Malattie Infettive, H. More Information. Lederman MM, Valdez H. Immune restoration with antiretroviral therapies: implications for clinical management. J Infect Dis. Epub Aug Erratum in: J Infect Dis Oct 15; 8 Time of initiation of antiretroviral therapy: impact on HIV-1 viraemia. Open Forum Infect Dis. Lessons learned: Infrastructure development and financial management for large, publicly funded, international trials.
Clin Trials. Epub Feb 8. Severity of cardiovascular disease outcomes among patients with HIV is related to markers of inflammation and coagulation.
AIDS: the Early Years and CDC's Response
J Am Heart Assoc. Glomerular filtration rate estimated using creatinine, cystatin C or both markers and the risk of clinical events in HIV-infected individuals. HIV Med. Epub Sep HIV replication alters the composition of extrinsic pathway coagulation factors and increases thrombin generation. Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: The SMART body composition substudy. J Bone Miner Res.
Platelet count kinetics following interruption of antiretroviral treatment. Hepatitis B and C co-infection are independent predictors of progressive kidney disease in HIV-positive, antiretroviral-treated adults. PLoS One. Epub Jul Inflammation predicts changes in high-density lipoprotein particles and apolipoprotein A1 following initiation of antiretroviral therapy.
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Antivir Ther. N-terminal-proB-type natriuretic peptide predicts cardiovascular disease events in HIV-infected patients.
A Comparison of Two Ways to Manage Anti-HIV Treatment (The SMART Study)
Changes in lipids and lipoprotein particle concentrations after interruption of antiretroviral therapy. J Acquir Immune Defic Syndr. Frequent hepatitis B virus rebound among HIV-hepatitis B virus-coinfected patients following antiretroviral therapy interruption. Activation and coagulation biomarkers are independent predictors of the development of opportunistic disease in patients with HIV infection. Continuous antiretroviral therapy decreases bone mineral density. Some of the reviewed studies reported improved mental health outcomes perceived stress, anxiety, and depressive symptoms , individual-level HIV competency acceptance, resilience, coping, self-management and improve perceived social support for the PLHIV in the household.
Sikkema et al. The improved outcomes of PLHIV demonstrated by community-based and household interventions are confirmed by Wu and Li [ 70 ] who showed that there are benefits of delivering a comprehensive set of interventions to PLHIV, along with their household members, caregivers, and other members of the community. Our review revealed that most of the interventions were delivered by trained lay counsellors and community health workers. The use of lower-level providers has been encouraged by many scholars and public health researchers [ 71 , 72 , 73 , 74 ]. This is in an effort to maximise the effective use of healthcare resources while ensuring the effective delivery of healthcare services [ 75 ].
Community health worker-led interventions appear to be effective and also cost-effective for certain health conditions, particularly when partnering with low-income, underserved, and racial and ethnic minority communities [ 76 ]. The review indicated that household-focused interventions are predominantly centred on providing information on HIV and medication adherence and relational components communication and social support. Although the experience of living with HIV negatively impacts the overall functioning of the affected households [ 77 ], having a supportive environment provided by members of the household may improve the health outcomes and quality of life of PLHIV [ 57 ].
According to Winskell et al. Therefore, interventions designed to improve the HIV competence of households affected by HIV can be conceptualised as strength- or resilience-based interventions [ 78 ]. The strength of this study lies on the fact that in addition to identifying and exploring the effects of various interventions implemented at the household-level to improve the HIV competency of the households of PLHIV, we also sought to identify the underlying programme theories informing their possible success.
Particularly, we unearthed the possible mechanisms of action driving the uptake and success of these interventions. Identifying the theory or theories that informed the development of the intervention was in some instances challenging. This also limited our ability to retroduce what possible mechanisms are in play in the intervention under consideration.
Prevention
To overcome this barrier, we traced the original article that reported on the design of the intervention. This process helped us to identify the proposed mechanism s of actions within each intervention. Following our article screening process, we observed that no large-scale studies were included, which could affect the inferences drawn on the effectiveness of the interventions under consideration.
The heterogenic nature of the studies included in the review did not allow for meta-analysis to be conducted to assess the overall impact of household-based HIV interventions to improve the household competency of the households of PLHIV. To this end, a scoping review with a narrative synthesis informed by thematic analysis became the possible option. Our understanding of the types of household-based interventions to improve the household-competency for PLHIV has three implications.
AIDS: the Early Years and CDC's Response
Second, the scoping review indicates which interventions have shown success and which ones have not been very successful on improving various aspects of household competency. Third, this article unveils the programme theories, underlying the understanding of how and why these interventions were expected to work. These understandings can enhance the design and implementation of interventions to improve the experiences of PLHIV within their households regarding the self-management of their disease, which in turn improves ART adherence and retention in care.
This is particularly useful in the context of LMICs with weak health systems. The importance of including other household members in the treatment and care of PLHIV has been long established. While a handful of interventions seek to improve the communication between PLHIV and their caregivers to enhance their disclosure, social support and reduce depressive symptoms, much still needs to be done to improve overall HIV household competency. The dataset s supporting the conclusions of this article is are included within the article and its additional file s.
Shao Y, Williamson C. The HIV-1 epidemic: low- to middle-income countries.
Account Options
Cold Spring Harb Perspect Med. Early mortality in adults initiating antiretroviral therapy ART in low- and middle-income countries LMIC : a systematic review and meta-analysis. PLoS One. Universal testing and treatment as an HIV prevention strategy: research questions and methods. Curr HIV Res. World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection recommendations for a Public Health approach [Internet]. Switzerland; Kober K, Van Damme W.
Scaling up access to antiretroviral treatment in southern Africa: Who will do the job? Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study. Hum Resour Health; ; Psychosocial care of people living with HIV in Benin. Sante Publique. Conceptualising the factors affecting retention in Care of Patients on antiretroviral treatment in Kabwe District, Zambia, using the ecological framework.
Decentralising HIV treatment in lower- and middle-income countries. Cochrane Database Syst Rev. A systematic review of task-shifting for HIV treatment and care in Africa. Hum Resour Health. Realist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocol. BMJ Open. Reimagining HIV service delivery: the role of differentiated care from prevention to suppression. Who Should We Target? Masquillier C. Antwerp: Department of Sociology. Interventions for families affected by HIV.
Transl Behav Med. Lightfoot M, Milburn N. Common elements of Family-based HIV interventions for adolescents.
Couple Fam Psychol. Bell C. Chandan U, Richter L. Strengthening families through early intervention in high HIV prevalence countries. AIDS Care. Towards a family-centered approach to HIV treatment and care for HIV-exposed children, their mothers and their families in poorly resourced settings. Future Virol. Fam Syst Heal. Tomlinson M. Family-centred HIV Interventions: lessons from the field of parental depression.
Wacharasin C. J Fam Nurs. PLoS Med. Public Library of Science. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. Sharma R. J Fam Med Prim Care. Wolters Kluwer -- Medknow Publications. Ball DW. Bender DR. A refinement of the concept of household: families, co-residence, and domestic functions.
Am Anthropol Assoc.
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