Can a Behavioral Alcohol Intervention be Delivered Cost-Effectively to Persons Living with HIV/AIDS in Sub-Saharan Africa?

2016 ◽  
Vol 40 (1) ◽  
pp. 50-51 ◽  
Author(s):  
Kevin L. Kraemer
Keyword(s):  
Sub Saharan Africa ◽  
Alcohol Intervention ◽  
Persons Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Factors Influencing Adherence to Anti-retroviral Therapy among Persons Living with HIV/AIDS in Enugu State Southeast Nigeria

2019 ◽  
pp. 1-8
Author(s):  
C. P. Igweagu ◽  
O. H. Chime ◽  
O. C. Ekwueme
Keyword(s):  
Health Education ◽  
Sub Saharan Africa ◽  
Limiting Factors ◽  
People Living With Hiv ◽  
Factors Influencing ◽  
Persons Living With Hiv ◽  
Enugu State ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Hiv Aids

Background: The Acquired Immune – deficiency syndrome (AIDS) is a terminal illness caused by a retrovirus known as the Human Immune-deficiency virus (HIV). HIV/AIDS is a leading cause of death in sub-saharan Africa. Nigeria has the second largest HIV epidemic in the world and one of the highest rates of new infection in sub-Saharan Africa with 1.9 million people living HIV in 2018. Antiretroviral therapy (ART) has significantly reduced morbidity and mortality, prolonged life expectancy and improved quality of life among people living with HIV/AIDS infection (PLWHA). To be most effective ART requires a near perfect level of adherence. Poor adherence compromises treatment effectiveness, leading to treatment failure and development of drug resistance. Non-adherence is also characterized by increased morbidity, mortality and great economic loss. This study assessed the effect of health education on factors influencing adherence to ART among PLWHAs in Enugu State. Methodology: A health education intervention was carried out among 312 persons living with HIV/AIDS receiving ART in Enugu metropolis to improve their perception and adherence to antiretroviral therapy. A structured questionnaire was used to collect data from 312 people living with HIV/AIDS (156 each in the study and control groups), who were selected by multistage sampling. Subsequently, health education was conducted among the study group. Three months after this intervention its effects were assessed through a survey using the same structured questionnaires employed in the baseline survey. Results: Knowledge of supportive and limiting factors of adherence improved significantly among the study group than the controls post-intervention (P<0.001). The factors that facilitated adherence included follow-up visits, adequate information education/counseling and supportive relationships. The limiting factors were drug side-effects, forgetfulness, finance and travel time to clinic. Conclusion: Health education improved knowledge of supportive factors of ART adherence among PLWHAs in Enugu State, and this should be promoted.

scholarly journals Targeting an Alcohol Intervention Cost-Effectively to Persons Living with HIV/AIDS in East Africa

2015 ◽  
Vol 39 (11) ◽  
pp. 2179-2188 ◽  
Author(s):  
Jason Kessler ◽  
Kelly Ruggles ◽  
Anik Patel ◽  
Kimberly Nucifora ◽  
Lingfeng Li ◽  
...  
Keyword(s):  
East Africa ◽  
Alcohol Intervention ◽  
Persons Living With Hiv ◽  
Intervention Cost ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Stigmatising Attitudes Towards Co-workers with HIV in the Workplace of a Metropolitan State, Southwestern Nigeria

2017 ◽  
Vol 11 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Idongesit Godwin Utuk ◽  
Kayode Omoniyi Osungbade ◽  
Taiwo Akinyode Obembe ◽  
David Ayobami Adewole ◽  
Victoria Oluwabunmi Oladoyin
Keyword(s):  
Sampling Technique ◽  
Sub Saharan Africa ◽  
Good Knowledge ◽  
People Living With Hiv ◽  
Cross Sectional Survey ◽  
Southwestern Nigeria ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Hiv Aids

Background:Despite demonstrating global concerns about infection in the workplace, very little research has explored how co-workers react to those living with HIV in the workplace in sub-Saharan Africa. This study aimed to assess the level of stigmatising attitude towards co-workers living with HIV in the workplace.Methods:The study was a descriptive cross-sectional survey involving 403 respondents. They were recruited from selected companies through a multistage sampling technique. Survey was carried out using pre-tested semi-structured questionnaires. Data were analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables at 5% level of significance. Logistic regression model was used to determine the predictors at 95% confidence intervals.Results:Mean age of respondents was 32.9 ± 9.4 years with 86.1% being females. Overall, slightly below two-third (63.0%) had good knowledge on transmission of HIV/AIDS while 218 (54.1%) respondents had a high stigmatising attitude towards co-workers with HIV in the workplace. More female respondents (69.6%) demonstrated high stigmatising attitudes towards co-workers with HIV in the workplace (p = 0.012). Female workers were twice more likely to have high stigmatising attitudes towards co-worker with HIV [OR 2.1 (95% CI: 1.13 – 3.83)].Conclusion:Stigma towards people living with HIV/AIDs is still very persistent in different settings. Good knowledge amongst our participants about HIV/AIDs did not translate to low stigmatising attitudes among workers. Concerted efforts and trainings on the transmission of HIV/AIDs are essential to reduce stigma that is still very prevalent in workplace settings.

scholarly journals Health system challenges affecting falls prevention in persons living with HIV: perspectives from physiotherapists in four sub-Saharan regions

2021 ◽  
Vol 22 ◽  
Author(s):  
Maria Y. Charumbira ◽  
Karina Berner ◽  
Quinette A. Louw
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health System ◽  
Fall Prevention ◽  
Falls Prevention ◽  
Sub Saharan Africa ◽  
Prevention Services ◽  
Persons Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv

Abstract Aim: The aim of this study was to explore the perspectives of physiotherapists in four selected regions of sub-Saharan Africa regarding health system challenges impacting the integration of physiotherapy-led falls prevention services in the primary care of persons living with HIV (PLWH). Background: Falls may pose a significant problem among younger PLWH in low- and middle-income countries. Physiotherapists’ role in optimising function and quality of life can do much in the prevention of falls in PLWH and reducing the harm that results. However, falls prevention strategies have not been implemented effectively especially in primary health care settings in sub-Saharan Africa. Physiotherapists’ account of the health system challenges they encounter may provide insights into potential strategies that may be considered in optimising fall prevention for PLWH in poorly resourced settings. Methods: A descriptive qualitative study was conducted in selected urban districts in the capital cities of four sub-Saharan African countries. In-depth interviews were conducted with 21 purposively selected physiotherapists involved in the primary care of PLWH. Audio recordings of interviews were transcribed verbatim and analysed using deductive thematic content analysis. Findings: The main results are presented in the theme ‘Health care system challenges’ and in nine categories informed by the WHO health system framework: lack of policies and clinical practice guidelines, shortage/Inaccessible falls prevention services, inadequate human resource, physiotherapists not adequately equipped in falls prevention, inaccessible/No facilities for BMD measurement, inefficient data capturing systems, lack of evidence regarding falls among PLWH, unclear physiotherapy role descriptions, inefficient referral system. Physiotherapists highlighted the need for more information and research regarding fall prevention for PLWH, promote their role in the primary care of PLWH and adopt a patient-centred approach to fall prevention.

scholarly journals Synthesizing evidence on nutrition challenges among people living with HIV/AIDS in sub- Saharan Africa: a protocol for a scoping review

2019 ◽  
Vol 6 (7) ◽  
pp. 3173 ◽  
Author(s):  
Tafadzwa Dzinamarira ◽  
Moreblessing Chipo Mashora
Keyword(s):  
Health Outcomes ◽  
Scoping Review ◽  
Sub Saharan Africa ◽  
Future Research ◽  
People Living With Hiv ◽  
Nutritional Management ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Improve Health ◽  
Hiv Aids

Background: Good nutritional status is highly significant for individuals who are infected with HIV. However, they still face a number of nutritional challenges. The proposed scoping review will map literature on the nutritional challenges facing people living with HIV/AIDS (PLWH) and guide future research in nutritional management to improve health outcomes for PLWH. Here we outline a scoping review protocol designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P 2015 Guidelines).Methods: The Arksey and O’Malley’s 2005 scoping methodological framework further improved by Levac et al. 2010 will guide the search and reporting. Searches will be conducted for eligible articles from MEDLINE (PubMed), MEDLINE, CINAHL, Academic Search Complete and ISI Web of Science (Science Citation Index) electronic databases. Two independent reviewers will conduct the search guided by an inclusion and exclusion criteria. Quality appraisal of the included articles will be conducted guided by the mixed methods appraisal tool 2018 version. We will employ NVivo version 12 for thematic content analysis.Conclusions: The findings of this review will guide future research in nutritional management to improve health outcomes for PLWH in sub-Saharan African. This review will be disseminated electronically in a published peer reviewed article and in print.

scholarly journals Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Patience Adzordor ◽  
Clement Avoka ◽  
Vitalis Bawontuo ◽  
Silas Agbesi ◽  
Desmond Kuupiel
Keyword(s):  
Hiv Infection ◽  
Scoping Review ◽  
Keyword Search ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Status Disclosure ◽  
Hiv Aids

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.

scholarly journals Are Expert Patients an Untapped Resource for ART Provision in Sub-Saharan Africa?

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Tom Decroo ◽  
Wim Van Damme ◽  
Guy Kegels ◽  
Daniel Remartinez ◽  
Freya Rasschaert
Keyword(s):  
Information Acquisition ◽  
Sub Saharan Africa ◽  
Art Programs ◽  
Problem Solving Skills ◽  
Adherence To Medication ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Expert Patients ◽  
Untapped Resource ◽  
Hiv Aids

Since the introduction of antiretroviral treatment, HIV/AIDS can be framed as a chronic lifelong condition, requiring lifelong adherence to medication. Reinforcement of self-management through information, acquisition of problem solving skills, motivation, and peer support is expected to allow PLWHA to become involved as expert patients in the care management and to decrease the dependency on scarce skilled medical staff. We developed a conceptual framework to analyse how PLWHA can become expert patients and performed a literature review on involvement of PLWHA as expert patients in ART provision in Sub-Saharan Africa. This paper revealed two published examples: one on trained PLWHA in Kenya and another on self-formed peer groups in Mozambique. Both programs fit the concept of the expert patient and describe how community-embedded ART programs can be effective and improve the accessibility and affordability of ART. Using their day-to-day experience of living with HIV, expert patients are able to provide better fitting solutions to practical and psychosocial barriers to adherence. There is a need for careful design of models in which expert patients are involved in essential care functions, capacitated, and empowered to manage their condition and support fellow peers, as an untapped resource to control HIV/AIDS.

scholarly journals Cytomegalovirus Viremia Associated With Increased Mortality in Cryptococcal Meningitis in Sub-Saharan Africa

2019 ◽  
Vol 71 (3) ◽  
pp. 525-531 ◽  
Author(s):  
Caleb Skipper ◽  
Mark R Schleiss ◽  
Ananta S Bangdiwala ◽  
Nelmary Hernandez-Alvarado ◽  
Kabanda Taseera ◽  
...  
Keyword(s):  
Cryptococcal Meningitis ◽  
Opportunistic Infections ◽  
Survival Rates ◽  
Hazard Ratio ◽  
Sub Saharan Africa ◽  
Persons Living With Hiv ◽  
Median Plasma ◽  
Sub Saharan ◽  
Immunodeficiency Syndrome ◽  
Living With Hiv

Abstract Background Cryptococcal meningitis and tuberculosis are both important causes of death in persons with advanced human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Cytomegalovirus (CMV) viremia may be associated with increased mortality in persons living with HIV who have tuberculosis. It is unknown whether concurrent CMV viremia is associated with mortality in other AIDS-related opportunistic infections. Methods We prospectively enrolled Ugandans living with HIV who had cryptococcal meningitis from 2010–2012. Subsequently, we analyzed stored baseline plasma samples from 111 subjects for CMV DNA. We compared 10-week survival rates among those with and without CMV viremia. Results Of 111 participants, 52% (58/111) had detectable CMV DNA (median plasma viral load 498 IU/mL, interquartile range [IQR] 259–2390). All samples tested were positive on immunoglobin G serology. The median CD4+ T cell count was 19 cells/µL (IQR 9–70) and did not differ by the presence of CMV viremia (P = .47). The 10-week mortality rates were 40% (23/58) in those with CMV viremia and 21% (11/53) in those without CMV viremia (hazard ratio 2.19, 95% confidence interval [CI] 1.07–4.49; P = .03), which remained significant after a multivariate adjustment for known risk factors of mortality (adjusted hazard ratio 3.25, 95% CI 1.49–7.10; P = .003). Serum and cerebrospinal fluid cytokine levels were generally similar and cryptococcal antigen-specific immune stimulation responses did not differ between groups. Conclusions Half of persons with advanced AIDS and cryptococcal meningitis had detectable CMV viremia. CMV viremia was associated with an over 2-fold higher mortality rate. It remains unclear whether CMV viremia in severely immunocompromised persons with cryptococcal meningitis contributes directly to this mortality or may reflect an underlying immune dysfunction (ie, cause vs effect). Clinical Trials Registration NCT01075152.

The contexts of housing stability and change among HIV-positive persons in the Lower Manya Krobo Municipality, Ghana

2020 ◽  
Author(s):  
Adobea Y Owusu ◽  
Mabel Teye-kau ◽  
Eric Y Tenkorang
Keyword(s):  
Sub Saharan Africa ◽  
Housing Conditions ◽  
Hiv Status ◽  
Policy Makers ◽  
Stability And Change ◽  
Housing Stability ◽  
Persons Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Depth Interviews

Summary Due to stigma, discrimination and economic insecurity, persons living with HIV/AIDS (PLWHAs) are highly vulnerable to housing instability. For instance, PLWHAs are more likely to either remain stable in inadequate homes or change residence. Yet, few studies explore the contexts of housing stability and change among PLWHAs, especially in sub-Saharan Africa, where the majority reside. This study used qualitative in-depth interviews to explore the narratives of 38 PLWHAs on the contexts of housing stability and the circumstances leading to change in residence. On diagnosis with HIV, the majority of PLWHAs (58%) changed housing locations, mostly from bad to worse conditions. Reasons for change include: eviction due to stigma and discrimination, inability to afford rent, quest to hide HIV status and death of a cohabiting partner. Our findings suggest policy makers should pay attention to the deplorable and poor housing conditions of PLWHAs in Ghana.

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