How are women living with HIV in France coping with their perceived side effects of antiretroviral therapy? Results from the EVE study

Abstract

ObjectiveSide effects of antiretroviral therapy (ART) can have a negative impact on health-related quality of life threatening long-term retention in HIV care and adherence to ART. The aim of the French community-based survey EVE was to document personal experiences with side effects, the related physician-patient communication, and solutions found to deal with them.DesignCross-sectional study of women between September 2013 to September 2014MethodsAn anonymous online questionnaire included the HIV Symptom Distress Module, which explores 20 symptoms.ResultsIn all, 301 women on ART participated in the study (median age: 49 years; median duration of ART: 14 years). They reported having experienced a median of 12 symptoms (Q1-Q3: 9–15) during the previous 12 months. Overall, 56% of them reported having found at least a partial solution to dealing with their symptoms. Women reporting financial difficulties were twice less likely to have found solutions to coping with their side effects (AOR: 0.5; 95% CI: 0.3–0.8). Feeling supported by the health-care provider (AOR: 2.1; 95% CI: 1.1–3.9) and being in contact with HIV/AIDS organisations (AOR: 1.9; 95% CI: 1.2–3.2) were positively associated with coping. Seventeen percent reported having modified their ART regimen to improve tolerance, with only 2 in 3 informing their physician afterwards. Reporting financial difficulties and living with more bothersome symptoms increased the risk of ART regimen modification without health-care provider consultation.ConclusionThe EVE study has called attention to the large number of side effects experienced by WLWHIV, only half of whom have found self-care strategies to manage their symptoms. Modification of ART regimen by the women themselves was not uncommon.

Coping Strategies for Adverse Effects of Antiretroviral Therapy among Adult HIV Patients Attending University of Gondar Referral Hospital, Gondar, Northwest Ethiopia: A Cross-Sectional Study

“…Most HIV patients in this study reported headache (48.2%). This finding is in agreement with other studies by Agu et al reported that headache (14.6%) in 2012, (9.4%)) in 2013 and France (34.6%) [18, 28, 29]. In this study gastritis (9.6%) was reported by HIV patients.…”

“…Some of these adverse effects are similar to other studies done in different countries [26, 28]. In this study fatigability (18%) was almost comparable to a study in San Francisco (17%), but much lower than studies in Uganda (67.5%) and France (73.4%) [7, 26, 28]. Loss of appetite (17.5%) was among the major adverse effects reported by study participants in this study which is almost similar to France study (16.9%), but lower than Ugandan study (53%) [26, 28].…”

“…In this study the most common adverse effects reported by the participants were headache (48.2%), fatigability (18%), loss of appetite (17.5%), burning sensation (13.2%), back pain (12.7%), itching (11.2%), and insomnia (10.7%). Some of these adverse effects are similar to other studies done in different countries [26, 28]. In this study fatigability (18%) was almost comparable to a study in San Francisco (17%), but much lower than studies in Uganda (67.5%) and France (73.4%) [7, 26, 28].…”

“…Although majority (91.1%) of the study participants were using positive emotion, there were also a significant number of patients (35.5%) who used nonadherence as a coping strategy in this study. Similarly, in other studies, 17% (France) [28], 14.4% (Nigeria) [18], and 27% (Uganda) [26] of HIV patients used nonadherence as coping strategy for adverse effect of ART.…”

Respective roles of migration and social deprivation for virological non-suppression in HIV-infected adults on antiretroviral therapy in France

“…This score is reliable when compared to the Townsend and the Carstairs indices and has been identified as an independent determinant of worse health status and premature mortality [10]. In different previous French studies, 58% of HIV-infected adults were classified as deprived using the EPICES score [11], 49% reported financial difficulties [12], 30% reported material deprivation [13]. The impressive level of deprivation in our study with nearly three over four participants classified as deprived using the EPICES score could be linked to the location of hospitals in two suburbs near Paris.…”