Life Instability Associated with Lower ART Adherence and Other Poor HIV-Related Care Outcomes in Older Adults with HIV

Weinstein, Elliott R.; Harkness, Audrey; Ironson, Gail; Shrader, Cho‐Hee; Duncan, Dustin T.; Safren, Steven A.

doi:10.1007/s12529-022-10095-5

Cited by 7 publications

(5 citation statements)

References 43 publications

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“…It can be argued that for MA, a main principle for patients is to reach an economic stability, and after being sure of this stable condition, the patient is prepared for the treatment stage. Another study suggested that greater life instability among HIV patients could lead to poor health outcomes (in case of HIV disease) over and above the effects of depression, anxiety, and drug abuse 33 . Therefore, efforts to provide shelter for patients and reduce therapeutic costs, including health subsidies, as well as to shorten the waiting time to use the services provided by social welfare institutions can be effective in removing financial barriers to MA.…”

Section: Discussionmentioning

confidence: 99%

Relationship between self‐efficacy and adherence to antiretroviral therapy in HIV/AIDS patients: An analytical cross‐sectional study in southern Iran

Hosseini,

Ezati Rad,

Shahabi

et al. 2024

Health Science Reports

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Background and AimsThe human immunodeficiency virus (HIV) infection, also known as acquired immunodeficiency syndrome (AIDS), is spreading rapidly in the world, especially in developing countries, and is considered a serious health threat. This study aimed to assess the relationship of adherence antiretroviral therapy (ART) and self‐efficacy among people living with HIV.MethodsThis cross‐sectional study was conducted in March–July 2022 at the Center for Behavioral Diseases in Bandar Abbas. A total number of 208 HIV patients treated with ART entered the study after voluntarily signing an informed letter of consent. The data collection instrument was the adherence to ART questionnaire with the six subscales and the General Self‐Efficacy Scale‐17 (GSE‐17) general self‐efficacy questionnaire. Multivariate regression analysis was used to test the relationship among the variables.ResultsThe participants' mean age was 41.7 ± 8.2 years. Self‐efficacy was positively correlated with adherence ART. With every one score of increased self‐efficacy, MA increased for 0.85 score (p < 0.001) and medical challenges have the strongest correlation (r = 0.27) with self‐efficacy. The multivariable regression analysis showed that moderate and high socioeconomic status (SES) each improved MA for 18 and 22 units, respectively, compared to poor SES. Alcohol consumption reduced MA for 11 units.ConclusionThis study proved the positive relationship of self‐efficacy in adherence to ART in HIV patients. The insights offered by this research can help develop a systematic and effective intervention to promote MA in HIV patients. SES and alcohol consumption significantly affect MA.

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Section: Discussionmentioning

confidence: 99%

Relationship between self‐efficacy and adherence to antiretroviral therapy in HIV/AIDS patients: An analytical cross‐sectional study in southern Iran

Hosseini,

Ezati Rad,

Shahabi

et al. 2024

Health Science Reports

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“…Other COVID-19 pandemic-related factors such as inadequate transport, police abuse, insufficient transportation funds [ 61 ], lockdowns [ 62 ], limited access to health services, reduced income, inability to afford travel to health facilities or facemasks, fear of COVID-19 [ 54 ], and fear of visiting hospitals [ 55 ] could have had a greater impact on the life stability of older PLHIV. This instability has been correlated with a higher risk of missed medical appointments compared to their peers with less life chaos [ 63 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on people living with HIV: a cross-sectional study in Caracas, Venezuela

Forero-Peña,

Carrión-Nessi,

Forero-Peña

et al. 2024

BMC Infect Dis

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Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. Methods We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. Results A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31–55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. Conclusion This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.

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“…Some insurance payers mandate members to use specific specialty mail-order pharmacies for their specialty medications that often includes ART [ 19 ]. Typically, such mandates allow for cost savings for the payer but disallow patient pharmacy choice potentially complicating medication adherence for PWH affected by social disparities such as housing instability [ 5 , 20 ], inconsistent access to a telephone or other electronic communication devices, social isolation [ 21 ], and language barriers.…”

Section: Introductionmentioning

confidence: 99%

“…Reasons for ART non-adherence among PWH and those on PrEP are vast and include forgetfulness, substance use, medication access/cost, stigma, and other social factors such as housing instability, poverty, etc. [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Patient perspectives of antiretroviral pharmacy services: A cross-sectional cohort study

et al. 2023

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Background Adherence to antiretroviral therapy (ART) remains the main predictor of sustained HIV virologic suppression for people with HIV (PWH). Mail-order pharmacy services are often offered to patients as an alternative option to traditional pharmacy services. Some payers mandate ART to be dispensed from specific mail-order pharmacies regardless of patient choice complicating ART adherence for patients affected by social disparities. Yet, little is known about patient perspectives regarding mail-order mandates. Methods Eligible patients of the HIV program at University of Nebraska Medical Center with experience receiving ART from both a local and mail-order pharmacy were invited to complete a 20-question survey with three core sections: experiences/perspectives on local and mail-order pharmacy settings; pharmacy attributes rankings; and pharmacy preference. Paired t-tests and Mann-Whitney tests were used to compare the agreement scores of pharmacy attributes. Results Sixty patients (N = 146; 41.1%) responded to the survey. Mean age was 52 years. Most were male (93%) and White (83%). The majority of participants were on ART for HIV treatment (90%) and 60% were using mail-order pharmacies for their prescription services. Significant scoring differences (p<0.05) were observed for all pharmacy attributes favoring local pharmacies. Refilling ease was the most important attribute noted. More respondents (68%) preferred local pharmacies versus mail-order pharmacies. Payer associated mail-order pharmacy mandates were experienced by 78% with half believing the mandates impacted their medical care negatively. Conclusions In this cohort study, respondents preferred local pharmacies compared to mail-order pharmacy for ART prescription services and noted ease of refilling as the most important pharmacy attribute. Two-thirds of respondents believed mail-order pharmacy mandates negatively affected their health. Insurance payers should consider the removal of mail-order pharmacy mandates to allow patient choice of pharmacy, which may help remove barriers to ART adherence and improve long-term health outcomes.

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Life Instability Associated with Lower ART Adherence and Other Poor HIV-Related Care Outcomes in Older Adults with HIV

Cited by 7 publications

References 43 publications

Relationship between self‐efficacy and adherence to antiretroviral therapy in HIV/AIDS patients: An analytical cross‐sectional study in southern Iran

Relationship between self‐efficacy and adherence to antiretroviral therapy in HIV/AIDS patients: An analytical cross‐sectional study in southern Iran

The impact of the COVID-19 pandemic on people living with HIV: a cross-sectional study in Caracas, Venezuela

Patient perspectives of antiretroviral pharmacy services: A cross-sectional cohort study

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