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Ali MW, Musa MS. The effect of mobile phone utilization for enhanced adherence counselling intervention among persons with HIV. AIDS Care 2023; 35:1919-1927. [PMID: 36781302 DOI: 10.1080/09540121.2023.2175771] [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: 10/03/2022] [Accepted: 01/22/2023] [Indexed: 02/15/2023]
Abstract
The conduct of physical enhanced adherence counselling (EAC) for antiretroviral therapy (ART) non-adherers is often flawed by objectionable time lag from commencement to timely completion of the process. Therefore, we conducted a retrospective cohort study of 342 adults (≥18 years) with HIV on ART to determine the outcome of utilizing mobile phone based EAC intervention. Structural equation modelling framework, with full information maximum likelihood estimator was used to elucidate the pathways linking the relationship between individual characteristics, perceived barriers to ART adherence, and the applied interventions. A total of 321(93.9%) participants completed the required 3 EAC sessions over 60-days. The proportion of viral load (VL) re-suppression (<1000 copies/mL) after EAC intervention was 66.6%. The mean durations of EAC onset from time of high VL confirmation and completion of EAC were 6.26 ± 3.22 and 59.99 ± 5.14 days, respectively. In the simultaneous model (Comparative Fit Index = 0.89, Tucker-Lewis Index = 0.851, Root Mean Square (RMS) Error of Approximation = 0.049, Standardized RMS Residual = 0.059), the variables: forgot, knowledge/beliefs, side effect of drugs, lost/ran out of drugs, scheduling, and stigma were significant barrier factors contributing to poor ART adherence. The use of mobile phones for EAC intervention was effective for early initiation and timely completion of the sessions.
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Affiliation(s)
- Mohammed Wulgo Ali
- College of Medical Sciences, Gombe State University/ Federal Teaching Hospital Gombe, Gombe, Nigeria
| | - Muhammad Sale Musa
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
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Rutstein SE, Sibley AL, Huffstetler HE, Nguyen TTD, Tran HV, Le Minh G, Sripaipan T, Nguyen M, Miller WC, Eron JJ, Gay CL, Go VF. Acceptability and feasibility of long-acting injectable antiretroviral therapy for HIV-infected persons who inject drugs in Vietnam: A qualitative study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 31:100603. [PMID: 36879789 PMCID: PMC9985034 DOI: 10.1016/j.lanwpc.2022.100603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND In Vietnam, HIV prevalence among people who inject drugs (PWID) is several times higher than in the general population (15% versus 0.3%). PWID also experience higher rates of HIV-related mortality, driven by poor antiretroviral therapy (ART) adherence. Long-acting injectable ART (LAI) is a compelling opportunity to improve treatment outcomes, but acceptability and feasibility among HIV-infected PWID remains unexplored. METHODS We conducted key informant in-depth interviews in Hanoi, Vietnam (February-November 2021). Participants were purposively sampled and included policymakers, ART clinic staff, and HIV-infected PWID. We applied the Consolidated Framework for Implementation Research to guide study design and analysis, using thematic coding to develop and iteratively refine a codebook and characterize barriers and facilitators to LAI implementation. FINDINGS We interviewed 38 key stakeholders: 19 PWID, 14 ART clinic staff, and five policymakers. Participants were enthusiastic about LAI convenience, highlighting less frequent and more discreet dosing. However, contrasting providers, several policymakers suggested LAI was not needed given perceived exceptional oral ART outcomes and rare viral failure among PWID. Policymakers also criticized strategies prioritizing PWID for LAI, emphasizing equity, whereas providers identified PWID as an ideal population for LAI given adherence challenges. LAI complexity, including storage and administration logistics, were deemed surmountable with training and resources. Finally, providers and policymakers acknowledged that adding LAI to drug formularies was key, but an onerous process. INTERPRETATION Although anticipated to be resource-intensive, LAI was a welcome addition for interviewed stakeholders and likely an acceptable alternative to oral ART among PWID living with HIV in Vietnam. Despite enthusiasm among PWID and providers that LAI could improve viral outcomes, some policymakers-whose buy-in is critical to LAI implementation-opposed strategies that preferentially distributed LAI to PWID, highlighting values of equity and revealing differences in perceived HIV outcomes among PWID. Results provide a vital foundation for developing LAI implementation strategies. FUNDING Supported by National Institutes of Health.
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Affiliation(s)
- Sarah E. Rutstein
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, North Carolina 27599, USA
| | - Adams L. Sibley
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
| | - Hanna E. Huffstetler
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
| | | | | | | | - Teerada Sripaipan
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
| | - Minh Nguyen
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
| | - William C. Miller
- Department of Epidemiology, The Ohio State University, 1841 Neil Ave, Columbus, Ohio 43210, USA
| | - Joseph J. Eron
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, North Carolina 27599, USA
| | - Cynthia L. Gay
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, North Carolina 27599, USA
| | - Vivian F. Go
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
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Medication Adherence of Vietnamese Outpatients with Chronic Diseases during the COVID-19 Pandemic. Trop Med Infect Dis 2022; 7:tropicalmed7060101. [PMID: 35736980 PMCID: PMC9228239 DOI: 10.3390/tropicalmed7060101] [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: 04/23/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to determine the medication adherence of outpatients with chronic diseases and the association between both patient attitudes and preventive practices regarding COVID-19 and their medication adherence. We performed a cross-sectional study in Vietnam. Medication adherence was determined using the translated and validated Vietnamese version of the General Medication Adherence Scale (GMAS). Patient attitudes and preventive practices regarding COVID-19 were measured using the 5K message of the Vietnam Ministry of Health (facemasks, disinfection, distance, no gatherings, health declarations). The associations between patient characteristics and medication adherence were determined by multivariable regression. The study included 1852 outpatients, and 57.6% of the patients adhered to their medications. Patients who recognized the pandemic’s obstruction of medical follow-ups (OR = 1.771; 95%CI = 1.461−2.147; p < 0.001), who applied ≥2 preventive methods (OR = 1.422; 95%CI = 1.173−1.725; p = 0.001), who were employed (OR = 1.677; 95%CI = 1.251−2.248; p = 0.001), who were living in urban areas (OR = 1.336; 95%CI = 1.090−1.637; p = 0.005,) who possessed higher education levels (OR = 1.313; 95%CI = 1.059−1.629; p = 0.013), or who had ≤2 comorbidities (OR = 1.293; 95%CI = 1.044−1.600; p = 0.019) were more likely to adhere to their medications. The adherence percentage for outpatients with chronic diseases was quite low during the pandemic. Patients who did not recognize the COVID-19 pandemic’s obstruction of medical follow-ups or who had poor preventive practices were less likely to adhere to medications. Healthcare providers should pay more attention to these groups to achieve desired treatment outcomes.
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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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