Pub Date : 2025-01-01Epub Date: 2025-11-20DOI: 10.1177/23259582251382269
Leslie Lauren Brown, Megan Leigh Wilkins, Latrice Crystal Pichon, Jamie Linn Stewart, Robert Kenneth Douglas McLean, Jessica McDermott Sales, Carolyn Marie Audet, Samantha Veronica Hill, April Christine Pettit
BackgroundYouth with HIV disproportionately experience psychological trauma, but implementation methods for trauma-informed care are lacking.MethodsTo identify potential processes and determinants of trauma-informed care implementation, we conducted process mapping and qualitative interviews and thematically applied the organizational trauma resilience framework to elicit perceived safety, stability, and nurturance in a pediatric HIV clinic.ResultsForty-three personnel and 8 patient representatives engaged in process mapping; 20 completed qualitative interviews. Clinic culture was described as supportive, cohesive, and equity-focused, but requiring workflow improvements for patient autonomy. Trauma screening, assessment, and interventions were limited/inconsistently applied, with duplicative risk assessments. Support for professional quality of life was limited, despite burnout/attrition reports. Some personnel had trauma-focused training, but ongoing education and culturally responsive policies were needed.ConclusionsProcess mapping presented as a low-burden tool for unveiling gaps and care standards; alongside qualitative interviews, these methods provided practical insights for trauma-informed HIV care.
{"title":"Pre-implementation Stage Research to Guide Trauma-Informed Care for Youth With HIV in the Southern US: A Multimethod Study.","authors":"Leslie Lauren Brown, Megan Leigh Wilkins, Latrice Crystal Pichon, Jamie Linn Stewart, Robert Kenneth Douglas McLean, Jessica McDermott Sales, Carolyn Marie Audet, Samantha Veronica Hill, April Christine Pettit","doi":"10.1177/23259582251382269","DOIUrl":"10.1177/23259582251382269","url":null,"abstract":"<p><p>BackgroundYouth with HIV disproportionately experience psychological trauma, but implementation methods for trauma-informed care are lacking.MethodsTo identify potential processes and determinants of trauma-informed care implementation, we conducted process mapping and qualitative interviews and thematically applied the organizational trauma resilience framework to elicit perceived safety, stability, and nurturance in a pediatric HIV clinic.ResultsForty-three personnel and 8 patient representatives engaged in process mapping; 20 completed qualitative interviews. Clinic culture was described as supportive, cohesive, and equity-focused, but requiring workflow improvements for patient autonomy. Trauma screening, assessment, and interventions were limited/inconsistently applied, with duplicative risk assessments. Support for professional quality of life was limited, despite burnout/attrition reports. Some personnel had trauma-focused training, but ongoing education and culturally responsive policies were needed.ConclusionsProcess mapping presented as a low-burden tool for unveiling gaps and care standards; alongside qualitative interviews, these methods provided practical insights for trauma-informed HIV care.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251382269"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12639230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564315","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}
Pub Date : 2025-01-01Epub Date: 2025-12-04DOI: 10.1177/23259582251404545
Nadide Ergün, Gürsel Ersan
BackgroundLate diagnosis of HIV remains a critical barrier to effective treatment and improved long-term outcomes. Individuals presenting with low CD4+ T cell counts at diagnosis are at greater risk for opportunistic infections, hospitalization, and mortality. This study aimed to compare clinical, immunological, and virological outcomes among early and late presenters, and to identify factors associated with virologic failure.MethodsWe conducted a retrospective cohort study of 200 patients newly diagnosed with HIV between 2012 and 2019. Participants were categorized into three diagnostic groups based on baseline CD4+ T cell counts: early diagnosis (>350 cells/mm3), late diagnosis 1 (200-350 cells/mm3), and late diagnosis 2 (<200 cells/mm3). Baseline demographics, laboratory markers, clinical outcomes, and treatment responses were compared. Logistic regression was used to evaluate predictors of virologic failure at 6 months.ResultsLate presenters accounted for 71% of the cohort and were more likely to be older, female, unmarried, and have lower education levels. They exhibited significantly lower CD4+ counts, CD4/CD8 ratios, and higher HIV RNA levels at diagnosis (P < .001). Opportunistic infections, hospitalization, and mortality were significantly more common in the late diagnosis 2 group (P < .001). Although virologic suppression was achieved in most patients, immune recovery was significantly impaired in those diagnosed late. Antiretroviral therapy (ART) initiation after 2015 was independently associated with lower risk of virologic failure (OR: 0.39; P = .039).ConclusionLate HIV diagnosis is associated with increased clinical morbidity and impaired immune reconstitution, even in virologically suppressed individuals. Early detection, prompt ART initiation, and routine CD4/CD8 monitoring are essential to optimize outcomes. Public health interventions targeting social determinants may help reduce delays in diagnosis and improve equity in HIV care.
艾滋病毒的晚期诊断仍然是有效治疗和改善长期预后的关键障碍。诊断时CD4+ T细胞计数低的个体发生机会性感染、住院和死亡的风险更大。本研究旨在比较早期和晚期患者的临床、免疫学和病毒学结果，并确定与病毒学失败相关的因素。方法对2012年至2019年新诊断的200例HIV患者进行回顾性队列研究。参与者根据基线CD4+ T细胞计数分为三个诊断组：早期诊断组（350细胞/mm3），晚期诊断组1（200-350细胞/mm3）和晚期诊断组2(3)。比较基线人口统计学、实验室标志物、临床结果和治疗反应。采用Logistic回归评估6个月时病毒学失败的预测因素。结果slate演讲者占队列的71%，并且更可能是年龄较大，未婚，女性，教育水平较低。他们在诊断时表现出明显较低的CD4+计数、CD4/CD8比率和较高的HIV RNA水平（P P P = 0.039）。结论HIV晚期诊断与临床发病率增加和免疫重建受损相关，即使在病毒学抑制的个体中也是如此。早期发现、及时开始抗逆转录病毒治疗和常规CD4/CD8监测对于优化结果至关重要。针对社会决定因素的公共卫生干预措施可能有助于减少诊断延误并改善艾滋病毒护理的公平性。
{"title":"Late HIV Diagnosis and Its Impact on Immune Recovery and Clinical Outcomes: A Retrospective Study From Turkey.","authors":"Nadide Ergün, Gürsel Ersan","doi":"10.1177/23259582251404545","DOIUrl":"10.1177/23259582251404545","url":null,"abstract":"<p><p>BackgroundLate diagnosis of HIV remains a critical barrier to effective treatment and improved long-term outcomes. Individuals presenting with low CD4+ T cell counts at diagnosis are at greater risk for opportunistic infections, hospitalization, and mortality. This study aimed to compare clinical, immunological, and virological outcomes among early and late presenters, and to identify factors associated with virologic failure.MethodsWe conducted a retrospective cohort study of 200 patients newly diagnosed with HIV between 2012 and 2019. Participants were categorized into three diagnostic groups based on baseline CD4+ T cell counts: early diagnosis (>350 cells/mm<sup>3</sup>), late diagnosis 1 (200-350 cells/mm<sup>3</sup>), and late diagnosis 2 (<200 cells/mm<sup>3</sup>). Baseline demographics, laboratory markers, clinical outcomes, and treatment responses were compared. Logistic regression was used to evaluate predictors of virologic failure at 6 months.ResultsLate presenters accounted for 71% of the cohort and were more likely to be older, female, unmarried, and have lower education levels. They exhibited significantly lower CD4+ counts, CD4/CD8 ratios, and higher HIV RNA levels at diagnosis (<i>P</i> < .001). Opportunistic infections, hospitalization, and mortality were significantly more common in the late diagnosis 2 group (<i>P</i> < .001). Although virologic suppression was achieved in most patients, immune recovery was significantly impaired in those diagnosed late. Antiretroviral therapy (ART) initiation after 2015 was independently associated with lower risk of virologic failure (OR: 0.39; <i>P</i> = .039).ConclusionLate HIV diagnosis is associated with increased clinical morbidity and impaired immune reconstitution, even in virologically suppressed individuals. Early detection, prompt ART initiation, and routine CD4/CD8 monitoring are essential to optimize outcomes. Public health interventions targeting social determinants may help reduce delays in diagnosis and improve equity in HIV care.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251404545"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668844","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}
Pub Date : 2025-01-01DOI: 10.1177/23259582241311912
Ragini Ram, Anuradha Subramanian, Rajeshwari K
<p><p>With the availability of free antiretroviral therapy (ART) across India, HIV in adults has become a chronic disease with prolonged survival. The emergence of various non-communicable diseases in these prolonged survivors is a cause of concern. Metabolic dysfunction-associated steatotic liver disease (MASLD) in adults with HIV infection in India has not been explored to date. In this study, we attempted to assess the existence of MASLD in thirty adults registered at the Centre of Excellence in ART Care at a tertiary teaching hospital in New Delhi. This center provides free first-line, second-line, and third-line ART to patients as well as comprehensive HIV care including counseling, nutritional advice, and inpatient admissions for intercurrent illnesses. A total of 30 subjects were enrolled in the study to assess the occurrence of MASLD among people living with HIV (PLHIV) and its risk factors and to assess hepatic fibrosis in the subjects with MASLD using transient elastography and clinical fibrosis scores. The study population included 13 subjects on ART (43.3%) and 17 ART-naïve subjects (56.6%). All the study subjects underwent ultrasonography (USG) for the identification of the development of MASLD in them. Steatosis was identified as an increase in the echogenicity of the liver seen as an increase in the hepatorenal contrast and was further graded into the 3 grades of fatty liver. Out of the 30 subjects, 16.6% (5 out of 30) were found to have MASLD on USG, with grade 1 fatty changes seen in 4 (13.3%) and grade 2 fatty changes seen in 1 out of 30 subjects (3.3%). A majority (40%) of the subjects were underweight (body mass index [BMI] < 18.5). 22.7% of the male subjects included in the study had MASLD whereas none of the females had fatty changes in the liver on USG. Out of the study subjects, MASLD was detected in 17.6% of ART-naïve subjects while it was detected in 15.4% of subjects on ART. Although no statistically significant association was seen with any of these parameters, a few important trends were observed. These might be statistically significant in a higher power study with a larger sample size. Higher BMI (mean difference [MD] = 3.25, <i>P</i> = .09), waist circumference (MD = 3.84, <i>P</i> = .15), hip circumference (MD = 4.36, <i>P</i> = .14), and older age (MD = 6.56, <i>P</i> = .07) were observed to be associated with MASLD in our study, whereas the biochemical parameters and HIV-related factors were not seen to have any particular trend of association in our study. However, a higher median CD4 count was associated with MASLD as compared to the group without fatty changes on USG. On FibroScan, all 5 subjects with fatty changes in our study were found to have liver stiffness less than 7 kPa which corresponds to F0-F1 stage of fibrosis. Using the nonalcoholic fatty liver disease score, 2 subjects had scores corresponding to F0-F2 stage of fibrosis (as per METAVIR score) while the rest (3 out of 5) had indeterminate values.
{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in People Living With HIV Attending Centre of Excellence in HIV Care at a Tertiary Level Teaching Hospital in North India-A Pilot Study.","authors":"Ragini Ram, Anuradha Subramanian, Rajeshwari K","doi":"10.1177/23259582241311912","DOIUrl":"10.1177/23259582241311912","url":null,"abstract":"<p><p>With the availability of free antiretroviral therapy (ART) across India, HIV in adults has become a chronic disease with prolonged survival. The emergence of various non-communicable diseases in these prolonged survivors is a cause of concern. Metabolic dysfunction-associated steatotic liver disease (MASLD) in adults with HIV infection in India has not been explored to date. In this study, we attempted to assess the existence of MASLD in thirty adults registered at the Centre of Excellence in ART Care at a tertiary teaching hospital in New Delhi. This center provides free first-line, second-line, and third-line ART to patients as well as comprehensive HIV care including counseling, nutritional advice, and inpatient admissions for intercurrent illnesses. A total of 30 subjects were enrolled in the study to assess the occurrence of MASLD among people living with HIV (PLHIV) and its risk factors and to assess hepatic fibrosis in the subjects with MASLD using transient elastography and clinical fibrosis scores. The study population included 13 subjects on ART (43.3%) and 17 ART-naïve subjects (56.6%). All the study subjects underwent ultrasonography (USG) for the identification of the development of MASLD in them. Steatosis was identified as an increase in the echogenicity of the liver seen as an increase in the hepatorenal contrast and was further graded into the 3 grades of fatty liver. Out of the 30 subjects, 16.6% (5 out of 30) were found to have MASLD on USG, with grade 1 fatty changes seen in 4 (13.3%) and grade 2 fatty changes seen in 1 out of 30 subjects (3.3%). A majority (40%) of the subjects were underweight (body mass index [BMI] < 18.5). 22.7% of the male subjects included in the study had MASLD whereas none of the females had fatty changes in the liver on USG. Out of the study subjects, MASLD was detected in 17.6% of ART-naïve subjects while it was detected in 15.4% of subjects on ART. Although no statistically significant association was seen with any of these parameters, a few important trends were observed. These might be statistically significant in a higher power study with a larger sample size. Higher BMI (mean difference [MD] = 3.25, <i>P</i> = .09), waist circumference (MD = 3.84, <i>P</i> = .15), hip circumference (MD = 4.36, <i>P</i> = .14), and older age (MD = 6.56, <i>P</i> = .07) were observed to be associated with MASLD in our study, whereas the biochemical parameters and HIV-related factors were not seen to have any particular trend of association in our study. However, a higher median CD4 count was associated with MASLD as compared to the group without fatty changes on USG. On FibroScan, all 5 subjects with fatty changes in our study were found to have liver stiffness less than 7 kPa which corresponds to F0-F1 stage of fibrosis. Using the nonalcoholic fatty liver disease score, 2 subjects had scores corresponding to F0-F2 stage of fibrosis (as per METAVIR score) while the rest (3 out of 5) had indeterminate values.","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582241311912"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971575","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}
Background: Anemia is among the frequently observed conditions among people living with HIV (PLWH). Zidovudine (AZT) is the most common ART that causes anemia. This study aimed to identify the incidence and risk factors of AZT-induced anemia in PLWH receiving AZT-containing regimens.
Methods: A retrospective cohort study was conducted on nonpregnant PLWH aged >18 years who received AZT-containing regimens for >6 months and had normal baseline hemoglobin levels. Data on medical history, clinical characteristics, and laboratory examination were collected. Cox proportional hazard regression analysis was performed to determine the risk factors of AZT-induced anemia.
Results: A total of 401 individuals were included in the study. In total, 71 individuals presented with AZT-induced anemia. The incidence rate of anemia was 1.98 per 100 person-years of observations. Female sex, low-normal baseline hemoglobin level, low recent and low baseline CD4 cell count were independently associated with an increased risk of anemia. However, a higher body mass index was independently associated with a decreased risk of anemia.
Conclusion: Routine screening, early detection, and treatment of anemia should be considered in PLWH receiving AZT-containing regimens.
{"title":"Incidence and Risk Factors of Zidovudine-Induced Anemia in Patients With HIV Infection Receiving Zidovudine-Containing Antiretroviral Therapy.","authors":"Lakkana Boonyagars, Peerawit Thinpangnga, Warangkana Munsakul","doi":"10.1177/23259582251321577","DOIUrl":"10.1177/23259582251321577","url":null,"abstract":"<p><strong>Background: </strong>Anemia is among the frequently observed conditions among people living with HIV (PLWH). Zidovudine (AZT) is the most common ART that causes anemia. This study aimed to identify the incidence and risk factors of AZT-induced anemia in PLWH receiving AZT-containing regimens.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on nonpregnant PLWH aged >18 years who received AZT-containing regimens for >6 months and had normal baseline hemoglobin levels. Data on medical history, clinical characteristics, and laboratory examination were collected. Cox proportional hazard regression analysis was performed to determine the risk factors of AZT-induced anemia.</p><p><strong>Results: </strong>A total of 401 individuals were included in the study. In total, 71 individuals presented with AZT-induced anemia. The incidence rate of anemia was 1.98 per 100 person-years of observations. Female sex, low-normal baseline hemoglobin level, low recent and low baseline CD4 cell count were independently associated with an increased risk of anemia. However, a higher body mass index was independently associated with a decreased risk of anemia.</p><p><strong>Conclusion: </strong>Routine screening, early detection, and treatment of anemia should be considered in PLWH receiving AZT-containing regimens.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251321577"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449482","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}
Pub Date : 2025-01-01Epub Date: 2025-11-20DOI: 10.1177/23259582251398934
Worku C Tassew, Agerie M Zeleke, Yeshiwas A Ferede, Moges T Abebe, Getaw W Assefa
IntroductionTo sustain progress toward epidemic control, it remains essential to enhance and refine Appointment Spacing Model (ASM) implementation while reinforcing coordination between health facilities and community services. Nonetheless, even with the rollout of the six-month multi-month scripting (MMS)/ASM, there is still limited evidence on its nationwide adoption and the factors that affect its utilization.MethodsThis systematic review and meta-analysis followed a protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the reference number CRD42024597279. Articles were retrieved from multiple electronic databases, including PubMed/MEDLINE, Wiley Online Library, Cochrane Library, and African Journal Online, with additional gray literature searched via Google Scholar. Data were initially extracted in Microsoft Excel and subsequently imported into STATA version 11 for analysis. Study heterogeneity was assessed using Cochran's Q test and the I² statistic.ResultsThe initial search yielded 1026 primary articles, which were managed using EndNote X7. Of these, 54 were from PubMed, 14 from Wiley Online Library, 6 from the Cochrane Library, 17 from African Journal Online, and 935 from Google Scholar. Ultimately, 8 studies with a combined sample size of 3328 were included in the review. In this study, the pooled prevalence of ASM uptake among people on antiretroviral therapy (ART) in Ethiopia was estimated at 48.22% (95% CI: 31.01-65.44, I² = 92.9%, P = .000). Strong social support (Pooled Odds Ratio [POR]: 1.92, 95% CI: 1.46, 2.54), baseline regimen change (POR: 2.26, 95% CI: 1.74, 2.93), and duration of ART more than five years (POR: 2.15, 95% CI: 1.57-2.97) were factors associated with ASM.ConclusionsThe uptake of the ASM for ART care was relatively low at 48.22%, falling short of the 70% target. Key factors influencing uptake included strong social support, changes to the baseline treatment regimen, and duration on ART. To enhance the adoption of the six-month MMS/ASM care model, public health hospitals and both governmental and nongovernmental organizations should implement targeted interventions addressing these determinants.
{"title":"Uptake of Appointment Spacing Model of Care and Determinants Among Adult Clients on Antiretroviral Treatment in Ethiopia.","authors":"Worku C Tassew, Agerie M Zeleke, Yeshiwas A Ferede, Moges T Abebe, Getaw W Assefa","doi":"10.1177/23259582251398934","DOIUrl":"10.1177/23259582251398934","url":null,"abstract":"<p><p>IntroductionTo sustain progress toward epidemic control, it remains essential to enhance and refine Appointment Spacing Model (ASM) implementation while reinforcing coordination between health facilities and community services. Nonetheless, even with the rollout of the six-month multi-month scripting (MMS)/ASM, there is still limited evidence on its nationwide adoption and the factors that affect its utilization.MethodsThis systematic review and meta-analysis followed a protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the reference number CRD42024597279. Articles were retrieved from multiple electronic databases, including PubMed/MEDLINE, Wiley Online Library, Cochrane Library, and African Journal Online, with additional gray literature searched via Google Scholar. Data were initially extracted in Microsoft Excel and subsequently imported into STATA version 11 for analysis. Study heterogeneity was assessed using Cochran's <i>Q</i> test and the <i>I</i>² statistic.ResultsThe initial search yielded 1026 primary articles, which were managed using EndNote X7. Of these, 54 were from PubMed, 14 from Wiley Online Library, 6 from the Cochrane Library, 17 from African Journal Online, and 935 from Google Scholar. Ultimately, 8 studies with a combined sample size of 3328 were included in the review. In this study, the pooled prevalence of ASM uptake among people on antiretroviral therapy (ART) in Ethiopia was estimated at 48.22% (95% CI: 31.01-65.44, <i>I</i>² = 92.9%, <i>P</i> = .000). Strong social support (Pooled Odds Ratio [POR]: 1.92, 95% CI: 1.46, 2.54), baseline regimen change (POR: 2.26, 95% CI: 1.74, 2.93), and duration of ART more than five years (POR: 2.15, 95% CI: 1.57-2.97) were factors associated with ASM.ConclusionsThe uptake of the ASM for ART care was relatively low at 48.22%, falling short of the 70% target. Key factors influencing uptake included strong social support, changes to the baseline treatment regimen, and duration on ART. To enhance the adoption of the six-month MMS/ASM care model, public health hospitals and both governmental and nongovernmental organizations should implement targeted interventions addressing these determinants.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251398934"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12638655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564343","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}
Background: In people living with human immunodeficiency virus (PLHIV), hyperuricemia may result from antiretroviral therapy (ART)-induced metabolic changes, lifestyle behaviors, and individual host factors. However, there is a scarcity of data on the prevalence and determinants of hyperuricemia among PLHIV on ART in sub-Saharan Africa. Objective: This study aimed to assess the magnitude of hyperuricemia and its associated factors among PLHIV who enrolled in first-line ART in the Amhara Region, Ethiopia. Method: A multi-center, institution-based cross-sectional study was conducted from March 15 to June 15, 2024. Referral hospitals were selected through simple random sampling, and a total of 401 participants were enrolled from these hospitals using a systematic sampling approach. Data were collected using a structured questionnaire, patient chart review, physical measurements, and biochemical analysis. Hyperuricemia was defined as a serum uric acid level is >6 mg/dL for females and >7 mg/dL for males. Multivariable logistic regression was employed to identify the factors that are associated with hyperuricemia, and a statistical significance was decided at P ≤ .05. Result: The overall magnitude of hyperuricemia among PLHIV was 28.2% (95% confidence interval (CI): 23.7-32.5%). Male sex (AOR = 1.79, 95% CI: 1.07, 2.98), older age (AOR = 1.03; 95% CI: 1-1.06), obesity (AOR = 2.21; 95% CI: 1.04-4.73), and longer ART duration (AOR = 1.13; 95% CI: 1.01-1.27) were significantly associated with hyperuricemia. Conclusion: Our study found a relatively high prevalence of hyperuricemia (28.2%) among PLHIV on first-line ART. Significant associated factors included male sex, older age, obesity, and longer ART duration. Therefore, early screening, particularly in males, older adults, those with obesity, and long-term ART users, is essential to prevent complications.
{"title":"Magnitude of Hyperuricemia and Its Associated Factors Among People Living with Human Immunodeficiency Virus Who Enrolled in First-Line Antiretroviral Therapy in Amhara Region, Ethiopia.","authors":"Mohammed Jemal, Desalegn Abebaw, Tabarak Malik, Muluken Getinet Mekuriaw, Dagmawi Abiy Abate, Temechew Munaw Abebe, Tilahun Bitew, Enatnesh Essa Osman, Adane Adugna","doi":"10.1177/23259582251400988","DOIUrl":"10.1177/23259582251400988","url":null,"abstract":"<p><p><b>Background:</b> In people living with human immunodeficiency virus (PLHIV), hyperuricemia may result from antiretroviral therapy (ART)-induced metabolic changes, lifestyle behaviors, and individual host factors. However, there is a scarcity of data on the prevalence and determinants of hyperuricemia among PLHIV on ART in sub-Saharan Africa. <b>Objective:</b> This study aimed to assess the magnitude of hyperuricemia and its associated factors among PLHIV who enrolled in first-line ART in the Amhara Region, Ethiopia. <b>Method:</b> A multi-center, institution-based cross-sectional study was conducted from March 15 to June 15, 2024. Referral hospitals were selected through simple random sampling, and a total of 401 participants were enrolled from these hospitals using a systematic sampling approach. Data were collected using a structured questionnaire, patient chart review, physical measurements, and biochemical analysis. Hyperuricemia was defined as a serum uric acid level is >6 mg/dL for females and >7 mg/dL for males. Multivariable logistic regression was employed to identify the factors that are associated with hyperuricemia, and a statistical significance was decided at <i>P</i> ≤ .05. <b>Result:</b> The overall magnitude of hyperuricemia among PLHIV was 28.2% (95% confidence interval (CI): 23.7-32.5%). Male sex (AOR = 1.79, 95% CI: 1.07, 2.98), older age (AOR = 1.03; 95% CI: 1-1.06), obesity (AOR = 2.21; 95% CI: 1.04-4.73), and longer ART duration (AOR = 1.13; 95% CI: 1.01-1.27) were significantly associated with hyperuricemia. <b>Conclusion:</b> Our study found a relatively high prevalence of hyperuricemia (28.2%) among PLHIV on first-line ART. Significant associated factors included male sex, older age, obesity, and longer ART duration. Therefore, early screening, particularly in males, older adults, those with obesity, and long-term ART users, is essential to prevent complications.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251400988"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12657777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604848","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}
Pub Date : 2025-01-01Epub Date: 2025-09-15DOI: 10.1177/23259582251377224
Cyrus Mutie, John Gachohi, Kawira Kithuci, Grace Mbuthia
BackgroundLong-distance truckers (LDTs) not only experience heightened risk of human immunodeficiency virus (HIV) infections due to risky sexual networks, but are also hard to reach with consistent risk reduction messages due to their often disruptive work schedules. Besides, evidence of the existing behavior change communication (BCC) strategies to enhance HIV/ acquired immunodeficiency syndrome (AIDS) risk reduction is limited. Thus, the study sought to explore the most effective and preferred BCC strategies for adoption among LDTs in Kenya.Methods and MethodologyNine key informants and 18 in-depth interviews were used to gather qualitative data from purposively sampled participants at Kenya's Busia and Namanga border points. A thematic analysis was conducted using a hybrid of inductive and deductive approaches, through the Qualitative Data Analysis Miner (QDA-Miner) software for QDA.ResultsAlmost half of the key informants (44%) were aged 25-34, whereas half of the in-depth interviewees were 35-44 years old. Media-based communication channels were the most common and accessible. Other BCC strategies included interpersonal communication and healthcare worker service-driven strategies, peer-led open discussions and shared experiences on HIV/AIDS risk reduction, outreach activities to reach more of the underserved LDTs, and non-governmental organization (NGO)-driven approaches to fill gaps left by the public healthcare systems.ConclusionMedia-based communication channels were the most common BCC strategies. However, a combination of interpersonal communication, peer-led services, outreach activities, and NGO-driven approaches played a key role in enhancing the HIV/AIDS risk reduction message reach to the LDTs.
{"title":"Behavior Change Communication Strategies on Human Immunodeficiency Virus /Acquired Immunodeficiency Syndrome Risk Reduction for Long-Distance Truckers in Kenya.","authors":"Cyrus Mutie, John Gachohi, Kawira Kithuci, Grace Mbuthia","doi":"10.1177/23259582251377224","DOIUrl":"10.1177/23259582251377224","url":null,"abstract":"<p><p>BackgroundLong-distance truckers (LDTs) not only experience heightened risk of human immunodeficiency virus (HIV) infections due to risky sexual networks, but are also hard to reach with consistent risk reduction messages due to their often disruptive work schedules. Besides, evidence of the existing behavior change communication (BCC) strategies to enhance HIV/ acquired immunodeficiency syndrome (AIDS) risk reduction is limited. Thus, the study sought to explore the most effective and preferred BCC strategies for adoption among LDTs in Kenya.Methods and MethodologyNine key informants and 18 in-depth interviews were used to gather qualitative data from purposively sampled participants at Kenya's Busia and Namanga border points. A thematic analysis was conducted using a hybrid of inductive and deductive approaches, through the Qualitative Data Analysis Miner (QDA-Miner) software for QDA.ResultsAlmost half of the key informants (44%) were aged 25-34, whereas half of the in-depth interviewees were 35-44 years old. Media-based communication channels were the most common and accessible. Other BCC strategies included interpersonal communication and healthcare worker service-driven strategies, peer-led open discussions and shared experiences on HIV/AIDS risk reduction, outreach activities to reach more of the underserved LDTs, and non-governmental organization (NGO)-driven approaches to fill gaps left by the public healthcare systems.ConclusionMedia-based communication channels were the most common BCC strategies. However, a combination of interpersonal communication, peer-led services, outreach activities, and NGO-driven approaches played a key role in enhancing the HIV/AIDS risk reduction message reach to the LDTs.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251377224"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069888","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}
Pub Date : 2025-01-01Epub Date: 2025-05-11DOI: 10.1177/23259582251341940
Jessica Lee, Robin T Higashi, Timothy P Hogan, Julia L Marcus, Emily C Repasky, M Brynn Torres, Douglas Krakower, Ank E Nijhawan
ObjectiveAlthough incarcerated individuals are at disproportionately higher HIV risk compared to the general US population, few jails offer linkage to preexposure prophylaxis (PrEP). We explored stakeholder perspectives about barriers and facilitators to PrEP for justice-involved individuals.MethodsSemi-structured interviews were conducted with three stakeholder groups in Dallas County, Texas: justice-involved individuals (n = 8), County Jail staff (n = 9), and employees of local community organizations that provide PrEP services (n = 9). Transcripts were analyzed using a combined deductive and inductive approach.ResultsBarriers to PrEP linkage included: limited provider knowledge of and capacity for PrEP care, stigma around incarceration and PrEP, and mistrust in healthcare and criminal justice systems among justice-involved individuals. Perceived facilitators included addressing competing priorities, partnering with community organizations, and providers' cultural competency training.ConclusionFuture research should focus on adapting successful implementation strategies to the needs of justice-involved populations to improve HIV prevention and health outcomes in high-burden regions like the Southern USA.
{"title":"Linking Criminal Justice-Involved Individuals to HIV Preexposure Prophylaxis: A Qualitative Analysis of Multiple Stakeholder Perspectives.","authors":"Jessica Lee, Robin T Higashi, Timothy P Hogan, Julia L Marcus, Emily C Repasky, M Brynn Torres, Douglas Krakower, Ank E Nijhawan","doi":"10.1177/23259582251341940","DOIUrl":"https://doi.org/10.1177/23259582251341940","url":null,"abstract":"<p><p>ObjectiveAlthough incarcerated individuals are at disproportionately higher HIV risk compared to the general US population, few jails offer linkage to preexposure prophylaxis (PrEP). We explored stakeholder perspectives about barriers and facilitators to PrEP for justice-involved individuals.MethodsSemi-structured interviews were conducted with three stakeholder groups in Dallas County, Texas: justice-involved individuals (<i>n</i> = 8), County Jail staff (<i>n</i> = 9), and employees of local community organizations that provide PrEP services (<i>n</i> = 9). Transcripts were analyzed using a combined deductive and inductive approach.ResultsBarriers to PrEP linkage included: limited provider knowledge of and capacity for PrEP care, stigma around incarceration and PrEP, and mistrust in healthcare and criminal justice systems among justice-involved individuals. Perceived facilitators included addressing competing priorities, partnering with community organizations, and providers' cultural competency training.ConclusionFuture research should focus on adapting successful implementation strategies to the needs of justice-involved populations to improve HIV prevention and health outcomes in high-burden regions like the Southern USA.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251341940"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030829","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}
Pub Date : 2025-01-01Epub Date: 2025-03-28DOI: 10.1177/23259582251327911
Neil Rupani, Diego H Vasquez, Carmen Contreras, Luis Menacho, Lenka Kolevic, Molly F Franke, Jerome T Galea
BackgroundThis study assessed the acceptability, among caregivers, of a mental health chatbot designed for adolescents living with HIV aged 10 to 19 years.MethodsFifteen caregivers interacted with the mental health chatbot. Pre-post assessments and semistructured interviews evaluated acceptability. Data were analyzed using a Framework Analysis approach.ResultsCaregivers aged 31 to 70 years found the chatbot acceptable on individual, interpersonal, and environmental levels. They appreciated the educational content and self-help tools, feeling the chatbot would benefit them personally. Caregivers also saw potential in the chatbot to improve communication with their children, particularly during critical periods like HIV diagnosis. Despite concerns about data costs or internet access, most viewed the chatbot as an accessible supplement to traditional mental health services.ConclusionThis study suggests that a mental health chatbot for Peruvian adolescents living with HIV was acceptable to their caregivers, potentially benefiting caregivers' mental health, enhancing caregiver-adolescent interactions, and fostering better communication.
{"title":"\"Like Someone Is Paying Attention to You, Listening to You, and Guiding You\": Acceptability of a Mental Health Chatbot Among Caregivers of Adolescents Living With HIV.","authors":"Neil Rupani, Diego H Vasquez, Carmen Contreras, Luis Menacho, Lenka Kolevic, Molly F Franke, Jerome T Galea","doi":"10.1177/23259582251327911","DOIUrl":"10.1177/23259582251327911","url":null,"abstract":"<p><p>BackgroundThis study assessed the acceptability, among caregivers, of a mental health chatbot designed for adolescents living with HIV aged 10 to 19 years.MethodsFifteen caregivers interacted with the mental health chatbot. Pre-post assessments and semistructured interviews evaluated acceptability. Data were analyzed using a Framework Analysis approach.ResultsCaregivers aged 31 to 70 years found the chatbot acceptable on individual, interpersonal, and environmental levels. They appreciated the educational content and self-help tools, feeling the chatbot would benefit them personally. Caregivers also saw potential in the chatbot to improve communication with their children, particularly during critical periods like HIV diagnosis. Despite concerns about data costs or internet access, most viewed the chatbot as an accessible supplement to traditional mental health services.ConclusionThis study suggests that a mental health chatbot for Peruvian adolescents living with HIV was acceptable to their caregivers, potentially benefiting caregivers' mental health, enhancing caregiver-adolescent interactions, and fostering better communication.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251327911"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729520","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}
Pub Date : 2025-01-01Epub Date: 2025-08-19DOI: 10.1177/23259582251370550
Rhulani Beji-Chauke MSc, Kudzai Hlahla MSc, Katya Govender PhD, Rashida A Ferrand PhD, Victoria Simms PhD
{"title":"Recreational Use of Efavirenz by Young People Living With HIV in Zimbabwe.","authors":"Rhulani Beji-Chauke MSc, Kudzai Hlahla MSc, Katya Govender PhD, Rashida A Ferrand PhD, Victoria Simms PhD","doi":"10.1177/23259582251370550","DOIUrl":"10.1177/23259582251370550","url":null,"abstract":"","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251370550"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883098","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}
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