Barriers to Care, and Current Medical and Social Needs of HIV-Positive Patients in Albania

Morrison, Shane D; Banushi, Vilson H.; Sarnquist, Clea; Gashi, Valbona; Osterberg, Lars; Maldonado, Yvonne; Harxhi, Arjan

doi:10.21101/cejph.a3644

Cited by 9 publications

(21 citation statements)

References 28 publications

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“…Many challenges face patients that are seeking care for HIV/AIDS in Albania, yet this study evidences that once patients reach care, adherence to ART is high [10,13,14,[16][17][18]47]. Factors contributing to poor medication adherence include being partnered, mental health issues, higher levels of barriers to care, and higher current medical and social needs.…”

Section: Discussionmentioning

confidence: 92%

“…Each index was then treated as a continuous variable in analysis. The development of the indices along with their parameters was described previously [10,47]. SAS 9.1.3 was used to analyze the data.…”

Section: Methodsmentioning

confidence: 99%

“…The study was undertaken at the University Hospital Center of Tirana (UHCT) HIV/AIDS Ambulatory Clinic, as previously described [10,47]. Since 2004 this clinic has been the sole site offering ART in Albania [13].…”

Section: Study Settingmentioning

confidence: 99%

“…Other parts of the survey used in this study along with the steps taken to ensure proper translation into Albanian were described previously [10,47]. The adherence section of the survey was adapted from the survey on adherence from the AIDS Clinical Trials Group (ACTG) (Appendix 1) [48].…”

Section: Surveymentioning

confidence: 99%

“…Numerous barriers to care, and current medical and social needs have been demonstrated amongst HIV-positive patients in Albania [47]. This study aims to explore ART adherence in the HIV-positive population in Albania along with determining predictors of and barriers to adherence.…”

Section: Introductionmentioning

confidence: 99%

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Antiretroviral therapy adherence and predictors to adherence in Albania: a cross-sectional study

Morrison

Rashidi

Sarnquist

et al. 2014

J Infect Dev Ctries

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Introduction: The possibility of an HIV/AIDS epidemic in southeastern Europe (SEE) is not improbable. Thus, an understanding of the current issues surrounding HIV/AIDS care, specifically antiretroviral therapy (ART) adherence, in countries within SEE is critical. This study was conducted to determine the ART adherence characteristics of Albania's HIV-positive population. Methodology: This cross-sectional study reports initial demographic and adherence characteristics of patients receiving HIV/AIDS treatment in Albania. Retrospective review of pharmacy medications dispensed supplemented reported adherence behavior. Further, an adherence index was utilized to explore adherence more thoroughly.

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Section: Discussionmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Study Settingmentioning

confidence: 99%

Section: Surveymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antiretroviral therapy adherence and predictors to adherence in Albania: a cross-sectional study

Morrison

Rashidi

Sarnquist

et al. 2014

J Infect Dev Ctries

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Role of Community-Level Factors Across the Treatment Cascade

Underwood

Hendrickson

Lith

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Addressing community-level factors (CLFs) is integral to the ongoing effort to design multilevel, effective, and sustainable interventions to address each element of the HIV/AIDS treatment cascade. This review, the first critical review of this topic, identified 100 articles that (1) assessed CLFs in relation to the HIV/AIDS treatment cascade, (2) had been peer-reviewed, and (3) were based on studies conducted in low- or middle-income countries. Social support and social networks, cultural norms, gender norms, and stigma were the key CLFs associated with treatment and care. This extensive review found only 5 evaluations of interventions designed to affect CLFs, reflecting a major gap in the literature. All were communication interventions designed to create a more positive environment for HIV testing and access to treatment and care, thus pointing to some of the potential extraindividual effects of communication interventions. The qualitative data are rich and vital for understanding the context; yet, more quantitative analysis to provide evidence regarding the distribution of these factors is essential, as only 19 of the studies were quantitative. There is a pressing need to (1) collect community-level data, (2) validate social and gender norm scales, and (3) better use available data regarding social norms, gender norms, and other CLFs. These data could be aggregated at the cluster, neighborhood, or community levels and incorporated into multilevel analysis to help clarify the pathways to enhanced outcomes across the treatment cascade and thereby mitigate HIV sequelae.

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Addressing HIV stigma in healthcare, community, and legislative settings in Central and Eastern Europe

Schweitzer,

Dišković,

Krongauz

et al. 2023

AIDS Res Ther

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Introduction Surging HIV prevalence across countries of Central and Eastern Europe (CEE) is largely a result of poor HIV care engagement and a lack of comprehensive support for key populations. This is fostered by widespread stigma across healthcare, community, and legislative settings. Discussion Throughout CEE, HIV stigma and intersectional stigma are serious obstacles to providing adequate medical care to people living with HIV. Anticipated and enacted (experienced) stigma from healthcare professionals, and fears of breaches in confidentiality, deter individuals from having an HIV test and engaging in HIV care. Furthermore, negative connotations surrounding HIV infection can lead to discrimination from family, friends, colleagues, and the public, leading to internalized stigma and depression. Key populations that have higher HIV prevalence, such as men who have sex with men, people who inject drugs, transgender individuals, and sex workers, experience additional stigma and discrimination based on their behaviour and identities. This contributes to the concentrated HIV epidemics seen in these populations in many CEE countries. The stigma is exacerbated by punitive legislation that criminalizes HIV transmission and penalizes sexual orientation, drug use, gender identities, and sex work. Despite high levels of HIV stigma and intersectional stigma, there are many evidence-based interventions that have reduced stigma in other parts of the world. Here, we discuss the interventions that are currently being enacted in various countries of CEE, and we suggest additional effective, evidence-based interventions that will tackle stigma and lead to increased HIV care engagement and higher rates of viral suppression. We cover the promotion of the undetectable = untransmittable (U = U) message, stigma-reduction education and training for healthcare professionals, patient-centric approaches for testing and treatment, and advocacy for non-discriminatory legislation, policies, and practices. We also consider targeted stigma-reduction interventions that acknowledge the wider challenges faced by marginalized populations. Conclusions HIV stigma and intersectional stigma in CEE drive poor engagement with HIV testing services and care. Widespread adoption of evidence-based interventions to tackle stigma highlighted in this review will improve the quality of life of people living with HIV, improve HIV care engagement, and ultimately slow the surging HIV prevalence and concentrated epidemics occurring throughout CEE.

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Barriers to Care, and Current Medical and Social Needs of HIV-Positive Patients in Albania

Cited by 9 publications

References 28 publications

Antiretroviral therapy adherence and predictors to adherence in Albania: a cross-sectional study

Antiretroviral therapy adherence and predictors to adherence in Albania: a cross-sectional study

Role of Community-Level Factors Across the Treatment Cascade

Addressing HIV stigma in healthcare, community, and legislative settings in Central and Eastern Europe

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