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

{"title":"Changes Over Time in the Proportion of Advanced HIV Disease in Two High HIV Prevalence Settings in Ndhiwa (Kenya) and Eshowe (South Africa).","authors":"Menard Chihana, Nolwenn Conan, Liesbet Ohler, Helena Huerga, Stephen Wanjala, Charles Masiku, Elisabeth Szumilin, Tom Ellman, Jean-Francois Etard, David Maman, Mary-Ann Davies","doi":"10.1177/23259582241260219","DOIUrl":"10.1177/23259582241260219","url":null,"abstract":"<p><strong>Background: </strong>The burden of advanced HIV disease remains a significant concern in sub-Saharan Africa. In 2015, the World Health Organization released recommendations to treat all people living with HIV (PLHIV) regardless of CD4 (\"treat all\") and in 2017 guidelines for managing advanced HIV disease. We assessed changes over time in the proportion of PLHIV with advanced HIV and their care cascade in two community settings in sub-Saharan Africa.</p><p><strong>Methods: </strong>Cross-sectional population-based surveys were conducted in Ndhiwa (Kenya) in 2012 and 2018 and in Eshowe (South Africa) in 2013 and 2018. We recruited individuals aged 15-59 years. Consenting participants were interviewed and tested for HIV at home. All participants with HIV had CD4 count measured. Advanced HIV was defined as CD4 < 200 cells/µL.</p><p><strong>Results: </strong>Overall, 6076 and 6001 individuals were included in 2012 and 2018 (Ndhiwa) and 5646 and 3270 individuals in 2013 and 2018 (Eshowe), respectively. In Ndhiwa, the proportion of PLHIV with advanced HIV decreased from 2012 (159/1376 (11.8%; 95% CI: 9.8-14.2)) to 2018 (53/1000 (5.0%; 3.8-6.6)). The proportion of individuals with advanced HIV on antiretroviral therapy (ART) was 9.1% (6.9-11.8) in 2012 and 4.2% (3.0-5.8) in 2018. In Eshowe, the proportion with advanced HIV was 130/1400 (9.8%; 8.0-11.9) in 2013 and 38/834 (4.5%; 3.3-6.1) in 2018. The proportion with advanced HIV among those on ART was 6.9% (5.5-8.8) in 2013 and 2.8% (1.8-4.3) in 2018. There was a significant increase in coverage for all steps of the care cascade among people with advanced HIV between the two Ndhiwa surveys, with all the changes occurring among men and not women. No significant changes were observed in Eshowe between the surveys overall and by sex.</p><p><strong>Conclusion: </strong>The proportion with advanced HIV disease decreased between the first and second surveys where all guidelines have been implemented between the two HIV surveys.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331233","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":"The Provider's Role in Retaining Black Women With HIV in Care: A Scoping Review.","authors":"Kenja S Hassan, David W Coon","doi":"10.1177/23259582231224232","DOIUrl":"10.1177/23259582231224232","url":null,"abstract":"<p><p>Black/African American women represent 54% of new HIV cases among all women in the United States, face higher rates of morbidity and mortality, and are often understudied. The patient-provider relationship is an important motivator to keeping people who live with HIV retained in care and adherent to a medical regimen, thereby improving chances for viral suppression and maintaining overall better health. This scoping review sought to determine the extent of documented provider actions that encourage Black women with HIV to stay engaged in care. The review investigated five databases for peer-reviewed studies in the United States that included Black women from 2009 to 2023 and specifically described beneficial provider actions or behaviors. Of 526 records, 12 met the criteria. Studies revealed that women are motivated by providers who create a respectful, nonjudgmental emotionally supportive relationship with them rather than those who rely on an authoritative transactional exchange of information and orders.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10793195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472331","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":"The Moderating Role of HIV Stigma on the Relationship between Perceived Social Support and Antiretroviral Therapy Adherence Self-Efficacy among Adult PLHIV in South Africa.","authors":"Muziwandile Qiniso Luthuli, Johannes John-Langba","doi":"10.1177/23259582241228743","DOIUrl":"10.1177/23259582241228743","url":null,"abstract":"<p><strong>Background: </strong>People living with human immune deficiency virus (PLHIV) grapple with distinct challenges, including HIV stigma which affects their antiretroviral therapy (ART) adherence self-efficacy. This study investigates the interaction of HIV stigma and perceived social support on ART adherence self-efficacy among adult PLHIV in South Africa.</p><p><strong>Methods: </strong>This study utilized a cross-sectional design that involved 201 participants selected using time location sampling at a tertiary health facility in Durban.</p><p><strong>Results: </strong>HIV stigma was significantly and negatively associated with self-efficacy (β = -7.860, <i>t</i> = -4.654, <i>p </i>= .001), with variations across different stigma levels (β = -5.844, <i>t</i> = -4.003, <i>p</i> = .001). Social support was significantly and positively associated with self-efficacy at lower HIV stigma levels (β = 7.440, <i>t</i> = 3.887, <i>p</i> = .001), in contrast to higher levels (β = -2.825, <i>t</i> = 1.400, <i>p</i> = .163).</p><p><strong>Conclusion: </strong>Social support significantly influences ART adherence self-efficacy, particularly at lower levels of HIV stigma, but the effect of support weakens as stigma intensifies.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850254","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":"Assessing the Impact of Social Determinants of Health on HIV Care Engagement in the Southern United States: A Cross-Sectional Study.","authors":"Maira Sohail, John D Cleveland, C Greer McCollum, Kaylee W Burgan, Larry R Hearld, Alyssa Carodine, Kendra Johnson, Melvin Fort, Jennifer Thompson, Michael J Mugavero","doi":"10.1177/23259582241251728","DOIUrl":"10.1177/23259582241251728","url":null,"abstract":"<p><p>Recent studies have shown social determinants of health (SDOH) to impact HIV care engagement. This cross-sectional study (Oct 20-Apr 21) assessed the impact of a range of SDOH on HIV care engagement using data from HIV Care Connect, a consortium of three HIV care facility-led programs (Alabama, Florida, Mississippi). The exposures were captured using the PRAPARE (Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences) scale. The outcome was captured using the Index of Engagement in HIV Care scale. Participants (n  =  132) were predominantly non-White (87%) and male (52%) with a median age of 41 years. Multivariable logistic regression adjusted for various sociodemographics showed lower HIV care engagement to be associated with being uninsured/publicly insured, having 1-3 unmet needs, socially integrating ≤five times/week, and having stable housing. Factors such as unmet needs, un-/underinsurance, and social integration may be addressed by healthcare and community organizations.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179947","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":"Barriers to Oral PrEP: A Qualitative Study of Female Sex Workers, PrEP Prescribers, Policymakers, and Community Advocates in Morocco.","authors":"Amal Ben Moussa, Abdallah M Badahdah, Khadija Hidous, Rime Barakad, Fodié Diallo, Mariam Traoré, Niloufer Khodabocus, Annette Ebsen Treebhoobun, Rosemary Delabre, Daniela Rojas Castro, Lahoucine Ouarsas, Mehdi Karkouri","doi":"10.1177/23259582241266691","DOIUrl":"10.1177/23259582241266691","url":null,"abstract":"<p><p>In 2017, Morocco became the first Arab country to incorporate pre-exposure prophylaxis (PrEP) in its HIV-prevention program. Yet no research has been published on PrEP from Morocco. Although female sex workers are one of the target populations of PrEP in Morocco, their enrollment in PrEP is lower than men who have sex with men. In this study, we conducted 38 semi-structured interviews with female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. We also investigated preferences for daily oral, vaginal ring, and long-acting injectable PrEP. A reflexive thematic analysis revealed seven themes: PrEP stigma; stigmatization and criminalization of sex work; one size doesn't fit all; knowledge and misconceptions about PrEP; economic burden; inconvenience of PrEP pills; and preferred PrEP modalities. This paper discusses the implications of the findings for increasing access and use of PrEP in Morocco.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889600","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":"Proportional Hazards Model on Attrition and its Predictors in Community Antiretroviral Refill Groups among ART Users in Eastern Ethiopia.","authors":"Lakew Asmare, Fekade Demeke Bayou, Mastewal Arefaynie, Asnakew Molla Mekonen, Abiyu Abadi Tareke, Awoke Keleb, Kaleab Mesfin Abera, Natnael Kebede, Endalkachew Mesfin Gebeyehu, Aznamariam Ayres, Yawkal Tsega, Abel Endawkie, Shimels Derso Kebede, Eyob Tilahun Abeje, Ermias Bekele Enyew, Chala Daba","doi":"10.1177/23259582241273338","DOIUrl":"10.1177/23259582241273338","url":null,"abstract":"<p><strong>Background: </strong>The HIV epidemic continues to be a major public health challenge worldwide, particularly in sub-Saharan African countries such as Ethiopia. Community-based antiretroviral refill groups are emerging as a patient-centered approach, but there is limited evidence. Therefore, this study aimed to assess attrition and predictors in community antiretroviral refill groups among ART users in Eastern Ethiopia.</p><p><strong>Methods: </strong>Institutional-based retrospective cohort study was conducted. Systematic random sampling techniques were used. Data were collected via Kobo Collect and exported to Stata. Statistically significant effects were assumed for a P-value < 0.05 at a confidence interval of 95%.</p><p><strong>Results: </strong>The incidence of attrition in community-based ART refill groups was 6.63 (95% CI: 5.78, 7.48) per 100 person-years. The median duration of months in CAGs from the start till the end of the follow-up period was 9 months (IQR = 24). Thus, recruitment level from health facilities, history of LTFU, and stage IV were statistically significant variables.</p><p><strong>Conclusion: </strong>The findings of this study highlight the importance of improving the use of community antiretroviral groups in care. Healthcare programs can ultimately improve health outcomes for individuals living with HIV.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008979","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":"Barriers and Facilitators of Physical Activity in People Living With HIV: A Systematic Review of Qualitative Studies.","authors":"Dan Song, Lisa Hightow-Weidman, Yijiong Yang, Jing Wang","doi":"10.1177/23259582241275819","DOIUrl":"10.1177/23259582241275819","url":null,"abstract":"<p><strong>Background: </strong>Most people living with HIV (PLWH) are sedentary. This study aimed to synthesize the findings of qualitative studies to understand barriers and facilitators of physical activity (PA) among PLWH, categorized using the Capability, Opportunity, Motivation-Behavior (COM-B) model and Theoretical Domains Framework (TDF).</p><p><strong>Methods: </strong>Systematic searches of four databases were conducted to identify eligible studies. Thematic synthesis was used to inductively code, develop, and generate themes from the barriers and facilitators identified. Inductive data-driven themes were deductively categorized using the relevant domains of the COM-B model and the TDF.</p><p><strong>Results: </strong>Fourteen articles were included. The most prominent TDF domain for barriers was skills, particularly symptoms/health issues such as fatigue and pain, while the most prominent TDF domain for facilitators was reinforcement, particularly experiencing benefits from PA.</p><p><strong>Conclusion: </strong>The breadth of factors identified suggests the need for comprehensive strategies to address these challenges effectively and support PLWH in adopting and sustaining PA routines.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000249","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":"Comparison of Self and Caregiver Reports of Antiretroviral Treatment Adherence among Children and Adolescents Living with HIV in Western Kenya.","authors":"Emma Gillette, Winstone Nyandiko, Aaron Baum, Ashley Chory, Josephine Aluoch, Celestine Ashimosi, Janet Lidweye, Tabitha Njorge, Festus Sang, Jack Nyagaya, Michael Scanlon, Rachel Vreeman","doi":"10.1177/23259582241242335","DOIUrl":"10.1177/23259582241242335","url":null,"abstract":"<p><strong>Background: </strong>Youth living with HIV with perinatal infection spend a lifetime taking antiretroviral treatment (ART) to suppress the virus, and face significant challenges to successfully maintaining ART adherence. Tools to measure adherence include self-report, medication event monitoring system (MEMS) pill bottle caps, pill counts, and plasma or hair drug levels; however, the inter-rater agreement between child and caregiver self-report has not been validated in an African setting. This study aims to assess inter-rater agreement between child and caregiver self-reports, compared to reporting from MEMS pill bottle caps.</p><p><strong>Methods: </strong>This was a secondary analysis of a cluster-randomized trial to evaluate an intervention for children living with HIV, conducted at the Academic Model Providing Access to Healthcare in western Kenya. We analyzed data from 285 child-caregiver dyads to compare adherence self-reported by children and their caregivers, and subsequently compared all self-reports to adherence reported by MEMS pill bottle caps to determine whether child or caregiver self-reports aligned more closely with adherence measured by MEMS.</p><p><strong>Results: </strong>Children and their caregivers reported similar levels of adherence and numbers of missed doses in the past month, and both reports were similarly associated with adherence reported by MEMS pill bottle caps. Children with a caregiver that was not a biological parent were significantly more likely to report more missed doses than their caregiver. The correlation coefficient for the relationship between the child and caregiver self-reports was 0.71; for the relationship between child report and MEMS was 0.23; and for the relationship between caregiver report and MEMS was 0.20. Both children and caregivers under-reported non-adherence compared to MEMS data.</p><p><strong>Conclusion: </strong>Children and caregiver self-reports were generally similar in reporting adherence and were not highly correlated with MEMS reports of adherence, with children and caregivers reporting higher level of adherence than the MEMS data. This may indicate that children and caregiver reports are similarly inaccurate or biased; however, further research with larger sample sizes is required to further understand the differences in these reports.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10989044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336133","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":"Risk Factors for Depression Among Middle-Aged to Older People Living With HIV in Lima, Peru.","authors":"Virgilio E Failoc-Rojas, Dan Tong Jia, Marcela Gil-Zacarias, Alana Latorre, Robinson Cabello, Patricia J Garcia, Monica M Diaz","doi":"10.1177/23259582241273452","DOIUrl":"10.1177/23259582241273452","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is prevalent among aging people living with HIV (PLWH) worldwide. We sought to identify depression risk factors among a group of middle-aged and older PLWH in Lima, Peru.</p><p><strong>Materials and methods: </strong>We assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered. We performed descriptive statistics and logistic regression analyses.</p><p><strong>Results: </strong>Mean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]).</p><p><strong>Discussion: </strong>Our study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early mental health interventions.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976014","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":"Provider Perspectives on Rapid Treatment Initiation Among People Newly Diagnosed With HIV: A New Message of \"Urgency\"?","authors":"Breana J Uhrig Castonguay, Noah Mancuso, Sarah Hatcher, Sable Watson, Eunice Okumu, Rica Abbott, Carol E Golin, Victoria Mobley, Erika Samoff, Heidi Swygard, Candice J McNeil, Cynthia L Gay","doi":"10.1177/23259582241269919","DOIUrl":"10.1177/23259582241269919","url":null,"abstract":"<p><strong>Background: </strong>Early initiation of antiretroviral therapy improves human immunodeficiency virus (HIV) outcomes. However, achieving earlier treatment initiation is challenging for many reasons including provider awareness and clinic barriers; this study sought to understand perceptions of an early initiation program.</p><p><strong>Methods: </strong>We interviewed 10 providers from 3 HIV clinics in North Carolina (October-November 2020). We asked providers about overall perceptions of early initiation and the pilot program. We developed narrative summaries to understand individual contexts and conducted thematic analysis using NVivo.</p><p><strong>Results: </strong>Providers believed earlier initiation would signal an \"extra sense of urgency\" about the importance of antiretroviral therapy-a message not currently reflected in standard of care. Safety was a consistent concern. Cited implementation barriers included transportation assistance, medication sustainability, and guidance to address increased staff time and appointment availability.</p><p><strong>Conclusion: </strong>Our qualitative findings highlight the need for training on the safety of early initiation and addressing staffing needs to accommodate quicker appointments.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133078","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}