Journal of the International Association of Providers of AIDS Care最新文献

{"title":"Decision conflict and the decision support needs of HIV PrEP-eligible Black patients in Toronto regarding the adoption of PrEP for HIV prevention.","authors":"Wale Ajiboye,&nbsp;LaRon Nelson,&nbsp;Apondi Odhiambo,&nbsp;Abban Yusuf,&nbsp;Pascal Djiadeu,&nbsp;De Anne Turner,&nbsp;M'Rabiu Abubakari,&nbsp;Cheryl Pedersen,&nbsp;Rebecca Brown,&nbsp;Zhao Ni,&nbsp;Genevieve Guillaume,&nbsp;Aisha Lofters,&nbsp;Geoffrey Williams","doi":"10.1177/23259582211073399","DOIUrl":"https://doi.org/10.1177/23259582211073399","url":null,"abstract":"<p><p><b>Objectives:</b> This study examined factors contributing to decision conflict and the decision support needs of PrEP-eligible Black patients. <b>Methods:</b>The Ottawa Decision Support Framework (ODSF) was used to guide the development of a key informant guide used for qualitative data collection. Black patients assessed by healthcare providers as meeting the basic criteria for starting PrEP were recruited through the St. Michael's Hospital Academic Family Health Team and clinical and community agencies in Toronto. Participants were interviewed by trained research staff. Qualitative content analysis was guided by the ODSF, and analysis was done using the Nvivo. <b>Results:</b> Four women and twenty-five men (both heterosexual and men who have sex with men) were interviewed. Participants reported having difficulty in decision making regarding adoption of PrEP. The main reasons for decision-conflict regading PrEP adoption were: lack of adequate information about PrEP, concerns about the side effects of PrEP, inability to ascertain the benefits or risk of taking PrEP, provider's lack of adequate time for interaction during clinical consultation, and perceived pressure from healthcare provider. Participants identified detailed information about PrEP, and being able to clarify how their personal values align with the benefits and drawbacks of PrEP as their decision support needs. <b>Conclusion:</b>Many PrEP-eligible Black patients who are prescribed PrEP have decision conflict which often causes delay in decision making and sometimes rejection of PrEP. Healthcare providers should offer decision support to Black patients who are being asked to consider PrEP for HIV prevention.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"21 ","pages":"23259582211073399"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/ea/10.1177_23259582211073399.PMC8808024.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9156870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situating HIV Stigma in Health Facility Settings: A Qualitative Study of Experiences and Perceptions of Stigma in ‘Clinics’ among Healthcare Workers and Service Users in Zambia","authors":"S. Mulubale, S. Clay, Corinne Squire, V. Bond, Kasoka Kasoka, Lucy Stackpool-Moore, Tessa Oraro-Lawrence, M. Chonta, C. Chiiya","doi":"10.1177/23259582221100453","DOIUrl":"https://doi.org/10.1177/23259582221100453","url":null,"abstract":"The study focused on the representations, processes and effects of HIV stigma for healthcare workers living with HIV within health facilities in Zambia. A descriptive study design was deployed. A total of 56 health workers and four service user participants responded to a structured questionnaire (n = 50) or took part in key informant interviews (n = 10) in five high HIV-prevalence provinces. Most participants did not disclose if they were living with HIV, except for four participants who responded to the questionnaire and were selected for being open about living with HIV. Semi-structured interviews were carried out with health workers in key government health facility positions. The questions were standardized and used a Likert scale. Descriptive statistical and thematic analyses were applied to the data. Results show that antiretroviral treatment (ART) has an impact on stigma reduction. Almost half the participants agreed that treatment is reducing levels of HIV stigma. However, fears of exposure of HIV status and labelling and judgemental attitudes persist. No comprehensive stigma reduction policies and guidelines in healthcare facilities were mentioned. Informal flexible systems to deliver HIV services were in place for health workers living with HIV, illustrating how stigma can be quietly navigated. Lack of confidentiality in healthcare facilities plays a role in fuelling disclosure issues and hampering access to testing and treatment. Stigma reduction training needs standardization. Further, codes of conduct for ‘stigma-free healthcare settings’ should be developed.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43071969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and Worry About COVID-19 Infection are Associated with Less Confidence in Ability to Engage in Treatment: Results from a South India Cohort of People Living with HIV (PLWH)","authors":"M. Ekstrand, E. Heylen, Matilda Pereira, S. Chandy, K. Srinivasan","doi":"10.1177/23259582221080303","DOIUrl":"https://doi.org/10.1177/23259582221080303","url":null,"abstract":"Following its initial outbreak in Wuhan in December 2019, SARS-CoV-2 spread rapidly around the world and was characterized byWHO as a global pandemic onMarch 12, 2020. Given its global impact, it led to a great deal of concern among the approximately 38 million people living with HIV (PWH). Although many governments worked hard to sustain HIV services, often in collaboration with community partners, it soon became clear that PWH faced multiple barriers and challenges to remain engaged in the HIV care continuum. Containment of the global COVID-19 pandemic required that governments implemented multiple strategies, including requirements to shelter-in-place, distancing, and placing restrictions on travel, which may serve as barriers to accessing non-COVID-related healthcare. OnMarch 25, 2020, the government of India announced an initial “lockdown,” due to the global COVID-19 pandemic, which restricted movement, social gatherings and economic activity until May 31. This resulted in many citizens returning to their native homes to shelter with their extended families. It is unknown what impact the lockdowns may have had on the ability of PWH to visit ART clinics, obtain prescription refills or adhere to their regimens. Since successfulmanagement of HIV requires excellent adherence and timely prescription refills to avoid treatment interruptions, real or perceived challenges, including HIV stigma and worries about coronavirus infection may have interfered with this effort.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44256306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV Related Stigma among Healthcare Providers: Opportunities for Education and Training.","authors":"Amanda Blair Spence,&nbsp;Cuiwei Wang,&nbsp;Katherine Michel,&nbsp;Joanne Michelle Ocampo,&nbsp;Michael Kharfen,&nbsp;Daniel Merenstein,&nbsp;Lakshmi Goparaju,&nbsp;Seble Kassaye","doi":"10.1177/23259582221114797","DOIUrl":"https://doi.org/10.1177/23259582221114797","url":null,"abstract":"<p><p><b>Background:</b> HIV-stigma can influence engagement in care and viral suppression rates among persons living with HIV (PLWH). Understanding HIV-provider level stigma and its associated factors may aid in development of interventions to improve engagement in care. <b>Methods:</b> We assessed HIV-related stigma, provider knowledge, and practices and beliefs among healthcare providers using an online survey tool. Generalized linear modeling was used to determine factors associated with HIV-stigma score. <b>Results:</b> Among 436 participants, the mean age was 42.3 (SD 12.3), 70% female, 62% white, 65% physicians, and 44% worked at an academic center. The mean HIV Health Care Provider Stigma Scale (HPASS) score was 150.5 (SD 18.9, total = 180 [higher score = less stigma]) with factor subscale scores of 67.1 (SD 8.2, total = 78) prejudice, 51.3 (SD 9.7, total = 66) stereotyping, and 32.1 (SD 5, total = 36) discrimination. Female sex and comfort with talking about sex and drug use had 4.97 (95% CI 0.61, 9.32) and 1.99 (95% CI 0.88, 3.10) estimated higher HPASS scores. Disagreement/strong disagreement versus strong agreement with the statement that PLWH should be allowed to have babies and feeling responsible for talking about HIV prevention associated with -17.05 (95% CI -25.96, -8.15) and -2.16 (95% CI -3.43, -0.88) estimated lower HPASS scores. <b>Conclusions:</b> The modifiable factors we identified as associated with higher HIV related stigma may provide opportunities for education that may ameliorate these negative associations.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"21 ","pages":"23259582221114797"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/f9/10.1177_23259582221114797.PMC9310064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10616616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and Anxiety in Youth and Young Adults Living with HIV: Frequency and Associated Factors in Thai Setting","authors":"S. Chantaratin, Kawita Trimetha, P. Werarak, K. Lapphra, Alan Maleesatharn, S. Rungmaitree, O. Wittawatmongkol, W. Phongsamart, N. Kongstan, Benjawan Khumcha, K. Chokephaibulkit","doi":"10.1177/23259582221101811","DOIUrl":"https://doi.org/10.1177/23259582221101811","url":null,"abstract":"Integrative mental health care in HIV patients is an important contributor to successful therapy. This is a cross-sectional study in youth and young adults who attend routine HIV clinic at a tertiary care centre in Bangkok. We recruited 100 youth and 130 young adults living with HIV to evaluate the frequency of depression and anxiety and associated sociodemographic including sexual orientation and health-related behaviours. Overall, about a fifth of the participants had significant depression or anxiety. Interestingly, we found different factors associated with depression in youth and young adults living with HIV. Loss of their father, loss of close relatives or friends, and being unemployed or school exclusion were the factors associate with depression in youth; while dangerous alcohol use, feeling discriminated against and having lipodystrophy were factors in young adults. The understanding of the frequency and different associated factors can inform more effective prevention and treatment strategies.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49022475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Bictegravir-Based Regimen in Pregnant Women Living with HIV: A Case Report.","authors":"Shaimaa Alsulami,&nbsp;Sultan N Alotaibi,&nbsp;Nader Damfu,&nbsp;Doaa M Aljefri,&nbsp;Hadeel Ahmed Altayib,&nbsp;Maher Alharbi","doi":"10.1177/23259582221146110","DOIUrl":"https://doi.org/10.1177/23259582221146110","url":null,"abstract":"<p><p>Bictegravir (BIC) is included in international guidelines as the first line of therapy for patients living with Human Immunodeficiency Virus (HIV), either as initial therapy or as a replacement for patients with prior antiretroviral therapy (ART). Due to limited efficacy and safety data, BIC is currently not recommended during pregnancy. Data on the safety and efficacy of BIC during pregnancy were unavailable at the time of drug approval. In our case, BIC/TAF/FTC was effective in suppressing viral load (VL) in pregnancy, and there were no reported safety issues for the mother or the baby.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"21 ","pages":"23259582221146110"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/d2/10.1177_23259582221146110.PMC9772963.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10512249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Antiretroviral Therapy on Kidney Disease in HIV Infected Individuals – A Qualitative Systematic Review","authors":"Harsha Adnani, Nirav Agrawal, A. Khatri, Jaclyn Vialet, Meng Zhang, J. Cervia","doi":"10.1177/23259582221089194","DOIUrl":"https://doi.org/10.1177/23259582221089194","url":null,"abstract":"Kidney disease is the fourth most common cause of non-AIDS-related mortality in people living with HIV. Combination antiretroviral therapy (cART) remains the cornerstone of treatment. However, little is known about the impact of cART on disease outcomes in patients with HIV-associated nephropathy (HIVAN) and HIV-immune complex kidney disease (HIVICK). This systematic review evaluates the impact of cART on progression to end-stage kidney disease (ESKD) and other outcomes in HIV-infected individuals. We conducted a literature search utilizing PubMed, and Cochrane database and 11 articles met inclusion criteria for analysis of which nine HIVAN studies showed decreased progression to ESKD or death for subjects when treated with cART versus those untreated. However, two studies showed no survival advantage with cART. Three HIVICK studies showed improvement in delaying ESKD in subjects on cART compared to untreated subjects. cART appeared to reduce the risk to ESKD or death in patients with both HIVAN and HIVICK.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43637116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Antiretroviral Therapy and Associated Factors Among People Living With HIV Following the Introduction of Dolutegravir Based Regimens in Dar es Salaam, Tanzania","authors":"Mary Spicar Kilapilo, Raphael Zozimus Sangeda, G. Bwire, G. Sambayi, I. Mosha, J. Killewo","doi":"10.1177/23259582221084543","DOIUrl":"https://doi.org/10.1177/23259582221084543","url":null,"abstract":"Background: Adherence to antiretroviral therapy (ART) is the key determinant of virological suppression in people living with HIV (PLHIV). This study reports factors associated with non-adherence among PLHIV one year after introducing dolutegravir (DTG) based regimens in Tanzania. Methods: A hospital-based cross-sectional study was conducted in two health facilities in Dar es Salaam, Tanzania, in 2020. Results: A total of 406 PLHIV were recruited, where the majority (73.4%) were females, with 94.6% of patients being on DTG based regimens. Factors such as refill interval and sharing of antiretrovirals had significant effects on adherence. Multivariate analysis found that patients attending care and treatment center (CTC) at Temeke Regional Referral Hospital (RRH) were 4.3 times more likely to have non-adherence compared to those attending Amana RRH (aOR [adjusted odds ratio] 4.3, 95% CI [confidence interval]: 2.38 – 7.91, p-value < 0.0001). Conclusions: Sustainable adherence counseling is warranted to overcome non-adherence to ART.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46935641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Network Strategy to Promote HIV Testing and Linkage to HIV Services among Young men who Have sex with men and Transgender Women in Thailand.","authors":"Nantika Paiboon,&nbsp;Wipaporn Natalie Songtaweesin,&nbsp;Prissana Wongharn,&nbsp;Jutamanee Moonwong,&nbsp;Sasiprapha Khamthi,&nbsp;Athiporn Premgamone,&nbsp;Tuangtip Theerawit,&nbsp;Chutima Saisaengjan,&nbsp;Surinda Kawichai,&nbsp;Suvaporn Anugulruengkitt,&nbsp;Thanyawee Puthanakit","doi":"10.1177/23259582221143672","DOIUrl":"https://doi.org/10.1177/23259582221143672","url":null,"abstract":"<p><p><b>Background:</b> Social network strategies (SNS) assumes that people in the same social share similar HIV risk. <b>Methods:</b> This study evaluated SNS to promote HIV testing of young men who have sex with men (YMSM) and transgender women (YTGW) aged 15-24 years. \"Recruiters\" referred their 'network members' (NMs) to clinic. NMs were provided HIV testing. Proportions of first-time HIV testers and number of NMs were analyzed. <b>Results:</b> Between April 2021 to March 2022, 83 recruiters referred 202 NMs. Median age of NMs was 19 years (IQR 17-20), 62% were YMSM. One-hundred-and-twenty-four NMs (61%) were first-time HIV testers. YTGW recruited more NMs per recruiter (5.4 vs 1.4, p  =  0.002). HIV prevalence was 3.0% (95% CI 1.1-6.4). Thirty-one-point-three percent of NMs at HIV risk initiated oral HIV preexposure prophylaxis. <b>Conclusions:</b> SNS is a good strategy to reach adolescents at risk of HIV infection. More than half of NMs were first-time HIV testers.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"21 ","pages":"23259582221143672"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/13/ed/10.1177_23259582221143672.PMC9726844.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10695132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroids Use and Incidence of Severe Infections in People Living with HIV Compared to a Matched Population","authors":"J. Damba, M. Laskine, Marc-Messier Peet, Yulan Jin, L. Sinyavskaya, Madeleine Durand","doi":"10.1177/23259582221107196","DOIUrl":"https://doi.org/10.1177/23259582221107196","url":null,"abstract":"Background: People living with HIV (PLWH) have been shown to have an increased risk of autoimmune diseases. Corticosteroids are the cornerstone of autoimmune diseases treatment, but their use is associated with an increased risk of infections. It is unclear how HIV status affects the risk of infection associated with corticosteroids use. Methods: We conducted a retrospective cohort study from 1991 to 2011, using a medico-administrative database from Quebec. Medical billing codes were used to identify PLWH, and we matched them on age, sex, and index date with up to 4 HIV-negative controls. The exposure of interest was the use of corticosteroids, defined as a systemic corticosteroid dispensation lasting at least 20 days. The outcome of interest was hospitalization for severe infection. Crude and adjusted incidence rates ratios of infection were obtained using a random effect Poisson model, and results were stratified by HIV status. Results: In total, 4798 PLWH were matched to 17 644 HIV-negative controls, among which 1083 (22.6%) PLWH and 1854 (10.5%) HIV-negative controls received at least one course of corticosteroid. The mean duration of corticosteroids use was 4 ± 4.4 months in PLWH and 1.6 ± 5.5 months in HIV-negative controls. The incidence rate ratio (IRR) for infections associated with corticosteroids use was 2.49[1.71–3.60] in PLWH and 1.32[0.71–2.47] in HIV-negative controls (P value for interaction 0.18). The most frequent infections were pulmonary infections (50.4%), followed by urinary tract infections (26%) and opportunistic infections (10.5%). Conclusion: Although our interaction term did not reach significance, the increased risk of infection associated with corticosteroids use was more pronounced in PLWH. However, further research with contemporary data is warranted to confirm if the risk associated with corticosteroids use remains high in PLWH with well-controlled HIV infection.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49112457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}