A Narrative Systematic Literature Review: A Focus on Qualitative Studies on HIV and Medication-Assisted Therapy in the United States

Alina Cernasev,Sunitha Kodidela,Santosh Kumar,Michael P Veve,Theodore Cory,Hilary Jasmin

doi:10.3390/pharmacy9010067

Abstract

Over the last two decades, the United States (U.S.) has experienced an opioid crisis that has had a significant negative societal and economic impact. Due to the high utilization of opioids in Persons Living with HIV and AIDS (PLWHA), there is a need for a qualitative literature review that presents opioid-use related problems in this population. This study aims to present and identify a thematic overview of the qualitative manuscripts on PLWHA who take opioid medications in the U.S., with a focus on perceptions surrounding medication assisted therapy. The systematic literature search was performed in December 2019. Four databases were searched: PubMed/MEDLINE, Scopus, Web of Science, and Cumulative Index to Nursing & Allied Health Literature (CINAHL). A total of 5348 results were exported from databases into EndNote x9, and duplicates were removed for a total of 3039 unique abstracts to screen. The records were imported into Rayyan, an online platform designed to expedite the screening process. Three authors screened titles and abstracts and determined 19 articles that would be screened in full text. On 9 April 2020, it was determined that eight articles would be included for review. The analysis of the eight manuscripts that fit the inclusion and exclusion criteria revealed barriers and facilitators to medication assisted therapy (MAT) in PLWHA. This review communicates or describes the story of PLWHA who might have delayed access to HIV healthcare providers and the commencement of antiretroviral therapy. In the literature, several studies have focused on the role of physicians in prescribing and addressing the medication regimens but none of the studies examined the role of pharmacists in access to care in this population. Therefore, further research is needed for a better understanding of the social aspects of taking opioid medications in PLWHA and the role of pharmacists within the continuum of care.

Highlights

Over the last two decades, the United States (U.S.) has experienced an opioid crisis that has had a significant negative societal and economic impact
The main conclusion of these articles is that people living with HIV/AIDS (PLWHA) face many barriers related to transportation, food security, access to medication assisted therapy (MAT) treatment
The above studies represent an empirical map of the current literature, which leaves a vast amount of information unknown, this study summarizes all available qualitative studies focused on the role of pharmacists in access to care in PLWHA taking opioid medication in the United States (US)

Summary

Introduction

Over the last two decades, the United States (U.S.) has experienced an opioid crisis that has had a significant negative societal and economic impact. Prescription opioids are generally used to treat different types of pain, including chronic pain associated with. People living with HIV/AIDS (PLWHA) are more likely to be prescribed opioids than uninfected individuals [4]. Long-term or overuse of opioids by PLWHA could lead to substance use disorder [2,5,6]. PLWHA with opioid use disorder (OUD) are at risk for serious opioid-antiretroviral drug interactions and HIV disease progression due to reduced antiretroviral (ARV) drug adherence [4,7–9]. While advancements have been made to curtail unnecessary opioid use in the U.S, PLWHA still lacks access to care for treatment of OUD. More data are needed that depict the perspectives of PLWHA with OUD, including barriers and facilitators of both treatments. The present study aimed to examine the literature in this area, given the lack of previous qualitative reviews of PLWHA’s perception of taking opioid medications

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