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A mixed-methods evaluation of an HIV pre-exposure prophylaxis educational intervention for healthcare providers in a NYC safety-net hospital-based obstetrics and gynecology clinic. 对纽约市一家安全网医院妇产科诊所的医护人员进行的艾滋病暴露前预防教育干预进行混合方法评估。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-29 DOI: 10.1080/09540121.2024.2364218
Antoinette Oot, Farzana Kapadia, Brandi Moore, Richard E Greene, Melinda Katz, Colleen Denny, Robert Pitts

Cisgender women and transgender men are less likely to be assessed for PrEP eligibility, prescribed PrEP, or retained in PrEP care. Thus, this pilot PrEP educational intervention was tailored for healthcare providers (HCPs) in obstetrics/gynecology who provide care to cisgender women and transgender men in an academically-affiliated, public hospital women's health clinic. The three-lecture educational curriculum designed for HCPs focused on PrEP eligibility and counseling, formulations and adherence, and prescription and payment assistance programs. Pre- and post-intervention surveys assessed HCP knowledge and barriers to PrEP counseling and prescription. Among n = 49 participants (mean age = 32.8 years; 85.7% cisgender women, mean years practicing = 4.2 years) pre-intervention, 8.7% had prior PrEP training and 61.2% felt very/somewhat uncomfortable prescribing PrEP. Post-intervention, knowledge of PrEP contraindications, eligibility, follow-up care, and assistance programs all increased. HCPs identified key barriers to PrEP care including lack of a dedicated PrEP navigator, culturally and linguistically appropriate patient materials on PrEP resources/costs, and PrEP-related content integrated into EHRs. Ongoing PrEP educational sessions can provide opportunities to practice PrEP counseling, including information on financial assistance. At the institutional level, incorporating PrEP screening in routine clinical practice via EMR prompts, facilitating PrEP medication monitoring, and enhancing telehealth for follow-up care could enhance PrEP prescription.

顺性别女性和变性男性不太可能接受 PrEP 资格评估、开具 PrEP 处方或继续接受 PrEP 治疗。因此,本试验性 PrEP 教育干预专为妇产科医护人员(HCPs)量身定制,这些医护人员在隶属于学术机构的公立医院妇女健康诊所中为顺性女性和变性男性提供护理服务。为保健医生设计的三讲教育课程侧重于 PrEP 的资格和咨询、配方和依从性以及处方和付款援助计划。干预前后的调查评估了保健医生对 PrEP 咨询和处方的了解程度和障碍。在 n = 49 名参与者(平均年龄 = 32.8 岁;85.7% 为顺性女性,平均从业年限 = 4.2 年)中,8.7% 的人在干预前接受过 PrEP 培训,61.2% 的人在开具 PrEP 处方时感到非常不舒服或有点不舒服。干预后,对 PrEP 的禁忌症、资格、后续护理和援助计划的了解都有所增加。保健医生指出了 PrEP 护理的主要障碍,包括缺乏专门的 PrEP 导航员、关于 PrEP 资源/费用的文化和语言上适当的患者资料,以及纳入电子病历的 PrEP 相关内容。持续的 PrEP 教育课程可以提供实践 PrEP 咨询的机会,包括有关经济援助的信息。在机构层面,通过 EMR 提示将 PrEP 筛查纳入常规临床实践,促进 PrEP 药物监测,加强远程医疗的后续护理,这些都可以提高 PrEP 处方的质量。
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引用次数: 0
The factor structure of the Hopkins Symptom Checklist 25 among persons seeking HIV testing. 霍普金斯症状核对表 25 在寻求艾滋病毒检测者中的因子结构。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-06-11 DOI: 10.1080/09540121.2024.2361829
Lisa Wolfaardt, Warona Mateane, Ashraf Kagee

Rates of anxiety and depression are high among individuals living with HIV. The Hopkins Symptom Checklist (HSCL) is a screening tool to identify symptoms of depression and anxiety. The objective of this study was to determine the factor structure of the 25-item HSCL in a population-based sample of individuals seeking HIV testing in the Western Cape in South Africa. Participants volunteered for HIV testing at two non-medical HIV testing sites in the Western Cape. We used convenience sampling to administer the scale prior to their undergoing HIV testing. Data were analysed using exploratory factor analysis, using an extraction method of principal components with Promax (oblique) rotation. The Cronbach's alpha reliability indices were calculated for each of the independent factors to determine internal consistency. Factor analysis revealed a three-factor structure that explained 56.86% of the total variance. These factors included depression (14 items), anxiety (7 items) and somatic symptoms (4 items). Alpha levels ranged from 0.67 to 0.94. We found that the HSCL is a reliable measure for depression and anxiety, and consists of 3 distinguishable factors depression, anxiety, and somatic symptoms.

艾滋病病毒感染者的焦虑和抑郁率很高。霍普金斯症状核对表(HSCL)是一种识别抑郁和焦虑症状的筛查工具。本研究的目的是通过对南非西开普省寻求 HIV 检测的人群进行抽样调查,确定 25 个项目的 HSCL 的因子结构。参与者自愿在西开普省的两个非医疗 HIV 检测点接受 HIV 检测。我们采用方便抽样的方法,在他们接受 HIV 检测之前对他们进行量表管理。我们使用探索性因子分析法对数据进行了分析,采用的是主成分提取法和 Promax(斜向)旋转法。计算了每个独立因子的 Cronbach's alpha 可靠性指数,以确定内部一致性。因子分析显示了一个三因子结构,解释了总方差的 56.86%。这些因子包括抑郁(14 个项目)、焦虑(7 个项目)和躯体症状(4 个项目)。α水平介于 0.67 和 0.94 之间。我们发现,HSCL 是一种可靠的抑郁和焦虑测量方法,由抑郁、焦虑和躯体症状三个可区分的因子组成。
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引用次数: 0
Quality of life among PLHIV enrolled under TANSACS during COVID era - a mixed method study. COVID 时代加入 TANSACS 的艾滋病毒感染者的生活质量--一项混合方法研究。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-01 Epub Date: 2024-01-03 DOI: 10.1080/09540121.2023.2299331
Janakiram Marimuthu, Sumathi Rajalingam, Kaustav Gauthaman, Karthikeyan Murugan

The burden of avoidable illness, accidents and impairments can be estimated by understanding the quality of life, and it can also offer important new insights into the connections between risk factors and the quality of life. This study assessed the quality of life of people living with HIV during the COVID-19 pandemic which would have caused substantial difficulties for such individuals. Data were collected using WHOQOL-BREF SCALE and FGD Semi-Structured Questionnaire. People living with HIV enrolled under TANSACS were included. Chi-square analysis was used to evaluate the association between the demographic variables and the domains of the quality of life. The quality of life was determined using 4 domains. The average score for each domain includes physical health, 54.39, psychological, 44.85, social relationships, 48.48 and environment 57.69. The average overall score for the quality of life was 51.35. The occupation variable is significant with all the domains; physical health (P = 0.030), psychological (P = 0.046), social relationships (P = 0.027) and environment (P = 0.023) and the gender variable is significant with physical health (P = 0.026), social relationship (P = 0.007) domains. COVID-19 worsened quality of life for HIV patients, impacting healthcare, support, jobs, and stigma. The employment status also significantly impacted.

通过了解生活质量,可以估算出可避免的疾病、事故和损伤所造成的负担,还可以为了解风险因素与生活质量之间的联系提供重要的新见解。这项研究评估了 COVID-19 大流行期间艾滋病毒感染者的生活质量。研究使用 WHOQOL-BREF SCALE 和 FGD 半结构式问卷收集数据。在 TANSACS 系统中登记的艾滋病毒感染者也包括在内。采用卡方分析法评估人口统计学变量与生活质量领域之间的关联。生活质量由 4 个领域决定。每个领域的平均得分包括身体健康 54.39 分、心理 44.85 分、社会关系 48.48 分和环境 57.69 分。生活质量的平均总分为 51.35。职业变量与所有领域都有显著关系:身体健康(P = 0.030)、心理(P = 0.046)、社会关系(P = 0.027)和环境(P = 0.023),性别变量与身体健康(P = 0.026)和社会关系(P = 0.007)领域有显著关系。COVID-19 恶化了艾滋病患者的生活质量,影响了医疗保健、支持、工作和耻辱感。就业状况也受到严重影响。
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引用次数: 0
Impact of serious adverse drug reactions on the quality of life of patients on highly active antiretroviral therapy in Maiduguri, northeast Nigeria: a four-year retrospective study. 严重药物不良反应对尼日利亚东北部迈杜古里高度活跃抗逆转录病毒疗法患者生活质量的影响:一项为期四年的回顾性研究。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-01 Epub Date: 2024-07-18 DOI: 10.1080/09540121.2024.2365857
Peter U Bassi, W Gashau

ABSTRACTSerious adverse drug reactions (sADRs) have a serious impact on the progress being made in providing antiretroviral therapy. The presence of HIV/AIDS and its complications associated with sADRs, has a negative effect on the quality of life (QoL) of people living with HIV/AIDS (PLWHA). This was a descriptive retrospective cohort study of 400 adult HIV patients in which the QoL of PLWHA with sADRs was compared to patients that did not experience ADR who had been on antiretroviral therapy (ART) was followed up for 48 months using the WHOQOL-HIV BREF to measure QoL. Out of 400 patients, 373 (93.25%) respondents completed the study with an overall mean age was 40.8 years (SD ± 8.64). One hundred and ninety-nine patients (53.4%) reported to have experiencing sADR. The response consistently showed significantly higher mean scores in the QoL of patients who had no ADRs in the psychological, social and environments state of health domains compared to those who had ADRs with mean scores (P = 0.000, 0.037 and 0.028), respectively. This study revealed significantly higher scores in patients who had no ADRs compared to those who had ADRs. Low QoL due to serious ADR may add additional burden to HIV disease and complications, and the related discrimination often faced by PLWHA. This study would help clinicians pay serious attention to identifying and promptly managing ADR.

摘要严重药物不良反应(sADRs)严重影响了抗逆转录病毒疗法的进展。艾滋病毒/艾滋病及其与药物不良反应相关的并发症对艾滋病毒/艾滋病感染者(PLWHA)的生活质量(QoL)产生了负面影响。这是一项对 400 名成年艾滋病患者进行的描述性回顾性队列研究,其中使用 WHOQOL-HIV BREF 对接受抗逆转录病毒疗法(ART)的患者的 QoL 进行了 48 个月的随访,并将出现 sADRs 的 PLWHA 与未出现 ADRs 的患者的 QoL 进行了比较。在 400 名患者中,有 373 名(93.25%)受访者完成了研究,总平均年龄为 40.8 岁(SD ± 8.64)。199 名患者(53.4%)表示曾经历过 sADR。研究结果一致显示,在心理、社会和环境健康状况方面,未发生 ADR 的患者的 QoL 平均得分明显高于发生 ADR 的患者,平均得分分别为(P = 0.000、0.037 和 0.028)。本研究显示,与出现 ADR 的患者相比,未出现 ADR 的患者得分明显较高。因严重 ADR 而导致的低 QoL 可能会增加 HIV 疾病和并发症的额外负担,以及 PLWHA 经常面临的相关歧视。这项研究将有助于临床医生重视识别和及时处理 ADR。
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引用次数: 0
Willingness to use PrEP among PrEP naïve men who have sex with men: a meta-analysis. PrEP 新手中使用 PrEP 的意愿:一项荟萃分析。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-01 Epub Date: 2024-05-21 DOI: 10.1080/09540121.2024.2354207
Swarnali Goswami, Taylor Gannon, Saara Nasruddin, Blake Mancuso, Minsoo Kang, John P Bentley, Kaustuv Bhattacharya, Marie Barnard

This study aimed to measure the pooled estimate of willingness to use HIV pre-exposure prophylaxis (PrEP) (WTUP) among PrEP-naïve United States (U.S.)-based men who have sex with men (MSM). PubMed, Embase, Web of Science, CINAHL, and PsycINFO were searched. The search strategy contained the keyword willingness and interest and the MeSH terms for HIV and PrEP. Articles were included if they were published between January 2005 and May 2022, reported quantitative data on WTUP among PrEP-naïve US-based MSM, and were available as full text in English. Meta-analysis was conducted to assess the pooled effect size of WTUP prevalence using a random-effects model, heterogeneity in the pooled estimate was assessed, and subgroup analyzes were conducted. Fifteen studies were included based on the inclusion and exclusion criteria. Meta-analysis revealed a pooled prevalence proportion for WTUP of 0.58 (95% CI 0.54-0.61) (or 58 out of 100) among PrEP-naïve MSM. High inter-study heterogeneity (Q = 548.10, df = 19, p < 0.01, I2 = 96.53, τ2 = 0.09) was observed. Age of the study sample and region where the data were collected significantly moderated the pooled WTUP estimate. Age-appropriate PrEP related messaging and a focus on HIV priority areas of the U.S. would be important strategies to improve WTUP among MSM in the U.S. moving forward.

本研究旨在衡量美国(U.S.)男男性行为者(MSM)中未接受过艾滋病暴露前预防(PrEP)治疗的人群使用艾滋病暴露前预防(PrEP)的意愿(WTUP)。对 PubMed、Embase、Web of Science、CINAHL 和 PsycINFO 进行了检索。检索策略包括关键词 "意愿和兴趣 "以及 MeSH 词语 "HIV "和 "PrEP"。纳入的文章必须发表于 2005 年 1 月至 2022 年 5 月之间,报告了 PrEP 尝试者中的美国 MSM 的 WTUP 定量数据,并有英文全文。采用随机效应模型进行 Meta 分析以评估 WTUP 流行率的集合效应大小,评估集合估计值的异质性,并进行亚组分析。根据纳入和排除标准,共纳入了 15 项研究。Meta 分析显示,在 PrEP 未接受治疗的 MSM 中,WTUP 的汇总流行率为 0.58(95% CI 0.54-0.61)(或 100 例中有 58 例)。研究间存在高度异质性(Q = 548.10, df = 19, p 2 = 96.53, τ2 = 0.09)。研究样本的年龄和数据收集地区在很大程度上影响了 WTUP 的汇总估计值。与年龄相适应的 PrEP 相关信息以及对美国 HIV 重点地区的关注将是改善美国 MSM WTUP 的重要策略。
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引用次数: 0
Determinants of HIV/AIDS treatment and care service quality in Woliso Town, Oromia, Ethiopia: in the case of HIV prevention and control project. 埃塞俄比亚奥罗莫州沃利索镇艾滋病毒/艾滋病治疗和护理服务质量的决定因素:以艾滋病毒预防和控制项目为例。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-01 Epub Date: 2024-06-13 DOI: 10.1080/09540121.2024.2365868
Teka Haile Uma, Mesfin Tesfaye

In Ethiopia, even though there is an effort to increase ART services, different challenges remain in the provision of HIV/AIDS treatment and care services, and little has been done to evaluate patient satisfaction levels. The purpose of this study is to assess the determinants of HIV/AIDS treatment and care service quality. A facility-based cross-sectional study was conducted during from October 2023 to November 2023 in Woliso Town. The total sample size was generated using a systematic random sampling method from the source population. The results of the study showed that client satisfaction with HIV/AIDS treatment and care service quality was 272 (81.4%) with 95% CI: 76.9-85.3%. Government employees were 67% less likely to be satisfied with HIV/AIDS treatment and care service quality (AOR = 0.33 95% CI: 0.11, 0.99) when compared to unemployed clients. The odds of client satisfaction were 6.72 times higher among study participants who do not have health insurance membership cards (AOR = 6.72 95% CI: 3.42, 13.91) compared to those who have health insurance membership cards. The odds of client satisfaction were 2.77 times higher among study participants who reported the availability of community referral for any social support (AOR = 2.77 95% CI: 1.12, 6.84) when compared to those who did not report. Those study participants for whom privacy was kept during the examination were 8.67 times higher to be satisfied (AOR = 8.67 95% CI: 2.53, 29.68) compared to those for whom privacy was not kept during the examination. In conclusion, the client satisfaction on HIV/AIDS treatment and care service quality was relatively high in the study area. Occupational status, health insurance membership cards, availability of community referral for any social support and keeping privacy during examination have significant associations with HIV/AIDS treatment and care service quality in terms of client satisfaction.

在埃塞俄比亚,尽管在努力增加抗逆转录病毒疗法服务,但在提供艾滋病毒/艾滋病治疗和护理服务方面仍然存在不同的挑战,而且在评估患者满意度方面也鲜有作为。本研究旨在评估艾滋病毒/艾滋病治疗和护理服务质量的决定因素。2023 年 10 月至 2023 年 11 月期间,在沃利索镇开展了一项基于设施的横断面研究。总样本量采用系统随机抽样法从来源人群中产生。研究结果显示,客户对艾滋病毒/艾滋病治疗和护理服务质量的满意度为 272 (81.4%),95% CI:76.9-85.3%。与失业客户相比,政府雇员对艾滋病治疗和护理服务质量的满意度要低 67%(AOR = 0.33 95% CI: 0.11, 0.99)。与拥有医疗保险会员卡的人相比,没有医疗保险会员卡的研究参与者的客户满意度要高出 6.72 倍(AOR = 6.72 95% CI:3.42, 13.91)。与未报告的人相比,报告可通过社区转介获得任何社会支持的研究参与者的客户满意度要高出 2.77 倍(AOR = 2.77 95% CI:1.12, 6.84)。与那些在检查过程中未保留隐私的人相比,那些在检查过程中保留隐私的研究参与者的满意度要高出 8.67 倍(AOR = 8.67 95% CI:2.53, 29.68)。总之,在研究地区,患者对艾滋病治疗和护理服务质量的满意度相对较高。就客户满意度而言,职业状况、医疗保险会员卡、社区转介是否可提供任何社会支持以及检查期间是否保护隐私与艾滋病毒/艾滋病治疗和护理服务质量有显著关联。
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引用次数: 0
Factors influencing the health-related quality of life of older men and women living with HIV in Spain. 影响西班牙感染艾滋病毒的老年男性和女性的健康相关生活质量的因素。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-01 Epub Date: 2024-06-05 DOI: 10.1080/09540121.2024.2361815
Néstor Nuño, Alberto Martínez, Susana Martínez, Marta Cobos, Juan Sebastián Hernández, Rosa Polo

The number of older people living with HIV (OPLHIV) is increasing worldwide. However, little is known about the factors that better predict their health-related quality of life (HRQoL). We administered the validated WHOQoL-HIV BREF questionnaire to 247 Spanish OPLHIV (192 men and 55 women). In addition to the six domains of the questionnaire, we constructed a seventh domain as theaverage of punctuations of all domains. Multivariable Poisson regression models with robust estimates by sex were constructed for the seven domains (14 in total). The best-subset selection method together with Mallow's Cp metric was used to select the model factors. The percentage of variability explained by Poisson models ranged from15-38% for men and 29-70% for women. The analysis showed that women were most affected by ageing (four domains), mobility impairments (five domains), and mental disorders (five domains). The factors with the greatest negative influence on men were heterosexuality (six domains), mental disorders (six domains), being single (five domains), and poverty risk (three domains). Physical activity was found to improve HRQoL in both men (six domains) and women (four domains). Future OPLHIV programmes would benefit from considering sex specific HRQoL factors. This could also improve the cost-effectiveness of interventions.

全球感染艾滋病毒的老年人(OPLHIV)数量正在不断增加。然而,人们对能够更好地预测其健康相关生活质量(HRQoL)的因素知之甚少。我们对 247 名西班牙 OPLHIV(192 名男性和 55 名女性)进行了经过验证的 WHOQoL-HIV BREF 问卷调查。除了问卷的六个领域外,我们还构建了第七个领域,即所有领域标点符号的平均值。我们针对这七个领域(共 14 个)构建了多变量泊松回归模型,并按性别进行了稳健估计。采用最佳子集选择法和 Mallow's Cp 指标来选择模型因子。泊松模型所解释的变异百分比,男性为 15%-38%,女性为 29%-70%。分析表明,女性受老龄化(四个领域)、行动障碍(五个领域)和精神障碍(五个领域)的影响最大。对男性负面影响最大的因素是异性恋(六个领域)、精神障碍(六个领域)、单身(五个领域)和贫困风险(三个领域)。研究发现,体育活动可以改善男性(六个领域)和女性(四个领域)的 HRQoL。考虑到特定性别的 HRQoL 因素将有益于未来的 OPLHIV 计划。这也可以提高干预措施的成本效益。
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引用次数: 0
Gender differences in symptom burden among people living with HIV/AIDS receiving antiretroviral therapy in Yunnan, China. 中国云南接受抗逆转录病毒治疗的艾滋病感染者症状负担的性别差异。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-01 Epub Date: 2024-01-04 DOI: 10.1080/09540121.2023.2300978
Qiao Zhou, Liying Yang, Yu Wan, Xucheng Li, Zheng Zhu, Jianhua Wang, Jibiao Huang, Fang Shen, Qiu Tan, Liting Dong, Qinmin Ni, Shixiao Zhang, Yanfen Fu

ABSTRACTLittle is known about gender differences in the symptom burden of people living with HIV/AIDS (PLWHA) on antiretroviral therapy in China. This study was conducted based on a biopsychosocial-medical model to describe gender differences in symptom burden among 1035 PLWHA in Yunnan Province, China. After propensity score matching, 798 PLWHA were included in this analysis. Feeling stressed, poor sleep, and memory loss were the most burdensome symptoms among men, while feeling stressed, memory loss, and dizziness were the most burdensome symptoms among women. Among men PLWHA, factors associated with symptom burden were being of the ethnic minority, CD4 count ≥ 500 cells/mm3, physical functioning, and social support. Among women PLWHA, factors associated with symptom burden were being an inpatient, physical functioning, psychological functioning, and social support. Our findings suggest that healthcare providers need to take into account gender differences when developing optimal prevention, treatment, and care programs that provide individualized care to reduce patients' symptom burden.

摘要 在中国,人们对接受抗逆转录病毒治疗的艾滋病感染者(PLWHA)在症状负担方面的性别差异知之甚少。本研究以生物-心理-社会-医疗模型为基础,描述了中国云南省 1035 名艾滋病病毒感染者和艾滋病患者在症状负担方面的性别差异。经过倾向得分匹配后,798 名 PLWHA 纳入了本分析。在男性感染者中,压力感、睡眠不佳和记忆力减退是最沉重的症状,而在女性感染者中,压力感、记忆力减退和头晕是最沉重的症状。在男性 PLWHA 中,与症状负担相关的因素包括少数族裔、CD4 细胞计数≥ 500 cells/mm3、身体机能和社会支持。在女性 PLWHA 中,与症状负担相关的因素包括住院患者、身体机能、心理机能和社会支持。我们的研究结果表明,医疗服务提供者在制定最佳预防、治疗和护理计划时,需要考虑到性别差异,提供个性化护理以减轻患者的症状负担。
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引用次数: 0
The burden of secrecy in the management of multimorbidity in older people living with HIV aged 70 and over. 70 岁及以上感染艾滋病毒的老年人在多病管理中的保密负担。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-01 Epub Date: 2024-07-08 DOI: 10.1080/09540121.2024.2372723
C Sambou, D Pourette, P Debeaudrap, L Slama, C Katlama, C Cazanave, F Bonnet, L Meyer, C Allavena

The secrecy surrounding HIV continues to be a major concern for older people living with HIV (OPWH) despite their long-term experience of HIV and the presence of other chronic diseases. Our study aims to highlight how the secrecy surrounding HIV can affect the management of the other conditions. The results of this socio-anthropological sub-study of the ANRS EP66 SEPTAVIH study, which assesses frailty in OPWH, are based on in-depth interviews conducted with 20 OPWH with multimorbidities aged 70 years and over and 9 caregivers. Based on a cross-sectional thematic analysis, this study shows that HIV infection differs from other chronic diseases due to the secrecy and stigma associated with HIV. These specific issues associated with HIV complicate the lives of OPWH, depriving them of support from loved ones and forcing them to exclude their general practitioner from their care system. This then causes OPWH with multiple chronic diseases to become socially vulnerable and isolated. Interventions that support the sharing of information on HIV among OPWH and also among caregivers need to be identified as a matter of urgency in order to improve the lives and management of OPWH with multimorbidities.Trial Registration: ClinicalTrials.gov identifier: NCT03958786.

尽管老年艾滋病病毒感染者(OPWH)长期遭受艾滋病病毒感染,并患有其他慢性疾病,但对艾滋病病毒的保密仍然是他们的主要担忧。我们的研究旨在强调围绕艾滋病病毒的保密性会如何影响对其他疾病的管理。这项社会人类学子研究是 ANRS EP66 SEPTAVIH 研究的一部分,该研究评估了 OPWH 的虚弱情况,研究结果基于对 20 名 70 岁及以上患有多种疾病的 OPWH 和 9 名护理人员进行的深入访谈。根据横断面主题分析,这项研究表明,由于与艾滋病毒相关的隐秘性和耻辱感,艾滋病毒感染不同于其他慢性疾病。这些与艾滋病相关的特殊问题使 OPWH 的生活变得更加复杂,使他们失去了亲人的支持,并迫使他们将全科医生排除在护理系统之外。这就导致患有多种慢性疾病的 OPWH 成为社会的弱势群体和孤立者。为了改善患有多种疾病的慢性病患者的生活和管理,我们需要紧急采取干预措施,支持慢性病患者和护理人员共享艾滋病信息:试验注册:ClinicalTrials.gov identifier:NCT03958786.
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引用次数: 0
Assessing the effect of COVida orphans and vulnerable children support services on viral load coverage and suppression among children and adolescents living with HIV in four provinces in Mozambique. 评估 COVida 孤儿和易感儿童支持服务对莫桑比克四个省份感染艾滋病毒的儿童和青少年病毒载量覆盖率和抑制率的影响。
IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-01 Epub Date: 2024-07-24 DOI: 10.1080/09540121.2024.2373400
Lara Lorenzetti, Belmiro Sousa, Andres Martinez, Aristides Almeida, Vance Harris, Horacio Mondlane, Gervasio Nazare, Tanya Medrano, Hayley Bryant

Orphans and vulnerable children (OVC) programs focusing on improving HIV outcomes for children and adolescents living with HIV (C&ALHIV) may improve viral load (VL) testing coverage, a critical step toward achieving VL suppression. In Mozambique, we conducted a retrospective medical record review comparing VL testing coverage and suppression between C&ALHIV receiving OVC support and two cohorts of non-participants constructed using propensity score matching. We collected data for 25,783 C&ALHIV in Inhambane, Maputo City, Nampula, and Tete between October 2020-September 2021. Unadjusted rates of VL testing were 62.9% among OVC participants compared with 39.2% and 50.4% of non-participants in OVC support and non-OVC support districts, respectively. In multivariate models, OVC participants were 18 and 10 percentage points more likely to have received a VL test than non-participants in OVC districts (p < 0.01) and non-OVC districts (p < 0.01), respectively. OVC participants under 5 years old were significantly more likely to have received a VL test than their same-age counterparts in both comparison groups. Overall, the OVC program did not demonstrate significant effects on VL suppression. This approach could be replicated in other contexts to improve testing coverage. It is crucial that clinical partners and governments continue to share data to enable timely monitoring through OVC programming.

孤儿和易受感染儿童 (OVC) 项目的重点是改善儿童和青少年艾滋病感染者(C&ALHIV)的治疗效果,该项目可提高病毒载量(VL)检测的覆盖率,这是实现 VL 抑制的关键一步。在莫桑比克,我们进行了一项回顾性病历审查,比较了接受孤儿和弱势儿童支持的 C&ALHIV 与使用倾向得分匹配法构建的两个非参与者队列之间的 VL 检测覆盖率和抑制率。我们收集了2020年10月至2021年9月期间伊尼扬巴内、马普托市、楠普拉和太特25783名C&ALHIV的数据。未经调整,OVC参与者的VL检测率为62.9%,而在OVC支持区和非OVC支持区,未参与者的VL检测率分别为39.2%和50.4%。在多变量模型中,在孤儿和易受感染儿童支持地区,孤儿和易受感染儿童参与者接受 VL 检测的可能性分别比非参与者高 18 个百分点和 10 个百分点(p p p)。
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引用次数: 0
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Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv
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