People With HIV/AIDS Research Articles

Relationship Between The Compliance of Antiretroviral Therapy and The Occurrence of Underweight Conditions, Calf Circumference, Handgrip Strength, and Triceps Skinfold in HIV/AIDS Patients at RSSA Malang

Background: Human Immunodeficiency Virus or commonly known as HIV is a virus that infects CD4 cells thereby impaired the human immune system. The number of new HIV cases in Indonesia in 2019 was reported to have reached 50,282 cases and tends to increase from year to year. What often happens in people with HIV/AIDS (PLWHA) tends to experience weight loss accompanied by opportunistic infections that do not occur in normal people. Adherence to therapy is the main factor that must be emphasized by PLWHA in order to achieve treatment success. However, ARV therapy adherence rates are reported to be <80%. This number can be a predictor of therapy failure. One indicator of the success of therapy is when there is clinical improvement in the patient's condition, such as no opportunistic infections or weight gain. Aim: The aim of this study was to determine whether there is a relationship between adherence to antiretroviral therapy and underweight conditions in HIV/AIDS patients. Methods: This study used a cross sectional design with an analytical observational nature and the research subjects were patients at RSSA Malang who visited from June to August 2023. Results: The results of the study showed that there was a significant relationship between adherence to taking ARVs and being underweight (p=0.018) and there was no significant relationship between adherence to taking ARVs with calf circumference, handgrip strength, and triceps skinfold. Conclusion: The conclusion of this study is that the more compliant the patient is with ARV therapy, the higher the increase in body mass index and the smaller the possibility of becoming underweight.

Social Functioning of People with HIV/ AIDS (PLWHA) Receiving Antiretroviral Therapy in the City of Bengkulu

The problem in the research is the low number of people with HIV/AIDS (PLWHA) who take antiretroviral drug therapy in Bengkulu City. This occurs because of shame and fear of being stigmatized and discriminated against if other people find out about their status, causing their social functioning to be disrupted (Social Dyscpunction). The purpose of the study was to determine the benefits of antiretroviral drug therapy for people with HIV/AIDS (ODHA) in Bengkulu City on their social functioning. The research uses applied research methods, this research approach uses qualitative research. The research informants were 8 people with HIV/AIDS (ODHA), determined by the snowball sampling technique because the group or person as an informant could not be identified. Data collection techniques include observation, in-depth interviews, and documentation. The results of the research show that there are many benefits for people with HIV/AIDS (PLWHA) who take antiretroviral drug therapy in terms of their social functioning. The physical condition is healthier because antiretroviral drug therapy makes the immune system of PLWHA stable so that the development of viruses can be prevented. Psychologically, people with HIV/AIDS (PLWHA) become better because the therapy process provides a lot of knowledge about HIV/AIDS, thus eliminating fear and worry about the disease they suffer from, ultimately making PLWHA more confident and able to socialize and be able to carry out their social roles or functions. Based on the results of the research, researchers recommend that PLWHA with new status should immediately undergo antiretroviral drug therapy. It is also necessary to carry out interventions to empower families to always provide support to PLWHA, and make efforts to prevent and treat depression problems so that PLWHA remains empowered.

Family Support for People Living with AIDS in North Halmahera District

People with HIV/AIDS are people who have been positively infected with HIV/AIDS. Comprehensive family support, namely informational, emotional, rewarding and instrumental support can have a major impact on individuals to live a sustainable life. Family support for people with HIV/AIDS (PLWHA) in North Halmahera Regency shows that each respondent has different perceptions in terms of providing support to people with HIV/AIDS (PLWHA) stating that in providing 4 family support, namely informational support, emotional support, appreciation, and instrumental. Information support, respondents who stated that they provided informational support to people with HIV/AIDS, namely respondents 1, 4 and respondents 2, 3 stated that they did not provide or receive information support from their families. Emotional support, all respondents stated that they provide emotional support to people living with HIV/AIDS (PLWHA). Appreciation support, respondents who give awards to PLWHA in the form of appreciation support, namely respondents 1, and 4, while respondents 2 and 3, do not receive appreciation support so that respondent 2 experiences rejection in the social environment. While the instrumental support, instrumental support in this study, it can be concluded that respondents 1, 3, 4 provide instrumental support as a whole while respondent 2 only gets partial instrumental support.

HUBUNGAN TINGKAT PENGETAHUAN DAN SIKAP PETUGAS KESEHATAN DENGAN KEPATUHAN TERAPI ANTIRETROVIRAL (ARV) PADA ORANG DENGAN HIV/ AIDS DI PUSKESMAS TIKALA KOTA MANADO

Background: Human Immunodeficiency Virus (HIV) is a virus that damages the body's immune system by infecting and destroying CD4 cells so that it requires adherence in undergoing ARV therapy to maintain the patient's immune system. Aims: This study aims to identify the relationship between level of knowledge and adherence to antiretroviral therapy (ARV) in people with HIV/AIDS (PWHA) at the Tikala Community Health Center, Manado City. Methods: The research method used was cross sectional with a sample of 87 respondents who were selected using a purposive sampling technique. The ARV therapy adherence questionnaire uses a standard questionnaire, namely Morisky Medication Adherence Scale-8 (MMAS-8). Results: The results of this study indicate that most HIV/AIDS patients undergoing ARV therapy have a good level of knowledge where the attitude given by health workers can affect the level of comfort, trust, and satisfaction of PWHA during the treatment process which makes PWHA have good adherence to therapy. Conclusion: Support for health workers in serving PWHA which is very influential in building good relations between health workers and PWHA, especially in increasing adherence to undergoing ARV therapy to slow disease progression and improve quality of life.

Molecular diagnosis of opportunistic infections in the central nervous system of HIV-infected adults in Manaus, Amazonas.

Opportunistic infections in the central nervous system (CNS) of people with HIV/AIDS (PLWHA) remain significant contributors to morbidity and mortality, especially in resource-limited scenarios. Diagnosing these infections can be challenging, as brain imaging is non-specific and expensive. Therefore, molecular analysis of cerebrospinal fluid (CSF) may offer a more accurate and affordable method for diagnosing pathogens. We conducted extensive real-time PCR testing (qPCR) on CSF to evaluate etiological agents in PLWHA with neurological manifestations. Primers targeting DNA from specific pathogens, including cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), John Cunningham virus (JCV), Toxoplasma gondii, and human T-lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2), were used. Cerebrospinal fluid samples revealed 90 pathogens (36.7%). Toxoplasma gondii was the most frequently detected pathogen, found in 22 samples (30.5%). Other pathogens included Cryptococcus sp. (7.7%), EBV (5.3%), CMV, VZV, and JCV (4.0% each). Despite antiretroviral therapy and medical follow-up, opportunistic central nervous system infections remain frequent in PLWHA. Herpesviruses are commonly detected, but T. gondii is the most prevalent opportunistic pathogen in our study population. Therefore, molecular diagnosis is a crucial tool for identifying opportunistic infections, even in patients undergoing treatment.

Access, Participation, Control, and Advantage of Digital-Based Healthcare Service for Women Living with HIV/AIDS

Gender inequality contributes to HIV/AIDS transmission, increased number of women living with HIV/AIDS (WLHA), and women’s reduced ability of resolving this epidemic. Mobile Health (mH) is used to treat, support, and medicate more efficiently people with HIV/AIDS (PWHA) including WLHA. This research studies access, participation, control, and advantage of digital-based healthcare service to WLHA using Harvard’s gender analysis model. Informants employed in this exploratory research were Surakarta City’s Health Service Office, medical workers, nurses, administrative staffs, patients, NGO Caring for AIDS, WLHA, Peer Support Group, and Citizens caring for AIDS di Surakarta Indonesia. Data validity test was conducted using source triangulation and data was analyzed using an interactive model of analysis. Result shows that several digital platforms have been developed by Public Health Centers and Hospitals in Surakarta including telemedicine, telenursing, telepharmacy, website, youtube and social media for promotive, preventive, curative, and rehabilitative healthcare services to WLHA in Surakarta Indonesia. WLHA, public, and medical personnel in Surakarta Indonesia have participated in and access mH, despite gender inequality. The factor determining gender inequality in digital-based healthcare service is men’s domination in mastering digital-based health technology, negative stigma, and discriminative treatment given by medical personnel and public to WLHA. The use of mH by WLHA has positive impact on knowledge, stance, access, participation, decision, and changing behavior of WLHA and the medical personnel responsible for the service.

Trends in Human Immunodeficiency Virus-Related Knowledge and Stigma among Men Who Have Sex with Men in the Republic of Korea from 2012 to 2022.

To evaluate the trends in human immunodeficiency virus (HIV)-related knowledge and stigma among men who have sex with men (MSM) in the Republic of Korea between 2012 and 2022, five cross-sectional surveys were conducted. Though general knowledge of HIV infections is high, some misconceptions persist. The initial set of five questions in the survey maintained consistent levels of understanding throughout the five recurring surveys. Notably, the study found a consistent decrease in personal stigma toward people with HIV/AIDS (PWHA) within the MSM community in Korea. The increasing willingness of individuals to engage in social interaction with HIV-positive individuals, ranging from dining to cohabitation, indicated a positive change in societal attitudes. It is crucial to implement active policies such as counseling, testing, education, promotion, and the creation of preventive programs to improve knowledge about HIV and reduce stigma.

Konseling Pencegahan Depresi Pada Ibu Rumah Tangga Dengan HIV/AIDS Di Kabupaten Cirebon

The problems that usually arise in people with HIV/AIDS (PLWHA) are that apart from physical problems, there is also stigma, namely the bad social reaction towards people with HIV/AIDS. Such complex problems in PLWHA are accompanied by loss of social support such as lack of attention from family and community. This reaction is a bad experience for PLWHA where when they need support there is no one to help them, so depression often occurs in PLWHA. Depression in HIV AIDS sufferers can increase the risk of non-adherence behavior towards treatment resulting in a high risk of shorter survival. Failure to recognize and treat depression in HIV/AIDS sufferers not only endangers the patient but also endangers society. Research related to depression in PLWHA at Cipto Mangunkusumo Hospital, Jakarta, found that more than half of the patients experienced depression, namely 51.1%. The general aim of providing this counseling is so that PLWHA are able to overcome the depression they are experiencing. The design used in this community service is counseling with communication, information and education methods. The targets of this community service activity are housewives with HIV/AIDS in Cirebon district. From the preliminary study carried out, it was found that data on the problems that arise among PLWHA in Cirebon district cannot be separated from the emergence of psychological problems, this occurs because of feelings of sadness, disappointment, shame, fear of being ostracized by friends and family and fear of being abandoned by their husbands.

Ambient particulate matter and renal function decline in people with HIV/AIDS.

We aimed to explore the effect of particulate matter exposure on renal function in people with HIV/AIDS (PWHA). A total of 37 739 repeated measurements were conducted on eGFR levels, serum creatinine (Scr), and the triglyceride-glucose (TyG) index in 6958 PWHAs. The relationship between 1 and 28 day moving averages of particulate matter concentrations with Scr and eGFR was assessed using linear mixed-effects models. Modified Poisson regression models were employed to assess the associations of cumulative particulate matter exposure with the incidence of chronic kidney disease (CKD). Mediation analyses were used to examine the role of TyG index. Short-term exposure to particulate matter was related to reduced renal function. The strongest associations between exposure to particulate matter (PM) 1 , PM 2.5 , and PM 10 and percentage changes in eGFR were observed at 7-day moving average exposure windows, with a respective decrease of 0.697% (-1.008%, -0.386%), 0.429% (-0.637%, -0.220%), and 0.373% (-0.581%, -0.164%) per IQR increment. Long-term exposure to PM 1 , PM 2.5 , and PM 10 was positively linked with the incidence of CKD, with each IQR increment corresponding to fully adjusted RRs (95% CIs) of 1.631 (1.446-1.839), 1.599 (1.431-1.787), and 1.903 (1.665-2.175), respectively. TyG index-mediated 8.87, 8.88, and 7.58% of the relationship between cumulative exposure to PM 1 , PM 2.5 , and PM 10 and increased risk of CKD, respectively. Exposure to particulate matter among PWHAs is linked to reduced renal function, potentially contributing to increased CKD incidence, where the TyG index might serve as a partial mediator.

2393. Factors Associated with Time to COVID-19 Vaccination among People with HIV

Abstract Background The COVID-19 pandemic has significantly impacted at-risk populations, including people with HIV/AIDS (PWHA). Several reports indicate a higher risk of SARS-CoV-2 infection and mortality in PWHA compared to the general population. Despite an effective vaccine, PWHA with low CD4 count develop a weak immune response and are at risk of severe breakthrough infections. Vaccination gaps have been identified amongst PWHA, but factors associated with time to mRNA COVID-19 vaccine initiation and first booster have not been studied. Methods PWHA age ≥ 18 years, in HIV care at an urban clinic, and who completed the primary series of COVID-19 vaccines were invited to complete an online survey. Socio-demographic and clinical characteristics and COVID-19 vaccination motivators were assessed and complemented by a review of medical records. Statements on motivators to vaccination were rated on a 5-point Likert scale treated as ordinal data (minimum score 19, maximum 95). Factors associated with time to first COVID-19 vaccine and first booster were analyzed by the Kaplan-Meier method. Results A total of 129 patients enrolled; 83% (108/129) received the COVID-19 booster. Mean age was 50.3 (±10.9) years; 26.4% were female; 54.3% were Black, and 34.1% were White; 91.5% were non-Hispanic. The mean nadir CD4 count throughout their care was 309.4 (±245.6) cells/mm3. The mean time to first COVID-19 vaccine dose was 2.8 (±1.8) months from December 2020 (Pfizer-BioNTech vaccine approval), and time to first booster was 9.9 (±3.8) months from the date of the first vaccine. Factors associated with quicker uptake of the first dose included being ≥ 51 years of age (p=0.001), White race (p=0.027), male sex (p=0.023), and gay/lesbian identity (p=0.014) (Fig 1). Factors associated with quicker uptake of the first booster included being ≥ 51 years of age (p < 0.000) and a COVID-19 motivators’ survey score > 69 (p=0.017) (Fig 2). Figure 1. Kaplan-Meier Curves for Time to COVID-19 First Dose Vaccination Among People Living with HIV/AIDS Receiving HIV Care through Penn Medicine. Figure 2. Kaplan-Meier Curves for Time to COVID-19 First Booster Vaccination Among People Living with HIV/AIDS Receiving HIV Care through Penn Medicine. Conclusion We found high rates of COVID-19 booster vaccination among PWHA. White and male patients got vaccinated quicker in the early phase of the pandemic; however, race and age-based inequities resolved in the later phase of the pandemic. Motivation to vaccination emerged as a facilitator for uptake of booster vaccines. Disclosures All Authors: No reported disclosures

Determinants of Notification Factors for Spouses of People with HIV-AIDS (PLWHA) in Care, Support, and Treatment Services Mojokerto City

A person with reactive HIV status does not always feel the need to inform their partner about their status, therefore the government is seeking a program to open their HIV status through partner notification. the application of partner notifications in reality still does not meet expectations. The aim is to analyze the determinants of notification of spouses of people with HIV-AIDS (PLWHA) in Care, Support, and Treatment Services in Mojokerto City. Research design with a cross-sectional approach. A sample of 92 PLWHA was taken based on purposive sampling. The research instrument used the partner notification checklist from the Ministry of Health of the Republic of Indonesia. Test data analysis using multiple linear regression: ANOVA. The results of the study showed that factors related to the notification of PLHIV partners include; age (0.02), education (0.02), and occupation (0.01) significantly (<0.05). it was found that the application of partner notification was poorly practiced. Some of the patient’s reasons were unwilling to provide information about their partner, feel embarrased, did not want the partner to know about their HIV-AIDS status

MDR PULMONARY TB + HIV Stage 3 + SUSPECTED RIGHT LUNG TUMOR

Acquired Immunodeficiency Syndrome is a collection of symptoms and infections or syndromes that arise due to damage to the human immune system due to infection with the Human Immunodeficiency Virus (HIV). HIV is a virus that weakens immunity in the human body. Pulmonary tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis (M. Tb). Tuberculosis is the most common opportunistic infection in people with HIV/AIDS (PLWHA) in Indonesia, HIV infection facilitates Mycobacterium tuberculosis infection. Tumors are abnormal lumps in the body, which can be benign or malignant, which are usually caused by malignancy or infection. Malignancy is a group of diseases in which the cells spread abnormally and grow uncontrollably.Hypercoagulation is a blood coagulation disorder, namely a shift in hemostatic balance due to an increase in procoagulant factors. This tends to cause a thrombus. The coagulation process is influenced by inhibitory factors that maintain the clotting status of a thrombus. Purpose: The purpose of this writing is to discuss the disease regardingHIV + MDR Pulmonary TB + Suspected Right Lung Tumor + Hypercoagulabilityfrom definition to nutritional management so that patients can be treated properly.

The Relationship of Peer Social Support and Gratitude Towards the Meaningfulness of Life of People with HIV / AIDS (PLWHA)

Introduction: of life is one of the critical variables in the lives of PLWHA. Social support and gratitude are among the factors that influence the meaning of life. This study aims to determine the relationship between peer social support and gratitude with the meaning of life in PLWHA. Methods: The respondents of this study were 44 people. Data were collected using a questionnaire that had been validated and tested for reliability. Results: The results of hypothesis testing showed a positive relationship between social support (rxy = 0.409; p = 0.007; p < 0.05) and gratitude with meaning of life (rxy = 0.338; p = 0.029; p < 0.05) in PLWHA. Conslusion: This indicates that the higher the social support and gratitude, the better the meaning of life of PLWHA.

IDEAL Model Education to Increase Knowledge and Self-Care Practices for People with HIV/AIDS (PLWHA): Quasi-Experimental Study

IDEAL Model Education to Increase Knowledge and Self-Care Practices for People with HIV/AIDS (PLWHA): Quasi-Experimental Study

Profile of People With HIV-AIDS (PLWHA) During The Covid-19 Pandemic By Stress Levels

The COVID-19 pandemic presents complex problems, especially in the health sector, especially for people with HIV-AIDS (PLWHA), who are one of the groups vulnerable to COVID-19 transmission. Psychological responses shown by PLWHA are anxiety and stress. Various factors allegedly affect stress in PLWHA. This study aimed to determine the factors influencing stress levels in PLWHA during the covid-19 pandemic. The research design is descriptive-analytic with a cross-sectional approach using primary data. The sample of 34 people living with HIV in the Kediri area was obtained by purposive sampling. Inclusion criteria were PLWHA aged 20-55 years and cooperative. Exclusion criteria included people living with HIV with advanced complications or severe opportunistic infections. The instrument measuring stress uses the Depression Anxiety Stress Scale 42 (DASS 42). Analysis of the Spearman rank correlation test data showed that there was no relationship between gender and age with stress levels (ρ-value = 0.428 > =0.05, -value = 0.131>α=0.05), and there was a relationship between education, knowledge , social support with stress levels in PLWHA in the Kediri area (ρ-value = 0.000 > =0.05, (r)=-600), -value = 0.000 < =0.05, (r)=-0.658 , p-value < d =0.05, (r)=-799). Respondents can actively increase knowledge related to COVID-19 through accountable information media and be open with families, communities, and health workers to get high support from families, communities and health workers as a priority for vulnerable groups in efforts to prevent COVID-19.

Digital-Based Care Support and Treatment for People with HIV/AIDS: Challenges and Opportunities

HIV/AIDS preventing and overcoming attempts keep developing and adaptive to technology development. Information digitization era supports the innovation potentially optimizing healthcare service including HIV/AIDS preventing and overcoming attempts for people in Surakarta. Healthcare Service Work and Care Support and Treatment (CST) Group as one out of 6 work groups established by Surakarta City Government is also affected by information digitization. In addition to opportunities, CST healthcare digitization also generates challenges to both medical workers and patients. This research aims to explore challenges and opportunities in digital-based CST implementation for people with HIV/AIDS (PWHA) using Parsons’ modernization theory. Informant of research consisted of Surakarta City’s Health Service Office, medical workers, nurses, administrative staffs, patients, NGO Caring for AIDS, Peer Support Group, and Citizens caring for AIDS. Data were collected through observation, in-depth interview, and documentation. Data analysis was carried out by applying an interactive model through data collection, data reduction, data display, and conclusion drawing. Data validity test used in this study was data source triangulation. The result shows that digital-based CST provides opportunities and challenges in the attempt of preventing and overcoming HIV/AIDS in Surakarta City. CST digitization potentially improves the qualities of healthcare, promotive, preventive, curative, and rehabilitative services and reduces bad stigma, but the challenges include poor understanding of human resource, limited internet access, and inadequate equipment availability.

Analysis of Prevention of COVID-19 Transmission Measures in People with HIV-AIDS at Jumpandang Baru Public Health Center, Makassar City

In light of the COVID-19 pandemic, people with HIV-AIDS (PLWHA) are a population with a weakened immune system that requires more attention. People living with HIV-AIDS are advised to take the same precautions as the general public, including frequent hand washing, coughing etiquette, physical distancing, mask use, and medical attention in the event of symptoms. This study seeks to identify the factors associated with the prevention of COVID-19 transmission among HIV-positive patients at the Jumpandang Baru Public Health Center in Makassar.

376. Testing for Cytomegalovirus Viremia in People with HIV/AIDS- An Opportunity for Diagnostic Stewardship

Abstract Background Guidelines recommend against testing for cytomegalovirus (CMV) viremia as a screening tool for CMV end-organ disease (EOD) in people with HIV/AIDS (PWHA) due to low positive predictive value. Additionally, a negative result does not exclude EOD. In this study, we aim to assess the clinical utility of plasma CMV quantitative PCR (qPCR) for the diagnosis of CMV EOD and to determine if positive results lead to further testing for EOD or earlier initiation of anti-CMV therapy. Methods We retrospectively identified PWHA who had a plasma CMV qPCR result or who were diagnosed with CMV EOD between 2014-2021. qPCR results that were undetectable or less than the minimum quantifiable value (300 IU/mL) were considered negative and results >300 IU/mL were considered positive. EOD was confirmed via tissue biopsy, ophthalmic exam, or cerebrospinal fluid analysis. We compared CMV qPCR results for participants with proven EOD and those without proven EOD. For participants diagnosed with CMV EOD, we evaluated if a positive qPCR prompted further workup for EOD diagnosis or triggered anti-CMV therapy. Results We identified 138 PWHA with a CMV qPCR result and 17 PWHA with CMV EOD. Participant characteristics are shown in Table 1. Among participants with a qPCR result, 27 (19.6%) were positive; 13 (9.42%) of those with a qPCR results had EOD. 4 participants with EOD did not have qPCR. Participants with a positive qPCR were 4.55 (95% CI 2.63-7.90) times more likely to have EOD than those with a negative result. Table 2 shows qPCR results among participants with and without EOD. Table 3 shows the performance of qPCR for the diagnosis of EOD. 9 (69.2%) of 13 participants with EOD had a positive qPCR. 7 of them were diagnosed with EOD and started on treatment before the qPCR resulted. In 1 case, the qPCR resulted as positive on the same day ophthalmology diagnosed CMV retinitis. In only 1 case did a positive qPCR result and initiation of therapy precede the diagnosis of EOD. Conclusion Contrary to guidelines, clinicians often order plasma CMV qPCR on PWHA. Although PWHA who have CMV EOD are more likely to a have a positive qPCR than those without EOD, our data confirm CMV qPCR should not be used as a screening tool for EOD. Instead, clinical assessment should guide diagnostic investigation. Disclosures All Authors: No reported disclosures.

Religious coping strategies for people with HIV/AIDS (PLWHA) Muslims in Indonesia: A qualitative study with a telling-the-stories

ObjectiveThe purpose of this study is to find out more about the psycho-social-spiritual problems experienced by People with HIV/AIDS (PLWHA) Muslims and their efforts to overcome them by using religious coping. MethodsThis research is a qualitative research method with a telling-the-stories approach. This study describes assumptions about the physical/behavioral, social/emotional, cultural/historical, and spiritual aspects related to clinical participants' body, life, and power. In the context of this research, telling the stories from HIV/AIDS patients about how psycho-social-spiritual problems are experienced and efforts to overcome them with religious coping. This study involved 33 HIV/AIDS patients informants at Central General Hospital (RSUP) of Dr. Kariadi Semarang, Central Java with the criteria of being Muslim, medication adherence (ARV therapy). FindingsThe results showed that most PLWHA experienced physical complaints such as pain in the early days of taking ARVs, opportunistic infections such as Stevens-Johnson, dizziness, temporary blindness, and body stiffness. Psychological problems including stress, anxiety, fear of death, and guilt. The physical and psychological problems experienced by PLWHA encourage them to use religious coping such as praying, dhikr, and prayer. This religious coping has a calming effect, which impacts reducing physical complaints and overcoming psychological problems. The psychoneuroimmunology pathway can explain the physical and psychological relationship, which shows that favorable psychological conditions trigger the nerves to work optimally to increase immunity. DiscussionIn conclusion, religious coping can be used to overcome the bio-psycho-social-religious problems of PLWHA. This strengthens the application of holistic therapy to PLWHA through palliative care to handle pain and other physical complaints and psychosocial-spiritual concerns.

Low Dehydroepiandrosterone (DHEA) Level Is Associated with Poor Immunologic Response among People Living with HIV/AIDS.

Dehydroepiandrosterone (DHEA) is an adrenal steroid converted to potent androgens. This study aimed to discover the association between serum DHEA levels and immunologic response in people with HIV/AIDS (PLWHA). We enrolled patients aged ≥ 18 years who were treated with combination antiretroviral therapy (cART). We measured CD4+ and CD8+ T-cell counts, HIV-RNA titres, and serum DHEA levels. We assigned each patient to a good- or poor-responder group depending on their CD4+ T-cell counts at study enrolment. Participants with CD4+ T-cell counts > 200/µL were assigned to the good-responder group, whilst those with CD4+ T-cell counts < 200/µL were assigned to the poor-responder group. The participants were followed up for 2 years. The poor-responder group showed lower CD4+ T-cell counts and higher HIV PCR titres at their initial HIV diagnosis and in their 2-year follow-up data. Serum DHEA level was lower in the poor-responder group. Multivariable logistic analysis showed that BMI, initial CD4+ T-cell counts, and serum DHEA level were clinical factors associated with poor immunologic responsiveness to cART in PLWHA. Therefore, DHEA may be used as an indicator of the immunological recovery of PLWHA.