Antiretroviral adherence for adolescents growing up with HIV: understanding real life, drug delivery and forgiveness

Foster, Caroline; Ayers, Sara; Fidler, Sarah

doi:10.1177/2049936120920177

Cited by 22 publications

(25 citation statements)

References 75 publications

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“…In addition, they tend to solve problems associated with missed doses. In recent years, systems with the capacity to sustain drug release up to years have emerged as ultra-long-acting systems [ 80 , 85 , 121 , 122 , 123 , 124 , 125 ].…”

Section: Nanotechnology Approaches For Hiv/aids Treatmentmentioning

confidence: 99%

Nanosystems Applied to HIV Infection: Prevention and Treatments

Macchione

Bedoya

Figueroa

et al. 2020

IJMS

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Sexually-transmitted infections (STIs) are a global health concern worldwide as they cause acute diseases, infertility, and significant mortality. Among the bacterial, viral, and parasitic pathogens that can be sexually transmitted, human immunodeficiency virus (HIV) has caused one of the most important pandemic diseases, which is acquired immune deficiency syndrome (AIDS). 32.7 million people have died from AIDS-related illnesses since the start of the epidemic. Moreover, in 2019, 38 million people were living with HIV worldwide. The need to deal with this viral infection becomes more obvious, because it represents not only a problem for public health, but also a substantial economic problem. In this context, it is necessary to focus efforts on developing methods for prevention, detection and treatment of HIV infections that significantly reduce the number of newly infected people and provide a better quality of life for patients. For several decades, biomedical research has been developed allowing quick solutions through the contribution of effective tools. One of them is the use of polymers as vehicles, drug carrier agents, or as macromolecular prodrugs. Moreover, nanosystems (NSs) play an especially important role in the diagnosis, prevention, and therapy against HIV infection. The purpose of this work is to review recent research into diverse NSs as potential candidates for prevention and treatment of HIV infection. Firstly, this review highlights the advantages of using nanosized structures for these medical applications. Furthermore, we provide an overview of different types of NSs used for preventing or combating HIV infection. Then, we briefly evaluate the most recent developments associated with prevention and treatment alternatives. Additionally, the implications of using different NSs are also addressed.

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Section: Nanotechnology Approaches For Hiv/aids Treatmentmentioning

confidence: 99%

Nanosystems Applied to HIV Infection: Prevention and Treatments

Macchione

Bedoya

Figueroa

et al. 2020

IJMS

View full text Add to dashboard Cite

show abstract

“…In Malawi, a study of depression in ALHIV revealed a prevalence rate of 18.9% [ 1 , 2 , 4 ]. Depression is significantly linked to non-adherence to medication, making its diagnosis and treatment vital in the long-term survival of ALHIV [ 6 , 8 , 10 ]. Despite the high burden of depression and the availability of effective treatments, approximately 60% to 80% of affected adolescents do not receive appropriate care [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Child and adolescent primary care clinics are an important site for the identification of depression in adolescents, the critical first step in connecting youth to treatment [ 3 , 8 , 10 , 11 ]. However, depression remains poorly identified in such settings [ 9 , 10 ]. Research supports the screening of adolescents for depression in primary care [ 7 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, depression remains poorly identified in such settings [ 9 , 10 ]. Research supports the screening of adolescents for depression in primary care [ 7 , 9 , 10 ]. Further, studies suggest that non-systematic approaches, such as primary care providers’ reliance on presenting complaints and family concerns to identify depressed youth, yields severe under-identification [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Research supports the screening of adolescents for depression in primary care [ 7 , 9 , 10 ]. Further, studies suggest that non-systematic approaches, such as primary care providers’ reliance on presenting complaints and family concerns to identify depressed youth, yields severe under-identification [ 9 , 10 ]. Research has demonstrated that it is feasible to implement a depression screening and treatment program in primary care settings [ 7 , 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Barriers and facilitators to implementing the HEADSS psychosocial screening tool for adolescents living with HIV/AIDS in teen club program in Malawi: health care providers perspectives

Kip

Udedi

Kulisewa

et al. 2022

Int J Ment Health Syst

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Background Adolescents living with HIV (ALHIV) are at high risk of experiencing mental health problems. Depression is a major contributor to the burden of HIV-related disease amongst ALHIV and is significantly linked to non-adherence to anti-retroviral therapy (ART), yet it is under-recognized. In 2015, the Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) recommended that the psychosocial screening tool Home, Education, Activities, Drugs, Sexuality, Suicide/Depression (HEADSS) be used to screen ALHIV in Malawi who were part of an adolescent antiretroviral therapy program termed “Teen Club”. However, the HEADSS tool has been substantially under-utilized. This study assessed barriers and facilitators to implementing HEADSS for ALHIV attending Teen Club Program in four selected health facilities in Malawi. Methods We conducted a qualitative study using semi-structured interviews at four program sites (one district hospital and one health center each in two districts) between April and May 2019. Twenty key informants were purposively selected to join this study based on their role and experiences. We used the five domains of the Consolidated Framework for Implementation Research (CFIR) to guide the development of the interview guides, analysis and interpretation of results. Results Barriers included inadequate planning for integration of the HEADSS approach; concerns that the HEADSS tool was too long, time consuming, lacked appropriate cultural context, and increased workload; and reports by participants that they did not have knowledge and skills to screen ALHIV using this tool. Facilitators to implementing the screening were that health care providers viewed screening as a guide to better systematic counselling, believed that screening could build better client provider relationship, and thought that it could fit into the existing work practice since it is not complex. Conclusions A culturally adapted screening tool, especially one that can be used by non-clinicians such as lay health workers, would improve the ability to address mental health needs of ALHIV in many primary care and social service settings where resources for professional mental health staff are limited. These findings are a springboard for efforts to culturally adapt the HEADSS screening tool for detection of mental and risky behaviors among ALHIV attending ART program in Malawi.

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Health‐related needs reported by adolescents living with HIV and receiving antiretroviral therapy in sub‐Saharan Africa: a systematic literature review

et al. 2022

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Introduction Adolescents living with HIV (ALHIV) on antiretroviral therapy (ART) have specific health needs that can be challenging to deliver. Sub‐Saharan Africa (SSA) is home to 84% of the global population of ALHIV, of whom about 59% receive ART. Several studies in SSA have demonstrated health service gaps due to lack of synchronized healthcare for ALHIV receiving ART. We conducted a systematic review of health‐related needs among ALHIV on ART in SSA to inform decisions and policies on care. Methods We searched MEDLINE, Web of Science, EMBASE, PsycINFO, Cochrane library and grey literature for studies reporting health‐related needs among ALHIV receiving ART in SSA, between January 2003 and May 2020. Results and discussion Of the 2333 potentially eligible articles identified, 32 were eligible. Eligible studies were published between 2008 and 2019, in 11 countries: Zambia (7), Uganda (6), Tanzania (4), South Africa (4), Kenya (3), Ghana (2), Zimbabwe (2), Rwanda (1), Malawi (1), Botswana (1) and Democratic Republic of Congo (1). Seven categories of health needs among ALHIV were identified. In descending order of occurrence, these were: psychosocial needs (stigma reduction, disclosure and privacy support, and difficulty accepting diagnosis); dependency of care (need for family and provider support, and desire for autonomy); self‐management needs (desire for better coping strategies, medication adherence support and reduced ART side effects); non‐responsive health services (non‐adolescent friendly facility services and non‐compatible school system); need for food, financial and material support; inadequate information about HIV (desire for more knowledge to fight misinformation and misconception); and developmental and growth needs (desire to experience sex, parenthood and love). Ecological analysis identified different priority needs between ALHIV, their caregivers and healthcare providers, including psychosocial needs, financial challenges and non‐responsive health services, respectively. Conclusions To respond effectively to the health needs of ALHIV and improve ART adherence, interventions should focus on stigma reduction, disclosure challenges and innovative coping mechanisms for ART. Interventions that address the health needs of ALHIV from the perspective of carers and providers, such as financial support schemes and adolescent‐friendly healthcare strategies, should supplement efforts to improve adolescent ART adherence outcomes.

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Antiretroviral adherence for adolescents growing up with HIV: understanding real life, drug delivery and forgiveness

Cited by 22 publications

References 75 publications

Nanosystems Applied to HIV Infection: Prevention and Treatments

Nanosystems Applied to HIV Infection: Prevention and Treatments

Barriers and facilitators to implementing the HEADSS psychosocial screening tool for adolescents living with HIV/AIDS in teen club program in Malawi: health care providers perspectives

Health‐related needs reported by adolescents living with HIV and receiving antiretroviral therapy in sub‐Saharan Africa: a systematic literature review

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