Antiretroviral Therapy Interruption Among HIV Postive People Who Use Drugs in a Setting with a Community-Wide HIV Treatment-as-Prevention Initiative

McNeil, Ryan; Coleman, Bill; Maher, Lisa; Milloy, M‐J; Small, Will

doi:10.1007/s10461-016-1470-2

Cited by 26 publications

(40 citation statements)

References 51 publications

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“…While requirements of a treatment regimen (e.g., number of pills, health care visits, and dosing restrictions) may increase risk for TRF, other patient characteristics (e.g., social support, quality of life, and cultural beliefs) may serve as protective factors. A recent qualitative study of 39 PLWH who used drugs in Vancouver, Canada underscored the importance of social and structural factors that may underlie the onset of TRF and result in ART treatment interruptions (McNeil et al, 2017). Specifically, prior negative experiences with early and complex ART regimens (e.g., side effects, development of drug resistance) emerged as a perceived factor associated with TRF.…”

mentioning

confidence: 99%

Development of a Conceptual Etiological Model of Treatment Regimen Fatigue Among Patients Engaged in HIV Care: A Qualitative Study

Claborn¹,

Miller²,

Meier³

et al. 2017

Journal of the Association of Nurses in AIDS Care

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Treatment regimen fatigue (TRF) is a decreased desire and motivation to maintain vigilance in adhering to treatment, and little is known about TRF in people living with HIV. We aimed to develop a conceptual framework of TRF. Five focus groups were conducted in 2014. Eligible participants were (a) HIV-infected, (b) at least 18 years of age, (c) prescribed antiretroviral therapy, and (d) fluent in English. Data were analyzed using thematic analysis. Analyses revealed these themes: patient experiences of TRF; etiological factors at the systems, provider, and patient levels; strategies to manage TRF; consequences of TRF; and protective factors that prevent the occurrence of TRF. The results provided a conceptual framework for future investigations to build on in an effort to improve adherence and retention in HIV care. Study results indicate avenues for intervention at multiple levels (systems, provider, and patient) to reduce treatment burden and improve patient resources and capacity.

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mentioning

confidence: 99%

Development of a Conceptual Etiological Model of Treatment Regimen Fatigue Among Patients Engaged in HIV Care: A Qualitative Study

Claborn¹,

Miller²,

Meier³

et al. 2017

Journal of the Association of Nurses in AIDS Care

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“…In correctional systems, issues in relation to difficulty accessing HIV medications were reported in two qualitative studies by McNeil et al [66] and Small et al [62] in Canada. In the two studies, some participants complained about the unavailability of HIV medication between the times of arrest, trial and arrival at the institution where they served their sentence, and upon release from custody [62,66]. As such, these structural factors increased the challenge of drug users' access to HIV care.…”

Section: Accessibility and Conditionality Of Hiv And Addiction Treatmentmentioning

confidence: 98%

“…Seven studies reported that HIV-positive drug users/inmates had experienced stigmatization and discrimination associated with HIV and illicit drug use [57,59,61,62,[64][65][66]. Some experienced violence in the prison settings [62] and others were shunned and discriminated against by family [57,[64][65][66], police officers [59] and health professionals [61,65,67] due to their HIV status. In addition to HIV status, participants' engagement in the everyday violence associated with their drug dependence appeared to exacerbate their negative image portrayed by society [66].…”

Section: Stigmatization In Relation To Hiv and Illicit Drug Usementioning

confidence: 99%

“…The impact of stigmas related to HIV and illicit drug use not only impeded HIV-positive drug users' acquisition of support, but worsened their psychological distress, self-stigmatization and willingness to seek support Adherence to antiretroviral medications [59,63,65,66]. With feelings of denial, shame and fear of stigmatization, some tended to not disclose their HIV status and were more likely to hide or not bring HAART medications with them [59,64,65].…”

Section: Stigmatization In Relation To Hiv and Illicit Drug Usementioning

confidence: 99%

“…Although HAART and addiction treatments play an important role in facilitating HIV-positive individuals' adherence to HAART, some drug users articulated difficulty in accessing HIV and addiction care [52,57,[60][61][62]66,67]. The accessibility of HIV and addiction care varied from country to country.…”

Section: Accessibility and Conditionality Of Hiv And Addiction Treatmentmentioning

confidence: 99%

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What do HIV‐positive drug users’ experiences tell us about their antiretroviral medication‐taking? An international integrated literature review

Holloway

Stenhouse

2019

Addiction

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Background and aims HIV‐positive drug users’ poor adherence to antiretroviral regimens can pose a significant and negative impact on individual and global health. This review aims to identify knowledge gaps and inconsistencies within the current evidence base and to measure HIV‐positive drug users’ adherence rates and the factors that influence their adherence. Methods A search of quantitative and qualitative studies in relation to HIV‐positive drug users’ adherence to antiretroviral treatment was performed using five databases: Applied Social Sciences Index and Abstract (ASSIA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and PsycINFO (Ovid interface). Relevant studies were retrieved based on the inclusion and exclusion criteria stated in the review. Findings were compared, contrasted and synthesized to provide a coherent account of HIV‐positive drug users’ adherence rates and the factors that influence their adherence. Results The proportion of HIV‐positive drug users who achieved ≥ 95% adherence across the studies varied widely, from 19.3 to 83.9%. Adherence rates changed over the course of HIV treatment. The factors that influenced adherence were reported as follows: stigmatization, motivation, active drug use, accessibility and conditionality of HIV and addiction care, side effects and complexity of treatment regimens, forgetfulness and non‐incorporation of dosing times into daily schedules. Conclusions HIV‐positive drug users’ medication‐taking is a dynamic social process that requires health professionals to assess adherence to HIV treatment on a regular basis.

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“It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia

Chayama

Small

et al. 2021

J Int AIDS Soc.

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Introduction People living with HIV (PLHIV) who use illicit drugs (other than or in addition to cannabis) are living longer due to antiretroviral therapy (ART). Older PLHIV who use drugs have an increased risk for comorbidities, and managing multiple health conditions is a growing concern among this population. However, in‐depth understandings of the lived realities and complexities of living with HIV alongside comorbidities among older PLHIV who use drugs remain limited. We sought to explore how older PLHIV who use drugs manage their comorbid conditions in a setting with universal ART access. Methods Between January 2019 and March 2020, semi‐structured, in‐depth interviews were conducted in Vancouver, Canada with 42 older PLHIV who use drugs and were living with at least one comorbidity. All participants were currently on ART, and had initiated treatment at least 2 years prior to the interviews. Data were analysed using inductive and deductive approaches. Results Several themes were identified through this analysis. First, comorbidities were perceived as more urgent health concerns and prioritized over HIV. Second, stigma and discrimination hindered access to care for comorbidities. Third, the concurrent management of HIV and comorbidities was often challenging due to unmanaged or poorly managed comorbidities. Fourth, the potential impact of ART on the development of comorbidities was a source of concern and frustration. Finally, integrated treatment approaches facilitated engagement with HIV and comorbidities care. Conclusions Our findings underscore the need for HIV care to shift from a primary focus on managing HIV to an integrated, patient‐centred approach that addresses both HIV and non‐HIV‐related health needs, as well as an equitable and non‐judgemental delivery of such care for an ageing population of PLHIV who use drugs.

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Antiretroviral Therapy Interruption Among HIV Postive People Who Use Drugs in a Setting with a Community-Wide HIV Treatment-as-Prevention Initiative

Cited by 26 publications

References 51 publications

Development of a Conceptual Etiological Model of Treatment Regimen Fatigue Among Patients Engaged in HIV Care: A Qualitative Study

Development of a Conceptual Etiological Model of Treatment Regimen Fatigue Among Patients Engaged in HIV Care: A Qualitative Study

What do HIV‐positive drug users’ experiences tell us about their antiretroviral medication‐taking? An international integrated literature review

“It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia

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