Consensus statement on the role of health systems in advancing the long-term well-being of people living with HIV

Lazarus, Jeffrey V.; Safreed-Harmon, Kelly; Kamarulzaman, Adeeba; Anderson, Jane; Leite, Ricardo Baptista; Behrens, Georg M. N.; Bekker, Linda Gail; Bhagani, Sanjay; Brown, Darren; Brown, Graham; Buchbinder, Susan; Caceres, Carlos F.; Cahn, Pedro; Carrieri, Patrizia; Caswell, Georgina; Cooke, Graham; Monforte, Antonella d’Arminio; Dedes, Nikos; Amo, Julia del; Elliott, Richard; El‐Sadr, Wafaa; Apodaca, María José; Guaraldi, Giovanni; Hallett, Timothy B.; Harding, Richard; Hellard, Margaret; Jaffar, Shabbar; Kall, Meaghan; Klein, Marina B.; Lewin, Sharon R; Mayer, Ken; Pérez‐Molina, José A.; Moraa, Doreen; Naniche, Denise; Nash, Denis; Noori, Teymur; Pozniak, Anton; Rajasuriar, Reena; Reiss, Peter; Rizk, Nesrine; Rockstroh, Jürgen K.; Romero, Diana; Sabin, Caroline; Serwadda, David; Waters, Laura

doi:10.1038/s41467-021-24673-w

Cited by 95 publications

(99 citation statements)

References 98 publications

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“…Furthermore, economic inactivity, receiving benefits, and having no fixed abode were risk factors across physical, mental and emotional, difficulty with day-to-day activities, and challenges to social participation HDQ disability domains. Our results align with existing literature highlighting the role and importance of social determinants of health [ 94 ], whereby social determinants such as low level of socioeconomic status, stigma, and social exclusion, influence health outcomes and quality of life among people living with HIV [ 95 – 97 ]. Our results emphasise the role of social determents of health influencing disability experienced by people living with HIV in the UK.…”

Section: Discussionsupporting

confidence: 89%

Prevalence, severity, and risk factors of disability among adults living with HIV accessing routine outpatient HIV care in London, United Kingdom (UK): A cross-sectional self-report study

et al. 2022

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Background The study objectives were to measure disability prevalence and severity, and examine disability risk factors, among adults living with HIV in London, United Kingdom (UK). Methods Self-reported questionnaires were administered: World Health Organization Disability Assessment Schedule 2.0 (WHODAS), HIV Disability Questionnaire (HDQ), Equality Act disability definition (EADD), and demographic questionnaire. We calculated proportion (95% Confidence Interval; CI) of “severe” and “moderate” disability measured using EADD and WHODAS scores ≥2 respectively. We measured disability severity with HDQ domain severity scores. We used demographic questionnaire responses to assess risk factors of “severe” and “moderate” disability using logistic regression analysis, and HDQ severity domain scores using linear regression analysis. Results Of 201 participants, 176 (87.6%) identified as men, median age 47 years, and 194 (96.5%) virologically suppressed. Severe disability prevalence was 39.5% (n = 79/201), 95% CI [32.5%, 46.4%]. Moderate disability prevalence was 70.5% (n = 141/200), 95% CI [64.2%, 76.8%]. Uncertainty was the most severe HDQ disability domain. Late HIV diagnosis was a risk factor for severe disability [Odds Ratio (OR) 2.71; CI 1.25, 5.87]. Social determinants of health, economic inactivity [OR 2.79; CI 1.08, 7.21] and receiving benefits [OR 2.87; CI 1.05, 7.83], were risk factors for “severe” disability. Economic inactivity [OR 3.14; CI 1.00, 9.98] was a risk factor for “moderate” disability. Economic inactivity, receiving benefits, and having no fixed abode were risk factors (P≤0.05) for higher HDQ severity scores in physical, mental and emotional, difficulty with day-to-day activities, and challenges to social participation domains. Personal factors, identifying as a woman and being aged <50 years, were risk factors (P≤0.05) for higher HDQ severity scores in mental and emotional, uncertainty, and challenges with social participation domains. Conclusions People living with well-controlled HIV in London UK experienced multi-dimensional and episodic disability. Results help to better understand the prevalence, severity, and risk factors of disability experienced by adults living with HIV, identify areas to target interventions, and optimise health and functioning.

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Section: Discussionsupporting

confidence: 89%

Prevalence, severity, and risk factors of disability among adults living with HIV accessing routine outpatient HIV care in London, United Kingdom (UK): A cross-sectional self-report study

et al. 2022

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“…1 IAS, Geneva, Switzerland; 2 Watipa, Sydney, New South Wales, Australia; 3 GNP+, Cape Town, South Africa; 4 Government of Zambia, Lusaka, Zambia; 5 Global Health Division-HIV, Bill and Melinda Gates Foundation, Seattle, Washington, USA; 6 Institute on Inequalities in Global Health, University of Southern California, Los Angeles, California, USA…”

Section: A U T H O R S ' a F F I L I At I O N Smentioning

confidence: 99%

“…Stigma is more subtle and is a process that devalues an individual through labels, which emanate from making people experience "otherness" resulting in social isolation and a diminished sense of self [3]. Stigma and discrimination negatively affect the quality of life of people living with HIV through multiple pathways, including social rejection, low self-esteem and barriers to accessing health and support services [4]. Healthcare settings can provide lifesaving care, and yet commonly are sites where stigma and/or discrimination may be experienced by people living with HIV, who additionally report devaluing experiences in other social, cultural and institutional settings [5,6].…”

mentioning

confidence: 99%

Addressing stigma and discrimination at scale: uniting for a common vision while acknowledging local realities

Stackpool-Moore

Nkosi²,

Zulu³

et al. 2022

J Int AIDS Soc.

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“…WHO also has a global strategy on people-centred health services, noting benefits across all aspects of health care [4]. Person-centred care (PCC) was also recently supported by a consensus statement from global HIV experts, emphasising the need for a more person-centred HIV agenda while recognising the lack of a common understanding of the definition and core values of PCC [5]. The President's Emergency Plan for AIDS Relief (PEPFAR) defines PCC as meeting the needs of individuals by increasing convenience, making services supportive and accessible, providing friendly services to diverse populations, and engaging communities and stakeholders.…”

Section: Introductionmentioning

confidence: 99%

Systematic review: Development of a person‐centered care framework within the context of HIV treatment settings in sub‐Saharan Africa

Duffy

Madevu‐Matson

Posner

et al. 2022

Tropical Med Int Health

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Objectives: Person-centred care (PCC) meets the needs of individuals by increasing convenience, providing supportive and culturally appropriate services to diverse populations, and engaging families, communities, and stakeholders in planning and provision of care. While the evidence demonstrates that PCC approaches can lead to clinical improvements across the HIV care continuum, it is not yet well defined in the context of HIV service delivery. Methods: A systematic review was conducted to define PCC practices for HIV treatment services in health facilities in sub-Saharan Africa. Data synthesis led to the development of a PCC framework including domain and sub-domain development. The study team used the Effective Public Health Project Practice tool for quantitative studies to assess the quality of the included studies. Results: Thirty-one studies from 12 countries met the inclusion criteria, including 56,586 study participants (females 42%-100% and males 0%-58%), resulting in three major domains and 11 sub-domains. These include staffing (sub-domains of composition, availability, and competency); service delivery standards (sub-domains of client feedback mechanisms; service efficiency and integration; convenience and access; and digital health worker support tools); and direct client support services (sub-domains of psychosocial services, logistics support, client-agency, and digital client support tools). Twenty-five of the person-centred interventions within these domains resulted in improvements in linkage to care, treatment retention, and/or viral suppression. Conclusions: The PCC framework can help to provide a more consistent classification of HIV treatment interventions and will support improved assessment of these interventions to ensure that people receive personalised care. K E Y W O R D S client-centred care, HIV, HIV care continuum, HIV treatment, person-centred care, sub-

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Consensus statement on the role of health systems in advancing the long-term well-being of people living with HIV

Cited by 95 publications

References 98 publications

Prevalence, severity, and risk factors of disability among adults living with HIV accessing routine outpatient HIV care in London, United Kingdom (UK): A cross-sectional self-report study

Prevalence, severity, and risk factors of disability among adults living with HIV accessing routine outpatient HIV care in London, United Kingdom (UK): A cross-sectional self-report study

Addressing stigma and discrimination at scale: uniting for a common vision while acknowledging local realities

Systematic review: Development of a person‐centered care framework within the context of HIV treatment settings in sub‐Saharan Africa

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