Nonfinancial Factors Associated With Decreased Plasma Viral Load Testing in Ontario, Canada

Raboud, Janet; Abdurrahman, Zainab; Major, Carol; Millson, Peggy; Robinson, Greg; Rachlis, Anita; Bayoumi, Ahmed M.

doi:10.1097/01.qai.0000143603.94728.b2

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…There are only a few studies from developed countries examining the frequency of VL testing [3], [8], [9], [10], [11], [12]. Haubrich et al [8] conducted a randomized trial in the early CART era in 1996/97 to compare the outcome of frequent VL measurement with infrequent VL measurement.…”

Section: Discussionmentioning

confidence: 99%

Frequency of HIV-1 Viral Load Monitoring of Patients Initially Successfully Treated with Combination Antiretroviral Therapy

et al. 2010

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BackgroundAlthough considered an essential tool for monitoring the effect of combination antiretroviral treatment (CART), HIV-1 RNA (viral load, VL) testing is greatly influenced by cost and availability of resources.ObjectivesTo examine whether HIV infected patients who were initially successfully treated with CART have less frequent monitoring of VL over time and whether CART failure and other HIV-disease and sociodemographic characteristics are associated with less frequent VL testing.MethodsThe study included patients who started CART in the period 1999–2004, were older than 18 years, CART naive, had two consecutive viral load measurements of <400 copies/ml after 5 months of treatment and had continuous CART during the first 15 months. The time between two consecutive visits (days) was the outcome and associated factors were assessed using linear mixed models.ResultsWe analyzed a total of 128 patients with 1683 visits through December 2009. CART failure was observed in 31 (24%) patients. When adjusted for the follow-up time, the mean interval between two consecutive VL tests taken in patients before CART failure (155.2 days) was almost identical to the interval taken in patients who did not fail CART (155.3 days). On multivariable analysis, we found that the adjusted estimated time between visits was 150.9 days before 2003 and 177.6 in 2008/2009. A longer time between visits was observed in seafarers compared to non-seafarers; the mean difference was 30.7 days (95% CI, 14.0 to 47.4; p<0.001); and in individuals who lived more than 160 kilometers from the HIV treatment center (mean difference, 16 days, p = 0.010).ConclusionsLess frequent monitoring of VL became common in recent years and was not associated with failure. We identified seafarers as a population with special needs for CART monitoring and delivery.

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Section: Discussionmentioning

confidence: 99%

Frequency of HIV-1 Viral Load Monitoring of Patients Initially Successfully Treated with Combination Antiretroviral Therapy

et al. 2010

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“…Carrico et al 21 observed five-fold higher HIV viral load among those endorsing regular stimulant use compared to those who did not report stimulant use. A history of substance use also has implications for care, with HIV infected individuals with substance use histories less likely to receive highly active antiretroviral therapies (HAART) 22 , and other clinical assessments such as viral load testing 23 . Hepatitis C (HCV) is observed in 60-90% of HIV infected drug users.…”

Section: Substance Use and Health Outcomesmentioning

confidence: 99%

Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis

Durvasula

Miller

2014

Behavioral Medicine

127

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This paper provides a review of the current literature addressing substance abuse treatment in persons living with HIV/AIDS. Clinical management of HIV must account for the “triple diagnosis” of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990's, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention.

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“…HIV-infected persons with a history of drug use are less likely to receive antiretroviral treatment Fairfield, Libman, Davis, & Eisenberg, 1999;Junghans et al, 1999;Lucas, Chaisson, & Moore, 1999;Mocroft et al, 1999;Murri et al, 1999;Palella et al, 1998;Strathdee et al, 1998;Turner et al, 2001), viral load testing (Laine et al, 2001;Raboud et al, 2005), or lipid screening (Korthuis et al, 2004); experience greater HIV-related symptoms (Mathews et al, 2000); and have higher hospitalization rates Gebo, Diener-West, & Moore, 2001;Schoenbaum, Lo, & Floris-Moore, 2002;Shapiro et al, 1999) compared with men who acquired HIV through sex with other men.…”

Section: Introductionmentioning

confidence: 99%

Substance abuse treatment in human immunodeficiency virus: The role of patient–provider discussions

Korthuis

Josephs

Fleishman

et al. 2008

Journal of Substance Abuse Treatment

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Substance abuse treatment is associated with decreases in human immunodeficiency virus (HIV) risk behavior and can improve HIV outcomes. The purpose of this study was to examine factors associated with substance abuse treatment utilization, including patient-provider discussions of substance use issues. We surveyed 951 HIV-infected adults receiving care at 14 HIV Research Network primary care sites regarding drug and alcohol use, substance abuse treatment, and provider discussions of substance use issues. Although 71% reported substance use, only 24% reported receiving substance abuse treatment and less than half reported discussing substance use issues with their HIV providers. In adjusted logistic regression models, receipt of substance abuse treatment was associated with patient-provider discussions. Patient-provider discussions of substance use issues were associated with current drug use, hazardous or binge drinking, and Black race or ethnicity, though substance use was comparable between Blacks and Whites. These data suggest potential opportunities for improving engagement in substance abuse treatment services.

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Nonfinancial Factors Associated With Decreased Plasma Viral Load Testing in Ontario, Canada

Abstract: Injection drug users, younger individuals, and residents of Toronto used fewer viral load tests than other individuals, even when financial barriers to testing were removed.

Cited by 11 publications

References 14 publications

Frequency of HIV-1 Viral Load Monitoring of Patients Initially Successfully Treated with Combination Antiretroviral Therapy

Frequency of HIV-1 Viral Load Monitoring of Patients Initially Successfully Treated with Combination Antiretroviral Therapy

Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis

Substance abuse treatment in human immunodeficiency virus: The role of patient–provider discussions

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