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Ndaba S, Mthembu M, Ramphabana LB. Healthcare workers’ perceptions about barriers and facilitators to effective communication with children during human immunodeficiency virus care in KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med 2022. [DOI: 10.4102/phcfm.v14i1.3177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Life loaded with threat and vulnerability: a qualitative inquiry into the experiences of HIV negative married women in serodiscordant heterosexual relationships. BMC Womens Health 2021; 21:402. [PMID: 34876115 PMCID: PMC8650320 DOI: 10.1186/s12905-021-01546-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 11/19/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Violence against women is a major, complex, multidimensional and widespread public health concern worldwide. The current qualitative study was conducted to understand the experience of violence among HIV negative married women in heterosexual serodiscordant relationships.
Methods
A qualitative description (QD) was conducted from October 2018 to January 2020 in Mashhad, Iran. The participants were 15 HIV negative women, who married and lived with HIV positive men, through purposive sampling method. The data were collected using semi-structured interviews. Data analyzed using conventional content analysis adopted by Graneheim and Lundman.
Results
The main overarching theme emerged entitled: life loaded with threat and vulnerability. This theme consisted of four categories of self-directed violence, intimate partner violence, cultural violence and structural violence. The violence began soon after awareness of husband's infection with acts such as suicide attempts and a sense of abhorrence for living with an infected person, and continued with confrontation with various types of violence in the family and society, which put women in constant threat and vulnerability.
Conclusions
This study provided an insight into different aspects of violence in Iranian women in HIV serodiscordant relationships. Considering the role of men in the occurrence of violence, policymakers must create and execute family-centered interventions to address attitudes and behaviors that lead to marital conflicts and spousal abuse in order to prevent violence. Health care professionals should also be trained to screen women for violence and refer those who require care to specialists to reduce vulnerability.
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Ngayo MO, Oluka M, Bulimo WD, Okalebo FA. Association between social psychological status and efavirenz and nevirapine plasma concentration among HIV patients in Kenya. Sci Rep 2021; 11:22071. [PMID: 34764325 PMCID: PMC8585942 DOI: 10.1038/s41598-021-01345-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/25/2021] [Indexed: 11/09/2022] Open
Abstract
HIV-related stigma, lack of disclosure and social support are still hindrances to HIV testing, care, and prevention. We assessed the association of these social-psychological statuses with nevirapine (NVP) and efavirenz (EFV) plasma concentrations among HIV patients in Kenya. Blood samples were obtained from 254 and 312 consenting HIV patients on NVP- and EFV-based first-line antiretroviral therapy (ART), respectively, and a detailed structured questionnaire was administered. The ARV plasma concentration was measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). There were 68.1% and 65.4% of the patients on NVP and EFV, respectively, who did not feel guilty for being HIV positive. The disclosure rates were approximately 96.1% and 94.6% of patients on NVP and EFV, respectively. Approximately 85% and 78.2% of patients on NVP and EFV, respectively, received social support as much as needed. There were 54.3% and 14.2% compared to 31.7% and 4.5% patients on NVP and EFV, respectively, with supratherapeutic and suboptimal plasma concentrations. Multivariate quantile regression analysis showed that feeling guilty for being HIV positive was associated with increased 954 ng/mL NVP plasma concentrations (95% CI 192.7 to 2156.6; p = 0.014) but not associated with EFV plasma concentrations (adjusted β = 347.7, 95% CI = - 153.4 to 848.7; p = 0.173). Feeling worthless for being HIV positive was associated with increased NVP plasma concentrations (adjusted β = 852, 95% CI = 64.3 to 1639.7; p = 0.034) and not with EFV plasma concentrations (adjusted β = - 143.3, 95% CI = - 759.2 to 472.5; p = 0.647). Being certain of telling the primary sexual partner about HIV-positive status was associated with increased EFV plasma concentrations (adjusted β 363, 95% CI, 97.9 to 628.1; p = 0.007) but not with NVP plasma concentrations (adjusted β = 341.5, 95% CI = - 1357 to 2040; p = 0.692). Disclosing HIV status to neighbors was associated with increased NVP plasma concentrations (adjusted β = 1731, 95% CI = 376 to 3086; p = 0.012) but not with EFV plasma concentrations (adjusted β = - 251, 95% CI = - 1714.1 to 1212.1; p = 0.736). Obtaining transportation to the hospital whenever needed was associated with a reduction in NVP plasma concentrations (adjusted β = - 1143.3, 95% CI = - 1914.3 to - 372.4; p = 0.004) but not with EFV plasma concentrations (adjusted β = - 6.6, 95% CI = - 377.8 to 364.7; p = 0.972). HIV stigma, lack disclosure and inadequate social support are still experienced by HIV-infected patients in Kenya. A significant proportion of patients receiving the NVP-based regimen had supra- and subtherapeutic plasma concentrations compared to EFV. Social-psychological factors negatively impact adherence and are associated with increased NVP plasma concentration compared to EFV.
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Affiliation(s)
- Musa Otieno Ngayo
- Centre of Microbiology Research, Kenya Medical Research Institute, Complex off Ngong Road Box, Nairobi, 19464-00202, Kenya. .,Department of Pharmacology and Pharmacognosy, University of Nairobi, Nairobi, Kenya.
| | - Margaret Oluka
- grid.10604.330000 0001 2019 0495Department of Pharmacology and Pharmacognosy, University of Nairobi, Nairobi, Kenya
| | - Wallace Dimbuson Bulimo
- grid.10604.330000 0001 2019 0495Department of Biochemistry, University of Nairobi, Nairobi, Kenya
| | - Faith Apolot Okalebo
- grid.10604.330000 0001 2019 0495Department of Pharmacology and Pharmacognosy, University of Nairobi, Nairobi, Kenya
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Senyurek G, Kavas MV, Ulman YI. Lived experiences of people living with HIV: a descriptive qualitative analysis of their perceptions of themselves, their social spheres, healthcare professionals and the challenges they face daily. BMC Public Health 2021; 21:904. [PMID: 33980195 PMCID: PMC8117647 DOI: 10.1186/s12889-021-10881-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection rates have been gradually increasing in Istanbul, Turkey. Many people living with HIV (PLWH) here encounter difficulties, for example, in adapting to the chronic disease and obtaining continuous access to healthcare services. In this study, we aimed to explore the challenges PLWH face in their daily lives and understand their perceptions of themselves, healthcare professionals and services, and their social spheres via their expressed lived experiences in the healthcare setting. METHOD Individual semi-structured in-depth interviews were conducted face-to-face with 20 PLWH in Istanbul. All the interviews were voice-recorded and transcribed verbatim except one, upon participant request, for which the interviewer took notes. These logs and the interviewer's notes were analyzed thematically using the inductive content analysis method. RESULTS The themes concerned experiences in three distinct contexts: 1) Interactions with healthcare providers; 2) Participants' responses to their HIV diagnosis; and 3) Interactions with their social networks. Firstly, the results highlighted that the participants perceived that healthcare professionals did not inform them about the diagnosis properly, failed to protect patients' confidentiality and exhibited discriminative behaviors towards them. Secondly, after the diagnosis the participants had difficulty in coping with their unsettled emotional state. While many ceased sexual activities and isolated themselves, some sought support. Lastly, living with HIV affected their relationships with their families and friends either positively or negatively. Moreover, they had to face the difficulties concerning spouse/partner notification issues about which many needed professional support. CONCLUSION Healthcare professionals' discriminative or inappropriate attitudes and customs in healthcare institutions are perceived to impair PLWH's utilization of healthcare services. Structural factors such as social pressure, societal ignorance about HIV, limited access to HIV prevention, and regulatory barriers might contribute to these challenges. The results suggest that it is necessary to raise healthcare professionals' and society's awareness about HIV and develop national policies to establish a well-functioning referral system and appropriate spouse/partner notification services.
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Affiliation(s)
- Gamze Senyurek
- Department of Medical Humanities, Amsterdam UMC, De Boelelaan 1089a
- , 1081 HV, Amsterdam, Netherlands.
| | - Mustafa Volkan Kavas
- Department of History of Medicine and Ethics, Faculty of Medicine, Ankara University, Morfoloji Binasi, Tip Tarihi ve Etik AD. 06230, Altindag, Ankara, Turkey
| | - Yesim Isil Ulman
- Department of History of Medicine and Ethics, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Kayisdagi Cad. No:32, Atasehir, Istanbul, Turkey
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Hossain MM, Min RBM, Muhammad Z, Mani KKC. Effectiveness of mobile SMS based counselling intervention in improving the knowledge, attitude, and practices of HIV/AIDS patients enrolled in hospitals/NGOs in Terengganu, Malaysia: a mixed mode study protocol. BMC Public Health 2020; 20:787. [PMID: 32456618 PMCID: PMC7251881 DOI: 10.1186/s12889-020-08910-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/13/2020] [Indexed: 11/28/2022] Open
Abstract
Background HIV/AIDS is one of the most serious problems in many parts of the world, and is a high priority for health managers and decision-makers. The aim of the qualitative part of this study will be to develop a mobile SMS (short messaging services) counselling intervention to prevent HIV/AIDS, while the quantitative part will be to test the effectiveness of a mobile SMS counselling intervention to improve the knowledge, attitude, and practices of patients concerning the prevention of HIV/AIDS. Method A mixed methods approach will be used. Qualitative part: Design: focus group discussions (FGDs) will be conducted. Setting: Hospital/NGOs in Terengganu, Malaysia. Participants: Three FGDs will be conducted with male and female HIV/AIDS patients, and one group of local community leaders. One FGD will be conducted for each group. Three in-depth interviews (IDIs) will be conducted with patients who had HIV/AIDS, of which one will be female. Quantitative part: Design: a cluster randomized clinical trial with 384 HIV/AIDS patients in Terengganu, Malaysia. Intervention: Mobile SMS counselling intervention for patients concerning the prevention of HIV/AIDS. Results The main outcomes of this study will be the differences in knowledge, attitude, and practices of patients concerning the prevention of HIV/AIDS between the baseline and immediate follow-up after the intervention, and after 3 months. Conclusions The mobile based SMS counselling intervention developed will be effective in improving the knowledge, attitude, and practices of patients concerning HIV/AIDS prevention in Terengganu, Malaysia. Trial registration Thai Clinical Trials Registry, TCTR20200212001; 7/02/2020.
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Affiliation(s)
- Md Mosharaf Hossain
- Faculty of Business, Economics & Social Development, University Malaysia Terengganu, 21030, Kuala Terengganu, Malaysia.
| | - Ruhani Binti Mat Min
- Faculty of Business, Economics & Social Development, University Malaysia Terengganu, 21030, Kuala Terengganu, Malaysia
| | - Zikri Muhammad
- Faculty of Business, Economics & Social Development, University Malaysia Terengganu, 21030, Kuala Terengganu, Malaysia
| | - Kulanthayan K C Mani
- Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
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Naidoo P, Premdutt R. Do challenges still exist amongst HIV/AIDS patients in managing their condition? A cross-sectional study of 297 participants in the Ethekwini Metro of KwaZulu-Natal, South Africa. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2019; 18:198-204. [PMID: 31575338 DOI: 10.2989/16085906.2019.1648305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: South Africa has the largest HIV/AIDS epidemic globally and the largest anti-retroviral treatment (ART) programme in the world, yet HIV incidence is still chronically high in South Africa, especially in KwaZulu-Natal province (KZN). In light of this, a study was conducted to investigate the extent of challenges making the management of HIV/AIDS difficult in people living with HIV (PLWH) in KZN, South Africa. Methods: A cross-sectional study was carried out with 297 study participants living with HIV and receiving ART from three selected clinics in the Ethekwini Metro of KZN. A self-administered questionnaire assessed the challenges experienced by PLWH, their knowledge of their condition and their management thereof. One-way frequency tables were used to descriptively assess participant responses. Associations between certain demographic characteristics and responses to HIV treatment management challenges were assessed using chi-square tests, with statistical significance set at p < 0.05. Results: One-fifth of the participants (n = 60; 20.1%) were within the 18-23 age group, with over 53% (n = 158) having secondary level education. Some of the challenges cited included: difficulty in obtaining medication, mainly due to cost; side effects resulting in non-adherence; shame for taking medication in public (younger patients were more likely to feel ashamed for taking their medication in public [χ2 = 20.3, p = 0.009]); and non-disclosure of HIV-positive status to partners. We found a significant association between education and financial status and management of their condition [χ2 = 11.2, p = 0.011]. Conclusion: These findings that challenges still exist have implications for more robust programmes on education and counselling to address such challenges.
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Affiliation(s)
- Panjasaram Naidoo
- Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal , Durban , South Africa
| | - Rayanta Premdutt
- Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal , Durban , South Africa
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Tuan Abdullah TN, Mat Min R, Hossain M, Abdullah SS. Relationship and career challenges faced by people infected with HIV in Malaysia. F1000Res 2019; 8:1994. [PMID: 33214871 PMCID: PMC7649721 DOI: 10.12688/f1000research.21079.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 12/04/2022] Open
Abstract
Background: In Malaysia, there are still lack of studies related to the challenges of people infected with HIV (PIWH). Therefore, this study was conducted to explore the experiences of PIWH and how they cope with HIV. Methods: This qualitative study was based on a social constructivist and grounded theory approach. A total of 12 PIWH were selected by purposive sampling, all of whom participated in semi-structured and audio-recorded interviews, which were supported with non-participant observations and diary entries on three occasions for each participant. The interviews and diaries were transcribed and analysed using the grounded theory approach, which was assisted by utilizing NVIVO-8 to identify the themes related to the experiences of the participants. Results: PIWH experienced challenges related to their career and relationships with family and others. These challenges led to difficulties in gaining employment and career development, as well as feelings of denial, being uncomfortable, rejection, and labelling. They found that their lives were totally and dramatically changed after being tested positive for HIV. Conclusions: Among PIWH, HIV impacted relationships with significant others and career development. The absence of support and acceptance from significant others affected the ability of PIWH to cope with their daily challenges. The results of this study have implications for policymakers in terms of gaining sufficient knowledge and awareness to provide prevention programmes for HIV/AIDS.
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Affiliation(s)
- Tuan Norbalkish Tuan Abdullah
- Faculty of Business, Economic and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Terengganu, 21030, Malaysia
| | - Ruhani Mat Min
- Faculty of Business, Economic and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Terengganu, 21030, Malaysia
| | - Mosharaf Hossain
- Faculty of Business, Economic and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Terengganu, 21030, Malaysia
| | - Siti Salina Abdullah
- Faculty of Business, Economic and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Terengganu, 21030, Malaysia
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Tuan Abdullah TN, Mat Min R, Hossain M, Abdullah SS. Relationship and career challenges faced by people infected with HIV in Malaysia. F1000Res 2019; 8:1994. [PMID: 33214871 PMCID: PMC7649721 DOI: 10.12688/f1000research.21079.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 08/08/2023] Open
Abstract
Background: In Malaysia, there are still lack of studies related to the challenges of people infected with HIV (PIWH). Therefore, this study was conducted to explore the experiences of PIWH and how they cope with HIV. Methods: This qualitative study was based on a social constructivist and grounded theory approach. A total of 12 PIWH were selected by purposive sampling, all of whom participated in semi-structured and audio-recorded interviews, which were supported with non-participant observations and diary entries on three occasions for each participant. The interviews and diaries were transcribed and analysed using the grounded theory approach, which was assisted by utilizing NVIVO-8 to identify the themes related to the experiences of the participants. Results: PIWH experienced challenges related to their career and relationships with family and others. These challenges led to difficulties in gaining employment and career development, as well as feelings of denial, being uncomfortable, rejection, and labelling. They found that their lives were totally and dramatically changed after being tested positive for HIV. Conclusions: Among PIWH, HIV impacted relationships with significant others and career development. The absence of support and acceptance from significant others affected the ability of PIWH to cope with their daily challenges. The results of this study have implications for policymakers in terms of gaining sufficient knowledge and awareness to provide prevention programmes for HIV/AIDS.
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Affiliation(s)
- Tuan Norbalkish Tuan Abdullah
- Faculty of Business, Economic and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Terengganu, 21030, Malaysia
| | - Ruhani Mat Min
- Faculty of Business, Economic and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Terengganu, 21030, Malaysia
| | - Mosharaf Hossain
- Faculty of Business, Economic and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Terengganu, 21030, Malaysia
| | - Siti Salina Abdullah
- Faculty of Business, Economic and Social Development, Universiti Malaysia Terengganu, Kuala Terengganu, Terengganu, 21030, Malaysia
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Morowatisharifabad MA, Movahed E, Farokhzadian J, Nikooie R, Hosseinzadeh M, Askarishahi M, Bidaki R. Antiretroviral therapy adherence and its determinant factors among people living with HIV/AIDS: a case study in Iran. BMC Res Notes 2019; 12:162. [PMID: 30902063 PMCID: PMC6431060 DOI: 10.1186/s13104-019-4204-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 03/16/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives This descriptive-correlational study was conducted on 122 Iranian people living with HIV (PWHIV), who referred to a behavioral diseases counseling center in 2018. The AIDS Clinical Trial Group (ACTG) questionnaire was used to collect the required data. The study aimed to determine the level of medication adherence and its determinants in PWHIV. Results About 75.4% (confidence interval 67.2%–82.8%) of the samples had a good combined antiretroviral therapy (cART) adherence and 74.6% (n = 91) of them were sure about the positive effects of medications on their health. Patients reported that most important reasons for medication non-adherence included forgetfulness, high drug dosage, lack of knowledge about ART value, and transportation problems.
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Affiliation(s)
| | - Ehsan Movahed
- Health Education and Health Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | | | - Ruhollah Nikooie
- Department of Exercise Physiology, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Mahdieh Hosseinzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Askarishahi
- Department of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reza Bidaki
- Research Center of Addiction and Behavioral Sciences & Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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