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Journal of the International Association of Providers of AIDS Care

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https://www.readbyqxmd.com/read/29770721/drivers-of-patient-costs-in-accessing-hiv-aids-services-in-tanzania
#1
Thomas Mnzava, Eunice Mmari, Andres Berruti
BACKGROUND: Patient costs pose a challenge in accessing antiretroviral therapy for people living with HIV in sub-Saharan Africa. The study aimed at identifying drivers for out-of-pocket (OOP) costs in Tanzania. METHODS: In 2009, 500 adult patients who attended 10 HIV clinics across 7 regions of Tanzania were asked about time and resources consumed to access HIV services. Bivariate and multivariate median regression models were used to determine the main drivers for OOP costs...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29756551/religion-and-hiv-related-stigma-among-nurses-who-work-with-people-living-with-hiv-aids-in-puerto-rico
#2
Marcos Reyes-Estrada, Nelson Varas-Díaz, Richard Parker, Mark Padilla, Sheilla Rodríguez-Madera
HIV-related stigma among nurses can impact health care services for people with HIV/AIDS (PWHA). health care professionals' religious views can potentially foster stigmatizing attitudes. There is scarce scientific literature exploring the role of religion on HIV/AIDS stigma among nurses. This study aimed to explore the role of religion in the stigmatization of PWHA by nurses in Puerto Rico. We conducted an exploratory study using qualitative techniques. We conducted 40 in-depth interviews with nurses who provided services to PWHA...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29756550/chronic-disease-self-management-challenges-among-rural-women-living-with-hiv-aids-in-prakasam-andhra-pradesh-india-a-qualitative-study
#3
Benissa E Salem, Yvita Bustos, Chidyaonga Shalita, Jordan Kwon, Padma Ramakrishnan, Kartik Yadav, Maria L Ekstrand, Sanjeev Sinha, Adeline M Nyamathi
Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29756549/family-functioning-in-adolescents-with-perinatal-hiv-infection
#4
Orawan Louthrenoo, Linda Aurpibul, Peninnah Oberdorfer, Virat Sirisanthana
This study aimed to assess family functioning in adolescents with perinatal HIV infection receiving antiretroviral therapy compared with healthy controls. Correlations between self-reported and caregiver-reported family functions were also evaluated. A sample of 195 participants including 65 perinatally HIV-infected adolescents and 130 healthy controls were enrolled. The total family functioning score in HIV-infected adolescents was significantly lower than that in healthy controls by self-report (105.86 vs 115...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29745312/comparing-patient-demographics-and-tumor-characteristics-of-hiv-positive-and-hiv-negative-patients-with-cancer-in-south-carolina
#5
Benjamin D Hallowell, Kristina W Kintziger, Wayne A Duffus, John E Vena, Sara W Robb
We compared the demographic and disease characteristics of HIV-positive (HIV+) and HIV-negative (HIV-) individuals with a diagnosis of cancer in South Carolina. HIV-positive patients with cancer were reflective of the HIV+ caseload in South Carolina, with HIV+ patients with cancer more likely to be male (odds ratio [OR]: 2.78: 95% confidence interval [CI]: 2.33-3.32), black (OR: 7.68; 95% CI: 6.52-9.06), and younger at cancer diagnosis (OR: 0.92; 95% CI: 0.91-0.92). Controlling for year of birth, HIV+ patients with cancer did not receive cancer diagnoses at a younger age than HIV- controls...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29745311/systemic-delays-in-the-initiation-of-antiretroviral-therapy-for-clinically-eligible-hiv-infected-patients-in-houston-texas-the-providers-report-card
#6
Osaro Mgbere, Maria Rodriguez-Barradas, Karen Joan Vigil, Melanie McNeese, Fazal Tabassam, Nadia Barahmani, Jason Wang, Raouf Arafat, Ekere James Essien
BACKGROUND: The current US HIV treatment guidelines support initiation of antiretroviral therapy (ART) for persons with HIV for personal health benefits and prevention of HIV transmission. However, high levels of adherence to ART are critical to maximize individual and public health benefits. We examined the nonclinical barriers to ART initiation for clinically eligible individuals and the provider- and patient-related factors associated with these barriers among HIV-infected patients in Houston/Harris County, Texas...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29745310/use-of-living-strategies-among-adults-aging-with-hiv-in-canada-comparison-by-age-group-using-data-from-the-hiv-health-and-rehabilitation-survey
#7
Kelly Kathleen O'Brien, Matthieu Dagenais, Patricia Solomon, Catherine Worthington, Soo Chan Carusone, Francisco Ibáñez-Carrasco, Steven Hanna, Jacqueline Gahagan, Larry Baxter, Gregory Robinson, Patriic Gayle, Dawn James, Tammy Yates
OBJECTIVE: To examine the type and frequency of living strategies used by adults living with HIV. METHODS: We conducted a cross-sectional web-based survey that included 51 living strategies: maintaining sense of control, attitudes and beliefs, blocking HIV out of the mind, and social interaction. We examined the frequency of use and compared the proportion of respondents who engaged in strategies across 3 age-groups (<40 years, 40-49 years, and ≥50 years). RESULTS: Of the 935 participants, the majority were men (79%) and most (≥60%) engaged "most" or "all of the time" in healthy lifestyle strategies and maintained a positive outlook living with HIV...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29667531/is-tobacco-use-associated-with-neurocognitive-dysfunction-in-individuals-with-hiv
#8
Billy Tsima, Sarah Jane Ratcliffe, Robert Schnoll, Ian Frank, Dennis Larry Kolson, Robert Gross
INTRODUCTION: The prevalence of HIV-associated neurocognitive disorders continues to rise despite the widespread use of antiretroviral therapy. We aimed to define the risk of neurocognitive dysfunction among smokers relative to nonsmokers. METHODS: We conducted a retrospective cohort study including HIV-infected adults ages 21 to 65 years. The Mental Alternation Test (MAT) was the primary outcome. The odds of cognitive impairment were compared using random-effects logistic regression to adjust for potential confounders...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29562847/oral-provocation-testing-in-cutaneous-adverse-drug-reactions-to-antiretroviral-and-antitubercular-therapy-a-study-at-a-tertiary-care-hospital-in-south-india
#9
Sowmya Kaimal, Jithendriya Madhukara
AIM: To collect data pertaining to oral drug provocation testing (DPT) in hospitalized patients with antiretroviral (ARV)/antitubercular agent-induced rashes. METHODS: Patients with cutaneous adverse drug reactions (ADRs) to ARV/antitubercular drugs and who underwent oral DPT during a 5-year period were included in this study. RESULTS: Data were collected from the records of 21 patients. Of the 21, 19 had HIV infection. The most commonly implicated drug was nevirapine (NVP), followed by cotrimoxazole and antitubercular agents...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29562846/the-effect-of-empowerment-and-educational-programs-on-the-quality-of-life-in-iranian-women-with-hiv
#10
Zahra Behboodi Moghadam, Elham Rezaei, Bahareh Sharifi, Saharnaz Nejat, Sara Esmaelzadeh Saeieh, Maryam Ordibeheshti Khiaban
AIDS affects physical, mental, social, and psychological health status. One of the goals of Health for All in the 21st century is to improve the quality of life. This study is a randomized clinical trial conducted on 120 HIV-positive women. Women were administered assessment questionnaires to be completed during the structured interview. After sample collection, participants were divided randomly into 3 groups by using the table of random numbers, then, respectively, received educational intervention, empowerment program, and routine procedures offered by the center and were followed by refilling the questionnaires 12 weeks after intervention...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29534655/high-prevalence-of-antibiotic-resistant-otitis-media-associated-bacterial-flora-of-asymptomatic-people-living-with-hiv-at-morogoro-hospital-tanzania
#11
Kennedy Daniel Mwambete, Mathias Eulambius
OBJECTIVES: The study aimed to determine the prevalence of otitis media (OM)-associated bacterial flora of asymptomatic people living with HIV (PLH) on antiretroviral therapy (ART) and assess antibiotic resistance profiles of the bacteria. METHODOLOGY: Ear secretion specimens were collected by syringe or cotton swabs. Isolated bacteria were subjected to antibiotic sensitivity tests. RESULTS: Of 290 recruited PLH, 81.7% were females and 18...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29534654/factors-associated-with-outcomes-of-pre-art-hiv-care
#12
Kristen A Stafford, Lucy W Nganga, Tuhuma Tulli, Karen G Fleischman Foreit
The World Health Organization recommended removing all CD4 requirements for initiation of antiretroviral therapy (ART) in resource-limited settings. We examined the pre-ART period to identify and assess factors associated with outcomes of pre-ART care. Four modes of transition out of pre-ART care were considered. Beta estimates from the competing risks Cox models were used to investigate whether the effects of covariates differed by mode of transition. Median CD4 counts at entry showed no meaningful change over time...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29534653/acute-trigeminal-neuralgia-associated-with-initiation-of-emtricitabine-tenofovir-for-hiv-pre-exposure-prophylaxis
#13
Loraine Van Slyke, Mia Scott
HIV pre-exposure prophylaxis (PrEP) with emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF) fixed-dose combination (FTC/TDF) is undergoing rapid scale-up in the United States. While FTC/TDF is typically well tolerated, to our knowledge, cranial nerve pathology associated with FTC/TDF has not been previously described. We report the case of a 35-year-old patient who began FTC/TDF PrEP and developed acute trigeminal neuralgia. The neurologic symptoms resolved after treatment discontinuation and recurred upon rechallenge, resulting in permanent discontinuation of PrEP treatment...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29534652/the-impact-of-absolute-cd4-count-and-percentage-discordance-on-pneumocystis-jirovecii-pneumonia-prophylaxis-in-hiv-infected-patients
#14
Henry Anyimadu, Chandra Pingili, Vel Sivapalan, Yael Hirsch-Moverman, Sharon Mannheimer
Current guidelines suggest that HIV-infected patients should receive chemoprophylaxis against Pneumocystis jirovecii pneumonia (PJP) if they have a cluster determinant 4 (CD4) count <200 cells/mm3 or oropharyngeal candidiasis. Persons with CD4 percentage (CD4%) below 14% should also be considered for prophylaxis. Discordance between CD4 count and CD4% occurs in 16% to 25% of HIV-infected patients. Provider compliance with current PJP prophylaxis guidelines when such discordance is present was assessed. Electronic medical records of 429 HIV-infected individuals who had CD4 count and CD4% measured at our clinic were reviewed...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29529910/safety-and-efficacy-of-dolutegravir-plus-rilpivirine-in-treatment-experienced-hiv-infected-patients-the-dorivir-study
#15
Rosario Palacios, M Mayorga, C M González-Domenech, C Hidalgo-Tenorio, C Gálvez, L Muñoz-Medina, J de la Torre, A Lozano, M Castaño, M Omar, Jesús Santos
OBJECTIVES: To analyze the efficacy and safety of dolutegravir/rilpivirine (DTG/RPV) in HIV-infected patients who switched from any other antiretroviral therapy (ART). METHODS: Open-label, multicenter study including patients who switched to DTG/RPV between February 2015 and February 2016. Efficacy (HIV RNA <50 copies/mL), adverse events, and metabolic changes at 24 weeks were analyzed. RESULTS: A total of 104 participants were included, who switched for the following reasons: toxicity/intolerance (42...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29529909/incidence-and-risk-factors-for-overweight-and-obesity-after-initiation-of-antiretroviral-therapy-in-dar-es-salaam-tanzania
#16
Alexander Kintu, Enju Liu, Ellen Hertzmark, Donna Spiegelman, Rachel Margaret Zack, Aisa Muya, David Sando, Till Bärnighausen, Wafaie Fawzi
OBJECTIVE: To describe the incidence of and risk factors for overweight and obesity following antiretroviral therapy (ART) initiation. METHODS: We used Cox proportional hazards models to investigate risk factors for incident overweight and obesity in 79 074 individuals aged 15 years or older who initiated ART in Dar es Salaam, Tanzania. RESULTS: Twenty-five percent of the patients became overweight and 10% became obese. The incidence rate of obesity was 3...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29473485/high-virologic-failure-rates-with-maraviroc-based-salvage-regimens-among-indian-patients-a-preliminary-analysis-maraviroc-effectiveness-in-hiv-1-subtype-c
#17
Sanjay Pujari, Sunil Gaikwad, Vivek Bele, Kedar Joshi, Digamber Dabhade
BACKGROUND: There is no information on the clinical effectiveness of Maraviroc (MVC) amongst People Living with HIV (PLHIV) in India infected with HIV-1 Subtype C viruses. METHODS: We conducted a retrospective chart review of adult PLHIV on MVC based Antiretroviral (ARV) regimens for at least 6 months. Maraviroc was initiated amongst PLHIV with documented R5 tropic viruses (determined by in-house population sequencing of the V3 loop in triplicate and interpreted using the Geno2Pheno algorithm) in combination with an Optimized Background regimen (designed using genotypic resistance testing and past ARV history)...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29473484/hiv-positive-patients-perceptions-of-antiretroviral-therapy-adherence-in-relation-to-subjective-time-imprinting-domino-effects-and-future-shadowing
#18
David Lessard, Isabelle Toupin, Kim Engler, Andràs Lènàrt, Bertrand Lebouché
Antiretroviral treatment adherence barriers are major concerns in HIV care. They are multiple and change over time. Considering temporality in patients' perceptions of adherence barriers could improve adherence management. We explored how temporality manifests itself in patients' perceptions of adherence barriers. We conducted 2 semi-structured focus groups on adherence barriers with 12 adults with HIV which were analyzed with grounded theory. A third focus group served to validate the results obtained. Three temporal categories were manifest in HIV-positive patients' perceptions of barriers: (1) imprinting (events with lasting impacts on patients), (2) domino effects (chain of life events), and (3) future shadowing (apprehension about long-term adherence)...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29473483/patient-perceptions-of-text-messaging-to-improve-antiretroviral-therapy-adherence-a-qualitative-study-of-patients-in-a-ryan-white-clinic
#19
Elizabeth Sherman, Kevin Alan Clauson, Shara Elrod, Paula Eckardt, Fadi Alkhateeb, Robin Jacobs
Evidence on the use of short message service (SMS) to improve medication adherence in people living with HIV (PLHIV) is mounting, yet qualitative research on patient perceptions regarding SMS content and utility for HIV/AIDS remains nascent. To explore the experience of receiving medication reminders via SMS among PLHIV, 45 uninsured and underinsured PLHIV nested within the intervention arm of a larger study received daily, 1-way SMS adherence reminders. Qualitative data were collected by face-to-face, structured interview and were analyzed using conventional content analysis methods...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29464973/trajectories-of-episodic-disability-in-people-aging-with-hiv-a-longitudinal-qualitative-study
#20
Patricia Solomon, Kelly Kathleen O'Brien, Stephanie Nixon, Lori Letts, Larry Baxter, Nicole Gervais
People living with HIV may experience disability which is episodic in nature, characterized by periods of wellness and illness. The purpose of this longitudinal qualitative study was to understand how the episodic nature of HIV and the associated uncertainty shape the disability experience of older adults living with HIV over time. Fourteen men and 10 women who were HIV positive and over 50 years (mean age: 57 years; range: 50-73) participated in 4 interviews over 20 months. Longitudinal analyses of the transcribed interviews identified 4 phenotypes of episodic disability over time: decreasing, increasing, stable, or significant fluctuations...
January 2018: Journal of the International Association of Providers of AIDS Care
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