Prevalence, severity, and risk factors of disability among adults living with HIV accessing routine outpatient HIV care in London, United Kingdom (UK): A cross-sectional self-report study

Disrupted HIV care during COVID-19 pandemic associated with increased disabilities among people living with HIV in Belize

The COVID-19 pandemic may have impacted disabilities among people living with HIV; however, data on the association between COVID-19 pandemic-related healthcare disruptions and disabilities among people living with HIV is limited. We aimed to evaluate the association between COVID-19-affected HIV care behaviors and disability domains among people living with HIV in Belize. A cross-sectional study was conducted at the Western Regional Hospital and Southern Regional Hospital between August and October 2021 among people living with HIV in Belize aged ≥ 21 years and on antiretroviral therapy. A self-reported questionnaire captured data on demographic and clinical characteristics (gender, age, ethnicity, marital status, employment, education, CD4 count, and viral load), COVID-19-affected HIV care behaviors, and disability across six domains (physical, cognitive, and mental-emotional symptoms and impairments; uncertainty; difficulties carrying out day-to-day activities; and social inclusion challenges) using the Short-Form HIV Disability Questionnaire. Univariate and multivariate logistic regression analyses were employed to analyze the data. Of the 489 participants, 276 (56.4%) were women and 213 (43.6%) were men. After adjusting for covariates, (age, gender, employment, CD4 count, viral load, COVID-19-affected HIV care behaviours), our results showed that people living with HIV, whose HIV care behaviors were greatly affected by COVID-19, were more likely to have disabilities across various domains: physical (adjusted odds ratio (AOR): 1.61, 95% confidence interval (CI): 1.08-2.41, p = 0.018), cognitive (AOR: 2.49, 95% CI: 1.58-3.94, p < 0.001), uncertainty (AOR: 2.94, 95% CI: 1.68-5.12, p < 0.001), difficulties carrying out day-to-day activities (AOR: 1.69, 95% CI: 1.06-2.69, p = 0.027), and social inclusion challenges (AOR: 1.89, 95% CI: 1.27-2.81, p = 0.002). Mitigating disruptions in care behaviors through the implementation of more accessible and comprehensive healthcare services may potentially address the multifaceted nature of HIV disabilities.

Epidemiologic characteristics of people living with human immunodeficiency virus in South Korea: a nationwide cohort study

Recent information regarding the characteristics of people living with human immunodeficiency virus (HIV) (PLWH) is lacking. Therefore, we examined the incidence of HIV infection and epidemiologic characteristics of PLWH in South Korea using recent National Health Insurance Service database data. The HIV infection rate was 4.13 per 100,000 in 2017, 4.19 per 100,000 in 2018, 6.61 per 100,000 in 2019, 5.98 per 100,000 in 2020, 8.81 per 100,000 in 2021, and 4.14 per 100,000 in 2022. In 2016, the mean age of PLWH was 45.7 years (SD: 13.8 years), and it gradually increased to 49.0 years (standard deviation: 13.7 years) in 2022 over 7 years in South Korea. The proportion of male individuals among PLWH was 90.7% (19,970/22,026) in 2016, and it gradually increased to 92.3% (22,943/24,857) in 2022 over 7 years in South Korea. The proportion of anti-retroviral therapy (ART) users among PLWH in South Korea was 92.6% (20,388/22,026) in 2016, and it gradually increased to 97.9% (24,328/24,857) in 2022 over 7 years. In this population-based cohort analysis, we presented the HIV infection incidence and epidemiologic features of PLWH in South Korea. This study's results may influence future infection prevention strategies and policies for PLWH.

Prevalence and predictors of HIV-related disability among people living with HIV in Nigeria

Background

People living with human immunodeficiency virus (PLWH) live longer, but experience human immunodeficiency virus (HIV)-related comorbidities and disabilities that lower their quality of life. Understanding the prevalence, risk factors, and disability patterns is crucial for tailored interventions.

Objectives

To explore the prevalence and predictors of HIV-related disability among PLWH in Nigeria.

Method

This cross-sectional survey involved 385 PLWH, exploring demographic data, HIV history, recent symptoms, disability (measured by the WHO Disability Assessment Schedule-WHODAS 2.0). Descriptive statistics summarised the data, all variables were entered into univariate and multivariate regression models. IBM SPSS 25® was used for all analyses at a 95% confidence level.

Results

The prevalence of disability among PLWH was 39.5%, the mean age was 42.2 ± 10.43 years, and 73% of the participants were females. Factors significantly associated with disability were marital status (p = 0.009) and level of education (p = 0.001).

Conclusion

The study reveals a prevalence of disability (39.5%) among PLWH on antiretroviral therapy (ART), emphasising the need for tailored interventions considering socio-demographic factors. Continuous screening, risk identification, and effective management strategies are imperative, recognising disability as an indicator of health and quality of life.

Clinical implications

With PLWH experiencing increased life expectancy, the study underscores the need for an informed patient-centred approach to care, recognising the specific challenges faced by PLWH in Nigeria and guiding the development of targeted interventions to enhance both functional outcomes and overall well-being.

Assessing the sensibility and utility of a short-form version of the HIV Disability Questionnaire in clinical practice settings in Canada, Ireland and the USA: a mixed methods study

OBJECTIVES

The Short-Form HIV Disability Questionnaire (SF-HDQ) was developed to measure the presence, severity and episodic nature of health challenges across six domains. Our aim was to assess the sensibility, utility and implementation of the SF-HDQ in clinical practice.

DESIGN

Mixed methods study design involving semistructured interviews and questionnaire administration.

PARTICIPANTS

We recruited adults living with HIV and HIV clinicians in Canada, Ireland and the USA.

METHODS

We electronically administered the SF-HDQ followed by a Sensibility Questionnaire (face and content validity, ease of usage, format) and conducted semistructured interviews to explore the utility and implementation of the SF-HDQ in clinical practice. The threshold for sensibility was a median score of >5/7 (adults living with HIV) and>4/7 (HIV clinicians) for ≥80% of items. Qualitative interview data were analysed using directed content analysis.

RESULTS

Median sensibility scores were >5 (adults living with HIV; n=29) and >4 (HIV clinicians; n=16) for 18/19 (95%) items. Interview data indicated that the SF-HDQ represents the health-related challenges of living with HIV and other concurrent health conditions; captures the daily episodic nature of HIV; and is easy to use. Clinical utility included measuring health challenges and change over time, guiding referral to specialists and services, setting goals, facilitating communication and fostering a multidisciplinary approach to care. Considerations for implementation included flexible, person-centred approaches to administration, and communicating scores based on personal preferences.

CONCLUSIONS

The SF-HDQ possesses sensibility and utility for use in clinical settings with adults living with HIV and HIV clinicians in three countries.