Successful treatment outcomes for chronic hepatitis B virus (HBV) infection requires high levels of adherence to treatment. We searched three databases and abstracts from two conferences up to January 2018 for studies reporting the proportion of patients who were adherent to HBV antiviral therapy and pooled data using random effects meta‐analysis. We included 30 studies, providing data for 23,823 patients. Overall, adherence to treatment was 74.6% (95% confidence interval [CI] 67.1%‐82.1%). Adherence was similar in high‐income settings (75.1%; 95% CI, 65.4%‐85.0%) and in low‐income and middle‐income settings (72.9%; 95% CI, 57.8%‐88.0%). Reported barriers to adherence included forgetting, limited understanding of the importance of adherence, and change to routine. Conclusion: There is a need to reinforce assessment and reporting of adherence as a routine part of HBV care and to assess the extent to which evidence‐based interventions to improve adherence to medication for human immunodeficiency virus [HIV] and other chronic diseases are effective for HBV infection.
ObjectivesStudies have shown high rates of intimate partner violence (IPV) in women living with HIV, but data from the UK are lacking. We aimed to estimate the prevalence of IPV and identify associated factors in women attending our inner London HIV clinic. MethodsWe conducted a cross-sectional study of women attending our HIV clinic in May to December 2011. Participants completed a standardized questionnaire and exposure to IPV was ascertained using a validated tool. Clinical data were collected from patient records. Logistic regression models were fitted to estimate adjusted odds ratios (AORs). ResultsThis analysis was based on 191 women with available data on IPV. The median age of women was 38 years (range 21-71 years); 74.1% were African-born Black. Over half (99 of 191; 52%) reported experiencing IPV in their lifetime, with 27 of 191 (14.1%) reporting IPV within the past year and 27 of 191 (14.1%) reporting it in pregnancy. Lifetime experience of IPV was associated with mental health problems [AOR 3.44; 95% confidence interval (CI) 1.24-9.57; P < 0.05] and 'other' Black (born outside sub-Saharan Africa) ethnicity (AOR 4.63; 95% CI 1.06-20.11; P < 0.05). We also found an association between older age and decreased likelihood of lifetime IPV (AOR 0.92; 95% CI 0.86-0.97; P < 0.05). ConclusionsOver half of the women in this study reported lifetime experience of IPV. We found associations between IPV and mental health problems, younger age and other Black ethnicity. In view of its high prevalence, we advocate greater awareness of IPV among HIV healthcare professionals and recommend universal screening.
19Background: Tuberculosis (TB) poses a global health crisis requiring robust international and 20 country-level action. Adopting and implementing TB policies from the World Health Organization 21 (WHO) is essential to meeting global targets for reducing TB burden. However, many high TB burden 22 countries lag in implementing WHO recommendations. Assessing the progress of implementation at 23 national level can identify key gaps that must be addressed to expand and improve TB care. 24 Methods: In 2016/2017, Médecins Sans Frontières and the Stop TB Partnership conducted a survey 25 on adoption and implementation of 47 WHO TB policies in the national TB programs of 29 countries. 26Here we analyze a subset of 23 key policies in diagnosis, models of care, treatment, prevention, and 27 drug regulation to provide a snapshot of national TB policy adoption and implementation. We 28 examine progress since an analogous 2015 survey of 23 of the same countries. 29Results: At the time of the survey, many countries had not yet aligned their national guidelines with 30 all WHO recommendations, although some progress was seen since 2015. For diagnosis, about half 31 of surveyed countries had adopted the WHO-recommended initial rapid test (Xpert MTB/RIF). A 32 majority of countries had adopted decentralized models of care, although one-third of them still 33 required hospitalization for drug-resistant (DR-)TB. Recommended use of the newer drugs 34 bedaquiline (registered in only 6 high-burden TB countries) and delamanid (not registered in any 35 high-burden country) was adopted by 23 and 18 countries, respectively, but short-course (9-month) 36 and newer pediatric regimens by only 13 and 14 countries, respectively. Guidelines in all countries 37 included preventive treatment of latent TB infection for child TB contacts and people living with 38 HIV/AIDS, but only four extended this to adult contacts. 39 Conclusion:To reach global TB targets, greater political will is needed to rapidly adopt and 40 implement internationally recognized care guidelines. 41 102 *At the time of the survey, all countries were WHO-defined as high burden for TB, MDR-TB, or TB/HIV co-103 infection, except for Afghanistan, Armenia, and Georgia. 107Policy Adoption Questionnaire 108 A semi-structured questionnaire was developed between September and November 2016, to assess 109 the national adoption and implementation of 47 WHO TB policies and related practices in five key 110 areas: diagnostics; models of care; treatment regimens for drug-sensitive (DS) and DR-TB; 111 prevention; and drug regulatory environment. The policies included in the survey were selected 112 based on their importance reflecting a relatively recent optimization or improvement over a 113
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.