamj.2022.43.102.28672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/15/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction Breast cancer (BC) is the most prominent cancer in females and is cited as a leading cause of cancer-related mortality in women worldwide. We aimed to determine factors influencing adherence to surgery and chemotherapy in women with BC in Mbingo Baptist Hospital (MBH). Methods we conducted a cross-sectional study in the MBH-Cameroon. Purposeful sampling was used to select participants for investigation. A structured questionnaire was applied to 82 women on chemotherapy in the oncology unit. Socio-demographic, clinical, and therapeutic data were collected from participants. The Morisky Medication Scale (MMS) was used to assess the patient's motivation and knowledge while the Adherence Starts with Knowledge (ASK12) questionnaire was used to measure the patient's barriers to treatment. SPSS was used for data analysis. Results the mean age was 46.37 (SD 11 years). Most participants (67.1%) were in the group of (25-50 years). The majority (75.6%) of respondents attended at least primary school. The results showed that adherence to surgery and chemotherapy is low 44% and 56.1% respectively, and this was greatly influenced by treatment delay (P = 0.034), missed chemotherapy dose without medical indication (P=0.029), patient's motivation, and knowledge towards their disease and treatment (P=0.0001 and P=0.0001), respectively. Conclusion our results revealed that adherence to surgery and chemotherapy among women with BC in MBH is low and is driven by the patient´s motivation, knowledge about the disease, and treatment.
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Affiliation(s)
- Nsom Gwendoline Nkenu
- Catholic University of Central Africa, Department of Public Health, School of Health Sciences, Yaoundé, Cameroon
- Cameroon Baptist Convention Health Services, Mbingo Baptist Hospital, Oncology Unit, Bamenda, Cameroon
| | - Marius Nsoh
- Catholic University of Central Africa, Department of Public Health, School of Health Sciences, Yaoundé, Cameroon
- Georgetown University, Centre for Global Health Practice and Impact, TIDE Project, Yaoundé, Cameroon
| | - Axler Jean Paul
- State University of Haiti, Faculty of Medicine and Pharmacy, State University Hospital of Haiti, Port-au-Prince, Haiti
| | - André Nkondjock
- Catholic University of Central Africa, Department of Public Health, School of Health Sciences, Yaoundé, Cameroon
- Ministry of Defense, Military Health Department, Yaoundé, Cameroon
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Knowledge of Antiretroviral Treatment and Associated Factors in HIV-Infected Patients. Healthcare (Basel) 2021; 9:healthcare9040483. [PMID: 33923916 PMCID: PMC8073643 DOI: 10.3390/healthcare9040483] [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: 02/04/2021] [Revised: 04/06/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to assess the knowledge of antiretroviral (ARV) treatment and the associated factors in HIV-infected patients in Vietnam. We conducted a cross-sectional descriptive study of 350 human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients being treated with ARV at outpatient clinics at Soc Trang, Vietnam, from June 2019 to December 2019. Using an interview questionnaire, patients who answered at least eight out of nine questions correctly, including some required questions, were considered to have a general knowledge of ARV treatment. Using multivariate logistic regression to identify factors associated with knowledge of ARV treatment, we found that 62% of HIV-infected patients had a general knowledge of ARV treatment, with a mean score of 8.2 (SD 1.4) out of 9 correct. A higher education level (p < 0.001); working away from home (p = 0.013); getting HIV transmitted by injecting drugs or from mother-to-child contact (p = 0.023); the presence of tension, anxiety, or stress (p = 0.005); self-reminding to take medication (p = 0.024); and a high self-evaluated adherence (p < 0.001) were found to be significantly associated with an adequate knowledge of ARV treatment. In conclusion, education programs for patients, as well as the quality of medical services and support, should be strengthened.
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Physical, Emotional, and Psychosocial Challenges Associated with Daily Dosing of HIV Medications and Their Impact on Indicators of Quality of Life: Findings from the Positive Perspectives Study. AIDS Behav 2021; 25:961-972. [PMID: 33026574 PMCID: PMC7936969 DOI: 10.1007/s10461-020-03055-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 12/22/2022]
Abstract
To assess challenges with daily oral antiretroviral therapy (ART), we analyzed data for 2389 participants in the 2019 Positive Perspectives survey of people living with HIV in 25 countries. ART-related challenges reported included difficulty swallowing pills (33.1% [790/2389]); stress from daily dosing routine (33.3% [795/2389]); bad memories from daily intake of HIV medication (35.1%[839/2389]), and concern “that having to take pills every day means a greater chance of revealing my HIV status to others” (37.9% [906/2389]). Individuals who felt empowered by daily oral dosing [“taking my pill(s) every day reassures me that my HIV is being kept under control”] had 69% higher odds of optimal overall health (AOR 1.69, 95% CI 1.40–2.04). Conversely, odds of optimal overall health were lower among those who felt daily pill intake “limits my day-to-day life” (AOR 0.53, 95% CI 0.44–0.64). These findings show that there is need for increased flexibility of ART delivery to meet diverse patient needs.
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Prevalence and Determinants of Medication Adherence among Patients with HIV/AIDS in Southern Vietnam. Infect Dis Rep 2021; 13:126-135. [PMID: 33562451 PMCID: PMC7931092 DOI: 10.3390/idr13010014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 01/25/2023] Open
Abstract
This study was conducted to determine the prevalence and determinants of medication adherence among patients with HIV/AIDS in southern Vietnam. METHODS A cross-sectional study was conducted in a hospital in southern Vietnam from June to December 2019 on patients who began antiretroviral therapy (ART) for at least 6 months. Using a designed questionnaire, patients were considered adherent if they took correct medicines with right doses, on time and properly with food and beverage and had follow-up visits as scheduled. Multivariable logistic regression was used to identify determinants of adherence. KEY FINDINGS A total of 350 patients (from 861 medical records) were eligible for the study. The majority of patients were male (62.9%), and the dominant age group (≥35 years old) accounted for 53.7% of patients. Sexual intercourse was the primary route of transmission of HIV (95.1%). The proportions of participants who took the correct medicine and at a proper dose were 98.3% and 86.3%, respectively. In total, 94.9% of participants took medicine appropriately in combination with food and beverage, and 75.7% of participants were strictly adherent to ART. The factors marital status (odds ratio (OR) = 2.54; 95%CI = 1.51-4.28), being away from home (OR = 1.7; 95%CI = 1.03-2.78), substance abuse (OR = 2.7; 95%CI = 1.44-5.05), general knowledge about ART (OR = 2.75; 95%CI = 1.67-4.53), stopping medication after improvement (OR = 4.16; 95%CI = 2.29-7.56) and self-assessment of therapy adherence (OR = 9.83; 95%CI = 5.44-17.77) were significantly associated with patients' adherence. CONCLUSIONS Three-quarters of patients were adherent to ART. Researchers should consider these determinants of adherence in developing interventions in further studies.
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Salleh NAM, Voon P, Karamouzian M, Milloy MJ, Richardson L. Methadone maintenance therapy service components linked to improvements in HIV care cascade outcomes: A systematic review of trials and observational studies. Drug Alcohol Depend 2021; 218:108342. [PMID: 33097340 PMCID: PMC7750271 DOI: 10.1016/j.drugalcdep.2020.108342] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/17/2020] [Accepted: 10/04/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The beneficial links between engagement in methadone maintenance therapy (MMT) and HIV treatment outcomes have been extensively described. Nevertheless, people who use drugs (PWUD) continue to experience suboptimal HIV treatment outcomes. In this systematic review, we sought to identify components of MMT service provision that are associated with improvements in HIV care outcomes across the HIV care cascade. METHODS We searched for peer-reviewed studies in online databases. To be eligible for inclusion in this review, studies must have involved a population or sub-population of PWUD engaged in MMT; report improved uptake of HIV testing, exposure to ART, or HIV-1 RNA plasma viral load suppression; provide details on MMT services; and be published in English between 1 January 2006 until 31 December 2018. RESULTS Out of the 5594 identified records, 22 studies were eligible for this systematic review. Components of MMT services associated with HIV care cascade outcomes described in the studies were classified in three categories of care models: 1) standard MMT care with adequate doses, 2) standard MMT care and alongside additional medical component(s), and 3) standard MMT care, additional medical component(s) as well as informational or instrumental social support. CONCLUSION The few studies identified reflect a scarcity of evidence on the role of social support to increase the benefits of MMT for PWUD who are living with HIV. Further research is needed to assess the role of medical and social service components in MMT care delivery in advancing PWUD along the HIV care cascade.
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Affiliation(s)
- NA Mohd Salleh
- Interdisciplinary Studies Graduate Program, University of
British Columbia, Vancouver, BC, Canada,British Columbia Centre on Substance Use, Vancouver, BC,
Canada,Department of Social and Preventive Medicine, Faculty of
Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pauline Voon
- British Columbia Centre on Substance Use, Vancouver, BC,
Canada,School of Population and Public Health, University of
British Columbia, Vancouver, BC, Canada
| | - Mohammad Karamouzian
- British Columbia Centre on Substance Use, Vancouver, BC,
Canada,School of Population and Public Health, University of
British Columbia, Vancouver, BC, Canada,HIV/STI Research Center, and WHO Collaborating Center for
HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - M-J Milloy
- British Columbia Centre on Substance Use, Vancouver, BC,
Canada,Department of Medicine, University of British Columbia,
Vancouver, BC, Canada
| | - Lindsey Richardson
- British Columbia Centre on Substance Use, Vancouver, BC, Canada; Department of Sociology, University of British Columbia, Vancouver, BC, Canada.
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Desai N, Burns L, Gong Y, Zhi K, Kumar A, Summers N, Kumar S, Cory TJ. An update on drug-drug interactions between antiretroviral therapies and drugs of abuse in HIV systems. Expert Opin Drug Metab Toxicol 2020; 16:1005-1018. [PMID: 32842791 DOI: 10.1080/17425255.2020.1814737] [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: 12/21/2022]
Abstract
INTRODUCTION While considerable progress has been made in the fight against HIV/AIDS, to date there has not been a cure, and millions of people around the world are currently living with HIV/AIDS. People living with HIV/AIDS have substance abuse disorders at higher rates than non-infected individuals, which puts them at an increased risk of drug-drug interactions. AREAS COVERED Potential drug-drug interactions are reviewed for a variety of potential drugs of abuse, both licit and illicit. These drugs include alcohol, cigarettes or other nicotine delivery systems, methamphetamine, cocaine, opioids, and marijuana. Potential interactions include decreased adherence, modulation of drug transporters, or modulation of metabolic enzymes. We also review the relative incidence of the use of these drugs of abuse in People living with HIV/AIDS. EXPERT OPINION Despite considerable improvements in outcomes, disparities in outcomes between PLWHA who use drugs of abuse, vs those who do not still exist. It is of critical necessity to improve outcomes in these patients and to work with them to stop abusing drugs of abuse.
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Affiliation(s)
- Nuti Desai
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Leah Burns
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Yuqing Gong
- Department of Pharmacy Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Kaining Zhi
- Plough Center for Sterile Drug Delivery Solutions, University of Tennessee Health Science Center , Memphis, TN, USA
| | - Asit Kumar
- Department of Pharmacy Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Nathan Summers
- Division of Infectious Diseases, University of Tennessee Health Science Center College of Medicine , Memphis, TN, USA
| | - Santosh Kumar
- Department of Pharmacy Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
| | - Theodore J Cory
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy , Memphis, TN, USA
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Zeng C, Li X, Qiao S, Yang X, Shen Z, Zhou Y. Anticipated stigma and medication adherence among people living with HIV: the mechanistic roles of medication support and ART self-efficacy. AIDS Care 2020; 32:1014-1022. [PMID: 32336130 DOI: 10.1080/09540121.2020.1728213] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study aimed to examine the relationship between anticipated stigma and medication adherence as well as the mechanistic roles of medication support and ART self-efficacy. Data were derived from the baseline assessment of a prospective cohort study in Guangxi, China. A total of 1198 PLWH were recruited and assessed on their sociodemographic characteristics, medication adherence, anticipated stigma, medication support, and ART self-efficacy. Path analysis was used to examine the direct effect from anticipated stigma to medication adherence and indirect effects through medication support and ART self-efficacy. Path model revealed that the indirect effect from anticipated stigma to medication adherence was statistically significant while the direct effect was not significant. Anticipated stigma could influence medication adherence through ART self-efficacy but not through medication support. The serial mediating effect of medication support and ART self-efficacy on the relationship between anticipated stigma and medication adherence was significant. Anticipated stigma affects medication adherence among PLWH through its adverse impact on medication support and ART self-efficacy. Tailored interventions promoting medication support and ART self-efficacy may alleviate the negative influence of anticipated stigma on medication adherence among PLWH. Additionally, policy efforts aiming to reduce stigma against PLWH and increasing medication support are warranted to improve medication adherence among PLWH.
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Affiliation(s)
- Chengbo Zeng
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xueying Yang
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, People's Republic of China
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, People's Republic of China
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McMahon JM, Braksmajer A, Zhang C, Leblanc N, Chen M, Aidala A, Simmons J. Syndemic factors associated with adherence to antiretroviral therapy among HIV-positive adult heterosexual men. AIDS Res Ther 2019; 16:32. [PMID: 31706357 PMCID: PMC6842154 DOI: 10.1186/s12981-019-0248-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/25/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Suboptimal adherence to HIV antiretroviral therapy (ART) and concomitant lack of viral control can have severe consequences for health and onward transmission among persons living with HIV. Little is known about the barriers and facilitators of optimal ART adherence among heterosexual HIV-positive men. METHODS Structural equation modeling (SEM) was performed to test a theory-derived model of ART adherence using data from a cross-sectional sample of 317 HIV-positive self-identified heterosexual men residing in New York City. We assessed a conceptual model in which mental health (depression, anxiety) and substance use dependence mediated the effects of socio-structural factors (HIV-related stigma, social support) on ART adherence, and subsequently, undetectable viral load. RESULTS Structural equation modeling analyses indicated that men who reported higher levels of HIV-related stigma tended to experience higher levels of general anxiety, which in turn was associated with reduced probability of optimal ART adherence. Moreover, men who reported higher levels of social support tended to exhibit less dependence on illicit substance use, which in turn was associated with increased probability of optimal ART adherence. African-American men reported lower ART adherence compared to other racial/ethnic groups. CONCLUSIONS Our findings support the hypothesis that substance use dependence and mental health problems, particularly anxiety, may be primary drivers of suboptimal ART adherence among heterosexual men, and that socio-structural factors such as HIV-related stigma and social support are potential modifiable antecedents of these drivers.
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