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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 54 Research Studies DisplayedChou R, Spencer H, Bougatsos C
Preexposure prophylaxis for the prevention of HIV: updated evidence report and systematic review for the US Preventive Services Task Force.
This article updates research used in the 2019 US Preventive Services Task Force final recommendation on use of oral preexposure prophylaxis (PrEP) to prevent HIV in adults at increased risk. The summary includes newer PrEP regimens that were not available for the 2019 final recommendation. A literature review was conducted that included randomized clinical trials of PrEP vs placebo or no PrEP or newer vs older PrEP regimens and diagnostic accuracy studies of instruments for predicting incident HIV infection. Thirty-two studies were included in the review (20 randomized clinical trials [n = 36,543] and 12 studies of diagnostic accuracy [n = 5,544,500]). Eleven trials in the 2019 review found oral PrEP associated with decreased HIV infection risk vs placebo or no PrEP. One new trial (n = 5335) found oral tenofovir alafenamide/emtricitabine (TAF/FTC) to be noninferior to tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in men who have sex with men. Two new trials found long-acting injectable cabotegravir associated with decreased risk of HIV infection vs oral TDF/FTC in cisgender men who have sex with men and transgender women [n = 4490] and RR, 0.11 in cisgender women [n = 3178]). Discrimination of instruments for predicting incident HIV infection was found to be moderate in men who have sex with men (5 studies; n = 25,488) and moderate to high in general populations of persons without HIV (2 studies; n = 5,477,291).
AHRQ-funded; 75Q80120D00006.
Citation: Chou R, Spencer H, Bougatsos C .
Preexposure prophylaxis for the prevention of HIV: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Aug 22; 330(8):746-63. doi: 10.1001/jama.2023.9865..
Keywords: U.S. Preventive Services Task Force (USPSTF), Human Immunodeficiency Virus (HIV), Prevention, Medication, Evidence-Based Practice
Sun CJ, Shato T, Steinbaugh A
Virtual voices: examining social support exchanged through participant-generated and unmoderated content in a mobile intervention to improve HIV antiretroviral therapy adherence among GBMSM.
The goal of this study was to investigate how social support was provided and sought by gay, bisexual, and other men who have sex with men (GBMSM) within a technology-based antiretroviral therapy (ART) adherence intervention. Participants used the messaging feature in to discuss and exchange support around HIV treatment and care. The most salient HIV treatment and care issues were lab results, upcoming tests, ART adherence and side effects, regimen changes, and relationships with healthcare providers. The authors concluded that this analysis provided an opportunity to understand how participants informally interact with one another, how they seek and provide social support online, and their relevant personal issues.
AHRQ-funded; HS022981.
Citation: Sun CJ, Shato T, Steinbaugh A .
Virtual voices: examining social support exchanged through participant-generated and unmoderated content in a mobile intervention to improve HIV antiretroviral therapy adherence among GBMSM.
AIDS Care 2023 Jan;35(1):7-15. doi: 10.1080/09540121.2022.2038364.
Keywords: Patient Adherence/Compliance, Human Immunodeficiency Virus (HIV), Telehealth, Health Information Technology (HIT), Medication, Vulnerable Populations
Coburn SB, Lang R, Zhang J
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
The purpose of this study was to describe trends in statin eligibility and subsequent statin initiation among people with HIV (PWH) from and identify the predictors of statin initiation. The researchers collected data from 12 United States cohorts between 2001 and 2017. The study found that among 16,409 PWH, 45% met statin eligibility criteria per guidelines for the time period from 2001 to 2017. Statin eligibility ranged from 22% to 25% from 2001 to 2013, and initiation increased from 13% to 45%. In 2014, 51% were statin-eligible, among whom 25% initiated statins, which increased to 32% by 2017. The researchers concluded that there is a substantial statin treatment gap, expanded by the 2013 ACC/AHA guidelines.
AHRQ-funded; 90047713.
Citation: Coburn SB, Lang R, Zhang J .
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
J Acquir Immune Defic Syndr 2022 Dec 15;91(5):469-78. doi: 10.1097/qai.0000000000003083..
Keywords: Medication, Human Immunodeficiency Virus (HIV), Access to Care, Practice Patterns, Cardiovascular Conditions
Korthuis PT, Cook RR, Lum PJ
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Opioid Use Disorder (OUD) treatment medications can improve outcomes for human immunodeficiency virus (HIV) and also reduce opioid use. The purpose of the study was to determine if outpatient naltrexone treatment could also reduce opioid use and improve outcomes for HIV. The researchers reported that enrollment was stopped early because of slower than expected recruitment, resulting in 114 final participants with untreated OUD and HIV, with 62% positive for fentanyl, 60% positive for cocaine, and 47% positive for other opioids at the baseline. The intervention compared treatment as usual (TAU) of methadone or buprenorphine with extended-release naltrexone (XR-NTX) on group differences in viral suppression at 24 weeks and past 30-day use of opioids at 24 weeks. The study reported that at 24 weeks the outcome of viral suppression was similar for TAU and XR-NTX, and that fewer XR-NTX participants initiated medication than TAU participants. The outcome of previous 30-day use of opioids was similar for TAU as compared to XR-NTX. Of those participants who did initiate medication, those administered XR-NTX experienced less days of opioid use when compared with TAU in the prior 30 days. The researchers reported that the study evidence was not conclusive but did support that XR-NTX is not inferior to TAU for HIV viral suppression, and that study participants who started XR-NTX used less opioids at 24 weeks than participants who were administered TAU.
AHRQ-funded; HS026370.
Citation: Korthuis PT, Cook RR, Lum PJ .
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Addiction 2022 Jul;117(7):1961-71. doi: 10.1111/add.15836..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Behavioral Health, Medication, Treatments, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Cedillo G, George MC, Deshpande R
Toward safer opioid prescribing in HIV care (TOWER): a mixed-methods, cluster-randomized trial.
Healthcare and behavioral health providers are lacking a methodology to implement the 2016 U.S. Centers for Disease Control and Prevention Opioid Prescribing Guideline (CDC Guideline), measure prescriber adherence to it, and systematically test its effect on patient and public health outcomes. The Guideline is currently being reviewed and revised due to concern that it may be harmful to people with chronic pain on long-term opioid therapy (CP-LTOT). The purpose of the study was to develop and test a CDC Guideline implementation strategy termed “TOWER,” focused on an outpatient HIV primary care setting with patients with CP-LTOT. The TOWER strategy included: 1) a patient-facing app for opioid management (OM-App); 2) a template for progress notes (OM-Note) intended to guide the patient’s office visit; and 3) a primary care provider (PCP) training. TOWER was developed in a multi-step, stakeholder-engaged process within a behavioral change framework. The researchers evaluated the TOWER strategy in a randomized-controlled trial of HIV-PCPs (N=11) and their patients with HIV and CP-LTOT (N=40). The main outcome was CDC Guideline adherence based on electronic health record (EHR) documentation and measured by the Safer Opioid Prescribing Tool (SOPTET). Qualitative data was also collected, including one-on-one PCP interviews. The study found that the PCPs randomized to utilize the TOWER strategy were 48% more CDC Guideline adherent. Qualitative data reflected high levels of intervention provider confidence in administering the TOWER processes, and that the OM-Note supported provider efforts, but experience with the patient-facing OM-App was mixed. The study concluded that adherence to the 2016 CDC Guidelines is not associated with worsening of outcomes for people with HIV with CP-LTOT, and adherence to the CDC Guidelines can be promoted and measured. The researchers recommend additional research into the scalability of these results and the impact of CDC Guideline adherence on public health.
AHRQ-funded; HS025641.
Citation: Cedillo G, George MC, Deshpande R .
Toward safer opioid prescribing in HIV care (TOWER): a mixed-methods, cluster-randomized trial.
Addict Sci Clin Pract 2022 May 16;17(1):28. doi: 10.1186/s13722-022-00311-8..
Keywords: Opioids, Medication, Human Immunodeficiency Virus (HIV), Guidelines, Evidence-Based Practice
Cook RR, Torralva R, King C
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
This study examined the associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder (OUD) among people living with uncontrolled HIV disease. Data from a multisite clinical trial was used to compare extended-release naltrexone (XR-NTX) with treatment as usual (TAU: buprenorphine or methadone) to achieve HIV viral suppression among people with OUD and uncontrolled HIV disease. Exposure to fentanyl use was measured by urine drug screening. The cohort was 11 participants had an average age of 47 years, were 62% male, 57% Black and 13% Hispanic. Baseline fentanyl use was 64% for participants. Participants with baseline fentanyl use were 11 times less likely to initiative XR-NTX than those negative for fentanyl, but there was no evidence that fentanyl use impacted the likelihood of TAU initiation.
AHRQ-funded; HS026370.
Citation: Cook RR, Torralva R, King C .
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
Drug Alcohol Depend 2021 Nov 1;228:109077. doi: 10.1016/j.drugalcdep.2021.109077..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Human Immunodeficiency Virus (HIV), Chronic Conditions
Johnson LF, Kariminia A, Trickey A
Achieving consistency in measures of HIV-1 viral suppression across countries: derivation of an adjustment based on international antiretroviral treatment cohort data.
This aim of this research is to propose that countries with different viral suppression thresholds make adjustments to standardize estimates to the <1000 HIV-1 RNA copies/ml threshold in patients on antiretroviral treatment (ART) by 2020. The authors considered three possible distributions for viral loads in ART patients: Weibull, Pareto and reverse Weibull. The models were fitted to data on viral load distribution in ART patients in the International epidemiology Databases to Evaluate AIDS (IeDEA) collaboration and the ART Cohort Collaboration, using separate random effects models for adults and children. The models were validated using data from the World Health Organization (WHO) HIV drug resistance report and the Brazilian national ART program. Models were calibrated using 921,157 adult and 37,431 pediatric viral load measurements from 2010 to 2019. The Parento and reverse Weibull models provided the best fits to the data.
J Int AIDS Soc 2021 Sep;24(Suppl 5):e25776. doi: 10.1002/jia2.25776.
Citation: Johnson LF, Kariminia A, Trickey A .
Achieving consistency in measures of HIV-1 viral suppression across countries: derivation of an adjustment based on international antiretroviral treatment cohort data.
AHRQ-funded; 90051652..
Keywords: Human Immunodeficiency Virus (HIV), Chronic Conditions, Medication
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation: Tsui JI, Akosile MA, Lapham GT .
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
Hill LM, Lightfoot AF, Riggins L
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
The authors conducted a venue-based community survey with 53 African American women living in low-income neighborhoods of a Southeastern city in order to understand women's knowledge of and attitudes toward pre-exposure prophylaxis (PrEP). They found that awareness of PrEP was very low, with only 16% being aware that PrEP is used for HIV prevention. The vast majority reported that they would use or would consider using PrEP, most frequently citing a general interest in HIV prevention or a lack of awareness of their partners' HIV status as motivations for their interest. Some women expressed concerns about side effects or low perceived HIV risk as disincentives for PrEP use.
AHRQ-funded; HS000032.
Citation: Hill LM, Lightfoot AF, Riggins L .
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
AIDS Care 2021 Feb;33(2):239-43. doi: 10.1080/09540121.2020.1769834..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Women, Low-Income, Prevention, Medication
Flynn G, Jia H, Reynolds NR
Protocol of the randomized control trial: the WiseApp trial for improving health outcomes in PLWH (WiseApp).
This paper outlines the protocol for the WiseApp randomized control trial. The WiseApp contains real-time medication monitoring linking an electronic pill bottle and fitness tracker to the app, helping persons living with HIV (PLWH) self-manage their medication adherence and improve their overall quality of life. The primary objective of the trial is to test the effect of the WiseApp's medication adherence features on antiretroviral adherence in underserved PLWH in New York City. The real-time monitoring of the WiseApp has the potential to help providers initiate interventions to help patients resume treatment before drug resistance begins.
AHRQ-funded; HS025071.
Citation: Flynn G, Jia H, Reynolds NR .
Protocol of the randomized control trial: the WiseApp trial for improving health outcomes in PLWH (WiseApp).
BMC Public Health 2020 Nov 25;20(1):1775. doi: 10.1186/s12889-020-09688-0..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Chronic Conditions, Care Management, Healthcare Delivery
Scherer M, Weiss L, Kamler A M, Weiss L, Kamler A
Patient recommendations for opioid prescribing in the context of HIV care: findings from a set of public deliberations.
It is widely acknowledged that the growing opioid epidemic and associated increase in overdose deaths necessitates a reexamination of processes and procedures related to an opioid prescription for the treatment of chronic pain. However, the perspectives of patients, including those at the highest risk for opioid-related harms, are largely missing from this reexamination. To partially address the gap, the investigators conducted a pair of one-day public deliberations on opioid prescribing in the context of HIV care.
AHRQ-funded; HS025641.
Citation: Scherer M, Weiss L, Kamler A M, Weiss L, Kamler A .
Patient recommendations for opioid prescribing in the context of HIV care: findings from a set of public deliberations.
AIDS Care 2020 Nov;32(11):1471-78. doi: 10.1080/09540121.2019.1705962..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Medication, Chronic Conditions, Pain
Baik D, Liu J, Cho H
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
Investigators conducted a secondary analysis of data collected from four projects focused on improving health outcomes in persons living with HIV (PLWH). They found that male patients displayed negative association between depression and engagement with healthcare providers and positive association between engagement with healthcare providers and medication adherence, while female patients showed no association between any of these factors. Anxiety and stigma were not significantly associated with medication adherence. They concluded that adherence interventions for PLWH should be tailored by biological sex.
AHRQ-funded; HS025071.
Citation: Baik D, Liu J, Cho H .
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
AIDS Behav 2020 Sep;24(9):2656-65. doi: 10.1007/s10461-020-02823-3..
Keywords: Human Immunodeficiency Virus (HIV), Sex Factors, Patient and Family Engagement, Patient Adherence/Compliance, Depression, Behavioral Health, Medication
O'Halloran JA, Sahrmann J, Butler AM
Brief report: integrase strand transfer inhibitors are associated with lower risk of incident cardiovascular disease in people living with HIV.
AHRQ-funded; HS019455.
Citation: O'Halloran JA, Sahrmann J, Butler AM .
Brief report: integrase strand transfer inhibitors are associated with lower risk of incident cardiovascular disease in people living with HIV.
J Acquir Immune Defic Syndr 2020 Aug 1;84(4):396-99. doi: 10.1097/qai.0000000000002357..
Keywords: Human Immunodeficiency Virus (HIV), Cardiovascular Conditions, Medication, Stroke, Heart Disease and Health, Risk
Brault MA, Spiegelman D, Abdool Karim SS
Integrating and interpreting findings from the latest treatment as prevention trials.
This paper examined findings from some 2018-2019 international studies assessing the effectiveness of reducing HIV incidence by expanding HIV testing, linkage to HIV treatment, and helping persons living with HIV adhere to their medications (called the 90-90-90 strategy). A number of these “treatment as prevention” (TasP) tests had complex results. The studies examined included the TasP/ANRS 12249 study in South Africa, the SEARCH study in Kenya and Uganda, and one comparison (arms A to C) of the HPtn 071 (PopART) study in South Africa and Zambia as well as the Botswana Ya Tsie study. All but the Botswana Ya Tsie study and the second comparison (arms B to C) of PopART did not demonstrate a community impact on HIV incidence. But those two studies indicated significant (30%) reductions in HIV incidence in the intervention communities.
AHRQ-funded; HS023000.
Citation: Brault MA, Spiegelman D, Abdool Karim SS .
Integrating and interpreting findings from the latest treatment as prevention trials.
Curr HIV/AIDS Rep 2020 Jun;17(3):249-58. doi: 10.1007/s11904-020-00492-4..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Implementation, Medication, Screening
Bourgi K, Jenkins CA, Rebeiro PF
Weight gain among treatment-naive persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada.
This study compared weight gain among persons with HIV (PWH) following different antiretroviral therapy (ART) drug classes. The cohort was part of the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). The 22,972 participants were 87% male and 41% white. Twenty percent started strand transfer inhibitor (INSTI), 31% started protease inhibitor (PI), and 49% started non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based ART. Average weight gain was higher with INSTI-based regimens compared to NNRTI-based regimens or PI-based regimens.
AHRQ-funded; 90047713.
Citation: Bourgi K, Jenkins CA, Rebeiro PF .
Weight gain among treatment-naive persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada.
J Int AIDS Soc 2020 Apr;23(4):e25484. doi: 10.1002/jia2.25484.
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Keywords: Human Immunodeficiency Virus (HIV), Obesity: Weight Management, Obesity, Medication
Rohner E, Butikofer L, Schmidlin K
Cervical cancer risk in women living with HIV across four continents: a multicohort study.
In this study, the investigators compared invasive cervical cancer (ICC) incidence rates in Europe, South Africa, Latin and North America among women living with HIV who initiated antiretroviral therapy (ART) between 1996 and 2014. The investigators concluded that improving access to early ART initiation and effective cervical cancer screening in women living with HIV should be key parts of global efforts to reduce cancer-related health inequities.
AHRQ-funded; 90047713.
Citation: Rohner E, Butikofer L, Schmidlin K .
Cervical cancer risk in women living with HIV across four continents: a multicohort study.
Int J Cancer 2020 Feb;146(3):601-09. doi: 10.1002/ijc.32260..
Keywords: Cancer: Cervical Cancer, Cancer, Human Immunodeficiency Virus (HIV), Women, Medication, Chronic Conditions
BJ BJ, McGinnis KA, Edelman EJ
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.
Researchers examined predictors of medications for alcohol use disorder initiation and retention across HIV status. Data from the Veterans Aging Cohort Study data was used to identify new alcohol use disorder diagnoses among 163,339 individuals from 1998 to 2015. The researchers found that the low frequency of retention precluded multivariable analyses for retention. They concluded that, for people living with HIV and uninfected individuals, targeted implementation strategies to expand medications for alcohol use disorder are needed, particularly for specific subpopulations.
AHRQ-funded; HS021112.
Citation: BJ BJ, McGinnis KA, Edelman EJ .
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.
J Subst Abuse Treat 2020 Feb;109:14-22. doi: 10.1016/j.jsat.2019.11.002..
Keywords: Alcohol Use, Substance Abuse, Medication, Human Immunodeficiency Virus (HIV)
Rentsch CT, Edelman EJ, Justice AC
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
A better understanding of predisposition to transition to high-dose, long-term opioid therapy after initial opioid receipt could facilitate efforts to prevent opioid use disorder (OUD). In this study, the investigators extracted data on 69,268 patients in the Veterans Aging Cohort Study who received any opioid prescription between 1998 and 2015. They identified four distinguishable dose trajectories. The authors indicate that their measures could potentially be used in future prevention research, including genetic discovery.
AHRQ-funded; HS021112; HS023258.
Citation: Rentsch CT, Edelman EJ, Justice AC .
Patterns and correlates of prescription opioid receipt among US Veterans: a national, 18-year observational cohort study.
AIDS Behav 2019 Dec;23(12):3340-49. doi: 10.1007/s10461-019-02608-3..
Keywords: Opioids, Medication, Substance Abuse, Human Immunodeficiency Virus (HIV), Pain, Chronic Conditions
Olivieri-Mui BL, Koethe B, Briesacher B
Economic barriers to antiretroviral therapy in nursing homes.
In this study, the investigators’ aim was to clarify if persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) have adequate economic access to antiretroviral therapy (ART) when admitted to nursing homes (NHs). They concluded that people living with HIV in NHs do not always receive lifesaving ART, but the reasons are unclear and appear unrelated to economic barriers.
AHRQ-funded; HS025662.
Citation: Olivieri-Mui BL, Koethe B, Briesacher B .
Economic barriers to antiretroviral therapy in nursing homes.
J Am Geriatr Soc 2020 Apr;68(4):777-82. doi: 10.1111/jgs.16288..
Keywords: Human Immunodeficiency Virus (HIV), Nursing Homes, Long-Term Care, Medication, Access to Care
Stringer KL, Marotta P, Baker E
Substance use stigma and antiretroviral therapy adherence among a drug-using population living with HIV.
Among people living with HIV (PLWH), HIV-related stigma predicts nonadherence to antiretroviral therapy (ART); however, the role of stigma associated with drug use is largely unknown. The this study the investigators examined the association between substance use (SU) stigma and optimal ART adherence in a sample of 172 self-reported HIV-infected drug users.
AHRQ-funded; HS013852.
Citation: Stringer KL, Marotta P, Baker E .
Substance use stigma and antiretroviral therapy adherence among a drug-using population living with HIV.
AIDS Patient Care STDS 2019 Jun;33(6):282-93. doi: 10.1089/apc.2018.0311..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Patient Adherence/Compliance, Medication, Substance Abuse
Fredericksen RJ, Yang FM, Gibbons LE
Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care.
The authors developed brief, computer-administered patient-reported measures in English and Spanish assessing prescribed medication adherence behaviors and barriers for use with patients living with chronic diseases focusing on clinical relevance, brevity, and content validity for use in clinical care.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Yang FM, Gibbons LE .
Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care.
Res Social Adm Pharm 2019 Sep;15(9):1168-76. doi: 10.1016/j.sapharm.2018.10.001..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Human Immunodeficiency Virus (HIV)
Wang L, Krebs E, Min JE
Combined estimation of disease progression and retention on antiretroviral therapy among treated individuals with HIV in the USA: a modelling study.
Accurately estimating HIV disease progression and retention on antiretroviral therapy (ART) can help inform interventions to control HIV microepidemics and mathematical models used to inform health-resource allocation decisions. The objective of the study was to estimate the monthly probabilities of on-ART CD4 T-cell count progression, mortality, ART dropout, and ART reinitiation using a continuous-time multistate Markov model. The investigators also aimed to validate health-state transition probability estimates to ensure they accurately reproduced the regional HIV microepidemics across the USA.
AHRQ-funded; 290201100007C.
Citation: Wang L, Krebs E, Min JE .
Combined estimation of disease progression and retention on antiretroviral therapy among treated individuals with HIV in the USA: a modelling study.
Lancet HIV 2019 Aug;6(8):e531-e39. doi: 10.1016/s2352-3018(19)30148-1.
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Keywords: Human Immunodeficiency Virus (HIV), Medication
McManus KA, Debolt C, Elwood S
Facilitators and barriers: clients' perspective on the Virginia AIDS Drug Assistance Program's Affordable Care Act implementation.
This study examined low-income HIV patients’ perspective on the Virginia AIDS Drug Assistance Program (ADAP) Affordable Care Act (ACA) implementation. Patients were recruited at three HIV clinics in Virginia with the goal of enrolling greater than 5% of those who were eligible for the Qualified Health Plan (QHP). The recruitment goals were met with 53 patients enrolled. Two-thirds of patients were recruited to the QHP via case managers and social workers at the HIV clinics. Concerns about privacy using the mail-order pharmacy was the biggest barrier with 9 out of 10 participants. Otherwise, most participants had positive perceptions of the QHP.
AHRQ-funded; HS024196.
Citation: McManus KA, Debolt C, Elwood S .
Facilitators and barriers: clients' perspective on the Virginia AIDS Drug Assistance Program's Affordable Care Act implementation.
AIDS Res Hum Retroviruses 2019 Aug;35(8):734-45. doi: 10.1089/aid.2018.0254..
Keywords: Human Immunodeficiency Virus (HIV), Access to Care, Medication, Low-Income, Vulnerable Populations
Hill LM, Golin CE, Gottfredson NC
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
The purpose of this study was to identify the mechanisms involved with antiretroviral therapy (ART) non-adherence among people living with HIV (PLHIV) after release from prison. Results showed that, on average, study participants achieved 79% ART adherence. Greater symptoms of depression were associated with greater drug use, which was in turn associated with lower adherence. Lower adherence self-efficacy was associated with depressive symptoms, but not with adherence. Results suggested that depression screening and targeted mental health and substance use services for depressed individuals at risk of substance use constitute important steps to promote adherence to ART after prison release.
AHRQ-funded; HS000032.
Citation: Hill LM, Golin CE, Gottfredson NC .
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
AIDS Behav 2019 Aug;23(8):2037-47. doi: 10.1007/s10461-018-2355-3..
Keywords: Behavioral Health, Depression, Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Substance Abuse, Vulnerable Populations
Lipira L, Williams EC, Huh D
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
Investigators recruited a sample of African-American women living with HIV to participate in a stigma-reduction intervention. The women lived in Chicago and Birmingham from 2013 to 2015. The relationship between HIV-related stigma and viral suppression was evaluated and the role of depression and nonadherence to antiretroviral therapy (ART) was assessed. Among 100 women who participated 95% reported some level of HIV-related stigma. Those who reported higher levels of stigma did have lower odds of being virally suppressed. The indirect effects of depression and ART nonadherence were not statistically significant.
AHRQ-funded; HS013853.
Citation: Lipira L, Williams EC, Huh D .
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
AIDS Behav 2019 Aug;23(8):2025-36. doi: 10.1007/s10461-018-2301-4..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Stigma, Women