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Nyashanu M, Lusota DA, Muddu M, Mbalinda SN. Effect of COVID-19 on older adults 50 years and above living with HIV in a less-developed country. Afr J AIDS Res 2022; 21:207-212. [PMID: 35901298 DOI: 10.2989/16085906.2022.2091464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Introduction: Globally, control measures have been communicated to reverse the COVID-19 pandemic. In Uganda, as soon as the first case of COVID-19 was identified, strict lockdown measures were enforced, including a ban on all public and private transport, night curfew, closure of schools, and suspension of religious and social gatherings and closure of non-essential shops and markets. These measures affected access to health services, which could have been worse for older people living with HIV (PLHIV). In this study, we explored how COVID-19 affected the health and social life of older PLHIV.Methods: We conducted a qualitative study in HIV clinics of two hospitals in Uganda. We completed 40 in-depth interviews with adults above 50 years who had lived with HIV for more than 10 years. The interviews explored the effect of COVID-19 on their health and social life during the lockdown. We analysed data thematically.Results: The overarching themes regarding the effects of COVID-19 on older adults living with HIV were fear and anxiety during the lockdown, lack of access to health care leading to missing HIV clinic appointments and not taking their ART medicines, financial burden, loss of loved ones, and effect on children's education. Some patients overcame health-related challenges by sending motorcycles to their health facilities with their identifying documents to get the medicines refilled. Some health care providers took the ART medicines to their patients' homes.Conclusion: The COVID-19 lockdown negatively affected the health and social well-being of older PLHIV. This calls for strategies to improve HIV care and treatment access during the lockdown to sustain the HIV program gains in this vulnerable population.
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Affiliation(s)
- Mathew Nyashanu
- Department of Health & Allied Professions, School of Social Science, Nottingham Trent University, United Kingdom
| | | | - Martin Muddu
- Makerere University Joint AIDS Program, Kampala, Uganda
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Cuzin L, Katlama C, Cotte L, Pugliese P, Cheret A, Bernaud C, Rey D, Poizot-Martin I, Chirouze C, Bani-Sadr F, Cabié A. Ageing with HIV: do comorbidities and polymedication drive treatment optimization? HIV Med 2016; 18:395-401. [PMID: 28858437 DOI: 10.1111/hiv.12441] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aim of the study was to describe the ageing HIV-infected population (> 50 years old) and their current antiretroviral therapy (ART), comorbidities and coprescriptions in France in 2013 and to compare them to the younger population. METHODS A retrospective analysis of a prospectively collected database was performed. The characteristics of patients receiving ART as well as their current ART and their numbers of comorbidities and comedications at the censoring date (1 July 2013) were compared between patients ageing with HIV infection, patients who seroconverted while ageing, and younger patients. RESULTS We compared 10 318 ageing patients [median age 56 years; 25% interquartile range (IQR) 53-62 years] with 13 302 younger patients (median age 42 years; 25% IQR 36-47 years). The ageing patients were more frequently male than the younger patients (77 vs. 65%). Among the ageing patients, 7025 were diagnosed with HIV infection before 2000 and represented a distinct group, the 'experienced ageing' group, by comparison with the 'recently diagnosed ageing' group. Triple therapy containing a boosted protease inhibitor was used in 28.2% of the patients (vs. 39% and 36% of the younger and "recently diagnosed ageing" groups, respectively); a nonnucleoside reverse transcriptase inhibitor in 27% (vs. 33% and 38%, respectively), an integrase strand transfer inhibitor (INSTI) in 9% (vs. 7% and 9%, respectively), and another regimen (fewer or more than three drugs) in 35.8% (vs. 21% and 16.5%, respectively). "Experienced ageing" patients typically had one or more comorbidities (62.1%) and were receiving at least one comedication (71%). Central nervous system (CNS) agents (prescribed in 44.6% of the "experienced ageing" patients) and antilipidaemics (in 44.2%) were the most frequently prescribed comedications. INSTIs were used in 23% of the population and were used significantly more often in patients with comorbidities and coprescriptions. For all comparisons, P < 0.0001. CONCLUSIONS In ageing HIV-infected patients, especially those with a long history of HIV infection, comorbidities and coprescriptions are highly prevalent.
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Affiliation(s)
- L Cuzin
- INSERM, UMR 1027, Toulouse, France.,Toulouse III University, Toulouse, France.,COREVIH, CHU Toulouse, Toulouse, France
| | - C Katlama
- UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Univ, Paris, France.,Infectious Diseases Department, Pitié Salpêtrière, AP-HP, Paris, France
| | - L Cotte
- Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France.,INSERM U1052, Lyon, France
| | - P Pugliese
- Infectious Diseases Department, CHU Archet, Nice, France
| | - A Cheret
- EA 3620, Université Paris-Descartes, Sorbonne Paris Cité, Paris, France.,Infectious Diseases Department, Tourcoing General Hospital, Tourcoing, France.,Internal Medicine Unit, Bicêtre Hospital, AP-HP, Paris, France
| | - C Bernaud
- Infectious Diseases Department, CHU Hotel Dieu, Nantes, France
| | - D Rey
- Le Trait d'Union, HIV care Center, CHU Strasbourg, Strasbourg, France
| | - I Poizot-Martin
- Immuno-Hematology Clinic, APHM Hôpital Sainte-Marguerite, Aix-Marseille Univ, Marseille, France.,Inserm U912 (SESSTIM), Marseille, France
| | - C Chirouze
- UMR CNRS 6249 Chrono-Environnement, Franche-Comté University, Besançon, France.,Infectious Diseases Department, Besançon University Hospital, Besançon, France
| | - F Bani-Sadr
- EA-4684/SFR CAP-SANTE, Reims Champagne-Ardenne University, Reims, France.,Tropical and Infectious Diseases, Hôpital Robert Debré, CHU Reims, Reims, France
| | - A Cabié
- Infectious Diseases Department, Université Antilles, Guyane, EA 4537.,Franch West Indies University, Fort de France, France
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