• Adherence to HIV post-exposure prophylaxis in victims of sexual assault: a systematic review and meta-analysis

      Chacko, Liza; Ford, Nathan; Sbaiti, Mariam; Siddiqui, Ruby; Imperial College London, St Mary's Hospital, London, UK; Médecins Sans Frontières, Doctors without Borders (MSF-UK), London, UK; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa (BMJ Publishing Group, 2012-02-13)
      ObjectiveTo assess adherence to post-exposure prophylaxis (PEP) for the prevention of HIV infection in victims of sexual assault.MethodsThe authors carried out a systematic review, random effects meta-analysis and meta-regression of studies reporting adherence to PEP among victims of sexual violence. Seven electronic databases were searched. Our primary outcome was adherence; secondary outcomes included defaulting, refusal and side effects.Results2159 titles were screened, and 24 studies matching the inclusion criteria were taken through to analysis. The overall proportion of patients adhering to PEP (23 cohort studies, 2166 patients) was 40.3% (95% CI 32.5% to 48.1%), and the overall proportion of patients defaulting from care (18 cohorts, 1972 patients) was 41.2% (95% CI 31.1% to 51.4%). Adherence appeared to be higher in developing countries compared with developed countries.ConclusionsAdherence to PEP is poor in all settings. Interventions are needed to support adherence.
    • Effect of Community ART Groups on Retention-In-Care Among Patients on ART in Tete Province, Mozambique: A Cohort Study

      Decroo, T; Telfer, B; Dores, C; White, R; Santos, N; Mkwamba, A; Dezembro, S; Joffrisse, M; Ellman, T; Metcalf, C (BMJ Publishing Group, 2017-08-11)
      Estimate the effect of participation in Community ART Groups (CAG) versus individual care on retention-in-care (RIC) on antiretroviral therapy (ART).
    • Eye exam with indirect ophthalmoscopy for diagnosis of disseminated tuberculosis in patients with HIV/AIDS

      Heiden, David; Margolis, Todd P; Lowinger, Alan; Saranchuk, Peter (BMJ Publishing Group, 2013-05-01)
    • Lived experiences of palliative care among people living with HIV/AIDS: a qualitative study from Bihar, India.

      Nair, M; Kumar, P; Mahajan, R; Harshana, A; Richardson, K; Moreto-Planas, L; Burza, S (BMJ Publishing Group, 2020-10-05)
      Objectives: This study aimed to assess the lived experiences of palliative care among critically unwell people living with HIV/AIDS (PLHA), caregivers and relatives of deceased patients. It also aimed to understand the broader palliative care context in Bihar. Design: This was an exploratory, qualitative study which used thematic analysis of semistructured, in-depth interviews as well as a focus group discussion. Setting: All interviews took place in a secondary care hospital in Patna, Bihar which provides holistic care to critically unwell PLHA. Participants: We purposively selected 29 participants: 10 critically unwell PLHA, 5 caregivers of hospitalised patients, 7 relatives of deceased patients who were treated in the secondary care hospital and 7 key informants from community-based organisations. Results: Critically ill PLHA emphasised the need for psychosocial counselling and opportunities for social interaction in the ward, as well as a preference for components of home-based palliative care, even though they were unfamiliar with actual terms such as 'palliative care' and 'end-of-life care'. Critically unwell PLHA generally expressed preference for separate, private inpatient areas for end-of-life care. Relatives of deceased patients stated that witnessing patients' deaths caused trauma for other PLHA. Caregivers and relatives of deceased patients felt there was inadequate time and space for grieving in the hospital. While both critically ill PLHA and relatives wished that poor prognosis be transparently disclosed to family members, many felt it should not be disclosed to the dying patients themselves. Conclusions: Despite expected high inpatient fatality rates, PLHA in Bihar lack access to palliative care services. PLHA receiving end-of-life care in hospitals should have a separate dedicated area, with adequate psychosocial counselling and activities to prevent social isolation. Healthcare providers should make concerted efforts to inquire, understand and adapt their messaging on prognosis and end-of-life care based on patients' preferences.
    • Seasonal variations in tuberculosis diagnosis among HIV-positive individuals in Southern Africa: analysis of cohort studies at antiretroviral treatment programmes

      Ballif, M; Zürcher, K; Reid, SE; Boulle, A; Fox, MP; Prozesky, HW; Chimbetete, C; Zwahlen, M; Egger, M; Fenner, L (BMJ Publishing Group, 2018-01-11)
      Seasonal variations in tuberculosis diagnoses have been attributed to seasonal climatic changes and indoor crowding during colder winter months. We investigated trends in pulmonary tuberculosis (PTB) diagnosis at antiretroviral therapy (ART) programmes in Southern Africa.