Client and Provider Perspectives on Antiretroviral Treatment Uptake and Adherence Among People Who Inject Drugs in Indonesia, Ukraine and Vietnam: HPTN 074

Go, Vivian F.; Hershow, Rebecca B.; Kiriazova, Tetiana; Sarasvita, Riza; Bui, Quynh; Latkin, Carl A.; Rose, Scott; Hamilton, Erica L.; Lancaster, Kathryn E.; Metzger, David S.; Hoffman, Irving; Miller, William C.

doi:10.1007/s10461-018-2307-y

Cited by 17 publications

(20 citation statements)

References 24 publications

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“…Details of the data analysis are described elsewhere [30]. Two senior data analysts from University of North Carolina-Chapel Hill were responsible for cross-site data analysis with support from the qualitative supervisor at each site.…”

Section: Discussionmentioning

confidence: 99%

“…To evaluate the feasibility of the HPTN 074 integrated intervention, two rounds of in-depth interviews were conducted with study participants (PWID living with HIV) randomized to the intervention group, and their health care providers (physicians and counselors / system navigators implementing the intervention) across three study sites (Kyiv, Ukraine; Thai Nguyen, Vietnam; and Jakarta, Indonesia) [30]. We present data from the rst round of the qualitative interviews conducted in June 2015 -March 2016, which was 1-3 months after each participant had enrolled in the trial and had completed introductory intervention sessions.…”

Section: Methodsmentioning

confidence: 99%

“…While the multi-site nature of this qualitative study is one of its strengths, it limits making general conclusions and recommendations. In addition, data were collected in multiple languages and then translated into English for analysis (Go et al, 2019). Although quality assurance/quality control procedures were used to minimize translation errors, some quality of the transcripts could be lost in translation.…”

Section: Limitationsmentioning

confidence: 99%

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Perspectives of Clients and Providers on Factors Influencing Medication Assisted Treatment Uptake Among People Who Use Drugs in Indonesia, Ukraine and Vietnam: HPTN 074 Study

Kiriazova¹,

Go²,

Hershow³

et al. 2020

Preprint

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Background: Medication-assisted treatment (MAT) is an effective method of addiction treatment and HIV prevention. However, globally, people who inject drugs (PWID) have insufficient MAT uptake. To expand MAT access and uptake, policy-makers, program-developers and health care providers should be aware of barriers to and facilitators of MAT uptake among PWID. Methods: As a part of the HPTN 074 study, which assessed the feasibility of an intervention to facilitate HIV treatment and MAT in PWID living with HIV in Indonesia, Ukraine, and Vietnam, we conducted in-depth interviews with 37 HIV-positive PWID and 25 health care providers to explore barriers to and facilitators of MAT uptake. All interviews were audio-recorded, transcribed, translated into English, and coded in NVivo for analysis. We developed matrices to identify emergent themes and patterns. Results: Despite some reported country-specific factors, PWID and health care providers at all geographic locations reported similar barriers to MAT initiation, such as complicated procedures to initiate MAT, problematic clinic access, lack of information on MAT, misconceptions about methadone, financial burden, and stigma towards PWID. However, while PWID reported fear of drug interaction (MAT and antiretroviral therapy), providers perceived that PWID prioritized drug use over caring for their health and hence were less motivated to take up ART and MAT. Motivation for a life change and social support were reported to be facilitators.Conclusion: These results highlight a need for support for PWID to initiate and retain in drug treatment. To expand MAT in all three countries, it is necessary to facilitate access and ensure low-threshold, financially affordable MAT programs for PWID, accompanied with supporting interventions. PWID attitudes and beliefs about MAT indicate the need for informational campaigns to counter misinformation and stigma associated with addiction and MAT (especially methadone).

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Perspectives of Clients and Providers on Factors Influencing Medication Assisted Treatment Uptake Among People Who Use Drugs in Indonesia, Ukraine and Vietnam: HPTN 074 Study

Kiriazova¹,

Go²,

Hershow³

et al. 2020

Preprint

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“…The HPTN 074 randomized controlled trial conducted in Indonesia, Ukraine, and Vietnam, assessed an intervention combining psychosocial counseling and supported referrals for ART and OAT for HIV-positive people who use drugs. The HPTN 074 study and the intervention have been described in detail elsewhere [30][31][32].…”

Section: Methodsmentioning

confidence: 99%

“…To evaluate the feasibility of the HPTN 074 integrated intervention, two rounds of in-depth interviews were conducted with study participants (PWID living with HIV) randomized to the intervention group and their healthcare providers (physicians and counselors/system navigators implementing the intervention) across three study sites (Kyiv, Ukraine; Thai Nguyen, Vietnam; and Jakarta, Indonesia) [31]. We present data from the first round of the qualitative interviews conducted in June 2015-March 2016, which was 1-3 months after each participant had enrolled in the trial and had completed introductory intervention sessions.…”

Section: Methodsmentioning

confidence: 99%

Perspectives of clients and providers on factors influencing opioid agonist treatment uptake among HIV-positive people who use drugs in Indonesia, Ukraine, and Vietnam: HPTN 074 study

Kiriazova

Hershow

et al. 2020

Harm Reduct J

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Background Opioid agonist treatment (OAT) is an effective method of addiction treatment and HIV prevention. However, globally, people who inject drugs (PWID) have insufficient OAT uptake. To expand OAT access and uptake, policymakers, program developers and healthcare providers should be aware of barriers to and facilitators of OAT uptake among PWID. Methods As a part of the HPTN 074 study, which assessed the feasibility of an intervention to facilitate HIV treatment and OAT in PWID living with HIV in Indonesia, Ukraine, and Vietnam, we conducted in-depth interviews with 37 HIV-positive PWID and 25 healthcare providers to explore barriers to and facilitators of OAT uptake. All interviews were audio-recorded, transcribed, translated into English, and coded in NVivo for analysis. We developed matrices to identify emergent themes and patterns. Results Despite some reported country-specific factors, PWID and healthcare providers at all geographic locations reported similar barriers to OAT initiation, such as complicated procedures to initiate OAT, problematic clinic access, lack of information on OAT, misconceptions about methadone, financial burden, and stigma toward PWID. However, while PWID reported fear of drug interaction (OAT and antiretroviral therapy), providers perceived that PWID prioritized drug use over caring for their health and hence were less motivated to take up ART and OAT. Motivation for a life change and social support were reported to be facilitators. Conclusion These results highlight a need for support for PWID to initiate and retain in drug treatment. To expand OAT in all three countries, it is necessary to facilitate access and ensure low-threshold, financially affordable OAT programs for PWID, accompanied with supporting interventions. PWID attitudes and beliefs about OAT indicate the need for informational campaigns to counter misinformation and stigma associated with addiction and OAT (especially methadone).

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Changing Knowledge and Attitudes Towards HIV Treatment-as-Prevention and “Undetectable = Untransmittable”: A Systematic Review

et al. 2021

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People on HIV treatment with undetectable virus cannot transmit HIV sexually (Undetectable = Untransmittable, U = U). However, the science of treatment-as-prevention (TasP) may not be widely understood by people with and without HIV who could benefit from this information. We systematically reviewed the global literature on knowledge and attitudes related to TasP and interventions providing TasP or U = U information. We included studies of providers, patients, and communities from all regions of the world, published 2008–2020. We screened 885 papers and abstracts and identified 72 for inclusion. Studies in high-income settings reported high awareness of TasP but gaps in knowledge about the likelihood of transmission with undetectable HIV. Greater knowledge was associated with more positive attitudes towards TasP. Extant literature shows low awareness of TasP in Africa where 2 in 3 people with HIV live. The emerging evidence on interventions delivering information on TasP suggests beneficial impacts on knowledge, stigma, HIV testing, and viral suppression.Review was pre-registered at PROSPERO: CRD42020153725

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Client and Provider Perspectives on Antiretroviral Treatment Uptake and Adherence Among People Who Inject Drugs in Indonesia, Ukraine and Vietnam: HPTN 074

Cited by 17 publications

References 24 publications

Perspectives of Clients and Providers on Factors Influencing Medication Assisted Treatment Uptake Among People Who Use Drugs in Indonesia, Ukraine and Vietnam: HPTN 074 Study

Perspectives of Clients and Providers on Factors Influencing Medication Assisted Treatment Uptake Among People Who Use Drugs in Indonesia, Ukraine and Vietnam: HPTN 074 Study

Perspectives of clients and providers on factors influencing opioid agonist treatment uptake among HIV-positive people who use drugs in Indonesia, Ukraine, and Vietnam: HPTN 074 study

Changing Knowledge and Attitudes Towards HIV Treatment-as-Prevention and “Undetectable = Untransmittable”: A Systematic Review

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