Psychiatric Symptoms and Barriers to Care in HIV-Infected Individuals Who Are Lost to Care

McLean, Carmen P.; Metzger, David; Foa, Edna B.

doi:10.1177/2325957417711254

Cited by 10 publications

(10 citation statements)

References 30 publications

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“…Of those, 7 were excluded for repeated data, 9 were excluded for targeting PLWH who received psychological intervention or suffered from genocide/natural disaster and 62 were excluded for not reporting the PTSD prevalence among PLWH. Finally, a total of 38 studies14 24 25 38–72 met inclusion criteria and were included in this meta-analysis. Search results are elaborated in figure 1.…”

Section: Resultsmentioning

confidence: 99%

Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: a systematic review and meta-analysis

et al. 2020

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ObjectivesAlthough people living with HIV (PLWH) have been disproportionately affected by post-traumatic stress disorder (PTSD), the global prevalence of PTSD among PLWH is unknown. This study aimed to systematically review the prevalence of PTSD among PLWH worldwide and explore variation in prevalence across sociodemographic and methodological factors.DesignA meta-analysis using a random-effects model was conducted to pool the prevalence estimated from individual studies, and subgroup analyses were used to analyse heterogeneities.Setting, participants and measuresObservational studies providing PTSD prevalence data in an adult HIV population were searched from January 2000 to November 2019. Measurements were not restricted, although the definition of PTSD had to align with the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases diagnostic criteria.ResultsA total of 38 articles were included among 2406 records identified initially. The estimated global prevalence of PTSD in PLWH was 28% (95% CI 24% to 33%). Significant heterogeneity was detected in the proportion of PLWH who reported PTSD across studies, which was partially explained by geographic area, population group, measurement and sampling method (p<0.05).ConclusionPTSD among PLWH is common worldwide. This review highlights that PTSD should be routinely screened for and that more effective prevention strategies and treatment packages targeting PTSD are needed in PLWH.

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Section: Resultsmentioning

confidence: 99%

Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: a systematic review and meta-analysis

et al. 2020

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“…1 Viral suppression rates are exceptionally low for populations that have not consistently been engaged in care, including vulnerable youth [2][3][4] as well as those who are homeless, 5,6 actively use substances, 7,8 and have persistent and untreated mental illness. [9][10][11] Ending the AIDS epidemic will require that more people living with HIV are engaged and sustained HIV care. 12 To this end, the Joint United Nations Programme on HIV/AIDS has set a 90-90-90 goal, which states that by 2020, 90% of those living with HIV will know their status, 90% of those diagnosed will receive sustained antiretroviral treatment, and 90% of those individuals will be virally suppressed.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Healthcare Environment and Associations with Clinical Outcomes of People Living with HIV/AIDS

Hawk

Coulter

Egan

et al. 2017

AIDS Patient Care and STDs

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Despite three decades of dramatic treatment breakthroughs in antiretroviral regimens, clinical outcomes for people living with HIV vary greatly. The HIV treatment cascade models the stages of care that people living with HIV go through toward the goal of viral suppression and demonstrates that <30% of those living with HIV/AIDS in the United States have met this goal. Although some research has focused on the ways that patient characteristics and patient-provider relationships contribute to clinical adherence and treatment success, few studies to date have examined the ways that contextual factors of care and the healthcare environment contribute to patient outcomes. Here, we present qualitative findings from a mixed-methods study to describe contextual and healthcare environment factors in a Ryan White Part C clinic that are associated with patients' abilities to achieve viral suppression. We propose a modification of Andersen's Behavioral Model of Health Services Utilization, and its more recent adaptation developed by Ulett et al., to describe the ways that clinic, system, and provider factors merge to create a system of care in which more than 86% of the patient population is virally suppressed.

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“…Various factors contribute to falling OOC [3][4][5][6][7][8][9][10][11], and thus, re-engaging OOC PWH in HIV care may require different strategies [12]. One common strategy is patient navigation, a person-centered intervention that helps PWH access resources and traverse complex healthcare and social service systems.…”

Section: Introductionmentioning

confidence: 99%

Strategies to improve HIV care outcomes for people with HIV who are out of care

Higa¹,

Crepaz²,

Mullins³

et al. 2022

Aids

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Objective: The aim of this study was to evaluate the effectiveness of five intervention strategies: patient navigation, appointment help/alerts, psychosocial support, transportation/appointment accompaniment, and data-to-care on HIV care outcomes among persons with HIV (PWH) who are out of care (OOC).Design: A systematic review with meta-analysis.Methods: We searched CDC's Prevention Research Synthesis (PRS) Project's cumulative HIV database to identify intervention studies conducted in the U.S., published between 2000 and 2020 that included comparisons between groups or prepost, and reported at least one relevant outcome (i.e. re-engagement or retention in HIV care, and viral suppression). Effect sizes were meta-analyzed using random-effect models to assess intervention effectiveness.Results: Thirty-nine studies reporting on 42 unique interventions met the inclusion criteria. Overall, intervention strategies are effective in improving re-engagement in care [odds ratio (OR) ¼ 1.79;95% confidence interval (95% CI): 1.36-2.36, k ¼ 14], retention in care (OR ¼ 2.01; 95% CI: 1.64-2.64, k ¼ 22), and viral suppression (OR ¼ 2.50;95% CI: 1.87-3.34, k ¼ 27). Patient navigation, appointment help/alerts, psychosocial support, and transportation/appointment accompaniment improved all three HIV care outcomes. Data-to-care improved re-engagement and retention but had insufficient evidence for viral suppression. Conclusion:Several strategies are effective for improving HIV care outcomes among PWH who are OOC. More work is still needed for consistent definitions of OOC and HIV care outcomes, better reporting of intervention and cost data, and identifying how best to implement and scale-up effective strategies to engage and retain OOC PWH in care and reach the ending the HIV epidemic goals.

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Psychiatric Symptoms and Barriers to Care in HIV-Infected Individuals Who Are Lost to Care

Cited by 10 publications

References 30 publications

Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: a systematic review and meta-analysis

Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: a systematic review and meta-analysis

Exploring the Healthcare Environment and Associations with Clinical Outcomes of People Living with HIV/AIDS

Strategies to improve HIV care outcomes for people with HIV who are out of care

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