Use of dietary supplements among people living with HIV/AIDS is associated with vulnerability to medical misinformation on the internet

Patients Are Using Dietary Supplement for the Treatment of Their Diseases without Consultation with Their Physicians and Pharmacists

Inappropriate use of dietary supplements by patients might exacerbate their diseases. The aim of this study was to clarify the situation of dietary supplement use for disease treatment among patients. A cross-sectional online questionnaire survey was conducted between 18 and 30 November 2022. A preliminary survey revealed that the proportion of patients who used dietary supplements to treat their disease ranged from 7.7% (cancer) to 28.2% (menopausal disorder). In the actual survey, across all diseases, patients who used dietary supplements for treatment purposes were satisfied with their therapeutic effects. Information obtained via the internet was the most common reason given for starting to use supplements. The proportions of patients who used supplements concurrently with medicine ranged from 25.4% (liver disease) to 72.2% (mental disorder). Most users of supplements did not consult with their physicians or pharmacists about them. However, patients preferred face-to-face consultation with a physician or pharmacist when discussing the concomitant use of medicines. In conclusion, the role of pharmacists is important for the appropriate use of dietary supplements among patients, especially concomitant use with medicines. More awareness about dietary supplements is needed for healthcare professionals to consult with their patients.

Factors governing consumers buying behavior concerning nutraceutical product

In recent years, consumers are increasingly attracted to nutraceuticals, an important part of food considered propitious for human health. Therefore, consumers are willingly switching to nutraceuticals and are ready to pay the premium price. This review aims to identify various factors that govern consumer purchasing of nutraceutical products. The outcomes presented in the review provide a closer understanding of consumer attitudes toward buying behavior and their impact on the growth of the global nutraceutical market. The nutraceutical market has been identified depending on the type of nutraceuticals, forms, and regions governing the nutraceutical market. Factors such as health consciousness, knowledge about a product, product availability, price, marketing strategies, and social factors influence consumers' actual buying behavior toward nutraceutical products. A mini survey in Mumbai city of India was conducted to add practical data to the review, and factors affecting consumers' willingness to buy nutraceutical products were identified. It was observed that the decision-making toward buying nutraceutical products was affected by gender, age, education level, and acculturation. It was also identified that the legislation governing nutraceuticals needs to be harmonized throughout many parts of the world, which restricts the growth of this sector to some extent. The findings elucidate that nutraceutical industries should overcome the regulatory barriers and focus on developing innovative products, which will keep current consumers intact and help increase the consumer base and thus expand the nutraceutical market globally.

Potential application of conversational agents in HIV testing uptake among high-risk populations

Human Immunodeficiency Virus (HIV) continues to be a significant public health problem, with ~1.2 million Americans living with HIV and ~14% unaware of their infection. The Centers for Disease Control and Prevention recommends that patients 13 to 64 years of age get screened for HIV at least once, and those with higher risk profiles screen at least annually. Unfortunately, screening rates are below recommendations for high-risk populations, leading to problems of delayed diagnosis. Novel technologies have been applied in HIV research to increase prevention, testing and treatment. Conversational agents, with potential for integrating artificial intelligence and natural language processing, may offer an opportunity to improve outreach to these high-risk populations. The feasibility, accessibility and acceptance of using conversational agents for HIV testing outreach is important to evaluate, especially amidst a global coronavirus disease 2019 pandemic when clinical services have been drastically affected. This viewpoint explores the application of a conversational agent in increasing HIV testing among high-risk populations.

Health literacy in dietary supplement use among working-age groups: systematic review and meta-analysis

Background

Globally, dietary supplement use (DSU) is very popular against COVID19. This study aims to investigate the characteristics of research on health literacy (HL) in DSU and compare HL among working-age groups by reviewing related research between 2011 and 2021 in PubMed, SCOPUS, ClinicalKey, Google Scholar and ThaiJO.

Methods

Twenty-five articles that met the inclusion criteria were selected for study and analyzed using Cohen's d.

Results

The results showed that HL affected dietary supplement (DS) consumption behavior among working-age groups with an average effect size of 0.423 (95% CI = 0.249-0.598), followed by disclosure of DSU with an average effect size of 0.220 (95% CI = 0.087-0.353). No effect was found on awareness of dietary supplement advertisements.

Conclusion

The discovery of such knowledge is a significant contribution to public health, leading to the development of interventions and policies for enhancing HL in DSU e.g. organizing knowledge-sharing workshops on DSU and building support networks across all sectors.

The Impact of Misinformation and Health Literacy on HIV Prevention and Service Usage

There are an increasing number of online resources people can use to gain access to information, including for health-related issues, such as for HIV prevention. Trend data show that the way individuals obtain news and information has changed from years past. Health literacy, therefore, is an important skill to ensure adequate understanding of the data available about HIV in the media and online. Unfortunately, the proliferation of misinformation is ubiquitous and may have deleterious effects on individual health behavior, and consequently, the public’s health. This commentary focuses on sources of online misinformation as it relates to HIV and how misinformation impacts seeking health services.

Dietary and herbal supplements for weight loss: assessing the quality of patient information online

Background

Given the high prevalence of dietary and herbal supplement (DHS) use in tandem with the growing ease of internet access, patients commonly search online for consumer health information about these products. One common reason for DHSs use includes weight loss. Healthcare providers need to be aware of the quality of online information about DHSs for weight loss so they can adequately counsel their patients and provide them with guidance surrounding the identification of high-quality information resources. This study aimed to assess the quality of online DHSs consumer health information for weight loss that a “typical” patient might access online.

Methods

Six search terms were used to generate the first 20 websites on the Google search engine in four countries: Australia, Canada, the United Kingdom, and the United States (n = 480 websites). After applying exclusion criteria, eligible websites were quality assessed using the DISCERN instrument. This tool is comprised of 16 questions, each evaluated on a 5-point scale. The averages and standard deviations for each DISCERN instrument item, in addition to overall summed scores between 15 and 75 were calculated.

Results

Across 87 eligible websites, the mean summed score was 44.80 (SD = 11.53), while the mean overall DISCERN score of each website was 2.72 (SD = 0.99). In general, websites detailed and achieved their specified aims and described treatment benefits. However, most websites failed to describe the impact of treatment on overall quality of life and the impact of a no treatment option. The highest-scoring websites were largely government or health portal websites, while the lowest-scoring websites were largely commercial in nature.

Conclusion

High variability in DISCERN instrument scores was found across all websites assessed. Healthcare providers should be aware of the fact that their patients may be accessing misinformation online surrounding the use of DHSs for weight loss. Therefore, it is important for healthcare providers to ensure that they are providing their patients with guidance on how to identify high-quality resources online, in order that safe, effective, and evidence-based decisions are made surrounding the use of DHSs for weight loss.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-021-00729-x.

Misinformation and public opinion of science and health: Approaches, findings, and future directions

A summary of the public opinion research on misinformation in the realm of science/health reveals inconsistencies in how the term has been defined and operationalized. A diverse set of methodologies have been employed to study the phenomenon, with virtually all such work identifying misinformation as a cause for concern. While studies completely eliminating misinformation impacts on public opinion are rare, choices around the packaging and delivery of correcting information have shown promise for lessening misinformation effects. Despite a growing number of studies on the topic, there remain many gaps in the literature and opportunities for future studies.

Possible Herb-Drug Interaction Risk of Some Nutritional and Beauty Supplements on Antiretroviral Therapy in HIV Patients

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.

Do Brief Educational Sessions Increase Electronic Health Literacy of Low-Income Persons Living With HIV/AIDS?

This research explored whether participating in a brief educational intervention using the National Library of Medicine video, Evaluating Health Information: A Tutorial From the National Library of Medicine, would increase electronic health literacy. A quasi-experimental longitudinal design was used in two randomly selected settings of a treatment program for low-income persons living with HIV/acquired immune deficiency syndrome (N = 100). Individuals in both intervention groups watched the video and completed an at-home assignment brought to the second session 1 week later; one group received an additional 15 minutes with an HIV nurse clinician who reinforced video content. Generalized linear models were used in order to account for the longitudinal nature of the data; a full model was fitted first that included age, gender, race, ethnicity, education, acquired immune deficiency syndrome diagnosis, time, group, and the interaction of time by intervention group with electronic health literacy as the dependent variable. Group means were not significantly different, and the overall group pattern were the same; the only significant variable was older age, which is consistent with the findings of other literature. Electronic health literacy can be increased by viewing a free video; making this video available in a variety of settings and encouraging clients to use the Internet as a source of health information may improve self-management strategies of persons living with chronic illnesses.

Antiretroviral Therapy (ART)-related Knowledge Seeking among People Living with HIV (PLHIV) in China: Role of Information & Communication Technology (ICT)

This paper investigated the use of information communication technology (ICT) to seek antiretroviral therapy (ART)-related knowledge among people living with HIV (PLHIV) taking antiretroviral treatment in Guangxi, China. A total 1902 participants who undertook ART and had used ICT were recruited from 12 sites with the highest cumulative HIV incidence. A questionnaire survey was used to collect data on the participants’ sociodemographic characteristics, clinical outcomes, infections in the family and comorbidity, access to healthcare resources, ICT using behavior in HIV management, and ART-related knowledge. The results showed that 15% of the participants had searched HIV-related information online, fewer participants had contacted healthcare providers via computer (1.6%) or text messaging (11.9%), and only 7.7% of the participants had contacted other PLHIV using ICT. Education had a positive impact on the knowledge level of all three categories of ART-related knowledge. Participants with better medication and mechanisms knowledge were more likely to search HIV-related information online and less likely to contact healthcare providers using text messages. Findings of this study suggested that ICT was used as an effective approach to acquire some type of ART-related knowledge. ICT was underutilized in health communication among the PLHIV in this study due to low education level and insufficient eHealth literacy. Future intervention programs should address the customization of the communication tools and focus on improving the education level and eHealth literacy of the PLHIV to better promote ICT as an efficient platform for ART-related knowledge seeking.

Food elimination, food substitution, and nutrient supplementation among ARV-exposed HIV-positive persons in southern Ghana

BACKGROUND

Optimal nutrition is a determinant of health in all persons. In persons living with HIV (PLHIV), nutrition is particularly important. Various factors, including dietary practices, play a role in guaranteeing nutritional health.

OBJECTIVES

We investigated multiple non-prescription drugs use among HIV-positive persons receiving antiretroviral therapy (ART) from four treatment centers in southern Ghana. This paper, however, focuses on nutrient supplement use, food elimination, and food substitution practices by the PLHIV.

METHODS

Using quantitative and qualitative methods, we collected data from 540 HIV-positive persons at the health facility level. This paper focuses on only the quantitative data. Individual study participants were selected using a systematic random sampling procedure. Participants were interviewed after informed consent. We used univariate analysis to generate descriptive tabulations for key variables. Multivariable logistic regression modeling identified predictors of three practices (nutrient supplementation, food elimination, and food substitution). P value less than 0.05 or 95% confidence intervals facilitated determination of statistical significance. All analyses were performed using IBM SPSS Statistics for Windows, version 20.0.

RESULTS

The use of nutrient supplements was a popular practice; 72% of the PLHIV used various kinds. The primary motive for the practice was to boost appetite and to gain weight. A little over 20% of the participants reportedly eliminated certain foods and beverages, while 17% introduced new foods since their initial HIV diagnosis. All the three practices were largely driven by the quest for improved health status. We determined predictors of nutrient supplementation to be ART clinic location and having an ART adherence monitor. Having an ART adherence monitor was significantly associated with reduced odds of nutrient supplementation (AOR = 0.34; 95% CI 0.12-0.95). The only predictor for food elimination was education level (AOR = 0.29; 95% CI 0.30-0.92); predictors of food substitution were ART clinic location (AOR = 0.11; 95% CI 0.02-0.69) and anemia (defined as hemoglobin concentration less than 11.0 g/dl) (AOR = 0.21; 95% CI 0.12-0.85).

CONCLUSIONS

The practice of supplementation is popular among this group of PLHIV. Food elimination and substitution are practiced, albeit in moderation. The predictors identified may prove helpful in provider-client encounters as well as local HIV programming.

Prevalence and risk factors of methicillin-resistant Staphylococcus aureus colonization among HIV patients in Mekelle, Northern Ethiopia

HIV-positive individuals are at higher risk of Methicillin Resistant Staphylococcus aureus (MRSA) colonization and its related infection. There is limited data in the nation on the prevalence and risk factors of MRSA colonization among HIV patients. The aim of this study was to address the existing knowledge gap. Cross sectional study was carried out from September 2014 to February 2015 in three selected health centers and one general hospital. A standardized questionnaire was developed for collection of socio-demographic and clinical data. A total of 498 Nasal and throat swabs (two for each patient) were collected from 249 patients, transported and processed using standard bacteriological procedures. Data was analyzed using Chi square (X²) test and associated risk factors were determined. P < 0.05 was considered statistically significant. Out of 249 study participants, S. aureus was isolated from 81 (32.5 %) patients, with MRSA colonization rate of 6 (2.4 %). MRSA isolates were resistant to Ciprofloxacin and trimethoprim-sulphamethoxazole (16.7 % each), clindamycin (33.3 %) and erythromycin (50 %). However, all MRSA isolates were 100 % sensitive to Amikacin. History of hospitalization, percutaneous device usage, patients with a household member’s hospitalization and low CD₄ count (<200 cells/mm³) were significantly associated with S. aureus colonization (p < 0.05).

Impact of daily supplementation of Spirulina platensis on the immune system of naïve HIV-1 patients in Cameroon: a 12-months single blind, randomized, multicenter trial

BACKGROUND

Micronutrient deficiencies occur early in Human Immunodeficiency Virus (HIV) infections they have reverse effects on the nutritional status. The diet supplementation with a natural nutraceutical rich in proteins and micronutrient like Spirulina platensis, may be effective and efficient in delaying HIV disease progression by frequently reported improvement in immune response.

METHODS

A prospective single-blind, randomized, multicenter study conducted on 320 HIV-1 ARV-naïve participants for 12 months. Participants received either S. platensis supplementation and standard care or standard care and local balanced diet without S. platenis. Selected hematological and biochemical as well as CD4 count cells, viral load copies were assessed at three separate times.

RESULTS

Among the 169 ART-naïve participants enrolled in the study, the female was mostly represented (67.1%). The significant increase of CD4 count cells (596.32-614.92 cells count) and significant decrease of viral load levels (74.7 × 10(3)-30.87 × 10(3) copies/mL) of the patients who received a supplementation of S. platensis was found after 6 months of treatment. Haemoglobin level was also significantly higher in the same group while the fasting blood glucose concentration decreased after 12 months compared to control.

CONCLUSION

A daily supplementation with S. platensis to diet combined with a reasonable balanced diet has significantly increased the CD4 cells and reduced the viral load after 6 months. Further studies are recommended among a large specific group of people infected by the HIV in order to investigate the mechanisms involved on the effect of S. platensis on immune system.

Effects of Spirulina platensis supplementation on lipid profile in HIV-infected antiretroviral naïve patients in Yaounde-Cameroon: a randomized trial study

Background

Cardiovascular diseases (CVD) and metabolic alterations are among the majors public health concern that have been reported in people living with HIV infections. Factors contributing to cardio metabolic syndrome in HIV include body fat distribution, dyslipidemia, insulin resistance, cardiovascular dysfunction and inflammation. The aim of the study was to determine the effect of Spirulina platensis (Cyanobacteriaceae) supplementation versus local diet on lipid profile in HIV-infected antiretroviral-naive patients.

Methods

A prospective single-blind, randomized, multicentre study was conducted from February 2010 to December 2012. A total of 320 HIV antiretroviral-naïve patients were screened and 169 were recruited in this study. Patients were randomized and received either Spirulina supplementation combined with local diet (n = 82) or local diet only (n = 87). Age, weight, body mass index (BMI), lipid profile, CD4 count, and local food intake variables were assessed on three separate occasions (three, six and twelve months).

Results

An average age of the patients was 35.6 ± 9 years. The majority of participants were female 67.1%. Regarding the lipid profile, there is a significant increase in HDL-cholesterol and a significant decrease in total cholesterol, LDL-cholesterol and triglycerides in the group of patients who consumed Spirulina platensis. A change in the atherogenic index defined by the ratio CT/HDL-C substitutable by LDL-C/HDL-C and the TC/HDL decreased significantly from 10.83 at baseline to 2.22 after 12 months (p = 0.21 and p <0.0001) in the patients taking Spirulina.

Conclusions

Nutritional supplementation with Spirulina combined with a quantitative and qualitative balanced diet for at least six months can retard an exposition to lipid abnormalities in HIV–infected antiretroviral-naive patients. Further studies are recommended on a large group of people not infected with HIV and exposed to cardiovascular risk factors.

Perceived stress levels among HIV/AIDS-infected mothers: the role of over-the-counter products

The purpose of this study was to identify correlates of perceived stress levels among 49 HIV/AIDS-infected mothers enrolled in a social services agency that provides HIV/AIDS support services in North Carolina. The author found in an Ordinary Least Squares regression analysis that the CD4 t-cell count, receipt of advice or support from church pastor, annual household income, and employed were all negatively related to seropositive mothers' perceived stress scores. Conversely, the need to have borrowed money from family members or friends to help pay for over-the-counter products like nutritional drinks, vitamins, or minerals was found to be positively related to these scores. The accessibility of these over-the-counter products could not only help to lower seropositive mothers' perceived stress levels but also potentially improve the functioning of their body's immune system. Implications for the Medicaid Program's prescription drug policy that excludes these over-the-counter products and prescription drug representatives are discussed.