Pub Date : 2024-07-01Epub Date: 2024-01-30DOI: 10.1080/09540121.2024.2308738
Tyrel J Starks, Joseph R Hillesheim, Juan Castiblanco, Demetria Cain, Rob Stephenson
Studies conducted early in the COVID-19 pandemic - before vaccines were widely available - indicated that drug use may have declined among sexual minority men (SMM). This study evaluated drug use trends in the second year of the pandemic. Cross-sectional responses from cisgender SMM living in the US and recruited online (n = 15,897) were grouped for analyses: Time 1: 3/1/2021-5/30/2021; Time 2: 6/1/2021-8/31/2021; Time 3: 9/1/2021-11/30/2021; and Time 4: 12/1 2021-2/28/2022. Results of multivariable models indicated that illicit drug use (excluding cannabis) increased at Times 2 (OR = 1.249, p < .001), 3 (OR = 1.668, p < .001), and 4 (OR = 1.674, p < .001) compared to Time 1. In contrast, cannabis use was relatively stable over time. Rates did not differ significantly among Times 1, 2, and 4. While rates of COVID-19 vaccination increased over time, illicit drug use was negatively associated with the odds of vaccination (OR = 0.361, p < .001). These findings highlight the need for ongoing attention to the risks drug use poses among SMM. Illicit drug use - a long-standing health disparity among SMM - increased significantly across the second year of the pandemic. Because they are less likely to be vaccinated, SMM who use illicit drugs may be at greater risk of COVID-19 infection or complications.
在 COVID-19 大流行的早期--疫苗尚未普及之前--进行的研究表明,性少数群体男性 (SMM) 中的吸毒现象可能有所减少。本研究对大流行第二年的吸毒趋势进行了评估。对居住在美国并通过网络招募的顺性别 SMM(n = 15,897)的横截面反应进行分组分析:时间 1:3/1/2021-5/30/2021;时间 2:6/1/2021-8/31/2021;时间 3:9/1/2021-11/30/2021;时间 4:12/1/2021-2/28/2022。多变量模型的结果表明,非法药物使用(不包括大麻)在时间 2 增加(OR = 1.249,p OR = 1.668,p OR = 1.674,p OR = 0.361,p OR = 0.361,p OR = 0.361)。
{"title":"Drug use during the second year of the COVID-19 pandemic: observations from repeated cross-sectional surveys of sexual minority men in the US active on social networking applications.","authors":"Tyrel J Starks, Joseph R Hillesheim, Juan Castiblanco, Demetria Cain, Rob Stephenson","doi":"10.1080/09540121.2024.2308738","DOIUrl":"10.1080/09540121.2024.2308738","url":null,"abstract":"<p><p>Studies conducted early in the COVID-19 pandemic - before vaccines were widely available - indicated that drug use may have declined among sexual minority men (SMM). This study evaluated drug use trends in the second year of the pandemic. Cross-sectional responses from cisgender SMM living in the US and recruited online (<i>n </i>= 15,897) were grouped for analyses: Time 1: 3/1/2021-5/30/2021; Time 2: 6/1/2021-8/31/2021; Time 3: 9/1/2021-11/30/2021; and Time 4: 12/1 2021-2/28/2022. Results of multivariable models indicated that illicit drug use (excluding cannabis) increased at Times 2 (<i>OR </i>= 1.249, <i>p </i>< .001), 3 (<i>OR </i>= 1.668, <i>p </i>< .001), and 4 (<i>OR </i>= 1.674, <i>p </i>< .001) compared to Time 1. In contrast, cannabis use was relatively stable over time. Rates did not differ significantly among Times 1, 2, and 4. While rates of COVID-19 vaccination increased over time, illicit drug use was negatively associated with the odds of vaccination (<i>OR</i> = 0.361, <i>p </i>< .001). These findings highlight the need for ongoing attention to the risks drug use poses among SMM. Illicit drug use - a long-standing health disparity among SMM - increased significantly across the second year of the pandemic. Because they are less likely to be vaccinated, SMM who use illicit drugs may be at greater risk of COVID-19 infection or complications.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"145-153"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-06DOI: 10.1080/09540121.2024.2312876
Eric Y Tenkorang, Akosua Pokua Adjei, Victor Agyei-Yeboah, Adobea Y Owusu
This study examines the prevalence and risk factors of physical, sexual, psychological, and economic violence during lockdowns associated with COVID-19 among HIV-positive women in Ghana. Data were collected in August 2021 from a cross-section of 538 HIV-positive women aged 18 years and older in the Lower Manya Krobo District in the Eastern region of Ghana. Logit models were used to explore relationships between women's self-reported experiences of physical, sexual, psychological /emotional, and economic violence under lockdown and key socio-economic and demographic characteristics. The findings indicate moderate to high prevalence of intimate partner violence (IPV) under lockdown in our sample: physical violence (30.1%), sexual violence (28.6%), emotional/psychological violence (53.7%), and economic violence (54.2%). IPV was higher on all four measures for educated women, poorer women, employed women, cohabiting and married women, and HIV seroconcordant couples.
{"title":"COVID-19, pandemic lockdowns and intimate partner violence among HIV-positive women in Ghana.","authors":"Eric Y Tenkorang, Akosua Pokua Adjei, Victor Agyei-Yeboah, Adobea Y Owusu","doi":"10.1080/09540121.2024.2312876","DOIUrl":"10.1080/09540121.2024.2312876","url":null,"abstract":"<p><p>This study examines the prevalence and risk factors of physical, sexual, psychological, and economic violence during lockdowns associated with COVID-19 among HIV-positive women in Ghana. Data were collected in August 2021 from a cross-section of 538 HIV-positive women aged 18 years and older in the Lower Manya Krobo District in the Eastern region of Ghana. Logit models were used to explore relationships between women's self-reported experiences of physical, sexual, psychological /emotional, and economic violence under lockdown and key socio-economic and demographic characteristics. The findings indicate moderate to high prevalence of intimate partner violence (IPV) under lockdown in our sample: physical violence (30.1%), sexual violence (28.6%), emotional/psychological violence (53.7%), and economic violence (54.2%). IPV was higher on all four measures for educated women, poorer women, employed women, cohabiting and married women, and HIV seroconcordant couples.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1018-1028"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-09DOI: 10.1080/09540121.2024.2321697
Lena Nilsson Schönnesson, Lucie Cluver, Lars E Eriksson, Udi Davidovich, Richard Harding, Bruno Spire, José Catalan, Mehdi Karkouri, Kathryn Steventon-Roberts, Bridgette Prince, Lorraine Sherr
{"title":"The power for action - now!","authors":"Lena Nilsson Schönnesson, Lucie Cluver, Lars E Eriksson, Udi Davidovich, Richard Harding, Bruno Spire, José Catalan, Mehdi Karkouri, Kathryn Steventon-Roberts, Bridgette Prince, Lorraine Sherr","doi":"10.1080/09540121.2024.2321697","DOIUrl":"10.1080/09540121.2024.2321697","url":null,"abstract":"","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-15DOI: 10.1080/09540121.2024.2308750
Steven A Safren, Jasper S Lee, Lena S Andersen, Amelia M Stanton, Ashraf Kagee, Norik Kirakosian, Conall O'Cleirigh, John A Joska
Multilevel factors (individual and structural) influence adherence to antiretroviral therapy, particularly in high HIV prevalence areas such as South Africa. The present study examined the relative importance of structural barriers to HIV care and behavioral health factors, depression and alcohol use, in Khayelitsha, Cape Town, South Africa. People receiving HIV care in six primary care clinics in Khayelitsha (N = 194) completed the Center for Epidemiologic Studies Depression Scale, the Alcohol Use Disorders Identification Test, the Structural Barriers to Medication Taking questionnaire, and a qualitative rating of past-two-week adherence. Correlations were employed to examine associations among these variables, and hierarchical regression analysis was used to examine the unique effects of structural barriers over and above depression and alcohol use as predictors of adherence. Participants were primarily Black South African (99%) women (83%), and 41 years old on average. All four variables were significantly correlated. The hierarchical regression analysis showed that among behavioral health predictors, alcohol use alone significantly predicted ART adherence (b = -.032, p = .002). When structural barriers was added to the model, it was the only significant unique predictor of ART adherence (b = -1.58, p < .001). Findings highlight the need to consider structural vulnerabilities in HIV care in South Africa when developing behavioral health interventions.
多层次因素(个人因素和结构性因素)会影响抗逆转录病毒疗法的依从性,尤其是在南非这样的艾滋病高发地区。本研究考察了南非开普敦卡耶利沙地区艾滋病护理的结构性障碍和行为健康因素(抑郁和酗酒)的相对重要性。在 Khayelitsha 的六家初级保健诊所接受 HIV 护理的患者(N = 194)填写了流行病学研究中心抑郁量表、酒精使用障碍鉴定测试、服药的结构性障碍问卷以及对过去两周依从性的定性评分。研究人员利用相关性分析来检验这些变量之间的关联,并利用层次回归分析来检验结构性障碍在抑郁和饮酒之外对坚持服药的独特影响。参与者主要是南非黑人(99%)和女性(83%),平均年龄 41 岁。所有四个变量都有明显的相关性。分层回归分析表明,在行为健康预测因素中,仅酗酒一项就能显著预测抗逆转录病毒疗法的依从性(b = -.032, p = .002)。当将结构性障碍加入模型时,它是唯一能显著预测抗逆转录病毒疗法依从性的独特因素(b = -1.58,p = 0.002)。
{"title":"The salience of structural barriers and behavioral health problems to ART adherence in people receiving HIV primary care in South Africa.","authors":"Steven A Safren, Jasper S Lee, Lena S Andersen, Amelia M Stanton, Ashraf Kagee, Norik Kirakosian, Conall O'Cleirigh, John A Joska","doi":"10.1080/09540121.2024.2308750","DOIUrl":"10.1080/09540121.2024.2308750","url":null,"abstract":"<p><p>Multilevel factors (individual and structural) influence adherence to antiretroviral therapy, particularly in high HIV prevalence areas such as South Africa. The present study examined the relative importance of structural barriers to HIV care and behavioral health factors, depression and alcohol use, in Khayelitsha, Cape Town, South Africa. People receiving HIV care in six primary care clinics in Khayelitsha (N = 194) completed the Center for Epidemiologic Studies Depression Scale, the Alcohol Use Disorders Identification Test, the Structural Barriers to Medication Taking questionnaire, and a qualitative rating of past-two-week adherence. Correlations were employed to examine associations among these variables, and hierarchical regression analysis was used to examine the unique effects of structural barriers over and above depression and alcohol use as predictors of adherence. Participants were primarily Black South African (99%) women (83%), and 41 years old on average. All four variables were significantly correlated. The hierarchical regression analysis showed that among behavioral health predictors, alcohol use alone significantly predicted ART adherence (b = -.032, <i>p</i> = .002). When structural barriers was added to the model, it was the only significant unique predictor of ART adherence (b = -1.58, <i>p</i> < .001). Findings highlight the need to consider structural vulnerabilities in HIV care in South Africa when developing behavioral health interventions.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"154-160"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-29DOI: 10.1080/09540121.2024.2307389
Johanna Nice, Leia Saltzman, Tonya R Thurman, Babalwa Zani
This study examined adherence to antiretroviral therapy (ART) among adolescents and young adults living with HIV in South Africa. Using survey data from 857 youth on ART, the study employed latent class analysis to identify subgroups based on self-reported reasons for missed ART doses. Three distinct classes emerged: the largest class (85%) occasionally forgot to take their medication or missed a dose because others were around, the second class (9%) missed doses only due to feeling sick, and the third class (6%) faced multiple barriers such as forgetting, feeling sick, worrying about side effects, or doubting the effectiveness of ART. Youth who reported multiple barriers to adherence had significantly lower adjusted odds (AOR = 0.35, 95% CI = 0.16-0.78) of reporting 90% past month adherence compared to those who occasionally forgot their medication. Additionally, contextual factors such as food security, being treated well at the clinic, and being accompanied to the clinic were associated with higher odds of adherence. The findings highlight the importance of considering co-occurring barriers to adherence and tailoring interventions accordingly. Addressing contextual factors, such as ensuring food security and providing supportive clinic environments, is also crucial for promoting optimal adherence among adolescents and young adults living with HIV.
本研究调查了南非青少年艾滋病感染者坚持抗逆转录病毒疗法(ART)的情况。该研究利用 857 名接受抗逆转录病毒疗法的青少年的调查数据,采用潜类分析法,根据他们自我报告的错过抗逆转录病毒疗法剂量的原因来确定亚组。结果发现了三个不同的群体:最大的群体(85%)偶尔会忘记服药或因周围有人而漏服;第二类群体(9%)仅因身体不适而漏服;第三类群体(6%)面临多种障碍,如忘记服药、身体不适、担心副作用或怀疑抗逆转录病毒疗法的效果。与偶尔忘带药物的青少年相比,报告存在多种坚持治疗障碍的青少年上个月坚持治疗达到 90% 的调整后几率(AOR = 0.35,95% CI = 0.16-0.78)明显较低。此外,食品安全、在诊所受到良好对待以及有人陪同就诊等环境因素也与较高的依从性相关。研究结果凸显了考虑影响坚持服药的并发障碍并相应调整干预措施的重要性。解决环境因素,如确保食品安全和提供支持性诊所环境,对于促进青少年和年轻成人艾滋病感染者达到最佳坚持治疗效果也至关重要。
{"title":"Latent class analysis of ART barriers among adolescents and young adults living with HIV in South Africa.","authors":"Johanna Nice, Leia Saltzman, Tonya R Thurman, Babalwa Zani","doi":"10.1080/09540121.2024.2307389","DOIUrl":"10.1080/09540121.2024.2307389","url":null,"abstract":"<p><p>This study examined adherence to antiretroviral therapy (ART) among adolescents and young adults living with HIV in South Africa. Using survey data from 857 youth on ART, the study employed latent class analysis to identify subgroups based on self-reported reasons for missed ART doses. Three distinct classes emerged: the largest class (85%) occasionally forgot to take their medication or missed a dose because others were around, the second class (9%) missed doses only due to feeling sick, and the third class (6%) faced multiple barriers such as forgetting, feeling sick, worrying about side effects, or doubting the effectiveness of ART. Youth who reported multiple barriers to adherence had significantly lower adjusted odds (AOR = 0.35, 95% CI = 0.16-0.78) of reporting 90% past month adherence compared to those who occasionally forgot their medication. Additionally, contextual factors such as food security, being treated well at the clinic, and being accompanied to the clinic were associated with higher odds of adherence. The findings highlight the importance of considering co-occurring barriers to adherence and tailoring interventions accordingly. Addressing contextual factors, such as ensuring food security and providing supportive clinic environments, is also crucial for promoting optimal adherence among adolescents and young adults living with HIV.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"45-53"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-03-06DOI: 10.1080/09540121.2024.2325100
Pradthana Ounchanum, Linda Aurpibul, Sirinya Teeraananchai, Pagakrong Lumbiganon, Wipaporn Natalie Songtaweesin, Tavitiya Sudjaritruk, Kulkanya Chokephaibulkit, Supattra Rungmaitree, Pope Kosalaraksa, Tulathip Suwanlerk, Jeremy L Ross, Annette H Sohn, Thanyawee Puthanakit
Transitioning from pediatric to adult care remains a challenge for adolescents and young adults with perinatally-acquired HIV (AYA-PHIV). We assessed treatment outcomes and mortality among Thai AYA-PHIV. The study included AYA-PHIV who reached age 18-24 years who started antiretroviral treatment during childhood at five pediatric HIV clinics across Thailand. From November 2020-July 2021, data were gathered from a cohort database, medical records, and the Thai National AIDS Program. Of 811 eligible AYA-PHIV, 93% were alive; median age 22.3 years (IQR 20.6-23.7), treatment duration 16.1 years (IQR 13.4-18.0). Current HIV care was provided in adults (71%) and pediatric clinics (29%). Treatment regimens included non-nucleoside reverse transcriptase inhibitors (55%), protease inhibitors (36%), and integrase inhibitors (8%); 78% had HIV RNA <200 copies/ml. Of the 7.0% who died, median age at death was 20.8 years (IQR 20.6-22.1); 88% were AIDS-related death. Mortality after age 18 was 1.76 per 100-person years (95% confidence interval 1.36-2.28). Those with CD4 <200 cell/mm3 at age 15 had higher risk of mortality (adjusted hazard ratio 6.16, 95% CI 2.37-16.02). In conclusion, the high mortality among Thai AYA-PHIV indicated the need for better systems to support AYA-PHIV during the transition to adulthood.
对于感染了围产期艾滋病病毒(AYA-PHIV)的青少年和年轻成人来说,从儿科治疗过渡到成人治疗仍然是一项挑战。我们对泰国青少年艾滋病病毒感染者的治疗效果和死亡率进行了评估。研究对象包括年满 18-24 岁、在儿童时期开始接受抗逆转录病毒治疗的青少年艾滋病病毒感染者,他们在泰国各地的五家儿科艾滋病诊所接受治疗。2020 年 11 月至 2021 年 7 月期间,研究人员通过队列数据库、医疗记录和泰国国家艾滋病计划收集数据。在811名符合条件的AYA-PHIV中,93%存活;中位年龄为22.3岁(IQR为20.6-23.7),治疗持续时间为16.1年(IQR为13.4-18.0)。目前的艾滋病治疗由成人诊所(71%)和儿科诊所(29%)提供。治疗方案包括非核苷类逆转录酶抑制剂(55%)、蛋白酶抑制剂(36%)和整合酶抑制剂(8%);78%的患者在 15 岁时 HIV RNA 为 3,其死亡风险较高(调整后危险比为 6.16,95% CI 为 2.37-16.02)。总之,泰国青年艾滋病病毒感染者的高死亡率表明,在青年艾滋病病毒感染者向成年过渡的过程中,需要有更好的系统为其提供支持。
{"title":"High mortality in adolescents and young adults with perinatally-acquired HIV in Thailand during the transition to adulthood.","authors":"Pradthana Ounchanum, Linda Aurpibul, Sirinya Teeraananchai, Pagakrong Lumbiganon, Wipaporn Natalie Songtaweesin, Tavitiya Sudjaritruk, Kulkanya Chokephaibulkit, Supattra Rungmaitree, Pope Kosalaraksa, Tulathip Suwanlerk, Jeremy L Ross, Annette H Sohn, Thanyawee Puthanakit","doi":"10.1080/09540121.2024.2325100","DOIUrl":"10.1080/09540121.2024.2325100","url":null,"abstract":"<p><p>Transitioning from pediatric to adult care remains a challenge for adolescents and young adults with perinatally-acquired HIV (AYA-PHIV). We assessed treatment outcomes and mortality among Thai AYA-PHIV. The study included AYA-PHIV who reached age 18-24 years who started antiretroviral treatment during childhood at five pediatric HIV clinics across Thailand. From November 2020-July 2021, data were gathered from a cohort database, medical records, and the Thai National AIDS Program. Of 811 eligible AYA-PHIV, 93% were alive; median age 22.3 years (IQR 20.6-23.7), treatment duration 16.1 years (IQR 13.4-18.0). Current HIV care was provided in adults (71%) and pediatric clinics (29%). Treatment regimens included non-nucleoside reverse transcriptase inhibitors (55%), protease inhibitors (36%), and integrase inhibitors (8%); 78% had HIV RNA <200 copies/ml. Of the 7.0% who died, median age at death was 20.8 years (IQR 20.6-22.1); 88% were AIDS-related death. Mortality after age 18 was 1.76 per 100-person years (95% confidence interval 1.36-2.28). Those with CD4 <200 cell/mm<sup>3</sup> at age 15 had higher risk of mortality (adjusted hazard ratio 6.16, 95% CI 2.37-16.02). In conclusion, the high mortality among Thai AYA-PHIV indicated the need for better systems to support AYA-PHIV during the transition to adulthood.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"964-973"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
High attrition rates from ART are the primary contributors to morbidity, death, hospitalisation, rising transmission rates, treatment failure, rising burden of opportunistic infections (OIs), and the evolution of HIV-virus resistance (HIVDR). In Sub-Saharan Africa, more than two-thirds of ART patients will not receive continuous care. There is little information about the correlates that contribute to attrition from ART services among ART patients in Southern Ethiopia. Hence, this study aims to identify correlates of attrition from antiretroviral therapy services for adults under antiretroviral therapy at Otona Teaching and Referral Hospital, Wolaita Zone, Southern Ethiopia. From 1 January 2013 to 31 December 2017, a retrospective cohort analysis was performed. The pre-determined 328 medical records were chosen using a simple random sampling technique using computer-generated random numbers. Epi Info version 3.5.3 was used to enter and clean the data, which were then exported to STATA version 11 for analysis. The Cox proportional hazards model, both bivariate and multivariable, was used. Variables with p-values less than 0.25 in bivariate analysis were considered candidates for multivariable analysis, and variables with p-values less than 0.05 were deemed statistically important in multivariable analysis. The intensity of the correlation and statistical significance were determined using the CHR, AHR, and 95 per cent confidence intervals. The magnitude of attrition from ART service was 21.60% (95% CI: 17.10, 26.10). The distance between home and hospital is more than five kilometres (AHR:3.84;95% CI: 1.99,7.38), no registered phone number (AHR:2.47;95%CI:1.32,4.09), have not taken isoniazid prophylaxis (AHR:2.23;95%CI:1.30,4.09), alcohol consumption (AHR: 1.77; 95% CI:1.01, 3.12), and had no caregiver (AHR: 2.11; 95% CI:1.23, 3.60) were statistically significant in the Cox proportional hazard model. Distance between home and hospital, phone number registration on follow-up chart, having a history of alcohol consumption, isoniazid prophylaxis provision, and having family support were independent correlates of attrition from antiretroviral treatment services.
{"title":"Correlates of ART attrition among adults under antiretroviral therapy in Southern Ethiopia, retrospective cohort study.","authors":"Molalegn Mesele, Getachew Asmare, Gizachew Ambaw, Misganaw Asmamaw, Mohammed Abdu, Endeshaw Chekol, Denekew Tenaw, Sefineh Fenta, Tadesse Asmamaw, Melkamu Aderajew, Anteneh Mengist, Yenealem Solomon, Berihun Bantie, Wubet Alebachew, Natnael Atnafu","doi":"10.1080/09540121.2023.2293758","DOIUrl":"10.1080/09540121.2023.2293758","url":null,"abstract":"<p><p>High attrition rates from ART are the primary contributors to morbidity, death, hospitalisation, rising transmission rates, treatment failure, rising burden of opportunistic infections (OIs), and the evolution of HIV-virus resistance (HIVDR). In Sub-Saharan Africa, more than two-thirds of ART patients will not receive continuous care. There is little information about the correlates that contribute to attrition from ART services among ART patients in Southern Ethiopia. Hence, this study aims to identify correlates of attrition from antiretroviral therapy services for adults under antiretroviral therapy at Otona Teaching and Referral Hospital, Wolaita Zone, Southern Ethiopia. From 1 January 2013 to 31 December 2017, a retrospective cohort analysis was performed. The pre-determined 328 medical records were chosen using a simple random sampling technique using computer-generated random numbers. Epi Info version 3.5.3 was used to enter and clean the data, which were then exported to STATA version 11 for analysis. The Cox proportional hazards model, both bivariate and multivariable, was used. Variables with <i>p</i>-values less than 0.25 in bivariate analysis were considered candidates for multivariable analysis, and variables with <i>p</i>-values less than 0.05 were deemed statistically important in multivariable analysis. The intensity of the correlation and statistical significance were determined using the CHR, AHR, and 95 per cent confidence intervals. The magnitude of attrition from ART service was 21.60% (95% CI: 17.10, 26.10). The distance between home and hospital is more than five kilometres (AHR:3.84;95% CI: 1.99,7.38), no registered phone number (AHR:2.47;95%CI:1.32,4.09), have not taken isoniazid prophylaxis (AHR:2.23;95%CI:1.30,4.09), alcohol consumption (AHR: 1.77; 95% CI:1.01, 3.12), and had no caregiver (AHR: 2.11; 95% CI:1.23, 3.60) were statistically significant in the Cox proportional hazard model. Distance between home and hospital, phone number registration on follow-up chart, having a history of alcohol consumption, isoniazid prophylaxis provision, and having family support were independent correlates of attrition from antiretroviral treatment services.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"1010-1017"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fewer adolescents achieve viral suppression compared to adults. One impediment may be a history of adverse childhood experiences (ACEs). To better develop targets and timeframes for intervention, this study created more robust estimates of the impact of cumulative adversity on viral suppression, tested whether the association is sensitive to the timing of adversity, and simultaneously tested several potential mechanisms. We focus on males, who have lower viral suppression than females and who may contribute to disproportionate incidence among young women. We recruited 251 male perinatally HIV-infected adolescents aged 15-19 from HIV clinics in Soweto, South Africa. Adversity was captured using the Adverse Childhood Experience - International Questionnaire (ACE-IQ). Viral load was measured using blood samples; viral suppression was defined as <20 copies/mL. Indicators of medication adherence, depression, post-traumatic stress disorder (, and substance misuse were captured. A series of pathway analysis were performed. Our sample experienced a median of 7 lifetime and 4 past-year adversities. Less than half (44%) exhibited viral suppression. Adversity demonstrated a significant association with suppression; depression mediated the association. Primary prevention of adversity among children living with HIV is paramount, as is addressing the subsequent mental and behavioral health challenges that impede viral suppression among adolescents.
与成年人相比,能达到病毒抑制效果的青少年较少。其中一个障碍可能是童年的不良经历(ACEs)。为了更好地制定干预目标和时间框架,本研究对累积性逆境对病毒抑制的影响进行了更可靠的估计,测试了这种关联是否对逆境发生的时间敏感,并同时测试了几种潜在的机制。我们的研究重点是男性,他们的病毒抑制率比女性低,而且可能导致年轻女性的发病率过高。我们从南非索韦托的 HIV 诊所招募了 251 名 15-19 岁的围产期感染 HIV 的男性青少年。我们使用 "童年不良经历--国际问卷"(ACE-IQ)来了解青少年的不良经历。病毒载量通过血液样本进行测量;病毒抑制定义为
{"title":"Pathways between adverse childhood experiences and viral suppression among male HIV-infected adolescents in South Africa.","authors":"Rachel Kidman, Sabera Hossain, Wei Hou, Avy Violari","doi":"10.1080/09540121.2024.2332451","DOIUrl":"10.1080/09540121.2024.2332451","url":null,"abstract":"<p><p>Fewer adolescents achieve viral suppression compared to adults. One impediment may be a history of adverse childhood experiences (ACEs). To better develop targets and timeframes for intervention, this study created more robust estimates of the impact of cumulative adversity on viral suppression, tested whether the association is sensitive to the timing of adversity, and simultaneously tested several potential mechanisms. We focus on males, who have lower viral suppression than females and who may contribute to disproportionate incidence among young women. We recruited 251 male perinatally HIV-infected adolescents aged 15-19 from HIV clinics in Soweto, South Africa. Adversity was captured using the Adverse Childhood Experience - International Questionnaire (ACE-IQ). Viral load was measured using blood samples; viral suppression was defined as <20 copies/mL. Indicators of medication adherence, depression, post-traumatic stress disorder (, and substance misuse were captured. A series of pathway analysis were performed. Our sample experienced a median of 7 lifetime and 4 past-year adversities. Less than half (44%) exhibited viral suppression. Adversity demonstrated a significant association with suppression; depression mediated the association. Primary prevention of adversity among children living with HIV is paramount, as is addressing the subsequent mental and behavioral health challenges that impede viral suppression among adolescents.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"36-44"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-22DOI: 10.1080/09540121.2023.2287734
Khaliah A Johnson, Caroline Owens, Hannah Claire Edelson, Magdalene Yonker, Shae Robinson-Mosley, Jenny Park, Miranda Cook
Advancing the well-being of individuals living with HIV necessitates attention to social determinants of health, including food insecurity. Through a clinical and community-based needs assessment, we aimed to gain insight into experiences of food insecurity among patients receiving care at a large pediatric HIV outpatient clinic in the Southeastern United States. We adopted a multimodal assessment approach involving a literature review, community profiling, key informant interviews, focus group discussions with staff, patients and parents and a community stakeholder advisory meeting. Our needs assessment demonstrates that food insecurity is an important aspect of the lived experience of children, adolescents and young adults living with HIV. Clinical staff agreed that food insecurity screening should be incorporated into the patient care workflow but ideally only in concert with providing resources that meet their needs. We formulated a recommendation matrix for addressing food insecurity based on priority importance and feasibility. Collaborative relationships between healthcare practitioners and leaders, community-based organizations and local and federal funding sources are vital for enhancing patients' access to sustainable, reliable solutions to this fundamental determinant of health. Our approach provides a tested model for other clinics seeking to identify and alleviate food insecurity among patients.
{"title":"Food insecurity in pediatric HIV: understanding a critical challenge in the United States.","authors":"Khaliah A Johnson, Caroline Owens, Hannah Claire Edelson, Magdalene Yonker, Shae Robinson-Mosley, Jenny Park, Miranda Cook","doi":"10.1080/09540121.2023.2287734","DOIUrl":"10.1080/09540121.2023.2287734","url":null,"abstract":"<p><p>Advancing the well-being of individuals living with HIV necessitates attention to social determinants of health, including food insecurity. Through a clinical and community-based needs assessment, we aimed to gain insight into experiences of food insecurity among patients receiving care at a large pediatric HIV outpatient clinic in the Southeastern United States. We adopted a multimodal assessment approach involving a literature review, community profiling, key informant interviews, focus group discussions with staff, patients and parents and a community stakeholder advisory meeting. Our needs assessment demonstrates that food insecurity is an important aspect of the lived experience of children, adolescents and young adults living with HIV. Clinical staff agreed that food insecurity screening should be incorporated into the patient care workflow but ideally only in concert with providing resources that meet their needs. We formulated a recommendation matrix for addressing food insecurity based on priority importance and feasibility. Collaborative relationships between healthcare practitioners and leaders, community-based organizations and local and federal funding sources are vital for enhancing patients' access to sustainable, reliable solutions to this fundamental determinant of health. Our approach provides a tested model for other clinics seeking to identify and alleviate food insecurity among patients.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"918-926"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-06-06DOI: 10.1080/09540121.2024.2361827
Rusty Souleymanov, Marni Still, Tara Christianson, Melissa Morris, Ann Favel, Danita Wahpoosewyan, Albert McLeod, Laverne Gervais, Alexandra King, Margaret Kîsikâw Piyesis, Randy Jackson, Mike Payne, Laurie Ringaert, Linda Larcombe, Gayle Restall, Dallas Montpetit
The Gigii-Bapiimin study explored the impacts of the COVID-19 pandemic on the health and wellbeing of First Nations, Inuit, and Métis people living with HIV in Manitoba and Saskatchewan, two provinces in Canada with alarmingly high rates of HIV infections. Participants (n = 28 in Manitoba and n = 23 in Saskatchewan) were recruited using various methods, including flyers, community organizations, peers, and social media. The qualitative interviews focused on the pandemic's impact on health, access to services, and ceremonies. The data were analyzed using inductive thematic analysis. The study identified three key themes: (a) resilience and coping; (b) negative impacts on health and substance use; (c) decreased access to health services, HIV care and harm reduction. The participants shared their experiences of social isolation and the loss of community support, which had deleterious effects on their mental health and substance use. The impacts on access to HIV care were exacerbated by poverty, homelessness, and distress over inadvertent disclosure of HIV status. Participants mitigated these impacts by relying on Indigenous knowledges, ceremonies, and resilience within their communities. Service providers must address the impacts of the COVID-19 pandemic on Indigenous people living with HIV and their access to HIV services and ceremonies.
{"title":"The Gigii-Bapiimin Study: resilience and the impacts of COVID-19 on health and wellbeing of Indigenous people living with HIV in Manitoba and Saskatchewan.","authors":"Rusty Souleymanov, Marni Still, Tara Christianson, Melissa Morris, Ann Favel, Danita Wahpoosewyan, Albert McLeod, Laverne Gervais, Alexandra King, Margaret Kîsikâw Piyesis, Randy Jackson, Mike Payne, Laurie Ringaert, Linda Larcombe, Gayle Restall, Dallas Montpetit","doi":"10.1080/09540121.2024.2361827","DOIUrl":"10.1080/09540121.2024.2361827","url":null,"abstract":"<p><p>The Gigii-Bapiimin study explored the impacts of the COVID-19 pandemic on the health and wellbeing of First Nations, Inuit, and Métis people living with HIV in Manitoba and Saskatchewan, two provinces in Canada with alarmingly high rates of HIV infections. Participants (<i>n</i> = 28 in Manitoba and <i>n</i> = 23 in Saskatchewan) were recruited using various methods, including flyers, community organizations, peers, and social media. The qualitative interviews focused on the pandemic's impact on health, access to services, and ceremonies. The data were analyzed using inductive thematic analysis. The study identified three key themes: (a) resilience and coping; (b) negative impacts on health and substance use; (c) decreased access to health services, HIV care and harm reduction. The participants shared their experiences of social isolation and the loss of community support, which had deleterious effects on their mental health and substance use. The impacts on access to HIV care were exacerbated by poverty, homelessness, and distress over inadvertent disclosure of HIV status. Participants mitigated these impacts by relying on Indigenous knowledges, ceremonies, and resilience within their communities. Service providers must address the impacts of the COVID-19 pandemic on Indigenous people living with HIV and their access to HIV services and ceremonies.</p>","PeriodicalId":48370,"journal":{"name":"Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv","volume":" ","pages":"899-907"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}