Antiretroviral adherence and virological outcomes in HIV-positive patients in Ugu district, KwaZulu-Natal province

Kapiamba, Germain; Masango, Thembekile; Mphuthi, Ditaba David

doi:10.2989/16085906.2016.1170710

Cited by 10 publications

(9 citation statements)

References 13 publications

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“…In three Indian studies, adherence was determined to be 76–93%,37, 38, 39 compared to only 55% of people in North America 40 . Moreover, despite optimal adherence there may not be a significant relationship between adherence and viral suppression 41 . This may be related to immunological non-responders in whom the CD4 counts fail to rise optimally despite adequate therapy 42 .…”

Section: The Role Of Cimt As Screening Techniquementioning

confidence: 99%

HIV related stigma, perceived social support and risk of premature atherosclerosis in South Asians

Bergmann

Sengupta

Bhrushundi

et al. 2018

Indian Heart Journal

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Objective This study sought to determine the association between social support and stigma experienced by HIV-positive patients and presence of subclinical cardiovascular disease. Methods We implemented a cross sectional study in 67 HIV-positive patients and 52 controls from a community health care center in central India. The participants underwent an in-depth survey and a clinical and laboratory assessment of cardiovascular risk. Carotid-intimal thickness (CIMT) was used as a marker of subclinical cardiovascular disease. Results On comparing the HIV and age and sex-matched control population, HIV patients had lower body weight (P=<0.001), and lower systolic blood pressures (P = 0.002). Despite the lack of higher cardiac risk factor prevalence and lower lipid abnormalities, HIV patients had higher right, left and average CIMT values than controls (P < 0.001 for all). HIV patients also showed higher prevalence of abnormal CIMT (≥ 0.9 mm) than controls (32% vs. 0%, P < 0.001). HIV patients with increased CIMT (n = 37) in comparison with those with normal CIMT (n = 30) were more frequently males (P = 0.023), had higher systolic blood pressures (P = 0.002), lower CD4 counts (P = 0.033) and experienced higher enacted stigma (P = 0.044). On multivariable stepwise logistic regression, systolic blood pressure (odds ratio:1.06, P = 0.002) and stigma score > 25 th percentile value (odds ratio:3.84, P = 0.037) were independent predictors of the abnormal CIMT. Conclusions HIV-positive patients from central India have a higher prevalence of abnormal CIMT as a marker of subclinical cardiovascular disease than the general population. This predisposition to increased cardiovascular risk may be related to complex interactions between HIV disease and stigma-related healthcare inequalities.

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Section: The Role Of Cimt As Screening Techniquementioning

confidence: 99%

HIV related stigma, perceived social support and risk of premature atherosclerosis in South Asians

Bergmann

Sengupta

Bhrushundi

et al. 2018

Indian Heart Journal

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“…Long-term adherence to antiretroviral therapy (ART) is key to improve and sustain quality of life amongst people living with HIV (PLWH) (Kapiamba, Masango, & Mphuthi, 2016; Kokeb & Degu, 2016; Mukherjee et al, 2014), improve the viral suppression (Viswanathan et. Al., 2015), reduce morbidity (Minkoff et.…”

Section: Introductionmentioning

confidence: 99%

Counseling for improving adherence to antiretroviral treatment: a systematic review

2018

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One-on-one counseling can be an effective strategy to improve patient adherence to HIV treatment, however a definitive systematic review demonstrating the critical components of one-on-one counselling for HIV treatment adherence has not been conducted. The aim of this systematic review is to examine articles with one-on-one counseling-based interventions, review their components and effectiveness in improving antiretroviral treatment adherence in HIV-infected patients. A systematic review, using the following criteria was performed: (i) experimental studies; (ii) published in Spanish, English or Portuguese; (iii) with interventions consisting primarily of counseling; (iv) adherence as the main outcome; (v) published between 2005 and 2016; (vi) targeted 18 to 60 year old, independent of gender or sexual identity. The author reviewed bibliographic databases: Literatura Peruana en Ciencias de la Salud (LIPECS), Literatura Latinoamericana en Ciencias de la Salud (LILACS), LATINDEX, Scientific Library online (Scielo), Virtual Health Library (VHL), CUIDEN, US National Library of Medicine (PubMed, PubMed Central), the Cochrane Library, and Google Scholar. Articles were analyzed according to the type of study, type of intervention, period of intervention, theoretical basis for intervention, time used in each counseling session and its outcomes. A total of 1790 records were identified. Nine studies were selected for the review, these applied different types of individual counseling interventions and were guided by different theoretical frameworks. Counseling was applied lasting between 4 to 18 months and these were supervised through three to six sessions over the study period. Individual counseling sessions lasted from 7.5 to 90 minutes (Me. 37.5). Six studies demonstrated significant improvement in treatment. Counseling is effective in improving adherence to ART, but methods vary. Face-to-face and computer counseling showed efficacy in improving the adherence, but not the telephone counseling. More evidence that can determine a basic counseling model without losing the individualized intervention for people with HIV is required.

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“…The significant positive association between social stigma and viral non-suppression in this study may reflect the adverse effect of alienation on a patient’s appropriate use of medication [ 88 , 97 , 98 ], which is particularly profound in prison populations [ 17 – 19 , 26 ]. Nonetheless, there existed no statistically significant association between social stigma and self-reported or pharmacy refill adherence in this study, which may represent a lower specificity of both methods in detecting adherence relative to plasma viral load measurement [ 41 , 43 , 99 , 100 ]. Educational interventions are required to reduce this health related social stigmatisation by improving a general understanding of HIV amongst prison staff and prisoners [ 101 ].…”

Section: Discussionmentioning

confidence: 59%

Factors affecting optimal adherence to antiretroviral therapy and viral suppression amongst HIV-infected prisoners in South Ethiopia: a comparative cross-sectional study

2022

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Background Maintaining optimal adherence and viral suppression in people living with HIV (PLWH) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of treatment adherence and viral suppression in incarcerated populations in low-income countries is unknown. This study aimed to determine factors affecting optimal adherence to antiretroviral therapy and viral suppression amongst HIV-infected prisoners in South Ethiopia. Methods A comparative cross-sectional study was conducted between June 1, 2019 and May 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWH. Patient information including demographic, socio-economic, behavioral, and incarceration-related characteristics were collected using a structured questionnaire. Medication adherence was assessed according to self-report and pharmacy refill. Plasma viral load measurements undertaken within the study period were prospectively extracted to determine viral suppression. Univariate and multivariate logistic and fractional regression models were used to analyse data. Results Seventy-four inmates living with HIV (ILWH) and 296 non-incarcerated PLWH participated in the study. While ILWH had a significantly higher pharmacy refill adherence compared to non-incarcerated PLWH (89 vs 75%), they had a slightly lower dose adherence (81% vs 83%). The prevalence of viral non-suppression was also slightly higher in ILWH (6.0%; 95% confidence interval (CI): 1.7–14.6%) compared to non-incarcerated PLWH (4.5%; 95%CI: 2.4–7.5%). Overall, missing ART appointments, dissatisfaction with ART services, inability to comply with a specified medication schedule, and types of methods used to monitor the schedule (e.g., news time on radio/TV or other social cues) were significantly associated with non-adherence according to self-report. In ILWH specifically, accessing ART services from a hospital, inability to properly attend clinic appointments, depressive symptoms, and lack of social support predicted NA. Viral non-suppression was significantly higher in males, people of age 31to 35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions Sub-optimal dose adherence and viral suppression are generally higher in HIV-infected prisoners in South Ethiopia compared to their non-incarcerated counterparts. A multitude of factors were found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

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Antiretroviral adherence and virological outcomes in HIV-positive patients in Ugu district, KwaZulu-Natal province

Cited by 10 publications

References 13 publications

HIV related stigma, perceived social support and risk of premature atherosclerosis in South Asians

HIV related stigma, perceived social support and risk of premature atherosclerosis in South Asians

Counseling for improving adherence to antiretroviral treatment: a systematic review

Factors affecting optimal adherence to antiretroviral therapy and viral suppression amongst HIV-infected prisoners in South Ethiopia: a comparative cross-sectional study

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