A person‐centred approach to enhance the long‐term health and wellbeing of people living with HIV in Europe

Journal of the International AIDS Society, Journal Year: 2023, Volume and Issue: 26(S1)

Published: July 1, 2023

Person-centred care is a critical attribute of high-quality healthcare, promoting quality life, improving an individual's interaction with the health system and valuing people's social networks [1]. Lifesaving antiretroviral therapy now increasingly widely available around world, although not all countries have reached their coverage targets related to prevention, diagnosis linkage care. As consequence enormous progress made, most people living HIV are able grow older rather than dying prematurely [2]. Therefore, it essential that systems respond changing needs ageing population HIV, who comparatively higher multimorbidity (both physical mental) experience persistent stigma [3, 4]. To achieve this, person-centred services for must focus on long-term wellbeing by monitoring managing multimorbidity, health-related life (HRQoL), discrimination [5]. In line WHO's global strategy 2022–2030 [2] UNAIDS' set in 2021 [6], people-centred approach allow this transformation systems. Health offer integrated response evolving choices HIV—and still case settings, including high-income Europe [7]. The crisis during 2020 worsening outcomes COVID-19 pandemic [8] demonstrated importance coordination among European protect across national borders, especially vulnerable. Against backdrop pandemic, 2020, Union put forward proposal [9]. Ambitious policy opportunities were identified, from Data Space, reinforcing Centre Disease Prevention Control mandate pushing Care Strategy [10]. Person-centricity at corej these initiatives, paving way personalized healthcare delivery. These initiatives particular relevance given multidimensional needs. A organized what important choices, focusing individual diseases [5, 11]; "consciously adopts perspectives individuals, families communities (…), sees them as participants beneficiaries trusted (…) humane holistic ways" "acknowledges experiences health-care providers may enable or prevent delivery [these services]" [12]. context be empowered supported make decisions about degree self-management they capable willing assume age, gender, socio-economic status support network. key objective ensure views, represented prioritizing enhancement health, HRQoL overall wellbeing, until end With goal mind, 2022, over 60 multidisciplinary organizations experts Outcomes initiative co-developed 27 asks recommendations authorities [13]. Qualitative input was collected representation clinicians, academics, public professionals, policymakers industry representatives. Expert interviews conducted via questionnaire seven workshops. Entitled "Enhancing well-being HIV," grouped into four areas where action urgent improve wellbeing: (1) comorbidity treatment management-including mental health; (2) HIV; (3) patient-reported measures HRQoL; (4) combatting discrimination. For each area, specific, implementable translatable made clinics/care providers, regional policymakers. Priority highlighted Table 1 Although challenging fewer resources available, greater burden comparison general reduced domains. actions can benefit both costs need adopted. This should tandem efforts increase numbers diagnosed, linked virally suppressed [14]. placed reaching diagnosed late high risk clinical progression poor outcomes. Currently, 53% newly WHO region late, whom 51% aged >50 [15]. We encourage adoption member states 2023. aforementioned tailored tackle shortcomings settings Europe. Different priority also considered other regions world. JVL reports grants speaker fees AbbVie, Gilead Sciences, MSD Roche Diagnostics his institution, Intercept, Janssen, Novo Nordisk ViiV consulting fess Novavax, outside submitted work. JA consultancy Sciences Healthcare, MC, SP RH no competing interest declare. conceived paper. JA, reviewed first full draft article. All authors involved subsequent revisions approved final version submission. members (https://hivoutcomes.eu/about-us/team-members/). acknowledges ISGlobal grant CEX2018-000806-S funded MCIN/AEI/10.13039/501100011033 'Generalitat de Catalunya' through CERCA Programme, Policy Asks developed collaboration Initiative, researchers, patient group representatives industry. Thank you everyone Outcomes. Outcomes, multi-stakeholder initiative, created 2016 advance HIV—beyond viral suppression. members: Steering Group Members: Antonella d'Arminio Monforte: University Milan; AIDS Action Europe: Sini Pasanen; Children's Association (CHIVA): Amanda Ely Williams; Treatment (EATG): Mario Cascio; Jane Anderson: Homerton Hospital NHS Foundation Trust, London (Steering Co-Chair); National Trust (NAT): Cheryl Gowar; Nikos Dedes: Positive Voice (Greek association HIV) Richard Harding: King's College London; Jeffrey Lazarus: Barcelona Institute Global (ISGlobal), Clinic, Stéphan Vernhes: AIDES & Coalition PLUS; Industry by: Andrea Zanaglio (Gilead Sciences) Rhon Reynolds (ViiV Healthcare). Adhara Asociación VIH/SIDA (ADHARA): Diego García Alejandro Bertó Morán; AFEW International: Yulia Komo; Correlation—European Harm Reduction Network [C-EHRN]: Roberto Pérez-Gayo; Dr Casper Rokx: Erasmus MC; Diana Barger: Bordeaux; Patrizia Carrieri: French Medical Research (INSERM); East Central Asia PLWH (ECUO): Vladimir Zhovtyak; GAMIAN-Europe: Nigel Olisa; Georg Behrens: Hannover School; Grupo Ativistas em Tratamentos (GAT Portugal): Luis Mendão; Igor Gordon: Eurasian Association; Maryan Said; Nurses (NHIVNA): Shaun Watson; Prof Alan Winston–Okeefe: Imperial Anna Mia Ekström: Karolinska Instituet; Caroline Sabin: Giovanni Guaraldi: Modena Reggio Emilia (UNIMORE); Kyriakos Souliotis: Peloponnese Institute; Lars E Eriksson: Sociedad Española Interdisciplinaria del SIDA (SEISIDA): María José Fuster-Ruíz Apodaca; Supporting Women Information (SWIFT Network): Yvonne Gilleece; SKUK-Magnus: Miran Solinc; Terrence Higgins (THT): Angell. Observer (ECDC); Joint United Nations Programme HIV/AIDS (UNAIDS); Clinical Society (EACS); Fast Track Cities Europe; UNITE Parliamentarians (UNITE). in-country initiatives: Germany; Italy; Spain; Romania; UK.

Language: Английский

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Breaking down global barriers: A multinational and multi‐community approach to combat stigma and enhance mental wellbeing in people with HIV

HIV Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 16, 2025

Abstract Introduction The Joint United Nations Programme on HIV/AIDS (UNAIDS) Global 2025 targets prioritize action to overcome the collective barriers affecting people and communities sitting outer margins of HIV care. Addressing social structural disparities that drive greater prevalence burden requires well‐resourced, community‐led responses are fully integrated into national global initiatives. Methods Community Council (HCC), composed 10 leaders from diverse communities, convened share their insights, amplify community's voice, identify solutions empower all live well with through a dynamic, stepwise process preparative work, deep discussion, prioritization, consensus. Results HCC created six recommendations address two important living HIV: stigma poor mental wellbeing. These informed by best practice community experience. They include suggestions for developing delivering actionable at level prompt opportunities support existing regional organizations. Conclusion calls implement community‐endorsed, culturally appropriate, practical tackle wellbeing improve long‐term health HIV.

Language: Английский

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Outcomes of a pilot randomized clinical trial testing brief interventions to increase HIV pre-exposure prophylaxis uptake among rural people who inject drugs attending syringe services programs

Therapeutic Advances in Infectious Disease, Journal Year: 2025, Volume and Issue: 12

Published: Jan. 1, 2025

Kentucky is one of seven states with high, sustained rural HIV transmission tied to injection drug use. Expanding access pre-exposure prophylaxis (PrEP) has been endorsed as a key prevention strategy; however, uptake among people who inject drugs (PWID) negligible in areas. Syringe services programs (SSPs) have implemented throughout Kentucky's Appalachian region, providing an important opportunity integrate PrEP services. The primary objective was examine preliminary efficacy and effect sizes the study interventions on initiation HIV-negative PWID. Parallel group randomized controlled trial. Eighty participants were enrolled from two SSP locations southeastern Kentucky. Following informed consent, completed baseline interview, intervention comparators. endpoint initiation, measured by dispensed prescription, within 6-month period. Analyses employed intent-to-treat (ITT) per protocol approaches. In total, 77/80 enrollees (96.2%) at least session their assigned intervention, regardless trial arm. Seventy (87.5%) linked embedded provider for initial clinical visit; 38 (47.5%) follow-up visit provider, 22 (27.5%) issued 7 (8.8%) initiated during We observed 12.1% difference (14.6% vs 2.5%; ITT) 12.8% (15.4% 2.6%; protocol) outcome (PrEP initiation), favor experimental intervention. This pilot established proof concept integrated care SSPs areas, demonstrated clinically meaningful between interventions, which warrants examination larger Rates early discontinuation indicate need ongoing patient engagement strategies implementation support community SSPs. Prospective registration ClinicalTrials.gov, NCT05037513 (registered August 5, 2021).

Language: Английский

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An (un)restricted living: a qualitative exploration of the mental health and well-being of people living with HIV in England

Social Science & Medicine, Journal Year: 2025, Volume and Issue: unknown, P. 118109 - 118109

Published: April 1, 2025

Language: Английский

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Prevalence and sociodemographic determinants of public stigma towards people with HIV and its impact on HIV testing uptake: A cross‐sectional study in 64 low‐ and middle‐income countries

HIV Medicine, Journal Year: 2023, Volume and Issue: 25(1), P. 83 - 94

Published: Sept. 6, 2023

Abstract Background HIV stigma and discrimination are drivers of adverse outcomes because they deter individuals from engaging in the care continuum. We estimate prevalence public towards people with HIV, investigate individuals' sociodemographic determinants for reporting stigmatizing attitudes, test impact on testing uptake. Methods This was an observational study based analysis cross‐sectional surveys 64 low‐ middle‐income countries. used nationally representative survey data population aged 15–49 years 2015 to 2021, which latest available data. measured using index two questions about attitudes HIV. First, estimates were calculated by country, across countries, characteristics. Second, country fixed‐effects multivariable logistic regression models fit assess holding Additional assessed country‐level income as role a driver Results A total 1 172 841 participants included study. prevalent all ranging 12.87% Rwanda 90.58% Samoa. There inverse dose–response association between educational level, wealth quintile, age group, whereby higher levels each associated lower odds stigmatized The among men adequate knowledge countries greater gross domestic product per capita prevalence. Holding uptake, including having ever tested or last year. Conclusion is present highly varying degree studied, so different approaches reducing required settings. Action eliminate crucial if we progress ending reduced testing.

Language: Английский

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Long-Term Treatment Success with Bictegravir/Emtricitabine/Tenofovir Alafenamide (BIC/FTC/TAF)

Published: April 14, 2024

The treatment paradigm for individuals living with human immunodeficiency virus (HIV) has evolved beyond solely focusing on viral load suppression to encompass a comprehensive approach that prioritizes health-related quality of life (HRQoL). Biktarvy (BIC/FTC/TAF) emerged as promising therapeutic option achieving this goal. During the 11th German-Austrian AIDS Congress (DÖAK), eight healthcare professionals from Germany, Austria, and Switzerland convened at non-public, industry-sponsored meeting discuss how BIC/FTC/TAF supports holistic, long-term, patient-centered optimize HRQoL people HIV (PwH). experts were invited share their experience examine relevant real-world data presented during DÖAK congress. expert-led was initiated provide valuable perceptions practicing in different clinical practical settings. This paper highlights key findings expert discussion. agreed regimen is highly suitable everyday use, showing efficacy tolerability across various patient groups, including those unclear prior therapies, hepatitis B status, low CD4 counts, opportunistic infections, engaged chemsex. Moreover, adherence crucial successful therapy, requiring personalized care structured, regular questioning process. Various factors, such substance abuse or changes circumstances, can affect adherence; hence, open discussions about patient's situations needs are important. In conclusion, achievement new goals virological by effectively catering groups. It also fosters leniency towards suboptimal adherence. regimen's versatility practicality make it an integral tool broader health objectives management. PEER REVIEWED ARTICLE Peer reviewers: Dr Rein Jan Piso, Kantonsspital Olten, One anonymous peer reviewer Received: September 1, 2023; Accepted after review: January 15, 2024

Language: Английский

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Validation of the HIV/AIDS-Targeted Quality of Life (HAT-QOL) for Evaluation of Health-related Quality of Life in People Living with HIV/AIDS in Brazil

AIDS and Behavior, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 12, 2024

Language: Английский

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Identifying the Unmet Medical Needs of HIV-Positive Subjects in Korea: Results of a Nationwide Online Survey

Infection and Chemotherapy, Journal Year: 2023, Volume and Issue: 55(3), P. 397 - 397

Published: Jan. 1, 2023

An online survey was conducted in Korea to identify the unmet medical needs of people living with human immunodeficiency virus (HIV) (PLWH). Participants (n = 105) were mostly male (93.3%), aged >40 years (75.2%), and treated for ≥6 post-diagnosis (61.9%). Most PLWH (71.4%) very satisfied/satisfied their HIV management. Areas concern quality life (QoL) mental health. Characteristics a long-term therapeutic agent 'low risk resistance', 'high viral suppression efficacy', degree safety'. Pre-consultation QoL health screening would be beneficial success

Language: Английский

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Ageing well with human immunodeficiency virus

Journal of Pharmacy Practice and Research, Journal Year: 2023, Volume and Issue: 53(6), P. 337 - 349

Published: Dec. 1, 2023

Abstract Human immunodeficiency virus (HIV) infection is now considered a manageable chronic condition. With the tolerable and highly active antiretroviral therapies that are available today, people diagnosed with HIV can experience longevity good health‐related quality of life. As result, number older living HIV, including in aged care, increasing. There are, however, challenges barriers to successful ageing for HIV. These include persistent inflammation immune dysfunction, earlier occurrence complex comorbidities, additional exacerbators such as polypharmacy. To mitigate these factors, clinicians should implement evidenced‐based interventions adopt multidisciplinary collaborative approach management so have best chance well.

Language: Английский

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Efficacy of Lamivudine and Dolutegravir simplification therapy compared with triple therapy in Northeast Brazil (LAMDO Study)

Journal of HIV for Clinical and Scientific Research, Journal Year: 2024, Volume and Issue: 11(1), P. 001 - 009

Published: Feb. 6, 2024

Background: Modern antiretroviral therapy provides numerous effective and well-tolerated treatment options for individuals living with HIV. However, due to medication tolerability, toxicity, cost optimization associated the emergence of highly potent drugs, dual has emerged as a new therapeutic alternative patients viral suppression. Observational studies worldwide are being conducted assess effectiveness in people HIV/AIDS. A real-world study is important validate findings obtained controlled studies. Objective: Assess lamivudine dolutegravir compared triple real-life settings. Methods: The was at São José Infectious Diseases Hospital, tertiary referral hospital state Ceará, northeast Brazil, PLWHA. Results: total 521 were taking double plus 450 therapy, mostly use association dolutegravir, analyzed. Patients on had higher median age those therapy. statistically significant suppression observed (p < 0,001). Viral under 200 copies 97.2%. There percentage CD4/CD8 ratio using Conclusion: current suggests response PLWHA real-world, supporting simplification sustainable option maintain virological experiencing toxicity or comorbidities.

Language: Английский

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