Showing 41 - 60 of 80 Results for "adherence"

Results

Additional outreach programs are needed for patients who miss ART clinic visits or fail to initiate treatment. A study showed that issues such as provider to patient ratios; adherence support programs; and needing transport from rural areas were associated with lower CD4 counts at initiation of ART. Other studies showed that patients were lost between initiation and maintenance sites. Another study found that one in five treatment-eligible HIV-positive individuals refused to initiate ART (Katz et al., 2011). Others who dropped out of treatment were using unproven remedies.
Provision and Access
1 study
Programs must adhere to the longstanding international agreement to voluntarism, informed consent, and ensuring the right of individuals and couples to decide freely and responsibly the number and spacing of their children. Studies found that women living with HIV had been sterilized against their will, were pressured by providers to terminate a pregnancy, or were stigmatized for becoming pregnant. Studies also found that provision of antiretroviral therapy was conditional on using certain types of contraception. Litigation is currently being undertaken. A study found that HIV-positive women who accessed contraceptive services were not informed of the benefits of PMTCT programs in reducing vertical transmission.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Interventions are needed to reduce the higher attrition rate among pregnant adolescents living with HIV, including those perinatally infected, and provide needed support by parents and others. [See also %{c:9}] Additional research may also be needed on how to best care for perinatally-infected pregnant women who have decreased virological suppression, increased risk of vertical transmission and increased challenges in remaining adherent. While currently noted in the United States, it is anticipated to be relevant to low- and middle-income countries as more perinatally-infected women give birth.
Antenatal Care - Treatment
1 study
Research and interventions are needed to better to support people living with HIV with disclosure and reduce stigma so they can adhere to ART and can continue to have a healthy and safer sex life. In-depth interviews with patients in South Africa who were acutely infected found that patients did not retain the information that they are very likely to transmit HIV and that condom use was particularly important, but were focused on identifying who transmitted HIV to them. In addition, patients were still in shock on learning of their HIV status and did not understand how they could be HIV-positive if they tested negative with a rapid HIV test (Wolpaw et al., 2014). Women who were acutely infected in South Africa faced profound "challenges, immediately after HIV diagnosis" (Tomita et al., 2014b: 1118). Focus groups of women living with HIV found that women were concerned that their access to lifelong treatment when becoming pregnant may discourage their men from condom use, as men know that treatment can decrease the risk of transmission.
Staying Healthy and Reducing Transmission
1 study
Interventions are needed to sustain viral suppression and reduce loss to follow up once a woman has initiated Option B+, including affordable means of monitoring virological response and effective adherence counseling. Research is needed on how long is optimal to provide care within maternal health systems or when to transfer cART provision outside of maternal health systems. Compared to people who started cART for their own health, a study found that women who started cART while pregnant were 5 times less likely to return to the clinics after the initial visit. Women who started cART while breastfeeding were twice as likely to miss their first follow up appointment. On average, 17% of pregnant women who started ART under Option B+ dropped out of care in the first six months of ART and 22% dropped out within one year (Tenhathi et al., 2014). Systems are rarely in place to track mothers six weeks post-partum (Psaros et al., 2015; Waiswa, 2016). A survey found that ART retention was greatest in those facilities where newly diagnosed pregnant women living with HIV were referred from ANC to the ART clinic in the same facility for initiation and follow up or were referred to facilities serving as ART referral sites that did not provide ANC (van Lettow et al., 2014). A review noted that women found challenges in accessing cART either through maternal care systems, postpartum or through HIV care. Input from pregnant and postpartum women living with HIV is needed
Antenatal Care - Treatment
1 study
Postnatal home visits by trained lay counselors may reduce mixed feeding.
Postpartum
1 study Gray II breastfeeding, counseling, formula feeding South Africa
Accelerating treatment access for adults with children can reduce the number of orphans, improve pediatric mortality and social well-being. [See also %{c:13}]
Orphans and Vulnerable Children
4 studies Gray IIIa, IIIb, V child labor, education, mortality, orphans, treatment Kenya, South Africa, Uganda, Ukraine
Treatment as Prevention
Prevention for Women
Antiretroviral medication has been successfully used in a number of ways: first and foremost to treat those with high viral load and diminishing CD4 counts; secondly to prevent vertical transmission of HIV from pregnant and breastfeeding women to their infants; third, as a prophylactic for those who have been exposed to HIV occupationally or through sexual assault (post-exposure prophylaxis, PE...
Highly-active antiretroviral therapy (HAART) with good nutritional intake and regular medical care can improve health and survival of orphaned children living with HIV in resource-poor settings.
Orphans and Vulnerable Children
2 studies Gray IIIb HAART, children, orphans, treatment Kenya, Tanzania
Home- and community-based antiretroviral treatment may be effective, but attention must be paid to potential effects of stigma and discrimination. [See also %{c:21}]
Provision and Access
5 studies Gray II, IIIa, IIIb community-based care, home-based care, treatment Rwanda, South Africa, Uganda
Treatment
Antiretroviral therapy has transformed HIV to a chronic - though still incurable - virus requiring ongoing therapy and strict adherence to treatment. For the most part, virally suppressed people living with HIV today have no difference in life expectancy than demographically similar HIV-negative individuals (Sabin, 2013 cited in Justice and Falutz, 2014; Maman et al. 2012a). This section does ...
Antenatal Care - Treatment
Safe Motherhood and Prevention of Vertical Transmission
Antiretroviral treatment (ART) for women living with HIV is vital to ensuring safe motherhood and reducing vertical transmission. But not all pregnant women access treatment. For women in high-income countries where access to triple therapy during pregnancy has been the standard of care and is near universal, rates of vertical HIV transmission are as low as 0.4%, for example, in Canada (Forbes ...
Structuring Health Services to Meet Women’s Needs
The manner in which health services are structured has an impact on HIV prevention, treatment and care services for women and girls. Women often need multiple reproductive health services such as family planning in addition to HIV prevention, treatment and care, but most health care facilities are not structured to provide integrated services. Integration can be defined broadly as 1) co-locatio...
When a couple is serodiscordant or both male and female partners are HIV-positive and wish to conceive, having an undetectable viral load and limiting unprotected sex to peak fertility (with the possible use of pre-exposure prophylaxis) may result in the lowest risk of perinatal transmission. [See also %{s:33}]
Pre-Conception
5 studies Gray IIIb, V pre-exposure prophylaxis, pregnancy, serodiscordant, sexual partners, transmission, treatment Kenya, Saudi Arabia, South Africa, Switzerland, Uganda
Staying Healthy and Reducing Transmission
Treatment
"Me, I try to tell the man that, 'In this house we have been found with this problem. We should accept it. I should not point a finger at you. You, too, should not point a finger at me. Just buy your protection.' And so, little by little what he does now is different from what he did in the past." --Malawi woman living with HIV (Mkandawire-Valhmu and Stephens, 2010: 691)Successfully treated peo...
Creating a sense of community, empowerment and leadership among sex workers can help support effective HIV prevention.
Female Sex Workers
6 studies Gray II, IIIb, V Armenia, HIV testing, community organizing, condoms, empowerment, peer education, prevention, sex workers, violence India, Kenya
Providing peer support, information and skills-building support to people living with HIV can reduce unprotected sex.
Staying Healthy and Reducing Transmission
7 studies Gray I, II, IIIa, IIIb, V condom use, counseling, sex behavior, sexual partners, support, support groups, treatment, violence Ethiopia, Nigeria, Rwanda, South Africa, Uganda, United States, Zambia
Increasing Access to Services
Prevention and Services for Adolescents and Young People
While the literature on access to HIV services by adolescents is limited, the literature on access to sexual and reproductive health services more broadly demonstrates that youth-friendly approaches can increase use of reproductive health care services by female adolescents (Gay et al., 2015). Young peoples service needs are frequently overlooked in HIV programming that is not specifically for ...
Community health workers and community-based support can increase uptake of safe motherhood interventions for women living with HIV and reduce vertical transmission
Antenatal Care - Treatment
9 studies Gray II, IIIa, IIIb community-based outreach, community-based support, infants, pregnancy, treatment Africa, Kenya, Malawi, Rwanda, South Africa
Provision and Access
Treatment
Antiretroviral therapy has been successfully administered in a range of situations with adherence, retention, and clinical outcomes similar to those achieved in resource-rich countries. Increasing provision and access, grounded in human rights based approaches, across all populations is critical to continuing that success. "I cook scones for my children and do not get tired. I do chores, pound...