Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv最新文献

Despite the progress made in expanding access to antiretroviral therapy, maternal non-adherence remains a major barrier to eliminating mother-to-child transmission of HIV and safeguarding infants' right to health. This scoping review maps and synthesises existing literature on maternal non-adherence to ART and the perspectives of nursing professionals supporting adherence, who are often underrepresented in research. A total of 34 studies published between 2020 and 2025 were included in the review conducted from January to July 2025 using the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Databases searched included JSTOR, EBSCOhost, ScienceDirect, Wiley Online Library, and Web of Science. Eligible studies comprised qualitative, quantitative, mixed-methods, and systematic reviews on maternal ART non-adherence, MTCT outcomes, and nursing experiences. Data were thematically analysed using Braun and Clarke's framework. Maternal non-adherence was found to be shaped by psychosocial distress, socioeconomic hardship, cultural beliefs, health system constraints, and timing of ART initiation. It heightened mother-to-child transmission risk through viral non-suppression, postpartum default, and programmatic gaps. Strengthening adherence requires effective communication, supportive care, patient-centred counselling, service integration, and systematic monitoring. Addressing mothers' lived realities while empowering nurses to deliver empathetic, context-specific care is key to improving adherence and reducing mother-to-child transmission of HIV in resource-limited settings.

PrEP (pre-exposure prophylaxis) is a medication used to prevent HIV infection, with the combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) being the most commonly used formulation. This review aims to evaluate the efficacy and safety of PrEP across various populations based on recent studies. Studies published in English, Portuguese, or Spanish from 2018 to 2023 that provided data on HIV incidence or adverse events (AEs) associated with PrEP use were included. Two meta-analyses were conducted: one for studies with a control group and another for studies including only PrEP users. After the initial search, 1,855 studies were identified, of which 21 met the inclusion criteria. PrEP reduced the HIV infection rate by 76% (RR 0.24, 95% CI 0.19 - 0.30) compared to the control group. In studies that included only PrEP users, there were 179 cases of infection among 19,982 participants, resulting in an approximate infection rate of 1% (95% CI: 0.00 - 0.02). The proportion of general and gastrointestinal symptoms was 34%, sexually transmitted infections (STIs) 69%, other infections 32%, and dermatological AEs 5%. Overall, the findings support PrEP as an effective and safe medication for primary HIV prevention in all populations.

Antiretroviral therapies (ARTs) have reduced mortality among people living with HIV (PLWH) in Nigeria. Nonetheless, there is limited research on the impact of perceived helplessness on the wellbeing of PLWH in Nigeria. This study examined the effect of perceived helplessness on middle-age and older PLWH using health-related quality of life (HRQoL), subjective health (SH), and subjective cognitive decline (SCD) as outcomes related to wellbeing. We invited 150 participants, all of whom completed a self-administered questionnaire assessing the variables of interest and key sociodemographic characteristics. Multiple linear regression models were fit to examine the relationship between perceived helplessness and wellbeing, accounting for relevant covariates such as age, sex, relationship status etc. Results showed that higher perceived helplessness was associated with lower physical HRQoL (B = -0.275, p < 0.001), lower mental HRQoL (B = -0.18, p < 0.001), better SH (B = 0.010, p < 0.001) and higher reports of SCD (B = 0.443, p < 0.001). PLWH in Nigeria are exposed to stressors that diminish their sense of control and increase their risk for poor wellbeing. The findings underscore the need for interventions to ameliorate perceived helplessness, thereby improving health and wellbeing among aging adult PLWH in Nigeria.

Human Immunodeficiency Virus (HIV) infection remains a common comorbidity among patients with fractures, yet a few studies have examined whether exercise can prevent bone demineralisation in this group. It is unclear whether people living with HIV who sustain fractures may experience improvements in bone mineral density (BMD), function or quality of life (QoL) following structured exercise. This study assessed the feasibility of a home-based exercise programme aimed at improving BMD, functional capacity and QoL, and explored whether densitometry can detect exercise-related changes in South African patients with femoral shaft fractures. A randomised controlled trial was conducted at the Chris Hani Baragwanath Orthopaedic Clinic. Participants with femoral shaft fractures were randomly allocated to an intervention or control group and assessed for gait, function, BMD, physical activity, and QoL at baseline and at 6 and 12 weeks post-surgery. Of the 22 participants (mean age 34.64 ± 8.09 years), 63.6% were male, and 27.3% were HIV positive. By week 12, the intervention group showed higher BMD at the right toe, right thumb and greater trochanter but decreased at fracture sites. Mobility scores improved in the intervention group. Exercise enhanced BMD at weight-bearing sites and supported faster recovery of mobility, although gains were limited at fracture locations.

Research on the diet of PLWH in South Africa is limited. We assessed the association between BMI and diet quality of PLWH on ART in Cape Town. We recruited 246 participants between 2021 and 2022. Information on demographics, infection, treatment, anthropometry, and physical activity was obtained. Diet quality was assessed using the Alternate Healthy Eating Index (aHEI). Anthropometry was measured using BMI, waist circumference, mid-upper-arm circumference, and waist-to-hip ratio. Participants were mostly females (70%) with an average age of 46 years, 28% were overweight, and 40% obese. Females were more obese than males (91% vs 9%, p < 0.001). Age was not associated with BMI. Leisure physical activity score was significantly different within BMI categories (p < 0.001). Over one-third of participants were being treated for at least one comorbidity, mostly hypertension, dyslipidemia, and dysglycemia. Average daily intakes of the components of the aHEI indicated a low compliance with the index recommendation. The mean aHEI score was 41.9, indicating diet quality was lower than average, and was not significantly different between BMI categories. Diet quality among PLWH in this study is suboptimal, irrespective of BMI; this needs to be addressed. Investigations of psychosocial factors affecting the nutritional and health status of PLWH is needed.

This study aimed to determine whether higher patient satisfaction with healthcare was associated with improved health-related quality of life (HRQoL) outcomes among adult patients living with HIV and AIDS (PLWHA) receiving antiretroviral treatment (ART). This cross-sectional study was conducted at a specialised clinic in Kampala, Uganda, in July-August 2015. The Consumer Assessment of Healthcare Providers and System (CAHPS) instrument was used to measure patient satisfaction, and the Medical Outcomes Study HIV Health survey (MOS-HIV) was used to determine Physical and Mental Health Summary scores (PHS and MHS, respectively) of HRQoL. Multivariable logistic and linear regression were used to examine associations between patient satisfaction and PHS and MHS scores. Higher scores on PHS and MHS were reported by 364 (79%) and 320 participants (70%), respectively. Patient satisfaction with the facility was independently associated with higher PHS (OR = 2.62, 95% CI: 1.60-4.33) and MHS (OR = 1.97, 95% CI: 1.27-3.06), and promoters of the clinic had higher scores on PHS (OR = 1.73, 95% CI: 1.06-2.87) and MHS (OR = 3.68, 95% CI: 2.33-5.93). Patient satisfaction with the facility was associated with higher HRQoL, suggesting that strengthening service quality could bolster patient satisfaction and HRQoL among PLWHA receiving ART.

In Việt Nam, men who have sex with men (MSM) have an estimated HIV prevalence of 13.3%. MSM in Việt Nam face significant stigma, which is a known factor increasing sexual risk behavior and HIV transmission. Interventions like Transdiagnostic LGBTQ-affirming Cognitive Behavioral Therapy (CBT) have been shown to reduce the impact of stigma, these interventions were developed in the context of the U.S. We aimed to identify cultural adaptations for LGBTQ-affirmative CBT skills in Vietnamese contexts. In-person interviews were conducted with MSM living in Ho Chi Minh City, Việt Nam (n = 17) in Vietnamese by native speakers, transcribed and translated to English. A team of four analysts used a Rapid Qualitative Analysis Method. Participants expressed a desire to learn emotional regulation skills, which aligns with existing LGBTQ-affirmative CBT skills content. They also suggested the inclusion of HIV prevention skills and most participants were in favor of group format. LGBTQ-affirmative CBT skills appear to be desired among MSM in Việt Nam to address the impact of identity-based stigma; however, content and format of the intervention should be adapted to meet their needs and maximize effectiveness. Future research should examine the impact of the adapted model on mental health and HIV risk.

Cost-effective approaches for integrating behavioral interventions for problematic alcohol and other drug (AOD) use into HIV care is needed, as problematic AOD is a primary barrier to adherence of antiretroviral therapy (ART). Thus, we investigated the cost-effectiveness of a recently completed pilot trial in South Africa, that showed promising findings in improved adherence of antiretroviral therapy (ART). The trial compared a task-shared, peer-delivered behavioral intervention (known as "Khanya") to enhanced treatment-as-usual (ETAU), a facilitated referral to a co-located AOD treatment center. A cost-effectiveness analysis was conducted from a healthcare-sector perspective and found that the mean incremental cost-effectiveness ratio was US0.4(0.7ZAR) per additional percentage point improvement in ART adherence over three - months, at which price the confidence of cost - effectiveness relative to ET AUwas108 (44 ZAR) to reach 95% confidence. The likelihood of cost-effectiveness regarding improvements in AOD score using the Global WHO-ASSIST score was low across a wide range of value thresholds.Trial registration: ClinicalTrials.gov identifier: NCT03529409.

Background: Antiretroviral therapy has markedly increased life expectancy among people living with human immunodeficiency virus (HIV), yet the long-term impact of chronic HIV infection on women's quality of life (QoL) and sexual functioning remains poorly understood. Female sexual dysfunction (FSD) is common in women and may impair psychological well-being and social relationships. Understanding how HIV infection intersects with FSD and QoL could inform holistic care for women in resource-limited settings.Objective: To compare QoL and FSD between women living with HIV and HIV-negative women and to identify socio-demographic predictors of poor QoL.Methods: We conducted a hospital-based cross-sectional study in 2024 among 200 women on antiretroviral therapy and 200 age-matched HIV-negative women attending the general outpatient clinic at Aminu Kano Teaching Hospital, Kano, Nigeria. Participants were recruited through systematic sampling; research assistants provided study information and obtained written informed consent. Quality of life was assessed with the World Health Organization Quality of Life 26-item Brief questionnaire (WHOQOL-BREF). Female sexual function was screened with the 19-item Female Sexual Function Index (FSFI); a total score ≤26.55 denoted FSD. Data were analyzed using chi-square tests, independent t-tests and multivariable logistic regression.Results: The mean (±SD) age of participants was 37.1 ± 9.4 years. Overall QoL was significantly worse among women with HIV than HIV-negative women (53% vs 63% reporting good QoL, p = 0.043). Mean QoL scores were lower in the HIV-positive group for the psychological (61 ± 18 vs 54 ± 14; p < 0.001) and environmental domains (69 ± 20 vs 65 ± 16; p < 0.001), while physical and social domain scores were comparable. FSD was highly prevalent in both groups (96% in HIV-positive and 98% in HIV-negative participants; p = 0.40), and FSFI scores were not associated with QoL. In multivariable analysis, rural residence (adjusted odds ratio 3.30, 95% CI 1.31-8.98) and primary-level education (aOR 3.06, 95% CI 1.50-6.38) independently predicted poor QoL.Conclusions: Women living with HIV experience poorer overall QoL than HIV-negative peers, particularly in psychological and environmental domains. Interventions that improve living conditions, strengthen psychosocial support and integrate sexual and mental health services into HIV care, are needed to improve the well-being of women in North-western Nigeria.

Most people living with HIV remain physically inactive, despite strong evidence that physical activity improves health outcomes and reduces premature mortality. While behavioral interventions are known to promote physical activity, few systematic reviews have focused specifically on these strategies for people with HIV. This review addresses that gap by evaluating the overall impact of behavioral interventions and examining the effectiveness of individual behavior change techniques used within them. A comprehensive search of four databases, completed by October 31, 2024, identified ten eligible studies, most of which had a low risk of bias. When data allowed, a meta-analysis was conducted and showed that behavioral interventions significantly increased both step counts and self-reported physical activity. Behavior change techniques were identified using the Behavior Change Technique Taxonomy version one, and a percentage effectiveness ratio was calculated for each technique. Of the ninety-three techniques in the taxonomy, only twenty were used across studies. Techniques that were used less frequently, such as providing social support, showed higher effectiveness. These findings suggest that future interventions should incorporate a wider range of evidence-based techniques and be tailored to the specific needs of people living with HIV to maximize the benefits of physical activity.