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Muccini C, Castagna A. HIV Pol: does it offer therapeutic targets for HIV? Expert Opin Ther Targets 2024:1-3. [PMID: 38696265 DOI: 10.1080/14728222.2024.2351510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/01/2024] [Indexed: 05/04/2024]
Affiliation(s)
- Camilla Muccini
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
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Bedert M, Moody K, Nieuwkerk P, van Holten N, de Wit J, van der Valk M. Between delivering chronic care and answering patients' burdens: Understanding HIV specialist nurses' experiences in the age of treatment. J Adv Nurs 2024; 80:1943-1954. [PMID: 37983876 DOI: 10.1111/jan.15941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/14/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
AIM(S) To understand the experiences of HIV nurses in the context of ambivalence between biomedical treatment advancements and the continuing burden for people living with HIV and negative representations of HIV. DESIGN An interpretative phenomenological study was conducted using in-depth interviews. METHODS Twenty-one interviews with nurses were conducted between November 2021 and March 2022. A thematic analysis was performed. RESULTS Six themes related to the nurses' experiences emerged. Despite effective treatment for most people with HIV, nurses identify patient populations that require additional care. Nurses are flexible in making extra appointments to accommodate complex issues in these patients. Nurses develop a unique relationship with their patients based on trust and empathy, linked to patient's experiences with stigma and discrimination for people with HIV. Nurses perceive their tasks as becoming increasingly complex. There is explicit awareness about the changes in HIV care from acute to chronic care and how this affects nurses' tasks. Nurses continue to differentiate HIV from other chronic conditions. CONCLUSION Biomedical advancements change the organization of HIV care while public health concerns remain and patient population has particular needs due to negative social representations of HIV. Nurses navigate these issues in their everyday care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE A potential re-evaluation of the role of nurses in providing chronic HIV care. IMPACT Our study addresses the roles of HIV nurses as care is shifting towards chronic care models. The unique relationship between nurses and patients is key in understanding the importance of nurses in the care trajectory. These findings impact the institutional role of nurses in HIV treatment centres and the institutional organization of HIV care. REPORT METHOD The COREQ guideline was used. PATIENT OR PUBLIC CONTRIBUTION Amsterdam UMC (AMC) staff, the national organization of HIV Nurses and patient organizations contributed to the study design.
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Affiliation(s)
- Maarten Bedert
- Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Kevin Moody
- Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Pythia Nieuwkerk
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Natasja van Holten
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - John de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Marc van der Valk
- Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, The Netherlands
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Zhabokritsky A, Klein M, Loutfy M, Guaraldi G, Andany N, Guillemi S, Falutz J, Arbess G, Tan DHS, Walmsley S. Non-AIDS-defining comorbidities impact health related quality of life among older adults living with HIV. Front Med (Lausanne) 2024; 11:1380731. [PMID: 38690177 PMCID: PMC11058201 DOI: 10.3389/fmed.2024.1380731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/18/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction The life expectancy of people living with HIV receiving effective combination antiretroviral therapy is approaching that of the general population and non AIDS-defining age-related comorbidities are becoming of greater concern. In order to support healthy aging of this population, we set out to explore the association between multimorbidity (defined as presence of 2 or more non AIDS-defining comorbidities) and quality of life (QoL). Methods We performed a cross-sectional analysis using data from the Correlates of Healthy Aging in Geriatric HIV (CHANGE HIV) study, a Canadian cohort of people living with HIV age 65 years and older. Study participants completed two QoL modules, the general QoL and health related QoL (HR-QoL). Results 433 participants were included in the analysis with a median age of 69 years (interquartile range, IQR 67-72). The median number of comorbidities among study participants was 3 (IQR 2-4), with 78% meeting the definition of multimorbidity. General QoL scores (median 66, IQR 58-76) were lower than HR-QoL scores (median 71, IQR 61-83) and were not associated with multimorbidity after adjusting for age, sex, relationship status, household income, exercise, tobacco smoking history, malnutrition, time since HIV diagnosis, and HIV-related stigma. In contrast, multimorbidity was associated with lower HR-QoL (adjusted β = -4.57, 95% CI -8.86, -0.28) after accounting for the same variables. Several social vulnerabilities (not having a partner, low household income), health behaviours (lower engagement in exercise, smoking), and HIV-related factors (HIV stigma, longer time since HIV diagnosis) were also associated with lower QoL. Discussion Overall, our study demonstrated a high burden of multimorbidity among older adults living with HIV in Canada, which has a negative impact on HR-QoL. Interventions aimed at preventing and managing non-AIDS-defining comorbidities should be assessed in people living with HIV to determine whether this can improve their HR-QoL.
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Affiliation(s)
- Alice Zhabokritsky
- Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Marina Klein
- Department of Medicine, McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Mona Loutfy
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Giovanni Guaraldi
- Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Nisha Andany
- Department of Medicine, Sunnybrook Health Science Centre, University of Toronto, Toronto, ON, Canada
| | - Silvia Guillemi
- BC Centre for Excellence in HIV/AIDS, University of British Columbia, Vancouver, BC, Canada
| | - Julian Falutz
- Department of Medicine, McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Gordon Arbess
- Unity Health Toronto, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Darrell H. S. Tan
- Unity Health Toronto, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sharon Walmsley
- Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
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Boardman E, Boffito M, Chadwick DR, Cheserem E, Kabagambe S, Kasadha B, Elliott C. Tackling late HIV diagnosis: Lessons from the UK in the COVID-19 era. Int J STD AIDS 2024; 35:244-253. [PMID: 38016099 PMCID: PMC10908195 DOI: 10.1177/09564624231202287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
INTRODUCTION Late diagnosis of HIV is associated with increased morbidity and mortality, and an increased risk of non-infectious comorbidities. On a societal level, late diagnosis leads to higher treatment and healthcare costs and is a major driver of HIV transmission. Despite improvements in other areas of the HIV care pathway, late diagnosis remains an individual and public health concern globally. OBJECTIVE To examine the barriers to HIV testing and highlight successful strategies to improve prompt diagnosis. This review describes the prevalence of late diagnosis in the UK and discusses key factors that contribute to late diagnosis, including the effect of the COVID-19 pandemic. Late HIV diagnosis is lower in the UK than in most other European countries. In this review, pilot projects and ongoing initiatives that have reduced late diagnosis in the UK are highlighted; moreover, further strategies for improving prompt diagnosis are suggested. CONCLUSIONS Insufficient testing is the fundamental reason for late HIV diagnosis, with societal, systemic, and individual factors all contributing to inadequate testing. Improving access to testing, removing barriers to health-seeking behaviour, and ensuring all people with HIV indicator conditions are promptly tested are key to reducing the rates of late diagnosis globally.
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Affiliation(s)
- Emily Boardman
- The Northern Contraception, Sexual Health and HIV Service, Manchester Royal Infirmary, Manchester, UK
| | - Marta Boffito
- Chelsea and Westminster Hospital, London, UK
- Imperial College London, London, UK
| | | | | | | | - Bakita Kasadha
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Noorman MAJ, de Wit JBF, Marcos TA, Stutterheim SE, Jonas KJ, den Daas C. Engagement of HIV-negative MSM and partners of people with HIV in HIV cure (research): exploring the influence of perceived severity, susceptibility, benefits, and concerns. AIDS Care 2024:1-12. [PMID: 38319908 DOI: 10.1080/09540121.2024.2307381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024]
Abstract
ABSTRACTAs the prospect of an HIV cure is gaining prominence, engaging key populations affected by an HIV cure becomes essential. This study examined the engagement of HIV-negative men who have sex with men (MSM) and/or partners of people with HIV (PHIV) in the Netherlands. Interviews were conducted with 19 MSM not in relationships with a partner with HIV and 16 partners of PHIV and were thematically analyzed. Perspectives on the importance of an HIV cure were shaped by the perceived severity of HIV and the level of susceptibility to the virus. Despite concerns about potential new HIV infections and treatment intensity, most participants believed that an HIV cure could reduce HIV burden. Both HIV eradication and HIV suppression were regarded as acceptable outcomes. Engagement was demonstrated through actions like accessing information, participating in research, and showing support for partners or community members involved in HIV cure research. In conclusion, we found that most participants were engaged due to their heightened perception of HIV's severity. However, this engagement tended to remain passive due to their perceived low susceptibility to HIV, resulting in a scenario where the perceived importance of an HIV cure is high, while personal relevance remains low.
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Affiliation(s)
- Maaike A J Noorman
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - Tamika A Marcos
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Sarah E Stutterheim
- Department of Health Promotion and Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Kai J Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Chantal den Daas
- Department of Health Promotion and Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Barger D, Hessamfar M, Neau D, Farbos S, Leleux O, Cazanave C, Rouanes N, Duffau P, Lazaro E, Rispal P, Dabis F, Wittkop L, Bonnet F. Factors associated with poorer quality of life in people living with HIV in southwestern France in 2018-2020 (ANRS CO3 AQUIVIH-NA cohort: QuAliV study). Sci Rep 2023; 13:16535. [PMID: 37783722 PMCID: PMC10545822 DOI: 10.1038/s41598-023-43434-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/23/2023] [Indexed: 10/04/2023] Open
Abstract
We evaluated people living with Human Immunodeficiency Virus' (PLWH) quality of life (QoL) and assessed whether their demographic, disease-related, socioeconomic, or behavioral characteristics were associated with poorer QoL. ANRS CO3 AQUIVIH-NA cohort participants (Nouvelle Aquitaine, France) were recruited to a cross-sectional study (2018-2020) and their QoL assessed (WHOQOL-BREF). We calculated median (Q1, Q3) QoL domain scores and assessed factors associated with poorer median QoL using bivariable and multivariable quartile regression. Of the 965 PLWH included, 98.4% were on antiretroviral therapy, 94.7% were virally-suppressed, 63.5% reported good/very good QoL. Median scores (0-100) were highest for physical (69;Q1, Q3: 56, 81) and environmental (69; 56, 75) QoL and lowest for social (56; 44, 69) and psychological (56; 44, 69) QoL. PLWH with ≥ 3 comorbidities, HIV-related stigma, or income of < 1500€/month had poorer median adjusted physical, psychological, social, and environmental QoL scores compared to reference groups. While more than half of PLWH reported good/very good QoL, we have not achieved good QoL in 90% of PLWH. Multi-morbidity, HIV-related stigma, and social determinants were consistently and independently associated with poorer QoL. Addressing structural factors in addition to those indirectly related to HIV is required to attain good QoL in all PLWH.
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Affiliation(s)
- Diana Barger
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France.
| | - Mojgan Hessamfar
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 33000, Bordeaux, France
- CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 33000, Bordeaux, France
| | - Didier Neau
- CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, 33000, Bordeaux, France
| | - Sophie Farbos
- CH de la Côte Basque, Service de Maladies Infectieuses, 64000, Bayonne, France
| | - Olivier Leleux
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, 33000, Bordeaux, France
| | - Charles Cazanave
- CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, 33000, Bordeaux, France
| | - Nicolas Rouanes
- CH de Périgueux, Service de Médecine Polyvalente, 24019, Périgueux, France
| | - Pierre Duffau
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 33000, Bordeaux, France
- Univ. Bordeaux, Department of Immunology, CNRS, ImmunoConcEpT, UMR 5164, 33000, Bordeaux, France
| | - Estibaliz Lazaro
- CHU de Bordeaux, Service de Médecine Interne, 33604, Pessac, France
| | - Patrick Rispal
- CH de Agen-Nerac, Service de Médecine Interne, 47923, Agen, France
| | - François Dabis
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France
- CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 33000, Bordeaux, France
| | - Linda Wittkop
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, 33000, Bordeaux, France
- INRIA, SISTEM Team, 33400, Talence, France
- CHU de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, 33000, Bordeaux, France
| | - Fabrice Bonnet
- Univ. Bordeaux, INSERM, BPH, U1219, 33000, Bordeaux, France
- CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 33000, Bordeaux, France
- Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, 33000, Bordeaux, France
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Hong C, Ochoa AM, Wilson BDM, Wu ESC, Thomas D, Holloway IW. The associations between HIV stigma and mental health symptoms, life satisfaction, and quality of life among Black sexual minority men with HIV. Qual Life Res 2023; 32:1693-1702. [PMID: 36648570 PMCID: PMC10953729 DOI: 10.1007/s11136-023-03342-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE With the advancement of antiretroviral therapy (ART), HIV/AIDS has become a manageable illness, similar to other chronic conditions. This study examined the associations between HIV stigma and patient-reported outcomes including mental health symptoms, life satisfaction, and quality of life among Black sexual minority men with HIV. METHODS We analyzed baseline data from a randomized comparison trial of a mobile app intervention aimed to address the social work and legal needs of Black sexual minority men with HIV in Los Angeles County. We used validated scales including the Berger HIV stigma scale, the Patient Health Questionnaire-9 & the General Anxiety Disorder-7, the Satisfaction with Life Scale, and the Ladder Scale to assess HIV stigma, depressive symptoms, anxiety, life satisfaction, and quality of life, and we conducted multivariable linear regression to examine their associations. RESULTS Participants experienced HIV stigma especially about disclosure concerns (e.g., 81.9% participants indicated "I am very careful who I tell that I have HIV") and public attitudes (52.3% believed "Most people with HIV are rejected when others find out"). In the multivariable models, higher overall stigma scores were associated with higher likelihood of experiencing depression (adjusted b = 0.235, p < 0.001) and anxiety (adjusted b = 0.188, p = 0.002), and lower life satisfaction (adjusted b = - 0.236, p < 0.001) and quality of life (adjusted b = - 0.053, p = 0.013), adjusting for clinical characteristics including ART initiation, viral load suppression, and medication adherence. In addition, being attacked or harassed in the past year were significantly associated with lower life satisfaction and quality of life (adjusted b = - 3.028, p = 0.046; adjusted b = - 1.438, p = 0.002). CONCLUSION Our findings highlight the need for focused HIV stigma reduction interventions to promote the overall well-being of Black sexual minority men with HIV. Strategies to promote the patient-reported outcomes may benefit from trauma-informed approaches.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California Los Angeles, 3250-Public Affairs Building, Los Angeles, CA, 90095-1656, USA.
| | - Ayako Miyashita Ochoa
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California Los Angeles, 3250-Public Affairs Building, Los Angeles, CA, 90095-1656, USA
| | - Bianca D M Wilson
- The Williams Institute, School of Law, University of California Los Angeles, Los Angeles, CA, USA
| | - Elizabeth S C Wu
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California Los Angeles, 3250-Public Affairs Building, Los Angeles, CA, 90095-1656, USA
| | | | - Ian W Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California Los Angeles, 3250-Public Affairs Building, Los Angeles, CA, 90095-1656, USA
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Mesías-Gazmuri J, Folch C, Palacio-Vieira J, Bruguera A, Egea-Cortés L, Forero CG, Hernández J, Miró JM, Navarro J, Riera M, Peraire J, Alonso-García L, Díaz Y, Casabona J, Reyes-Urueña J. Syndemic conditions and quality of life in the PISCIS Cohort of people living with HIV in Catalonia and the Balearic Islands: a cross sectional study. Health Qual Life Outcomes 2023; 21:42. [PMID: 37165368 PMCID: PMC10173626 DOI: 10.1186/s12955-023-02120-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/24/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND People living with HIV (PLWH) face structural and psychosocial factors that affect health-related quality of life (HRQoL). We aimed to evaluate how syndemic conditions affected HRQoL in PLWH. METHODS A cross-sectional survey was conducted among 861 PLWH, to determine whether syndemic conditions (monthly income; sexual satisfaction; depressive symptoms; social role satisfaction; social isolation; cognitive function; nicotine dependence; perception of stigma) have an effect on HRQoL. A linear regression model and measures of Additive Interaction (AI) were used to determine the effects of syndemic conditions on HRQoL, controlling for other risk factors. RESULTS Overall, the most frequently observed were stigma perception (56.9%), poor cognitive function (50.6%) and the perception of social isolation (51.6%). The presence of depressive symptoms was the risk factor most associated with worse Physical Health (PH) (B 3.93, 2.71-5.15) and Mental Health (MH) (B 5.08, 3.81-6.34) in linear regression model. Specifically, an interaction was observed between poor cognitive function and poor satisfaction with social role on worse PH and MH (AI 2.08, 0.14-4.02; AI 2.69, 0.15-5.22, respectively); and low income and perception of stigma (AI 2.98, 0.26-5.71), low income and perception of social isolation (AI 2.79, 0.27-5.32), and low income and poor satisfaction with social role (AI 3.45, 0.99-5.91) on MH. CONCLUSION These findings provide evidence that syndemic factors impact HRQoL. HIV prevention programs should screen and address co-occurring health problems to improve patient-centered health care and outcomes.
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Affiliation(s)
- Jocelyn Mesías-Gazmuri
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- PhD in Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universidad Autonoma de Barcelona, Badalona, Spain
| | - Cinta Folch
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain.
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
| | - Jorge Palacio-Vieira
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Andreu Bruguera
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- PhD in Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universidad Autonoma de Barcelona, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Laia Egea-Cortés
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Carlos G Forero
- Department of Medicine. School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat, Spain
| | - Juan Hernández
- Grupo de Trabajo Sobre Tratamientos del VIH (gTt), Barcelona, Spain
| | - José M Miró
- Infectious Diseases Service. Hospital Clínic-IDIBAPS. University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Navarro
- Infectious Diseases Department. Hospital, Universitari Vall d'Hebron, Barcelona, Spain
- Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | | | - Joaquim Peraire
- Infectious Diseases Department. Hospital, Universitari Vall d'Hebron, Barcelona, Spain
- Hospital Joan XXIII, IISPV, Universitat Rovira I Virgili, Tarragona, Spain
| | - Lucía Alonso-García
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
| | - Yesika Díaz
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Univ Autonoma de Barcelona, Badalona, Spain
| | - Juliana Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
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Rodriguez S, Yaya I, Huntingdon B, Juraskova I, Preau M, Etemadi F, Dimi S, Carrieri MP, Bessonneau P, Chassany O, Duracinsky M. Positive relations between sexual quality of life and satisfaction with healthcare in women living with HIV and/or HCV: Results from a multicountry study. PLoS One 2023; 18:e0278054. [PMID: 36662750 PMCID: PMC9858467 DOI: 10.1371/journal.pone.0278054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/08/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION The sexual quality of life is a neglected concern in women living with HIV (WHIV) or with HCV (WHCV), which can further be affected by their experience with stigma, social instability, fear of transmission and reduced access to treatment. The objective of this study was to identify sociodemographic, psychosocial, and behavioural factors associated with sexual quality of life (SQoL) in this study group. METHODS Between December 2017 and December 2018, PROQoL-Sex Life questionnaire was administered to 404 WHIV and WHCV in five countries. PROQoL-SQoL consists of four dimensions: positive sexual perception (Psp), stigma and social distress (Sti), soft sexual practices (Sof), sexual practices with a partner (Sp), all of which were scored from 0 to 100 and considered as main outcomes, lower scores mean better sexual quality of life. Linear mixed effects models were used to evaluate the association with sociodemographic and psychosocial factors. RESULTS Of the participants analyzed, 191 were living with HCV, 180 with HIV and 33 with HIV and HCV, median age was 48. Among WHIV, a higher satisfaction with health care, and talking about sexuality with healthcare workers were associated with lower scores in all the dimensions of the SQoL, while psychoactive substance use was associated with lower scores of Sti and Sof. Moreover, higher satisfaction with health care, talking about sexuality with healthcare workers, and psychoactive substance use (except cocaine use) in WHCV were associated with lower scores in Psp, Sti, and Sof. Besides, cocaine use was associated with higher scores of Sof. CONCLUSION This study highlighted strong relationship between the quality of health care, and psychoactive substance use (except cocaine) and the sexual quality of life in WHIV and WHCV in these five countries. These findings draw attention to the different interventions that can be proposed for improving the sexual quality of life.
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Affiliation(s)
- Sara Rodriguez
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Issifou Yaya
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Patient-Centered Outcomes Research Unit, UMR 1123, INSERM, Université de Paris, Paris, France
| | - Ben Huntingdon
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Ilona Juraskova
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), The University of Sydney, Sydney, New South Wales, Australia
| | - Marie Preau
- Groupe de Recherche en Psychologie Sociale (GRePS), Université Lyon 2, Lyon, France
| | - Fatima Etemadi
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Svetlane Dimi
- Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | - Maria Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - Pascal Bessonneau
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Patient-Centered Outcomes Research Unit, UMR 1123, INSERM, Université de Paris, Paris, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Patient-Centered Outcomes Research Unit, UMR 1123, INSERM, Université de Paris, Paris, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Patient-Centered Outcomes Research Unit, UMR 1123, INSERM, Université de Paris, Paris, France
- Département de Médecine Interne et d’Immunologie Clinique, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
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10
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Nurwijayanti N, Rias YA, Nasution N, Samsudin RR, Priyono D, Rosyad YS. Synergist effect of antiretroviral therapy adherence and viral load suppression on quality of life of people with HIV/AIDS. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S12-S18. [PMID: 36626260 DOI: 10.12968/bjon.2023.32.1.s12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIMS This study investigated the synergistic and independent effects of adherence to antiretroviral therapy (ART) and viral load on quality of life (QoL) among people with HIV/AIDS. METHODS This was a cross-sectional study of 129 patients with HIV/AIDS. The WHOQOL-BREF and the Morisky Medication Adherence Scale were used to measure QoL and adherence respectively. Information on viral load and CD4 cell count was obtained from patients' records and verified by a physician. An additive interaction method was used to estimate the synergistic effect of the linear regression. FINDINGS Patients who were adhering to ART and had an undetectable viral load had significantly higher scores on four domains of QoL - environment, physical health, social relationships and psychological - than those who were non-adherent. Moreover, ART adherence and undetectable viral load had a positive synergistic effect on QoL after controlling for covariate variables. CONCLUSION Participants were more likely to have a good QoL if they had both undetectable viral loads and good ART adherence.
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Affiliation(s)
- Nurwijayanti Nurwijayanti
- Lecturer, Post-Public Health Science Programme, Institut Ilmu Kesehatan Strada Indonesia, Kediri, Indonesia
| | - Yohanes Andy Rias
- Lecturer, Faculty of Health and Science, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
| | - Nurhafizah Nasution
- Lecturer, Faculty of Health and Medicine, College of Nursing, Universitas Batam, Batam, Indonesia
| | - Rinza Rahmawati Samsudin
- Lecturer, Medical Laboratory Technology Programme, Faculty of Health Sciences, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | - Djoko Priyono
- Lecturer, Department of Community and Mental Health Nursing, Faculty of Medicine, Universitas Tanjugpura, Pontianak, Indonesia
| | - Yafi Sabila Rosyad
- Lecturer, Faculty of Health and Medicine, College of Nursing, Sekolah Tinggi Ilmu Kesehatan Yogyakarta, Yogyakarta, Indonesia
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11
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Michel M, Wahl A, Anders M, Alqahtani SA, Kremer WM, Galle PR, Labenz C, Grimm D, Sprinzl M, Schattenberg JM. Significant liver fibrosis is a predictor of poor health-related quality of life in people living with HIV. Qual Life Res 2023; 32:401-411. [PMID: 35996039 PMCID: PMC9911489 DOI: 10.1007/s11136-022-03232-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Liver-related comorbidities can impair the health-related quality of life (HRQL) in people living with human immunodeficiency virus (HIV) (PLWH). However, the role of hepatic steatosis and significant fibrosis in PLWH remains incompletely characterized. Therefore, the aim of this study was to explore the association of hepatic steatosis and significant fibrosis on the HRQL using the medical outcomes study HIV health survey (MOS-HIV) in PLWH. METHODS A total of 222 PLWH were included in the final analysis of this cohort study. Metabolic comorbidities, socioeconomic factors, and HIV-related parameters were assessed. Hepatic steatosis and fibrosis were measured using vibration-controlled transient elastography (VCTE). The MOS-HIV survey, containing two summary scores (physical health summary (PHS) and mental health summary (MHS)) and ten domains, was used to assess the HRQL. Clinical predictors were identified using multivariable linear regression models. RESULTS The majority of this cohort was male, and the median age was 52 years, with a high prevalence of hepatic steatosis (n = 81, 36.5%). Significant fibrosis was present in 7.7% (n = 17). The mean PHS and MHS scores were 52.7 ± 9.5 and 51.4 ± 10.5, respectively. The lowest scores were in the general health perception (GHP) and energy/fatigue (EF) domains. A high BMI and waist circumference were associated with a poor PHS score. Lower education, unemployment, arterial hypertension, and significant fibrosis remained independent predictors of an impaired HRQL. CONCLUSION Metabolic comorbidities, significant fibrosis, and a lower socioeconomic status may negatively affect the HRQL in PLWH. Considering the negative impact of significant fibrosis on the outcome, counseling and preventive measures according to current guidelines are recommended in this subgroup of PLWH.
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Affiliation(s)
- Maurice Michel
- grid.410607.4Metabolic Liver Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany ,grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Alisha Wahl
- grid.410607.4Metabolic Liver Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany ,grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Malena Anders
- grid.410607.4Metabolic Liver Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany ,grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Saleh A. Alqahtani
- grid.415310.20000 0001 2191 4301Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia ,grid.21107.350000 0001 2171 9311Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD USA
| | - Wolfgang M. Kremer
- grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Peter R. Galle
- grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Christian Labenz
- grid.410607.4Metabolic Liver Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany ,grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Daniel Grimm
- grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Martin Sprinzl
- grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Jörn M. Schattenberg
- grid.410607.4Metabolic Liver Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany ,grid.410607.4I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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12
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Alford K, Banerjee S, Daley S, Hamlyn E, Trotman D, Vera JH. Health-Related Quality of Life in People Living With HIV With Cognitive Symptoms: Assessing Relevant Domains and Associations. J Int Assoc Provid AIDS Care 2023; 22:23259582231164241. [PMID: 36945871 PMCID: PMC10034276 DOI: 10.1177/23259582231164241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
This study aimed to validate and assess a comprehensive set of illness-specific health-related quality of life (HRQL) domains in people living with HIV (PLWH) with cognitive symptoms. One hundred and three HIV patients with cognitive symptoms (n = 93 male, 90.3%) were identified from two UK HIV clinics and complete a series of validated scales measuring seven HRQL domains identified as important to HRQL by PLWH with cognitive impairment. These included: physical functioning, cognition, social connectedness, self-concept, HIV stigma, acceptance of and perceived control over cognitive health, and physical and mental health and wellbeing. Exploratory factor analysis confirmed that domain total scores loaded onto one main factor, representing HRQL. Scale cut-off scores revealed a significant proportion of patients scored outside the normal range on single domains (between 26.2% and 79.6%), and many patients on multiple domains (40.8% on 4 or more domains). We found evidence of poor HRQL across domains in the majority of PLWH with cognitive symptoms and identified domains driving these experiences. This provides targets for intervention development and clinical action to maintain or improve HRQL in PLWH with cognitive symptoms or impairment.
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Affiliation(s)
- Kate Alford
- Department of Global Health and Infection, 12190Brighton and Sussex Medical School, Brighton, UK
| | - Sube Banerjee
- Faculty of Health, 6633University of Plymouth, Plymouth, UK
| | - Stephanie Daley
- Centre for Dementia Studies, 12190Brighton and Sussex Medical School, Brighton, UK
| | - Elizabeth Hamlyn
- 111990HIV and Sexual Health Service, King's College Hospital NHS Foundation Trust, London, UK
| | - Daniel Trotman
- 111990HIV and Sexual Health Service, King's College Hospital NHS Foundation Trust, London, UK
| | - Jaime H Vera
- Department of Global Health and Infection, 12190Brighton and Sussex Medical School, Brighton, UK
- 8721HIV and Sexual Health Service, University Hospitals Sussex NHS Trust, Brighton, UK
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13
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Michel M, Labenz C, Anders M, Wahl A, Girolstein L, Kaps L, Kremer WM, Huber Y, Galle PR, Sprinzl M, Schattenberg JM. Effect of hepatic steatosis and associated metabolic comorbidities on health-related quality of life in people living with HIV. Hepatol Commun 2022; 6:2011-2021. [PMID: 35411570 PMCID: PMC9315116 DOI: 10.1002/hep4.1958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/17/2022] [Accepted: 03/11/2022] [Indexed: 12/31/2022] Open
Abstract
Hepatic steatosis (HS) related to nonalcoholic fatty liver disease (NAFLD) is increasing globally. In people living with human immunodeficiency virus (PLWH) risk factors of HS are increased. The impact of HS on outcomes and in particular health-related quality of life (HRQL) in PLWH remains unknown. The aim of this cross-sectional cohort study (FLASH, Prevalence of Advanced Fibrosis in Patients Living With HIV) was to determine the contribution of HS on HRQL in PLWH and to identify confounders on HRQL. A total of 245 PLWH were prospectively enrolled. HS was assessed using vibration-controlled transient elastography and defined as a controlled attenuation parameter (CAP) of ≥ 275 dB/m. The analysis was performed between CAP < 275 and ≥ 275 dB/m. The generic European Quality-of-Life 5-Dimension 5-Level questionnaire was used to determine differences in the HRQL. Univariable and multivariable linear regression models were applied to identify predictors with impaired HRQL in both groups. In this cohort, 65% (n = 160) presented without and 35% (n = 85) with HS, of whom most had NAFLD (n = 65, 76.5%). The HRQL (UI-value) was significantly lower in PLWH and steatosis (0.86 ± 0.18) in comparison with no steatosis (0.92 ± 0.13). Unemployment (p = 0.025) and waist circumference (p = 0.017) remained independent predictors of a poor HRQL in the steatosis subgroup. In turn, age (p = 0.045), female sex (p = 0.030), body mass index (p = 0.010), and arterial hypertension (p = 0.025) were independent predictors of a low HRQL in the subgroup without steatosis. Conclusion: HS and metabolic comorbidities negatively affect the HRQL. Addressing these factors may improve patient-reported and liver-related outcomes in PLWH.
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Affiliation(s)
- Maurice Michel
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Christian Labenz
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Malena Anders
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Alisha Wahl
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Lisann Girolstein
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Leonard Kaps
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Wolfgang M Kremer
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Yvonne Huber
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Peter R Galle
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Martin Sprinzl
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
| | - Jörn M Schattenberg
- Metabolic Liver Disease Research Program, I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany.,I. Department of MedicineUniversity Medical Center of the Johannes Gutenberg-UniversityMainzGermany
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