Patients Living With HIV/AIDS Research Articles

Changing Characteristics of Patients Living with HIV/AIDS After the COVID-19 Pandemic in Turkey.

The COVID-19 pandemic has substantially changed lives and presented several barriers to health services. HIV care continuum needs a high rate of diagnosis, effective treatment, and sustained suppression of viral replication. The COVID-19 pandemic has affected these three steps of HIV care. This study investigated the characteristics of newly diagnosed patients living with HIV/AIDS (PLWH) during the COVID pandemic and compared them with those before the pandemic. All newly diagnosed patients in three HIV healthcare centers, in Istanbul, Turkey, were included in the study. The pandemic period included April 1, 2020, to April 1, 2021, and the prepandemic period included March 1, 2019, to March 1, 2020. 756 patients were diagnosed with HIV/AIDS. In the pandemic period, this figure was 58% less: 315. Patients in the pre-pandemic and pandemic period had comparable age and gender distributions. PLWH diagnosed in the pandemic period had higher rates of low CD4 cells: low CD4 (<350 cells /mm3) was measured in 243 (36.4%) patients in the pre-pandemic period, while it was done in 126 (47.9%) in the pandemic period (p<0.01). Also, the distribution of CD4 cells was significantly different between periods: In the pandemic period, CD4 cell distribution significantly skewed to lower CD4 categories. Symptomatic patient rates and AIDS-defining disorder rates among symptomatic patients were comparable. Viral loads were not significantly different in the two periods. A low number of newly diagnosed PLWH can be explained by less HIV testing, less admission to health care, or an actual decrease of HIV prevalence during the pandemic. Sexual behaviors may have changed during the COVID-19 pandemic, leading to HIV transmission restriction. Lower CD4 counts among the newly diagnosed PLWH suggest that admittance to health care is late and a significant portion of PLWH remain undiagnosed.

Assessment of Knowledge and Attitude among MAHSA Medical Students towards HIV/AIDS

According to the Ministry of Health Statistics, there have been 87,710 confirmed HIV infectedcases in Malaysia. Objective: To determine how well MAHSA University medical studentsknew about HIV/AIDS. Method: This was a cross-sectional questionnaire-based studyconducted at MAHSA University's School of Medicine. The surveys focused on differentmechanisms of transmission, high-risk behaviours, and prevention strategies. Result: A total of360 medical students participate in this study. Medical students in pre-clinical years hadsubstantially higher knowledge ratings than those in clinical years (p=0.045). Comfortablenessdealing with HIV/AIDS patients had the highest stigmatizing score (3.78 ± 0.86). Attitudestoward imposed measures had the lowest stigmatization score (mean 2.60 ± 0.62), knowledgescore is significantly correlate with stigmatizing attitude (P=0.004). In addition, higherknowledge scores were shown among medical students who reported to have previousencounters with patients living with HIV/AIDS (PLWHA) (p&lt;0.001). Knowledge scores weresignificantly low among the patients living with HIV (PEWHIV) (4.2 ± 1.67) (P=0.019).Concerning mother to child transmission of HIV/AIDS infection, clinical medical studentsshowed higher degree of knowledge as compare with preclinical years medical students with P&lt;0.05. Conclusion: The knowledge of medical students in Mashsa University is generallyhigh, awareness of HIV transmission from mother to child through breast milk is still lacking,indicating that this is the most significant feature that has to be stressed and improved in futuremedical curriculum for better health care services and public education.

New Jersey FQHC Process Improvement Increases Oral Health Access for HIV Patients

Introduction: Patients living with HIV/AIDS (PLWHA) have more unmet oral health care needs than the general population, outpacing unmet medical needs [1]. Poor oral health can impact a person’s confidence and ability to speak, eat, work, sleep, and socialize [2]. Lack of access to dental care is a national issue for HIV patients; providing access is a challenge faced by many health centers and practices, including Zufall Health in New Jersey, a federally qualified health center (FQHC). In collaboration with Northeast/Caribbean AIDS Education and Training Center (NECA AETC), Zufall embarked on an initiative to improve access to quality dental care for PLWHA. AETC is the training component of the Ryan White Program, a federally funded program that provides medical care, support services, and medications for PLWHA who are low income, uninsured, or underserved [3-5]. Materials and Methods: In 2019, Zufall Health launched a quality improvement project to increase oral health access and services for Ryan White patients by integrating all partners involved in providing health care: medical, dental, psychological, behavioral, and HIV/AIDS providers and case managers. The project goal was to increase the number of patients receiving dental care to improve oral and overall health. Results/Observations: As a result of the project, there were significant quantitative and qualitative improvements in the oral health and quality of life of PLWHA: more dental encounters, a higher percentage of patients with a dental home, and the surpassing of the project goal of a 10% increase in dental referrals.

Patients\u2019 high acceptability of a future therapeutic HIV vaccine in France: a French paradox?

BackgroundFrance is the European country with the lowest level of confidence in vaccines. Measurement of patients’ acceptability towards a future therapeutic HIV vaccine is critically important. Thus, the aim of this study was to evaluate patients’ acceptability of a future therapeutic HIV vaccine in a representative cohort of French patients living with HIV-AIDS (PLWHs).MethodsThis multicentre study used quantitative and qualitative methods to assess PLWHs’ opinions and their potential acceptance of a future therapeutic HIV vaccine. Cross-sectional study on 220 HIV-1 infected outpatients, aged 18–75 years.ResultsThe participants’ characteristics were similar to those of the overall French PLWH population. Responses from the questionnaires showed high indices of acceptance: the mean score for acceptability on the Visual Analog Scale VAS was 8.4 of 10, and 92% of patients agreed to be vaccinated if a therapeutic vaccine became available. Acceptability depended on the expected characteristics of the vaccine, notably the duration of its effectiveness: 44% of participants expected it to be effective for life. This acceptance was not associated with socio-demographic, clinical (mode of contamination, duration of disease), quality of life, or illness-perception parameters. Acceptability was also strongly correlated with confidence in the treating physician.ConclusionThe PLWHs within our cohort had high indices of acceptance to a future therapeutic HIV vaccine.Trial registrationThis study was retroactively registered on ClinicalTrials.gov with ID: NCT02077101 in February 21, 2014.

Hepatitis B infection among HIV infected individuals in Gabon: Occult hepatitis B enhances HBV DNA prevalence.

In Gabon, a central African country, human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are endemic. In a recent study, conducted in a semi-urban area (Franceville, Gabon), HBV infection was found to be more prevalent among HIV infected individuals. This study aims to investigate the prevalence and genetic diversity of hepatitis B virus infection among HIV infected individuals, predominantly under antiretroviral therapy, living in fully urbanized area: Libreville, capital of Gabon. Serological and molecular tests were performed to detect HBV infection among patients living with HIV/AIDS (PLHA). We used Monolisa HBsAg ULTRA, Anti-HBc Plus and Anti-HBs Plus EIA kits for serological analyses. HBV DNA viral load (HBV DNA VL) was determined by real time PCR and molecular characterization of HBV strains was performed by sequencing and phylogenetic analysis of partial HBV surface and core genes. At all, 70.2% of patients were under antiretroviral therapy. The prevalence of HBsAg was 8.8% (43/487). Detectable HBV DNA was found in 69.7% (30/43) of HBsAg positive patients and in 17.5% (24/137) HBsAg negative patients. HBV DNA VL was significantly higher among patient with CD4 cell counts less than 200 cells/mm3 than those with CD4 cell counts greater than 500 cells/mm3 (p = 0.008). We confirmed the presence of HBV sub-genotypes QS-A3 (40%), and A4 (20%) and HBV-E genotype (40%). The percentage of resistance to Lamivudine was high (40%) and varied according to the M204V/I motif. Occult hepatitis B infection (OBI) was found in patients with isolated HBcAb and among patients who had completed their HBsAg seroconversion. We detected HBV DNA for one patient without any HBV serological marker. This study provides a new landmark for the comprehension of HBV infection in PLHA in urban areas. OBI enhances HBV DNA prevalence and should be investigated in all HBsAg negative individuals.

Knowledge and Attitudes of HIV Infected Patients on the Adverse Effects of Antiretroviral Medicines in Ghana

Antiretroviral Therapy (ART) is effective in reducing morbidity and mortality in patients living with HIV/AIDS (PLWHA). However, Adverse Effects (AEs) to ART pose major problems and threaten adherence to therapy. We evaluated the knowledge and attitudes of patients to ART following routine adherence counselling and education in the Korle Bu Teaching Hospital in Accra, Ghana. This cross-sectional study was conducted by administering a questionnaire on socio-demographics, knowledge of AEs of antiretrovirals and attitude to AEs to 98 patients who were on antiretroviral therapy. A 3-point Likert-scale was used to assess knowledge of AEs of ART and a 5 point Likert-scale to assess attitudes to AEs. Mean rated scores for attitude to AEs were estimated and factor analysis was used to reduce the dimensions of the attitudes observed to identify relevant latent constructs. Sixty one percent of participants were females and most of the participants were aged 35-44 years (35%). Ninety nine percent of participants answered that they had been counselled on unpleasant effects of their medicines and 93% knew that all medicines could cause some unpleasant effects. Concerning attitude, 90% of study participants strongly agreed that they benefit from their medicines and get better taking them (mean rated score=4.87 ± 0.49) whilst 27% strongly agreed that medicines may have side effects (mean rated score=3.12 ± 1.55). Majority of the study participants (74%) strongly disagreed that there was no need to tell their doctor/pharmacist about AEs to antiretrovirals (mean rated score=4.60 ± 0.83). Factor analysis yielded two underlying dimensions (cognitive and behavioural/affective aspects) that described participants’ attitude towards AEs. Study participants rating for participants’ knowledge on AEs was good and exhibited positive attitudes to AEs of ART. Adherence counselling and education provided to PLWHA before initiation of antiretroviral therapy is beneficial and should be continued.

Patients infected by tuberculosis and human immunodeficiency virus facing their disease, their reactions to disease diagnosis and its implication about their families and communities, in Burkina Faso: a mixed focus group and cross sectional study.

BackgroundPatients facing tuberculosis (TB) and human immunodeficiency virus (HIV) infection receive particular care. Despite efforts in the care, misconceptions about TB and HIV still heavily impact patients, their families and communities. This situation severely limits achievement of TB and HIV programs goals. This study reports current situation of TB patients and patients living with HIV/AIDS (PLWHA) facing their disease and its implications, by comparing results from both qualitative and quantitative study design.MethodsCross sectional study using mixed methods was used and excluded patients co-infected by TB and HIV. Focus group included 96 patients (6 patients per group) stratified by setting, disease profile and gender; from rural (Orodara Health District) and urban (Bobo Dioulasso) areas, all from Hauts-Bassins region in Burkina Faso. Quantitative study included 862 patients (309 TB patients and 553 PLWHA) attending TB and HIV care facilities in two main regions (Hauts-Bassins and Centre) of Burkina Faso.ResultsA content analysis of reports found TB patients and PLWHA felt discriminated and stigmatized because of misconceptions with its aftermaths (rejection, emotional and financial problems), mainly among PLWHA and women patients. PLWHA go to healers when facing limited solutions in health system. There are fewer associations for TB patients, and less education and sensitization sessions to give them opportunity for sharing disease status and learning from other TB patients. TB patients and PLWHA still need to better understand their disease and its implication. Access to care (diagnosis and treatment) remains one of the key issues in health system, especially for PLWHA. Individual counseling is centered among PLWHA but not for TB patients. With research progress and experiences sharing, TB patients and PLWHA have some hope to implement their life project, and to receive psychosocial and nutritional support.ConclusionDespite international aid, TB patients and PLWHA are facing misconceptions effects. There is a need to reinforce health education towards patients and healers, inside community, health centers and associations, and for specific settings. International aid must be adapted to specific targets and strategies implementing programs. Maintaining psychosocial and nutritional support is crucial for better outcomes of medication adherence. Individual counseling has to be centered among TB patients and PLWHA.

Eastern Caribbean Physicians' Responses to Providing HIV/AIDS Care in Resource-Limited Settings: We've Come a Long Way, but We're Not There Yet.

Physicians' ability to provide care to patients living with HIV/AIDS (PLWHA) in the Eastern Caribbean is influenced by economic constraints, sociocultural norms that govern interpersonal interactions, and the pervasive stigma linked to the disease. Although the economic environment determines national capacity to acquire various treatment and monitoring technologies, Eastern Caribbean physicians respond to practicing in a resource-limited setting by making choices that are influenced by the collectivist ethos that governs interpersonal relationships. Through qualitative interviews, the study finds that the social stigma associated with the disease requires physicians to "go the extra mile" to provide care in ways that allow PLWHA to protect their privacy in small, closely networked societies.

Analysis of Information, Impact and Control of HIV amongst Dental Professionals of Central India.

Dental health care providers may be exposed to a variety of microorganisms via blood, oral or respiratory secretions. Though the risk of transmission of Human Immunodeficiency Virus (HIV) in dental settings is low, the consequences of being infected are life threatening. Therefore, high standards in infection control and waste management are required in controlling occupational contagion and cross infection. To obtain comprehensive information about the HIV related information, its impact on the health care provider's attitude towards treating patients living with HIV/AIDS (PLWHA), infection control & waste disposal practices among dental professionals of Malwa region of Madhya Pradesh; situated in Central India. A cross-sectional survey was conducted among 320 private dental practitioners. Data was collected using a pretested, self administered 40 item questionnaire and statistically analysed. The response rate was 81.25%. Over all 50.76% dentists were graded as having good knowledge of HIV. Unfortunately, their willingness to treat these patients remained low. In all 39.23% dentist were willing to render care to PLWHA. Junior dentists expressed less hesitation with regard to acceptance of risk patients than other dentists. Over 65% of the respondents reported adherence to universal precautions. The most alarming observation was that dentists were not following safe waste management practices. Dental professionals continue to indicate a reluctance to treat patients with HIV/AIDS or those in high- risk groups. The results suggest need to have a comprehensive motivational program and implementing ways to ensure access and availability of safe dental care for PLWHA. The desire to get training on how to handle PLWHA illustrates that receptiveness to change exists.

P4.103 Assessing Intentions of Dentists For Provision of Dental Treatment to the Patients Living with HIV/AIDS (PLWHAs) in Pakistan

A cross-sectional survey was carried out in Balochistan province in Pakistan to assess the intentions of dentists to provide dental treatment to the patients living with HIV/AIDS. All dentists of...

Public Health Hospital pharmacists’ knowledge about and attitude toward HIV/AIDS and patients living with HIV/AIDS in Kedah, Malaysia

IntroductionThe current study aims to explore the knowledge, attitude, and perception of hospital pharmacists towards HIV/AIDS and patients living with HIV/AIDS (PLWHA) in the state of Kedah, Malaysia.Material and methodsThis was a cross-sectional study conducted among the hospital pharmacists in three government hospitals in Kedah, using a self-administered 43-item questionnaire. Data analysis was done using non-parametric and multinomial regression.ResultsA total of 75 respondents participated in this study, resulting in a response rate of 60.8%. The majority were found to be well aware of the causes of HIV/AIDS. However, about 34 (45.3%) believed erroneously that HIV/AIDS cannot be transmitted through tattooing or body piercing. Nearly 25 (33.3%) of the respondents believed that preventing the use of intravenous drugs may not be effective to prevent HIV/AIDS and endorsed social isolation as a measure to prevent HIV/AIDS. The majority (66.6%) had negative attitudes and about 20% held extremely negative attitudes. Findings from regression modelling revealed that hospital (–2 log likelihood = 215.182, χ2 = 18.060, Df = 8, p = 0.021) and gender (–2 log likelihood = 213.643, χ2 = 16.521, Df = 8, p = 0.035) were more likely to affect the attitudes of respondents.ConclusionsOverall, more than one third of the respondents were found to have negative attitudes towards PLWHA. Gender, job experience, and hospitals with more HIV/AIDS patient visits were the main factors affecting attitudes.

Empathy and avoidance in treating patients living with HIV/AIDS (PLWHA) among service providers in China

This study aims to investigate health care providers' empathy levels and its association with avoidance in providing service to patients living with HIV/AIDS (PLWHA) in China. A total of 1760 health service providers were randomly sampled from 40 county hospitals in two provinces of China. Using a self-administered questionnaire, participants' demographic characteristics, work history, empathy level, and avoidance attitudes toward PLWHA were collected in a cross-sectional survey. Empathy was higher among participants aged 31–40 years, those who had an associated medical degree, and those who had served in the medical profession for less than 20 years. Nurses, younger providers, and providers with lower education tended to avoid contact with PLWHA. Multiple linear regression model showed that a higher level of empathic attitude toward patients was significantly negatively associated with avoidance attitude toward PLWHA. Service providers' empathy level plays an important role in providing quality care to HIV-infected patients. Future stigma reduction interventions should cultivate empathy as a platform for understanding, effective communication, and trusting provider–patient relationships. PLWHA could potentially benefit from attitudinal change in medical settings.

HIV-related avoidance and universal precaution in medical settings: opportunities to intervene.

To determine the association between adherence to universal precaution (UP) and avoidance attitudes toward patients living with HIV/AIDS (PLH) among service providers. A total of 1,760 health service providers were randomly selected from 40 county hospitals in two provinces of China. A self-administered questionnaire was used to collect demographic characteristics, UP knowledge and training, UP adherence, availability of UP supplies at work, and avoidance attitudes toward PLH in a cross-sectional survey. A series of regression models were used to examine associations among the UP-related factors and their relationship to avoidance attitudes toward PLH. UP training was associated with better knowledge of and adherence to UP and perceived availability of UP supplies in hospitals. UP training, knowledge, and adherence were significantly associated with avoidance attitudes toward PLH in medical practice. Being a nurse was also related to HIV-related avoidance. UP promotion campaigns, including in-service training and reinforcement of UP adherence, could play an important role in the battle against HIV-related avoidance in medical settings. Intervention programs should focus on not only individual providers' attitudes and behaviors but also on structural support for norms shifts in the medical community.

User fees and access to ARV treatment for persons living with HIV/AIDS: implementation and challenges in Burkina Faso, a limited-resource country

Access to antiretroviral (ARV) treatment remains a crucial problem for patients living with HIV/AIDS (PLWHA) in limited-resources countries. Some African countries have adopted the principle of providing ARV free of charge, but Burkina Faso opted for a direct out-of-pocket payment at the point of care delivery, with subsidized payments and mechanisms for the poorest populations to receive these services free of charge. Our objectives were to determine the proportion of PLWHA who pay for ARV and to identify the factors associated with ARV access in Burkina Faso. A cross-sectional study was performed in 13 public health facilities, 10 Nongovernmental Organizations and association health facilities, and three faith-based health facilities. In each facility, 20 outpatients receiving ARV were interviewed during a routine clinic visit. A multivariate analysis by logistic regression was performed. Among the expected 520 patients receiving ARV, 499 (96.0%) were surveyed. The majority of patients (79%) did not pay for their ARV treatment, thereby limiting cost recovery from patient payments. In a multivariate analysis, level of education and income were associated with free access to ARV. Patients with no education more frequently received free ARV than those who had received some level of education (OR 2.7, 95% CI [1.3–5.6]). Patients without any income or with less than US$10 per month were more likely to receive free ARV (OR 2.6 [95% CI 1.3–5.2]) than those who earned more than US$10 per month. However, 16% of patients without any income and 21% of those without employment paid for ARV, and the costs of drugs for opportunistic infections, food, and transport remained a burden for 85%, 91%, and 74%, respectively, of those who did not pay for ARV. Free access to a minimum care package for every PLWHA would enhance access to ARV.

Stigma, social reciprocity and exclusion of HIV/AIDS patients with illicit drug histories: A study of Thai nurses' attitudes

BackgroundStigma is a key barrier for the delivery of care to patients living with HIV/AIDS (PLWHA). In the Asia region, the HIV/AIDS epidemic has disproportionately affected socially marginalised groups, in particular, injecting drug users. The effect of the stigmatising attitudes towards injecting drug users on perceptions of PLWHA within the health care contexts has not been thoroughly explored, and typically neglected in terms of stigma intervention.MethodsSemi-structured interviews were conducted with a group of twenty Thai trainee and qualified nurses. Drawing upon the idea of 'social reciprocity', this paper examines the constructions of injecting drug users and PLWHA by a group of Thai nurses. Narratives were explored with a focus on how participants' views concerning the high-risk behaviour of injecting drug use might influence their attitudes towards PLWHA.ResultsThe analysis shows that active efforts were made by participants to separate their views of patients living with HIV/AIDS from injecting drug users. While the former were depicted as patients worthy of social support and inclusion, the latter were excluded on the basis that they were perceived as irresponsible 'social cheaters' who pose severe social and economic harm to the community. Absent in the narratives were references to wider socio-political and epidemiological factors related to drug use and needle sharing that expose injecting drug users to risk; these behaviours were constructed as individual choices, allowing HIV positive drug users to be blamed for their seropositive status. These attitudes could potentially have indirect negative implications on the nurses' opinions of patients living with HIV/AIDS more generally.ConclusionDecreasing the stigma associated with illicit drugs might play crucial role in improving attitudes towards patients living with HIV/AIDS. Providing health workers with a broader understanding of risk behaviours and redirecting government injecting drug policy to harm reduction are discussed as some of the ways for stigma intervention to move forward.

Sistemas de información: internet, acceso y uso por trabajadores de salud y personas viviendo con VIH/SIDA

The National Institute of Health developed NETLAB, a Web based information system that increases the availability of laboratory results to health workers and patients living with HIV / AIDS (PLWHA) in HAART. To assure its effectiveness it is necessary to explore issues available like resources access to Internet Objectives: To describe the characteristics of Internet access and NETLAB access by potential users and the IT infrastructure in places where HAART is administered. Methods: We included 48 public and private health facilities where HAART is administered for 23 departments for Peru. 3 questionnaires were prepared, one for health professionals, another for PLWA and another for informatics specialists from each center. Results: We included in the survey 246 health workers, 201 PLWA and 45 informatics workers. 95,5% of the health workers reported they know how use the Internet, 62,6% had Internet connection with in his offices. 85% knew about NETLAB, but only 36% had an access code. 50,7% of PLWA knew how to use Internet (85,5% in Lima and 47,7% in provinces p<0,01). 81% access trough the public Internet booths (“cabinas publicas”) and 93% are interesting accessing their lab results trough the Internet. All the health facilities have Internet access though the quality of the connection is very heterogeneous. Discussion: The high proportion of health workers who knew how and uses the Internet is encouraging and favors the introduction and the use of NETLAB and communications technology. The access gap between PLWA in Lima and regions and the high frequency of use of public Internet booths represent a challenge but also opportunities to promote the use of NETLAB in this group.

Knowledge and attitudes of nursing students toward patients living with HIV/AIDS (PLHIV): A Turkish perspective

The aim of this study was to assess the knowledge and attitudes towards HIV/AIDS of nursing students in Turkey. HIV/AIDS has become one of the most serious health problems in the world. It is important to understand nursing students’ knowledge and attitudes towards people living with HIV (PLHIV) because the educational preparation of nurses has been known to affect the attitudes of the nurse and the effectiveness of the care provided to PLHIV. The study was conducted with 227 nursing students from the School of Health in Antalya, Turkey during the calendar year 2005/2006. Qualitative and quantitative methods were both used to collect data for the study. Analysis of variance, t-test, Mann-Whitney U-test, Kruskal-Wallis and inductive methods were used in data analysis. The majority of nursing students in this study had a moderate level of HIV/AIDS knowledge. Students correctly answered 64.4% of HIV/AIDS-related questions in the questionnaire (Mean 28.99; SD 7.03 out of 45 points). Scores increased parallel with student grade (F=26.925; p=0.000) and age (X2 (K−W)=35.117; p=0.000). Fear of being infected and feelings of pity and empathy were the feelings most commonly indicated by the students. Students who had previous experience in caring for an AIDS patient and had known someone with HIV/AIDS were willing to care for PLHIV. Results underline the need to strengthen education on all aspects of HIV/AIDS. To improve nursing students willingness to care for PLHIV, particular emphasis should be placed on the training of nursing students as skilled nursing staff with humane attitudes towards PLHIV.