Knowledge Of Antiretroviral Therapy Research Articles

Adherence to Antiretroviral Therapy in People Living with HIV Accessing Care in a Secondary Healthcare Facility in Lagos State, Nigeria

Background: Achieving optimal adherence, referred to as ≥95%, is crucial for the success of antiretroviral therapy (ART) to maintain viral suppression among people living with HIV (PLHIV). Objectives: To assess level of adherence to ART in adult PLHIV in Ikorodu General Hospital, Lagos, Nigeria. Methods: A cross-sectional study in 340 PLHIV ≥18 years using questionnaires to assess knowledge of HIV, ART, adherence, and its barriers. Adherence measures were done with a 4-day self-reported AIDS clinical trial group (ACTG) tool and retrospective pharmacy refill record. Data were analysed using SPSS version 23.0. Good knowledge is a percentage score of ≥ 70. The level of significance was set at p < 0.05. Results: A total of 227 (females 66.8%) with mean age of 42.3±11.3 years were assessed. Poor knowledge of HIV (66.8%), ART (64.9%), and adherence to ART (52.3%) was demonstrated by the respondents. Mean self-reported adherence was 92.78%, while pharmacy refill adherence was 90.91%. Overall, 84.1% achieved viral suppression, with a significant negative correlation between adherence to ART and viral load (R=-0.293, p= 0.035). Waiting time to see caregivers for treatment (Odds ratio (OR): 0.919; 95% confidence interval (CI): 0.745-1.135, p= 0.045), reasons for forgetting to take medicines (OR: 1.135; 95% CI: 0.985-1.308, p= 0.039), and how satisfied patients were with the current ARV regimen (OR: 1.868; 95% CI: 1.040-3.358, p= 0.037) were significant predictors to ART adherence. Conclusion: The sub-optimal self-reported and pharmacy refill adherence rates at the facility shows a need for adherence support interventions for PLHIV on ART.

Knowledge, Attitude, Practice, and Adherence to Antiretroviral Therapy among People Living with HIV in Nepal.

Patient's knowledge and attitude towards their treatment avert stereotypical misconceptions about the disease and its treatment, as well as aid in attaining optimal adherence. This study investigated the knowledge, attitude, practice, and adherence of antiretroviral therapy (ART) clients in Nepal. A cross-sectional study was conducted among 165 ART clients visiting five ART sites in the far western region and the capital city of Nepal. The convenience sampling method was employed, and the data were collected through interviews with ART clients using a validated questionnaire. Binary logistic regression was used to identify associated factors. Approximately 80.7% had adequate knowledge and 55% had a positive attitude towards ART. Stigmatization was associated with ARV by only 4.2%. Half of the participants (50.3%) revealed that they had surreptitiously stored their ART medication, diverging from the recommended storage guidelines. A significant proportion of respondents (33.3%) chose to repackage the medication as a strategy to prevent unintended disclosure of their HIV status. Many (59.3%) believed that ART does not prolong life. Nevertheless, they advocated the regular use of ART rather than taking it only when the health deteriorates (81.8%). The majority (97.6%) were found to be adherent to their ART. There was a significant association of age with a level of knowledge and attitude (p < 0.05). A significant association was also found between knowledge and attitude towards ART (p < 0.05). None of the variables had a significant association with adherence (p > 0.05). Overall, adequate knowledge was demonstrated, whereas efforts are still needed to improve the attitude of ART clients towards ART. A need for counseling regarding the storage practices of ART is needed. A focus on ensuring the perfect translation of adequate knowledge and a positive attitude to the practice of ART clients is essential. Whether adequate ART knowledge and attitude scores will lead to near-perfect ART adherence needs further investigation.

A QUALITATIVE STUDY OF THE KNOWLEDGE OF INFORMAL CAREGIVERS OF CHILDREN WITH HIV/AIDS ON ANTIRETROVIRAL THERAPY ADHERENCE

The burden faced by informal caregivers in caring for a child diagnosed with HIV/AIDS, and placed on Antiretroviral Therapy (ART) is high due to the nature of the child’s dependence on the caregiver for fulfilling the child’s necessary needs. Evidence linking knowledge to the likelihood of performing the desired action exists. It is therefore crucial to explore caregivers’ knowledge of ART, and how that influences their children’s adherence to ART. The sought to explore the knowledge of informal caregivers on adherence to ART among their children with HIV/AIDS who received care at St. Joseph’s Hospital, Jirapa, Ghana. A qualitative phenomenology design was used. Data were collected from 13 purposively chosen caregivers of children with HIV/AIDS on ART at a hospital, using a semi-structured in-depth interview guide. A reflexive thematic analysis approach was used for data analysis. Informal caregivers were knowledgeable in the regularity of visits to the HIV Testing and Counselling (HTC) Centre for ARTs, identifying ARTs, ARTs administration, ARTs side effects identification, HIV transmission, and the nutritional restrictions for ARTs. A few, however, had misconceptions about HIV transmission. Informal caregivers still need education in the area of HIV transmission. The findings will guide nurses to focus on areas of education for informal caregivers to improve upon their knowledge of ART and to ensure increased adherence among children living with HIV/AIDS under their care.

A QUALITATIVE STUDY OF THE KNOWLEDGE OF INFORMAL CAREGIVERS OF CHILDREN WITH HIV/AIDS ON ANTIRETROVIRAL THERAPY ADHERENCE

The burden faced by informal caregivers in caring for a child diagnosed with HIV/AIDS, and placed on Antiretroviral Therapy (ART) is high due to the nature of the child’s dependence on the caregiver for fulfilling the child’s necessary needs. Evidence linking knowledge to the likelihood of performing the desired action exists. It is therefore crucial to explore caregivers’ knowledge of ART, and how that influences their children’s adherence to ART. The sought to explore the knowledge of informal caregivers on adherence to ART among their children with HIV/AIDS who received care at St. Joseph’s Hospital, Jirapa, Ghana. A qualitative phenomenology design was used. Data were collected from 13 purposively chosen caregivers of children with HIV/AIDS on ART at a hospital, using a semi-structured in-depth interview guide. A reflexive thematic analysis approach was used for data analysis. Informal caregivers were knowledgeable in the regularity of visits to the HIV Testing and Counselling (HTC) Centre for ARTs, identifying ARTs, ARTs administration, ARTs side effects identification, HIV transmission, and the nutritional restrictions for ARTs. A few, however, had misconceptions about HIV transmission. Informal caregivers still need education in the area of HIV transmission. The findings will guide nurses to focus on areas of education for informal caregivers to improve upon their knowledge of ART and to ensure increased adherence among children living with HIV/AIDS under their care.

Understanding the Unique Barriers and Facilitators that Affect Men’s Initiation and Retention in HIV Care: A Qualitative Study to Inform Interventions for Men Across the Treatment Cascade in Malawi

Men in sub-Saharan Africa are underrepresented in antiretroviral therapy (ART) programs. Our secondary analysis of 40 in-depth interviews with Malawian men living with HIV examined barriers and facilitators for ART initiation versus retention. Interviewees included men who never initiated or initiated ART late (initiation respondents, n = 19); and men who initiated ART but were late for an appointment (retention respondents, n = 21). Transcribed interviews were coded using deductive and inductive coding techniques and analyzed using constant comparison methods. Long wait times, frequent facility visits, and insufficient in-clinic privacy were barriers for initiation and retention. Poor knowledge of ART was primarily a barrier for initiation; unexpected travel was a barrier for retention. Key facilitators for initiation and retention included previous positive experiences with health facilities. Having examples of successful men using ART primarily facilitated initiation; support from spouses and male peers facilitated retention. Results may inform interventions to increase men’s engagement in ART services.

Barriers and Facilitators to Successful Intensive Adherence Counseling in Rural Northern Uganda: An Exploratory Interview with HIV-Positive Clients Using the COM-B Framework.

Intensive adherence counseling (IAC) was introduced as a strategy to enhance adherence to antiretroviral therapy (ART) among HIV clients with non-suppressed viral loads. There has been sub-optimal viral load suppression among HIV clients in Uganda enrolled in IAC. However, there is a scarcity of literature on the barriers and facilitators of successful IAC. We aim to explore the barriers and facilitators to successful IAC among HIV-positive clients seeking care in public health facilities in rural northern Uganda. This was an exploratory qualitative study conducted among 15 purposively sampled HIV-positive clients enrolled in IAC in public health facilities offering ART services in northern Uganda. We conducted in-depth interviews using semi-structured interview guides based on the capability, opportunity, motivation, and behavior (COM-B) framework for behaviour change. Data were analyzed using the deductive thematic approach of Braun and Clarke following the COM-B framework. The majority of the participants were females (60%), married (53%), and attained primary education (47%). Barriers to successful IAC were Capability - alcoholism and promiscuity, Opportunity - stigma and discrimination, delayed viral load result, shortage of food, and heavy workload; and Motivation - deteriorating health and lack of incentives. Facilitators to successful IAC were Capability - good knowledge of ART, good memory, and reminder alerts; Opportunity - availability of ART, social support, availability of ART, prolonged ART refill, and good counseling; and Motivation - desire to live longer and healthy and the desire to fulfill dreams and goals. Successful implementation of IAC needs to consider the context of the person in care thus the need to strengthen individualized IAC sessions. HIV care providers can adopt the COM-B framework to perform individualized IACs and use the information to strengthen the counseling sessions.

Traditional Human Immunodeficiency Virus treatment and family and social influence as barriers to accessing HIV care services in Belu, Indonesia.

Access to HIV care services, including antiretroviral therapy (ART), is essential for improving health outcomes of people living with HIV (PLHIV) and reducing HIV transmission and AIDS-related deaths. As a part of a qualitative study in Belu, this paper describes the use of traditional medicines for HIV treatment and family and social influence as barriers to access to HIV care services among PLHIV. One-on-one in-depth interviews were employed to collect data from 46 PLHIV (26 women and 20 men) and 10 healthcare professionals. They were recruited using the snowball sampling technique. The study information sheets were initially posted on information boards in healthcare facilities. Potential participants who contacted to confirm their participation were recruited for an interview and then asked for help to distribute the information sheets to their eligible colleagues who might be willing to participate. Data analysis was performed using NVivo 12 software and guided by a qualitative data analysis framework. The findings showed that the use of traditional medicines, a well-known cultural practice in Belu, was a barrier to access to HIV care services among PLHIV. The influence of family in determining the use of traditional medicines for HIV treatment, supported by the lack of knowledge of ART, effectiveness of traditional medicines in treating other health issues, and social influence of relatives, neighbours, and friends, were also significant barriers to PLHIV's access to HIV care services. The findings indicate the need for dissemination of HIV care-related information for PLHIV, family, and community members to increase their knowledge of the service, ART and its function, and to support and improve access to HIV care services especially ART by PLHIV.

Determinants of antiretroviral treatment adherence among patients attending secondary health care facilities in north-east and south-west Nigeria: a comparative study

Background: Four decades after its discovery, HIV continues to be a major global public health issue, even with antiretroviral therapy (ART). Strict adherence to ART remains a challenge, with attendant implications for treatment success. This study aimed at comparing ART adherence between north-east and south-west Nigeria. Methods: A comparative cross-sectional study was conducted in two regions in Nigeria among 400 HIV/AIDS patients on ART. Data were collected using a pre-tested, semi-structured interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of ART adherence in the regions. The level of significance was set at 0.05. Results: The majority of respondents from both the north-east (87.5%) and south-west (92.5%) of Nigeria had good knowledge about ART. The self-reported adherence level was 90.0% in the north-east and 87.5% in the south-west. Predictors of ART adherence in the north-east were knowledge about ART (AOR 9.949; 95% CI 2.009–49.284) and transport costs to the clinic (AOR 0.177; 95% CI 0.047–0.661). In the south-west, education (AOR 0.198; 95% CI 0.047–0.832) and knowledge of ART (AOR 8.945; 95% CI 1.749–45.751) were identified as predictors of ART adherence. Conclusion: In both regions, knowledge about ART was appreciable, but adherence was sub-optimal. Strategies to support adherence should be tailored to specific predictors in each region.

Psychosocial interventions for improving engagement in care and health and behavioural outcomes for adolescents and young people living with HIV: a systematic review and meta-analysis.

IntroductionAdolescents and young people comprise a growing proportion of new HIV infections globally, yet current approaches do not effectively engage this group, and adolescent HIV‐related outcomes are the poorest among all age groups. Providing psychosocial interventions incorporating psychological, social, and/or behavioural approaches offer a potential pathway to improve engagement in care and health and behavioural outcomes among adolescents and young people living with HIV (AYPLHIV).MethodsA systematic search of all peer‐reviewed papers published between January 2000 and July 2020 was conducted through four electronic databases (Cochrane Library, PsycINFO, PubMed and Scopus). We included randomized controlled trials evaluating psychosocial interventions aimed at improving engagement in care and health and behavioural outcomes of AYPLHIV aged 10 to 24 years.Results and discussionThirty relevant studies were identified. Studies took place in the United States (n = 18, 60%), sub‐Saharan Africa (Nigeria, South Africa, Uganda, Zambia, Zimbabwe) and Southeast Asia (Thailand). Outcomes of interest included adherence to antiretroviral therapy (ART), ART knowledge, viral load data, sexual risk behaviours, sexual risk knowledge, retention in care and linkage to care. Overall, psychosocial interventions for AYPLHIV showed important, small‐to‐moderate effects on adherence to ART (SMD = 0.3907, 95% CI: 0.1059 to 0.6754, 21 studies, n = 2647) and viral load (SMD = −0.2607, 95% CI −04518 to −0.0696, 12 studies, n = 1566). The psychosocial interventions reviewed did not demonstrate significant impacts on retention in care (n = 8), sexual risk behaviours and knowledge (n = 13), viral suppression (n = 4), undetectable viral load (n = 5) or linkage to care (n = 1) among AYPLHIV. No studies measured transition to adult services. Effective interventions employed various approaches, including digital and lay health worker delivery, which hold promise for scaling interventions in the context of COVID‐19.ConclusionsThis review highlights the potential of psychosocial interventions in improving health outcomes in AYPLHIV. However, more research needs to be conducted on interventions that can effectively reduce sexual risk behaviours of AYPLHIV, as well as those that can strengthen engagement in care. Further investment is needed to ensure that these interventions are cost‐effective, sustainable and resilient in the face of resource constraints and global challenges such as the COVID‐19 pandemic.

Factors influencing self-management of adults living with HIV on antiretroviral therapy in Northwest\xa0Ethiopia: a cross-sectional study

BackgroundEffective self-management is an important consideration for adults living with HIV on therapy to enable people to maintain their health and well-being whilst living with chronic HIV. Although numerous attempts have been made to implement and improve HIV self-management practice, there is limited evidence on effective self-management strategies, particularly in sub-Saharan Africa. This study aimed to identify the level and factors influencing the self-management practice of adults living with HIV on antiretroviral therapy.MethodsA cross-sectional survey was conducted on a sample of 415 adults living with HIV on antiretroviral therapy at a major referral hospital in Northwest Ethiopia using convenience sampling. A theory of self-management – the Individual and Family Self-Management Theory - guided the study design, analysis and presentation of the data. A face-to-face survey tool was administered for data collection, and the data were entered and analyzed using SPSS version 25.0.ResultsOver half (58.1%) of the respondents were female. Many of the respondents did not know their HIV stage (76.9%) but reported adequate knowledge of their treatment (79.5%). The mean self-management score was 1.94+ 0.22 out of a total score of 3. Female gender was associated with decreased self-management. Contextual factors (gender, educational level, job status, income, living in a rural area, and awareness of HIV stage) explained 8.2% of the variance in self-management. The explanatory power increased by 9.2% when self-management process variables (self-efficacy, setting a goal, knowledge of antiretroviral therapy, HIV disclosure, and use of reminders) were added. Intervention-focused variables (encouraging disclosure and adherence support) increased the proportion of explained variance by 2.3%.ConclusionsThe findings of the study indicate that the level of self-management practice amongst the population studied was low compared to international literature. Our study findings support the theoretical model and previously identified factors influencing HIV self-management. The most important predictors of lower self-management practice in Ethiopia were female gender, illiteracy, lack of awareness of HIV stage, low self-efficacy, absence of reminders, lack of encouragement to disclose and absence of adherence support. HIV care providers should seek ways to empower and support adults living with HIV to self-manage, particularly through enhancing self-efficacy and encouraging the use of reminders.

Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

ObjectiveThe aim of the study was to explore the experiences of Papuans living with HIV to take antiretroviral therapy (ART) from the patient and the healthcare providers (HCPs) perspective.DesignThis was...

Understanding adherence in virally suppressed and unsuppressed human immunodeficiency virus-positive urban patients on second-line antiretroviral treatment.

BackgroundUnderstanding antiretroviral therapy (ART) adherence may assist in designing effective support interventions.ObjectivesThis study elicited perspectives on how to promote treatment adherence from virologically suppressed and unsuppressed patients receiving second-line ART.MethodsThis was a cross-sectional study conducted with randomly selected patients active on second-line ART, from five public health facilities in the Johannesburg inner city. Data were collected on demographics, clinical information, participant’s experiences and ART knowledge. Virological failure was defined as exceeding 1000 copies/mL.ResultsThe study sample comprised 149 participants; of which 47.7% (n = 71) were virally unsuppressed and 69.1% (n = 103) were women; the median age of the participants was 42 years (interquartile range [IQR] 36–47 years). Experiencing medication-related difficulties in taking second-line ART (p = 0.003), finding second-line regimen more difficult to take than a first-line regimen (p = 0.001) and experiencing side effects (p < 0.001) were all subjective predictors of virological failure. Participants’ recommendations for improving adherence included the introduction of a single tablet regimen (31.6%, n = 55), reducing the dosage to once daily (26.4%, n = 46) and reducing the pill size for second-line regimen (4.0%, n = 7).ConclusionThe results of this study highlight the importance of improving patients’ knowledge about adherence and motivation to continue ART use despite the persistence of side effects and difficulties with taking medication.

Assessing the relationship between knowledge of antiretroviral therapy and stigma regarding adherence to ART among men who have sex with men

This study aimed to assess the relationship between knowledge of antiretroviral therapy (ART) and stigma regarding adherence to ART. This cross-sectional study used a purposive sampling technique and involved 175 men who have sex with men (MSM), all of whom have HIV/AIDS. Levels of knowledge, stigma, and adherence were measured using the ART knowledge instrument, the Berger HIV Stigma Scale, and the Medication Adherence Questionnaire (MAQ), respectively. Most of the respondents had a high level of ART knowledge (76.6%), HIV-related stigma (51.4%), and non-adherence to ART (52%). The study showed a statistically significant negative correlation between stigma and adherence to ART (p=0.043; α=0.05). In addition, ART knowledge correlated positively with adherence to ART (p=0.010; α=0.05). Regression analysis showed that ART knowledge is an important factor influencing ART adherence (OR=2.817). It was found that as the level of ART knowledge increased, self-motivation and attitudes toward adherence to treatment increased.

Knowledge, attitudes, perception and practices regarding antiretroviral therapy among HIV-infected adults in Antananarivo, Madagascar: a cross-sectional survey

BackgroundAdherence to antiretroviral therapy (ART) may be influenced by knowledge, perception and perception regarding ART. The purpose of this study was to assess knowledge, attitude/perception and practice regarding ART among people living with HIV/AIDS (PLHIV).MethodsWe conducted a cross-sectional survey to assess knowledge, attitudes, perception and practices ART in PLHIV. The survey was suggested to all PLHIV of at least 18 years old and who were on ART for at least 1 month. PLHIV who were unable to answer questions correctly and those who did not complete the survey for any reason were excluded.ResultsDuring the study period, 234 PLHIV were included. Participants were mostly men (75.2%). The median age was 33 years (IQR: 27–41). The median time since HIV diagnosis was 25 months (IQR: 9–56) and the median duration of ART was 18 months (IQR: 8–48). 87.6% had an overall good knowledge of ART. However, only 3.2% knew the name of their ART, 31.2% were aware that ART should be taken at a fixed time and 17.1% knew how to take ART in relation to food intake. 75.6% of participants had an overall positive attitude/perception of ART. However, 10.7% were convinced that other methods were more effective than ART for treating HIV and 42.7% thought that taking ART was shameful. The assessment of practices showed that in case of missed dose, 48.3% of participants routinely skipped this dose instead of trying to take it as soon as possible. In multivariate analysis, good knowledge of ART was independently associated with high level of education (aOR: 4.7, IC95%: 1.6–13.7, p = 0.004) and disclosure of HIV status (aOR: 2.7, IC95%: 1.1–6.6, p = 0.029).ConclusionsThis study showed an overall good knowledge and a predominantly positive attitude/perception of ART. However, accurate knowledge of ART intake was insufficient and the stigma associated with taking ART remained very present. Furthermore, very heterogeneous practices may reflect lack of instruction given by the physician regarding ART intake.

Hubungan Pengetahuan HIV/AIDs, Terapi Antiretroviral, dan Infeksi Oportunistik Terhadap Kepatuhan ODHA dalam Menjalani Terapi Antiretroviral

Peningkatan pravelensi Orang Dengan HIV/AIDS (ODHA) dari tahun ke tahun merupakan masalah kesehatan global yang serius. Antiretroviral (ARV) merupakan satu-satunya terapi bagi ODHA yang harus dikonsumsi seumur hidup dengan kepatuhan tinggi (95%) guna mencapai efektifitas obat. Tetapi, masalah kepatuhan menjadi masalah utama bagi ODHA. Pengetahuan merupakan salah satu faktor yang mendukung tingkat kepatuhan dalam menjalani terapi. Tujuan penelitian ini adalah untuk mengetahui hubungan antara tingkat pengetahuan HIV/AIDS, terapi ARV dan infeksi oportunistik dengan tingkat kepatuhan ODHA dalam menjalani terapi antiretroviral. Penelitian menggunakan metode cross sectional dengan jumlah sampel 50 responden yang dipilih menggunakan teknik total sampling. Hasil penelitian menunjukkan tidak terdapat hubungan bermakna antara tingkat pengetahuan dengan tingkat kepatuhan ODHA dalam menjalani terapi ARV (p value = 0.107 &gt; 0.05). Hasil tersebut kontradiktif hasil penelitian sebelumnya yang menyatakan terdapat hubungan pengetahuan terapi ARV dengan tingkat kepatuhan ODHA dalam menjalani terapi ARV di rumah Sakit Padang.

Adherence to Treatment and Retention to Care of Adult Patients on Antiretroviral Therapy

The introduction of antiretroviral therapy came as a relief to people living with HIV and AIDS as it improved their quality of life and chances of survival, and delayed the progression to AIDS. Maintaining high adherence levels to antiretroviral therapy remains a challenge for many, yet strict adherence and retention to care are critical for the successful suppression of the human immunodeficiency virus. The objective of the study was to determine factors that influence adherence and retention to care for adult patients who are undergoing antiretroviral therapy. A qualitative research design was used. Purposive sampling was used to select 23 participants who met the specified criteria. Data were collected by means of in-depth individual unstructured interviews. A thematic analysis revealed six themes, namely staff-patient relationships, adherence support networks, patients’ knowledge of antiretroviral therapy, motivation to live, counselling, and factors related to medication. The study concluded that adherence to antiretroviral therapy and retention to care were facilitated by good interpersonal relationships between hospital staff and patients and efficient service delivery at the institutions.

Enhancing health among youth living with HIV using an iPhone game

ABSTRACTBackground: Despite promising outcomes of antiretroviral therapy (ART), challenges to improving adherence among youth living with HIV (YLWH) exist. Mobile games are popular among youth and may improve skills related to resilience, coping, and ART adherence. This study examines the preliminary effects of an iPhone game/app on ART adherence, viral load, and relevant knowledge and attitudes among YLWH in Jackson, MS. Methods: A RCT with 61 YLWH tested the impact of BattleViro, an ART-related iPhone game, over 16 weeks. Participants, ages 14–26, were recruited from HIV clinics and randomly assigned to receive BattleViro or a non-HIV-related game. All participants received a medication monitoring device. Chi-square and t-test analyses examined baseline differences between conditions. Continuous outcomes were examined using analyses of covariance (ANCOVAs) controlling for baseline scores. Cohen’s d effect size differences (ESD) between groups were calculated. Results: The sample was 79% male, 97% Black, and 74% non-heterosexual, with a mean age of 22 years. A third had started ART in the past 3 months. There were no demographic differences between conditions. Examination of ESDs revealed that BattleViro demonstrated promising, but nonsignificant, improvements in HIV knowledge (ESD = 0.50), ART knowledge (ESD = 0.42) and social support (ESD = 0.62). Exploratory moderation analyses revealed interactions between BattleViro and newly starting ART. Those newly starting ART in the BattleViro condition, compared to those in the control, experienced a 0.96 log greater decrease in viral load (ESD=−2.21, F = 4.33, p = 0.04), better adherence (71% vs. 48%; ESD = 1.15, F = 3.90, p = 0.05), more HIV knowledge (ESD = 0.90), and more ART knowledge (ESD = 0.72). Conclusion: BattleViro showed promising improvements in HIV knowledge, ART knowledge and social support. Also, there was improved adherence and viral load outcomes specifically among those newly starting ART. ART initiation may be an opportunity to empower and motivate YLWH to build healthy skills.

Assessment of ART knowledge and adherence to ARVs among PLWHA accessing care in two Nigerian Military HIV/AIDS Treatment sites

Background: Adherence to Highly Active Antiretroviral Therapy (HAART) is critical in achieving treatment goals, avoiding antimicrobial resistance, preventing treatment failure and improving the patient’s quality of life. Objectives: To assess the knowledge of antiretroviral therapy (ART) and adherence to antiretroviral (ARVs) medicines amongst People Living With HIV/AIDS (PLWHA) accessing care in two Nigerian Military HIV/AIDS Treatment sites. Methods: Four hundred patients on HAART who visited the study sites during the study period were recruited for the study using systematic random sampling method. A semi-structured, pretested, interviewer-administered questionnaire was used to obtain demographic details. Patients’ knowledge of HIV was assessed using an 8-item questionnaire while adherence was measured using the Simplified Medication Adherence Questionnaire (SMAQ). Results: The predominant age group was 31-40 years (46.4%). There were more females (69%) than males (31%). Only 45.5% answered knowledge questions correctly. The adherence level in this study was 64.0%. The major reasons cited for non-adherence included being away from home (23.6%), forgetfulness (17.1%), busy schedule (14%), need to conceal medication (12.7%) and feeling better (11.6%). Conclusion: Patients’ knowledge of ART and adherence to ARVs medicines were sub-optimal. Appropriate strategies to improve patients’ knowledge of ART and adherence to ARVs are recommended.

Knowledge of anti-retroviral therapy among people living with HIV/AIDS: A cross-sectional study

Background: Anti-retroviral therapy (ART) has substantially improved the survival of people living with HIV-AIDS (PLHAs). The individual and public health responsiveness to ART is, in turn, determined by ART-related knowledge of PLHAs. Objective: To study the knowledge of HIV positive individuals regarding ART and also to study its association with education and duration of HIV positivity. Materials and Methods: This cross-sectional study was conducted at a tertiary level hospital. The study participants were 102 PLHAs who were not yet started on ART and data were collected using a face-to-face interview. Results: The mean age was 35.5 years and 58.8% were educated to 10th standard. About 92.2% were married, and more than 70% belonged to rural areas. Nearly 11.8% felt that there is no treatment available. Surprisingly, 60.8% of the participants had incorrect knowledge about the correct time of initiating ART while 60 (58.8%) participants were aware that ART needs to be taken lifelong. 26.5% said that antiretroviral drugs were associated with side effects. As per predetermined knowledge scores, 79.4% had satisfactory knowledge regarding the treatment. A statistically significant (P = 0.03) relationship was observed between the knowledge scores regarding ART among the study participants and educational status while it was not statistically significant (P = 0.56) as regards duration of HIV positivity. Conclusion: There still exists a considerable gap in knowledge regarding treatment options for HIV/AIDS among the PLHA of this region. Hence, there is a need to increase the awareness regarding the same and implement the same into practice. Periodic counseling is necessary to increase awareness and to clear misconceptions about ART among PLHA.

A pilot study to evaluate the magnitude of association of the use of electronic personal health records with patient activation and empowerment in HIV-infected veterans.

The HITECH Act signed into law in 2009 requires hospitals to provide patients with electronic access to their health information through an electronic personal health record (ePHR) in order to receive Medicare/Medicaid incentive payments. Little is known about who uses these systems or the impact these systems will have on patient outcomes in HIV care. The health care empowerment model provides rationale for the hypothesis that knowledge from an electronic personal health record can lead to greater patient empowerment resulting in improved outcomes. The objective was to determine the patient characteristics and patient activation, empowerment, satisfaction, knowledge of their CD4, Viral Loads, and antiretroviral medication, and medication adherence outcomes associated with electronic personal health record use in Veterans living with HIV at the San Francisco VA Medical Center. The participants included HIV-Infected Veterans receiving care in a low volume HIV-clinic at the San Francisco VA Medical Center, divided into two groups of users and non-users of electronic personal health records. The research was conducted using in-person surveys either online or on paper and data abstraction from medical records for current anti-retroviral therapy (ART), CD4 count, and plasma HIV-1 viral load. The measures included the Patient Activation Measure, Health Care Empowerment Inventory, ART adherence, provider satisfaction, current CD4 count, current plasma viral load, knowledge of current ART, knowledge of CD4 counts, and knowledge of viral load. In all, 40 participants were recruited. The use of electronic personal health records was associated with significantly higher levels of patient activation and levels of patient satisfaction for getting timely appointments, care, and information. ePHR was also associated with greater proportions of undetectable plasma HIV-1 viral loads, of knowledge of current CD4 count, and of knowledge of current viral load. The two groups differed by race and computer access. There was no difference in the current CD4, provider satisfaction, Health Care Empowerment Inventory score, satisfaction with provider-patient communication, satisfaction with courteous and helpful staff, knowledge of ART, or ART adherence. The use of electronic personal health records is associated with positive clinical and behavioral characteristics. The use of these systems may play a role in improving the health of people with HIV. Larger studies are needed to further evaluate these associations.