To Take or Not to Take: Decision-Making About Antiretroviral Treatment in People Living with HIV/AIDS

Kremer, Heidemarie; Ironson, Gail; Schneiderman, Neil; Hautzinger, Martin

doi:10.1089/apc.2006.20.335

Cited by 58 publications

(55 citation statements)

References 33 publications

(8 reference statements)

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“…Conversely, when spirituality is a source of meaning and growth and important in medical decision making, PLWH are often comforted by sharing beliefs with their clinician. [15][16][17][18][48][49][50]52 This is why clinicians should not defer the spiritual assessment to others, although providing spiritual interventions is best left to experts in spiritual care. 47 Koenig et al 47 dovetails our own experience that we as clinicians benefit too from bringing spirituality back to medicine by experiencing both greater work and patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

“…18 Third, spirituality plays a role in medical decision-making, adherence, quality of life, and clinician-patient relationship. 12,15,16,18,[48][49][50]52 Finally, it is important to assess the spiritual needs in order to identify people who may benefit from spiritual intervention. Potentially, spirituality-based interventions may aid in trauma treatment, as some experimental studies suggest.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal Spiritual Coping with Trauma in People with HIV: Implications for Health Care

Kremer

Ironson

2014

AIDS Patient Care and STDs

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This 10-year study (N = 177) examines how people with HIV use spirituality to cope with life's trauma on top of HIV-related stress (e.g., facing death, stigma, poverty, limited healthcare) usual events. Spirituality, defined as a connection to a higher presence, is independent from religion (institutionalized spirituality). As a dynamic adaptive process, coping requires longitudinal studying. Qualitative content-analysis of interviews/essays yielded a coding of specific aspects and a longitudinal rating of overall spiritual coping. Most participants were rated as spiritual, using spiritual practices, about half experienced comfort, empowerment, growth/transformation, gratitude, less than one-third meaning, community, and positive reframing. Up to one-fifth perceived spiritual conflict, struggle, or anger, triggering post-traumatic stress, which sometimes converted into positive growth/transformation later. Over time, 65% used spiritual coping positively, 7% negatively, and 28% had no significant use. Spirituality was mainly beneficial for women, heterosexuals, and African Americans ( p < 0.05). Results suggest that spirituality is a major source of positive and occasionally negative coping (e.g., viewing HIV as sin). We discuss how clinicians can recognize and prevent when spirituality is creating distress and barriers to HIV treatment, adding a literature review on ways of effective spiritual assessment. Spirituality may be a beneficial component of coping with trauma, considering socio-cultural contexts.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Longitudinal Spiritual Coping with Trauma in People with HIV: Implications for Health Care

Kremer

Ironson

2014

AIDS Patient Care and STDs

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“…S & D associated with HIV is a complex social process which interacts with and reinforces existing S & D associated with gender, race and poverty (Vanden Driessche et al, 2009). Numerous studies have documented attitudes of healthcare providers toward people living with HIV (PLHIV) (Chan et al, 2008, Kremer et al, 2006, Oku et al, 2013, Vanden Driessche et al, 2009. Although the literature characterizes the attitudes and behaviour of healthcare providers as positive and respectful, many studies also report poor communication between patients and healthcare providers (Chan et al, 2008, Kremer et al, 2006, which functions as a major barrier in providing proper care for these patients (Tawfik and Kinoti, 2001).…”

Section: Introductionmentioning

confidence: 99%

Stigma and discrimination associated with HIV/AIDS in health care settings: a comparative study in two hospitals of different categories in Douala-Cameroon

Essomba¹,

Kollo²,

Ngambi³

et al. 2014

J. Med. Biomed. Sci.

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The response to the human immunodeficiency virus epidemic faces many challenges with stigma and discrimination being two of them. The aim of this study is to determine the extent of effects of stigmatization and discrimination against people living with HIV-AIDS, and the influence of the type of hospital structure, in the manifestations of stigma and discrimination. A prospective cross sectional study was conducted among a total of 400 patients, using a pre-tested questionnaire. An observation form was also filled to evaluate attitudes and behaviour of health care providers towards patients. Chi-Square test and Fisher test were used to test association between two variables, then multi logistic regression tests were done to check predictive factors of discrimination. The level of significance was chosen at p<0.05. Among the participants, 104 (26%) patients reported having been victims of discrimination. Laquintinie hospital of Douala has a risk factor for blames and maltreatment (p = 0.0060) and (p= 0.0091) respectively. Also 152 (76.1%) patients of Laquintinie vs 103 (51.5%) of Nylon have been victims of stigmatization. The stigmatizing elements were: the name of the treatment center (p<0.0001) and the unconfidential manner of handling medical files (p=0.0527). Among the 400 patients, fifty nine (14.8%) avoided going to the hospital because of past experience of stigma and discrimination. Patients encounter several difficulties and those related to stigma and discrimination experienced in a hospital milieu can particularly constitute obstacles to better health seeking and therapeutic adherence. The human immunodeficiency virus infection response strategy should address stigma and discrimination by reviewing the management of treatment centers, elaborating relevant public health policies and training of healthcare practitioner.

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“…Some studies have also identified patient level barriers to the use of health services among people with substance abuse histories. For instance, research conducted with people living with HIV/AIDS found that individuals' decisions to take or not to take antiretroviral treatment were influenced by their perceptions about the treatment and alternative therapies, spirituality, and desire to avoid adverse side effects (Kremer, Ironson, Schneiderman, & Hautzinger, 2006). However, few studies have explored HCV-positive drug users' attitudes about HCV pharmacological therapy or the decisions they make when contemplating HCV treatment.…”

Section: Introductionmentioning

confidence: 99%

Exploring drug users’ attitudes and decisions regarding hepatitis C (HCV) treatment in the U.S.

Munoz-Plaza

Strauß

Astone-Twerell

et al. 2008

International Journal of Drug Policy

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Individuals with a history of injecting drugs are at the highest risk of becoming infected with the hepatitis C virus (HCV), with studies of patients in methadone maintenance treatment programmes (MMTPs) reporting that 60-90% of intravenous drug users (IDUs) have the virus. Fortunately, HCV therapy has been shown to be effective in 42-82% of all patients with chronic HCV infection, including IDUs. While the decision to start HCV therapy requires significant consideration, little research exists that explores the attitudes of drug users toward HCV therapy. Therefore, this paper examines how drug users perceive the treatment, as well as the processes by which HCV-positive individuals examined the advantages and disadvantages of starting the HCV medications. Interviews were conducted with 164 patients from 14 drug treatment programmes throughout the United States, and both uninfected and HCV-positive drug users described a pipeline of communication among their peers that conveys largely negative messages about the medications that are available to treat HCV. Although many of the HCV-positive individuals said that these messages heightened their anxiety about the side effects and difficulties of treatment, some patients said that their peers helped them to consider and/or initiate HCV treatment. Gaining a better understanding of drug users' perceptions of HCV treatment is important, because so many of them, particularly IDUs, are already infected with HCV and may benefit from support in addressing their HCV treatment needs. In addition, currently uninfected drug users will likely remain at high risk for contracting HCV and may need to make decisions about whether or not to start the HCV medical regimen in the future.

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To Take or Not to Take: Decision-Making About Antiretroviral Treatment in People Living with HIV/AIDS

Cited by 58 publications

References 33 publications

Longitudinal Spiritual Coping with Trauma in People with HIV: Implications for Health Care

Longitudinal Spiritual Coping with Trauma in People with HIV: Implications for Health Care

Stigma and discrimination associated with HIV/AIDS in health care settings: a comparative study in two hospitals of different categories in Douala-Cameroon

Exploring drug users’ attitudes and decisions regarding hepatitis C (HCV) treatment in the U.S.

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