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Hiv medical home model

Gabriel J Culbert, Ann B Williams
Cultural adaptation is a research strategy used to tailor evidence-informed interventions for new populations and settings. We describe a pragmatic approach used to culturally adapt a nurse-led medication adherence intervention, Adherence Through Home Education and Nursing Assessment (ATHENA), for prisoners living with HIV in Indonesia. Researchers reviewed data from completed studies in Indonesia and identified core components of the ATHENA intervention considered essential for effectiveness. Adaptations likely to render ATHENA acceptable and feasible in the Indonesian prison setting were proposed...
December 5, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
Nigora Abidjanova
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at
August 10, 2017: Journal of Pain and Symptom Management
Juan Xu, Yong Yin, Hao Zhang, Wen Wei Zhong, Lei Zhang, Jing Zhang, Shu Hua Yuan, Fen Zhang, Li Xia Zhao
INTRODUCTION: Childhood asthma is globally one of the most common respiratory disorders and accounts for more school absences and more hospitalizations than any other chronic illness. The worldwide economic burden of this disease exceeds those of HIV/AIDS and tuberculosis combined. Proper intervention and effective management is of paramount importance for the control and prognosis of paediatric asthma. Unfortunately, the rate of uncontrolled and partially controlled paediatric asthma in China is >90%...
August 4, 2017: BMJ Open
Pinar Kuecuekbalaban, Tim Rostalski, Silke Schmidt, Holger Muehlan
BACKGROUND: The Internet enables an unprecedented opportunity to access a broad range of self-tests (e.g. testing for HIV, cancer, hepatitis B/C), which can be conducted by lay consumers without the help of a health professional. However, there is only little knowledge about the determinants of the use of self-tests. Thus, the aims of this study were (1) to experimentally investigate the impact of situational and application-related characteristics on the intention to use a self-test (ST), compared to being tested by a health professional at home (HPH) or at a doctor's office (HPD), (2) to examine the applicability of social-cognitive health behaviour theories on self-testing, and (3) to explore the advantages of integrating technological affinity into social-cognitive health behaviour models to predict self-testing...
July 10, 2017: BMC Health Services Research
Joyce Jones, Barbara S Taylor, Hong-Van Tieu, Timothy J Wilkin
The 2017 Conference on Retroviruses and Opportunistic Infections (CROI) featured exciting preclinical data on investigational antiretroviral agents with good in vitro efficacy and long half-lives. Investigational medications, including bictegravir, demonstrated excellent efficacy and tolerability, as did dual-agent therapy with dolutegravir paired with rilpivirine or with lamivudine. Dolutegravir monotherapy proved inadvisable due to virologic failure and resistance. The gap between high- and low-income settings along the HIV care continuum is narrowing, with Zimbabwe, Malawi, and Zambia approaching the 90-90-90 targets established by the joint United Nations Programme on HIV/AIDS (UNAIDS), whereas communities in the Southern United States are falling behind...
May 2017: Topics in Antiviral Medicine
Julie N Bergmann, Rhoda K Wanyenze, Jamila K Stockman
Patient costs are a critical barrier to the elimination of mother to child HIV transmission. Despite the Ugandan government providing free public HIV services, infant antiretroviral (ARV) prophylaxis coverage remains low (25%). To understand costs mothers incur in accessing ARV prophylaxis for their infants, we conducted a mixed methods study to quantify and identify their direct costs. We used cross-sectional survey data and focus group discussions from 49 HIV-positive mothers in Uganda. Means and standard deviations were calculated for the direct costs (e...
November 2017: AIDS Care
Alastair van Heerden, Danielle M Harris, Heidi van Rooyen, Ruanne V Barnabas, Nithya Ramanathan, Nkosinathi Ngcobo, Zukiswa Mpiyakhe, W Scott Comulada
mHealth has been proposed to address inefficiencies in the current South African healthcare system, including home-based HIV testing and counseling (HTC) programs. Yet wide-scale adoption of mHealth has not occurred. Even as infrastructure barriers decrease, a need to better understand perceived adoption barriers by stakeholders remains. We conducted focus group discussions (FGD) in South Africa in 2016 with 10 home-based HTC field staff, 12 community health workers (CHWs) and 10 persons living with HIV (PLH)...
June 2017: Social Science & Medicine
Deborah J Gelaude, Jamie Hart, James W Carey, Damian Denson, Clarke Erickson, Cynthia Klein, Alejandra Mijares, Nicole L Pitts, Theresa Spitzer
Engaging and retaining persons with HIV in care and treatment is key to reducing new HIV infections in the United States. Understanding the experiences, barriers, and facilitators to engaging and retaining persons in HIV care from the perspective of HIV care providers could help provide insight into how best to achieve this goal. We present qualitative data from 30 HIV care providers in three cities. We identified three facilitators to HIV care: providing a medical home, team-based care and strategies for engaging and retaining patients in HIV care, and focus on provider-patient relationships...
March 30, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
Mariana Sarango, Alexander de Groot, Melissa Hirschi, Chukwuemeka Anthony Umeh, Serena Rajabiun
CONTEXT: People living with human immunodeficiency virus (HIV) (PLWH) who are most at risk for falling out of HIV primary care and detectable viral loads include homeless and unstably housed individuals and those codiagnosed with behavioral health disorders. The patient-centered medical home (PCMH) is a model that promotes provision of comprehensive, patient-centered, accessible, coordinated, and quality care for patients. This initiative provided patient navigation to HIV-positive homeless and unstably housed individuals codiagnosed with a mental health or substance use disorder as a means to create an adapted PCMH to meet the specific needs of this population...
May 2017: Journal of Public Health Management and Practice: JPHMP
Lisa E Cox, Mark Brennan-Ing
Older people living with HIV are increasingly requiring formal supportive community-based services. Supportive services are essential to medical care and treatment for older people living with HIV/AIDS. This chapter considers Andersen's behavioral model of health services, and explores the predisposing, enabling, and need factors that affect service utilization among the older HIV population. The Andersen model provides a lens to understand the need for supportive services to go beyond primary medical care...
2017: Interdisciplinary Topics in Gerontology and Geriatrics
Katrina D Hermetet-Lindsay, Katharine F Correia, Paige L Williams, Renee Smith, Kathleen M Malee, Claude A Mellins, Richard M Rutstein
Among perinatally HIV-infected (PHIV) and perinatally HIV-exposed, uninfected (PHEU) youth, we evaluated the contributions of home environment, psychosocial, and demographic factors and, among PHIV only, HIV disease severity and antiretroviral treatment (ART), to cognitive functioning (CF) and behavioral functioning (BF). A structural equation modeling (SEM) approach was utilized. Exploratory factor analysis was used to reduce predictor variables to major latent factors. SEMs were developed to measure associations between the latent factors and CF and BF outcomes...
July 30, 2016: AIDS and Behavior
Leah Karliner, Angela Marks, Sunita Mutha
Despite improvements in overall health of the American population, disparities persist, particularly for minority women. The Affordable Care Act (ACA) offers the potential to reduce disparities through expanded insurance coverage, greater access to high-quality care, and bolstered prevention efforts in the context of new models of care such as the patient-centered medical home (PCMH). We use case studies representing three clinical conditions (breast cancer, HIV, and coronary heart disease) to present strategies for how a PCMH could reduce disparities for minority women...
2016: Journal of Health Care for the Poor and Underserved
Amy Hawkins, Michael Evangeli, Kate Sturgeon, Marthe Le Prevost, Ali Judd
Due to the success of antiretroviral (ART) medications, young people living with perinatally acquired HIV (PHIV+) are now surviving into adolescence and young adulthood. Understanding factors influencing ART non-adherence in this group is important in developing effective adherence interventions. Most studies of ART adherence in HIV-positive populations assess differences in adherence levels and adherence predictors between participants, over a period of time (global adherence). Many individuals living with HIV, however, including PHIV+ young people, take medication inconsistently...
2016: AIDS Care
Carlos Roncero, Raquel Domínguez-Hernández, Tomás Díaz, José Manuel Fernández, Rafael Forcada, José Manuel Martínez, Pedro Seijo, Antonio Terán, Itziar Oyagüez
The objective was to estimate the annual interaction management cost of agonist opioid treatment (AOT) for opioid-dependent (OD) patients with buprenorphine-naloxone (Suboxone®) (B/N) or methadone associated with concomitant treatments for infectious (HIV) or psychiatric comorbidities. A costs analysis model was developed to calculate the associated cost of AOT and interaction management. The AOT cost included pharmaceutical costs, drug preparation, distribution and dispensing, based on intake regimen (healthcare center or take-home) and type and frequency of dispensing (healthcare center or pharmacy), and medical visits...
September 15, 2015: Adicciones
Paul K Drain, Elena Losina, Sharon M Coleman, Laura Bogart, Janet Giddy, Douglas Ross, Jeffrey N Katz, Ingrid V Bassett
Poor social support and mental health may be important modifiable risk factors for HIV acquisition, but they have not been evaluated prior to HIV testing in South Africa. We sought to describe self-perceived mental health and social support and to characterize their independent correlates among adults who presented for voluntary HIV testing in Durban. We conducted a large cross-sectional study of adults (≥18 years of age) who presented for HIV counseling and testing between August 2010 and January 2013 in Durban, South Africa...
2015: AIDS Care
Carla S Alexander, Gregory Pappas, Anthony Amoroso, Mei Ching Lee, Yvonne Brown-Henley, Peter Memiah, Joseph F O'Neill, Olivia Dix, Robert R Redfield
Palliative care (PC), introduced early in the management of chronic illness, improves patient outcomes. Early integration of a palliative approach for persons with HIV has been documented to be effective in identifying and managing patient-level concerns over the past decade in African settings. The experience of implementing PC in multiple African and other resource-constrained settings (RCSs) emphasizes the need for essential palliative competencies that can be integrated with chronic disease management for patients and their families facing life-limiting illness...
September 2015: Journal of Pain and Symptom Management
A K Gupta, C R Garg, B C Joshi, N Rawat, V Dabla, A Gupta
In India, programme for prevention of mother-to-child transmission (PMTCT) of HIV is primarily implemented through public health system. State AIDS Control Societies (SACSs) encourage private hospitals to set up integrated counselling and testing centres (ICTCs). However, private hospitals of Delhi did not set up ICTCs. Consequently, there is no information on PMTCT interventions in private hospitals of Delhi. This study was undertaken by Delhi SACS during March 2013 through September 2013 to assess status of implementation of PMTCT programme in various private hospitals of Delhi to assist programme managers in framing national policy to facilitate uniform implementation of National PMTCT guidelines...
2015: AIDS Care
Erin Gael Friedman, Megan Crowley, Kim Ammann Howard, M Paoloma Pavel
This article details the processes and findings of a 3-year demonstration project implementing population health management and the Patient-Centered Medical Home (PCMH) model in 3 community health centers in Alameda County, California. The article provides a first look at the PCMH Continuum, a tool for aiding staff in conceptualizing and implementing complex organizational change. Findings of the project evaluation also are shared, comprising a road map for other organizations looking to implement population health management, panel management, and PCMH...
October 2015: Population Health Management
Becky L Genberg, Violet Naanyu, Juddy Wachira, Joseph W Hogan, Edwin Sang, Monicah Nyambura, Michael Odawa, Corey Duefield, Samson Ndege, Paula Braitstein
BACKGROUND: Few population-based studies exist on the HIV care continuum in sub-Saharan Africa. We aimed to describe engagement in care in all adults with an existing diagnosis of HIV and to assess the time to and predictors of linkage and engagement in adults newly diagnosed via home-based counselling and testing (HBCT) in a high-prevalence setting in western Kenya. METHODS: Data were derived from AMPATH (Academic Model Providing Access to Healthcare), which has provided HIV care in western Kenya since 2001 and the HBCT programme, which has been operating since 2007...
January 2015: Lancet HIV
Sean J Haley, Mary Jeanne Kreek
Patients with chronic HCV have predictable overlapping comorbidities that reduce access to care. The Affordable Care Act (ACA) presents an opportunity to focus on the benefits of the medical home model for integrated chronic disease management. New, highly effective HCV treatment regimens in combination with the medical home model could reduce disease prevalence. We sought to address challenges posed by comorbidities in patients with chronic HCV infection and limitations within our health care system, and recommend solutions to maximize the public benefit from ACA and the new drug regimen...
March 2015: American Journal of Public Health
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