Objective:The aim of this study was to identify the range and frequency of patient-reported barriers and facilitators to antiretroviral treatment (ART) adherence in sub-Saharan Africa (SSA).Design:Studies from 2005 to 2016 were identified by searching 10 electronic databases and through additional hand and web-searching.Methods:Inclusion criteria were HIV-positive adults taking ART based in any SSA country, qualitative study or quantitative survey and included at least one patient-reported barrier or facilitator to ART adherence. Exclusion criteria were only including data from treatment-naive patients initiating ART, only single-dose treatment, participants residing outside of SSA and reviews.Results:After screening 11 283 records, 154 studies (161 papers) were included in this review. Forty-three barriers and 30 facilitators were reported across 24 SSA countries. The most frequently identified barriers across studies were forgetting (n = 76), lack of access to adequate food (n = 72), stigma and discrimination (n = 68), side effects (n = 67) and being outside the house or travelling (n = 60). The most frequently identified facilitators across studies were social support (n = 60), reminders (n = 55), feeling better or healthier after taking ART (n = 35), disclosing their HIV status (n = 26) and having a good relationship with a health provider (n = 22).Conclusion:This review addresses the gap in knowledge by collating all the patient-reported barriers and facilitators to ART adherence in SSA. Current barriers measures need to be adapted or new tools developed to include the wide variety of factors identified. The factors that have the greatest impact need to be isolated so interventions are developed that reduce the barriers and enhance the facilitators.

Purpose Human papillomavirus (HPV) is the most common sexually transmitted virus worldwide. Our purpose was to examine people's experiences with HPV using narratives posted on a website entitled, Experience Project. Method We conducted a content analysis of 127 HPV narratives to identify stigma, emotion-focused and problem-focused coping, and misinformation. Results Negative self-image was the most commonly identified type of stigma. There were more instances of problem-focused than emotion-focused coping. Sources of confusion were mostly about HPV treatment and side effects/symptoms. Conclusions These findings have implications for how nurses and other health professionals can care for individuals living with HPV. Based on these findings, it would be beneficial for clinics/providers to implement on-line forums where myths about HPV can be debunked and accurate information provided. Both patients and the public need to be better informed about HPV, in order to decrease the negative stigma that can create a mental burden for individuals with HPV.

Few studies have assessed the underlying theoretical components of the Common Sense Model. Past studies have found, through implicit priming, that coping strategies are embedded within illness schema. Our aim was to evaluate the effect priming 'headache' illness schema upon attentional engagement to pain relief medication and to examine the interaction with illness treatment beliefs. Attentional engagement to the pain relief medication ('Paracetamol') was assessed using a 2 (primed vs. control) × 2 (strong belief in medication efficacy vs. weak belief in medication efficacy) design. During a grammatical decision task (identifying verbs/non-verbs), participants were randomised to receive a headache prime or a control. Response latency to the target word, 'Paracetamol' was the dependent variable. 'Paracetamol' treatment beliefs were determined using the brief illness perception questionnaire. Sixty-three participants completed the experiment. There was a significant interaction between illness-primed vs. control and high vs. low treatment efficacy of Paracetamol (p < .001), suggesting an attentional disengagement effect to the coping strategy in illness-primed participants whom held stronger treatment beliefs regarding the efficacy of Paracetamol. In summary, implicit illness schema activation may simultaneously activate embedded coping strategies, which appears to be moderated by specific illness beliefs.

Staphlycoccous aureus was present in large numbers. The patient was prescribed Nystaform Ò cream and oral flucloxacillin which has improved the appearance of the upper lips. The patient has been referred for patch testing, and also to gastroenterology for investigation. Discussion: Staphylococcal mucositis has been reported previously in a series of patients with OFG. This case demonstrates an unusual presentation of Staphylococcus aureus infection, previously unreported, in a child with OFG.