Pub Date : 2004-01-01DOI: 10.1177/154510970400300103
R. Hewitt, K. Stewart
Background: The purpose of this study was to evaluate the effectiveness of a nursing telephone intervention to help persons with HIV manage their adherence to HIV medications. The specific aim of the study was to test the hypothesis that there would be no difference in medication adherence between participants randomly assigned to receive usual patient education and support from clinic staff (the control group), and the intervention group to receive, in addition to the usual patient education and support, a telephone call (once a week for 12 weeks) that provides an individualized program of education, community referrals, and counseling. Methods: Participants were recruited by their caregivers (n=95), had the study explained to them, and gave informed consent. Adherence was measured by electronic caps and by self-report, as well as viral loads and CD4 counts. Participants were assigned to the intervention or control treatment group. Results: This was a Repeated Measures Design and follow-up data were difficult to collect because of difficulty in maintaining communication with participants over the four months of the study. Many subjects recruited at baseline were dropped from all analyses due to incomplete data, resulting in a sample size of 17 in the intervention group and 24 in the control group. For this reason, generalizations to the population of HIV subjects should not be made. Significant differences between groups within time point, or between time points within group were found for adherence using the cap as a measurement tool, viral load, CD4 counts, and adherence using the self-report as the measurement tool. The intervention group had significantly lower mean viral loads than the control group at both time point 1 (p = 0.0003) and time point 2 (p = 0.0030). For CD4 counts, differences between the intervention and control groups were seen. At time point 3 (p = 0.0021) the intervention group had significantly higher mean CD4 counts than the control group. Conclusions: In future research, phone disconnections will be countered with letters and with mailed phone cards. The researchers are developing the strategy of a closer working partnership with the clinic staff who make the appointments and who often have a relationship with the patients. Suggestions for future intervention strategies include the provision of cell phones for participants.
{"title":"Select Abstracts from Elements of Success: An International Conference on Adherence to Antiretroviral Therapy, December 4-7, 2003, Dallas, Texas, USA","authors":"R. Hewitt, K. Stewart","doi":"10.1177/154510970400300103","DOIUrl":"https://doi.org/10.1177/154510970400300103","url":null,"abstract":"Background: The purpose of this study was to evaluate the effectiveness of a nursing telephone intervention to help persons with HIV manage their adherence to HIV medications. The specific aim of the study was to test the hypothesis that there would be no difference in medication adherence between participants randomly assigned to receive usual patient education and support from clinic staff (the control group), and the intervention group to receive, in addition to the usual patient education and support, a telephone call (once a week for 12 weeks) that provides an individualized program of education, community referrals, and counseling. Methods: Participants were recruited by their caregivers (n=95), had the study explained to them, and gave informed consent. Adherence was measured by electronic caps and by self-report, as well as viral loads and CD4 counts. Participants were assigned to the intervention or control treatment group. Results: This was a Repeated Measures Design and follow-up data were difficult to collect because of difficulty in maintaining communication with participants over the four months of the study. Many subjects recruited at baseline were dropped from all analyses due to incomplete data, resulting in a sample size of 17 in the intervention group and 24 in the control group. For this reason, generalizations to the population of HIV subjects should not be made. Significant differences between groups within time point, or between time points within group were found for adherence using the cap as a measurement tool, viral load, CD4 counts, and adherence using the self-report as the measurement tool. The intervention group had significantly lower mean viral loads than the control group at both time point 1 (p = 0.0003) and time point 2 (p = 0.0030). For CD4 counts, differences between the intervention and control groups were seen. At time point 3 (p = 0.0021) the intervention group had significantly higher mean CD4 counts than the control group. Conclusions: In future research, phone disconnections will be countered with letters and with mailed phone cards. The researchers are developing the strategy of a closer working partnership with the clinic staff who make the appointments and who often have a relationship with the patients. Suggestions for future intervention strategies include the provision of cell phones for participants.","PeriodicalId":81716,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care","volume":"3 1","pages":"12 - 28"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/154510970400300103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65510606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2004-01-01DOI: 10.1177/154510970400300101
Cameron Dw
In this issue Rabbi Spira and Dr. Wainberg remind us of religious ethical imperatives that demand universal access to HIV treatment internationally. But who will pay? According to whose needs and whose means? They state that both the needs and the means are shared and should be addressed on a societal level. HIV treatment is a fragment of wider secular issues. Religious ethics may instruct policy-making but this must be kept a secular process to address the needs of all. When you are unsure of your company we used to be taught there are three unsafe topics to be avoided in polite dinner conversation: sex politics and religion. In each area opinions and beliefs may be as divergent as they are strongly held. The more we discuss the less anything or anybody may change. And you never know who may be offended. So better to talk about the weather--we can still disagree nothing changes and everything is done without offending someone we do not know yet. (excerpt)
{"title":"Sex, politics, and religion: why AIDS is a secular issue.","authors":"Cameron Dw","doi":"10.1177/154510970400300101","DOIUrl":"https://doi.org/10.1177/154510970400300101","url":null,"abstract":"In this issue Rabbi Spira and Dr. Wainberg remind us of religious ethical imperatives that demand universal access to HIV treatment internationally. But who will pay? According to whose needs and whose means? They state that both the needs and the means are shared and should be addressed on a societal level. HIV treatment is a fragment of wider secular issues. Religious ethics may instruct policy-making but this must be kept a secular process to address the needs of all. When you are unsure of your company we used to be taught there are three unsafe topics to be avoided in polite dinner conversation: sex politics and religion. In each area opinions and beliefs may be as divergent as they are strongly held. The more we discuss the less anything or anybody may change. And you never know who may be offended. So better to talk about the weather--we can still disagree nothing changes and everything is done without offending someone we do not know yet. (excerpt)","PeriodicalId":81716,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care","volume":"3 1","pages":"6-6"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/154510970400300101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65511033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-10-01DOI: 10.1177/154510970300200404
D. Cameron
{"title":"Book Review: A Clinical Guide to Supportive & Palliative Care for HIV/AIDS","authors":"D. Cameron","doi":"10.1177/154510970300200404","DOIUrl":"https://doi.org/10.1177/154510970300200404","url":null,"abstract":"","PeriodicalId":81716,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care","volume":"2 1","pages":"152 - 152"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/154510970300200404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65511003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-01-01DOI: 10.1177/154510970300200103
R. Hewitt, K. Stewart
Background: Patients with serious mental illness are presumed to be at high risk for poor adherence to HIV antiretrovirals; yet, there are no published studies of adherence to HIV medications in this population to substantiate this assumption. Methods: To assess the rates and correlates of adherence to HIV antiretrovirals in a sample of patients with serious mental illness, we conducted a study in which antiretroviral adherence was measured with electronic monitoring caps over a two-week observation period. Results: Forty-seven participants enrolled in the study. Psychiatric diagnoses included schizophrenia (n=12), schizoaffective disorder (n = 5), bipolar depression (n = 24), and major depression with psychotic features (n = 6). Mean age was 41, 79 percent were male, 23 percent did not complete high school, most were Caucasian (49 percent) or African American (43 percent), 25 percent were employed, 24 percent had temporary/unstable housing (including five participants who were homeless), and 50 percent had a history of intravenous drug use (IVDU). Mean CD4 count was 621 (SD = 335) and average viral load log was 2.7 (36 percent had an undetectable viral load). Average electronic monitored antiretroviral adherence was 66 percent (SD = 34), with 40 percent of the sample demonstrating at least 90 percent adherence. Lower adherence was significantly associated (p < .05) with higher viral load, history of IVDU, having missed recent clinic appointments, lower satisfaction with medical care and the relationship with one’s doctor, greater perceived interference in one’s life caused by treatment side effects, and alcohol and marijuana use. Conclusions: These findings suggest that as a group, persons with serious mental illness achieve an adherence level that is relatively low and similar to what other studies have found in groups suspected to be at high risk for poor adherence (active drug users, marginally housed), but the results also confirm that a large subgroup of this population are indeed able to adhere very well to antiretroviral regimens.
{"title":"Select Abstracts from Elements of Success: An International Conference on Adherence to Antiretroviral Therapy, December 5-8, 2002, Dallas, Texas, USA","authors":"R. Hewitt, K. Stewart","doi":"10.1177/154510970300200103","DOIUrl":"https://doi.org/10.1177/154510970300200103","url":null,"abstract":"Background: Patients with serious mental illness are presumed to be at high risk for poor adherence to HIV antiretrovirals; yet, there are no published studies of adherence to HIV medications in this population to substantiate this assumption. Methods: To assess the rates and correlates of adherence to HIV antiretrovirals in a sample of patients with serious mental illness, we conducted a study in which antiretroviral adherence was measured with electronic monitoring caps over a two-week observation period. Results: Forty-seven participants enrolled in the study. Psychiatric diagnoses included schizophrenia (n=12), schizoaffective disorder (n = 5), bipolar depression (n = 24), and major depression with psychotic features (n = 6). Mean age was 41, 79 percent were male, 23 percent did not complete high school, most were Caucasian (49 percent) or African American (43 percent), 25 percent were employed, 24 percent had temporary/unstable housing (including five participants who were homeless), and 50 percent had a history of intravenous drug use (IVDU). Mean CD4 count was 621 (SD = 335) and average viral load log was 2.7 (36 percent had an undetectable viral load). Average electronic monitored antiretroviral adherence was 66 percent (SD = 34), with 40 percent of the sample demonstrating at least 90 percent adherence. Lower adherence was significantly associated (p < .05) with higher viral load, history of IVDU, having missed recent clinic appointments, lower satisfaction with medical care and the relationship with one’s doctor, greater perceived interference in one’s life caused by treatment side effects, and alcohol and marijuana use. Conclusions: These findings suggest that as a group, persons with serious mental illness achieve an adherence level that is relatively low and similar to what other studies have found in groups suspected to be at high risk for poor adherence (active drug users, marginally housed), but the results also confirm that a large subgroup of this population are indeed able to adhere very well to antiretroviral regimens.","PeriodicalId":81716,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care","volume":"2 1","pages":"21 - 46"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/154510970300200103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65510946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-01-01DOI: 10.1177/154510970200100103
G. Thompson
{"title":"Issue Update","authors":"G. Thompson","doi":"10.1177/154510970200100103","DOIUrl":"https://doi.org/10.1177/154510970200100103","url":null,"abstract":"","PeriodicalId":81716,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care","volume":"1 1","pages":"11 - 11"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/154510970200100103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65510875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-01-01DOI: 10.1177/154510970200100104
Neeraj Singhal
{"title":"Access to Medicines is not a Business","authors":"Neeraj Singhal","doi":"10.1177/154510970200100104","DOIUrl":"https://doi.org/10.1177/154510970200100104","url":null,"abstract":"","PeriodicalId":81716,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care","volume":"187 1","pages":"12 - 14"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/154510970200100104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65510890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1997-11-01DOI: 10.4324/9780203053607-21
S. Dougherty
Venezuela's Accion Solidaria and other non-governmental organizations are set to launch the country's first HIV prevention and education effort. In addition to the $7 million campaign, activists in the country have seen a number of recent successes. Accion Solidaria has been successfully incorporated into a nonprofit group in the United States, called Action of Solidarity. Other successes include the First National Venezuelan Meeting of People Living with HIV and AIDS to be held in mid-October, and the upcoming launch of Venezuela's first AIDS hotline. The hotline, part of the education and prevention campaign, will be launched by Red MetSIDA, an umbrella organization for AIDS groups in Venezuela. The effort will also feature a high-profile media campaign to bring prevention information to the public and dispel AIDS-related myths. Accion Cuidadana Contra el SIDA, Venezuela's first AIDS organization, has successfully represented 37 HIV-infected individuals who were either irregularly receiving AZT and 3TC or whose physicians were not prescribing triple-drug therapies. The lawsuit, filed against the Venezuelan social security system, argued that the patients' rights were being violated.
委内瑞拉“团结行动”和其他非政府组织将启动该国首个艾滋病预防和教育项目。除了700万美元的活动外，该国的活动人士最近还取得了一些成功。“团结行动”已经成功地并入了美国一个名为“团结行动”的非营利组织。其他成功包括将于10月中旬举行的第一次委内瑞拉艾滋病毒和艾滋病感染者全国会议，以及即将启动的委内瑞拉第一条艾滋病热线。这条热线是教育和预防运动的一部分，将由委内瑞拉艾滋病团体的伞型组织Red MetSIDA发起。这项工作还将以高调的媒体宣传为特色，向公众传播预防信息，消除与艾滋病有关的神话。委内瑞拉第一个艾滋病组织“反对艾滋病行动”(acion Cuidadana Contra el SIDA)成功地代表了37名艾滋病毒感染者，这些人要么不定期接受AZT和3TC治疗，要么医生没有开三联药物治疗的处方。这起针对委内瑞拉社会保障体系的诉讼称，患者的权利受到了侵犯。
{"title":"Breaking the silence.","authors":"S. Dougherty","doi":"10.4324/9780203053607-21","DOIUrl":"https://doi.org/10.4324/9780203053607-21","url":null,"abstract":"\u0000 Venezuela's Accion Solidaria and other non-governmental organizations are set to launch the country's first HIV prevention and education effort. In addition to the $7 million campaign, activists in the country have seen a number of recent successes. Accion Solidaria has been successfully incorporated into a nonprofit group in the United States, called Action of Solidarity. Other successes include the First National Venezuelan Meeting of People Living with HIV and AIDS to be held in mid-October, and the upcoming launch of Venezuela's first AIDS hotline. The hotline, part of the education and prevention campaign, will be launched by Red MetSIDA, an umbrella organization for AIDS groups in Venezuela. The effort will also feature a high-profile media campaign to bring prevention information to the public and dispel AIDS-related myths. Accion Cuidadana Contra el SIDA, Venezuela's first AIDS organization, has successfully represented 37 HIV-infected individuals who were either irregularly receiving AZT and 3TC or whose physicians were not prescribing triple-drug therapies. The lawsuit, filed against the Venezuelan social security system, argued that the patients' rights were being violated.\u0000","PeriodicalId":81716,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care","volume":"3 11 1","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"1997-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70572701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1995-01-01DOI: 10.1201/9781315380353-16
C. Cockerell
The following major forms of neoplastic disorders which may develop in patients with HIV disease are examined: epithelial, lymphoreticular, vascular, smooth muscle, and melanocytic. Each disorder is discussed in terms of its epidemiology, pathogenesis, clinical manifestations, histopathology, laboratory findings, differential diagnosis, diagnosis, and treatment. A brief discussion of other cutaneous neoplasms is included.
{"title":"Neoplastic disorders.","authors":"C. Cockerell","doi":"10.1201/9781315380353-16","DOIUrl":"https://doi.org/10.1201/9781315380353-16","url":null,"abstract":"The following major forms of neoplastic disorders which may develop in patients with HIV disease are examined: epithelial, lymphoreticular, vascular, smooth muscle, and melanocytic. Each disorder is discussed in terms of its epidemiology, pathogenesis, clinical manifestations, histopathology, laboratory findings, differential diagnosis, diagnosis, and treatment. A brief discussion of other cutaneous neoplasms is included.","PeriodicalId":81716,"journal":{"name":"Journal of the International Association of Physicians in AIDS Care","volume":"1 8 1","pages":"23-8"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65957489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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