Hubungan Self Efficacy Dan Dukungan Sosial Terhadap Tingkat Kepatuhan Minum Obat Arv Pada Pasien Hiv Di Puskesmas Dempo Palembang

Background: Human Immunodeficiency Virus (HIV) is a virus that damages the human immune system whose population is increasing throughout the world as well as in Indonesia with 48,300 cases in 2017. HIV patients must get Anti Retro Viral (ARV) therapy that works by inhibiting the growth of the virus. HIV patients have difficulty in accepting and adapting to themselves, thus affecting self- efficacy. Self-efficacy is influenced by parents, siblings, friendships, etc. that are the social support. Objective: This study aimed to know the Correlation between Self-efficacy and Social Support to the Level of Compliance with Taking ARV Drugs in HIV Patients Method: This study uses a type of quantitative research with a Correlation Study design using Purposive Sampling techniques with the number of respondents 33 using the Kendall Tau statistical test. Results: The results showed that there was no significant relationship between self-efficacy and adherence to taking ARV drugs with a p-value of 0.170. There is a significant relationship between social support and adherence to taking ARV drugs with p-value 0.001. Suggestion: the people with HIV should improve their adherence to consuming ARVs

Examining catastrophic costs and benefit incidence of subsidized antiretroviral treatment (ART) programme in south-east Nigeria.

OBJECTIVES: To examine the extent to which costs of subsidized antiretrovirals treatment (ART) programmes are catastrophic and the benefit incidence that accrues to different population groups. METHODS: Data on expenditures to patients for receiving treatment from a government subsidized ART clinic was collected using a questionnaire. The patient costs excluded time and other indirect costs. Catastrophic cost was determined as the percentage of total expenditure on ART treatment as a proportion of household non-food expenditures on essential items. RESULTS: On average, patients spent 990 Naira (US$8.3) on antiretroviral (ARV) drugs per month. They also spent an average of$8.2 on other drugs per month. However, people that bought ARV drugs from elsewhere other than the ART clinic spent an average of $88.8 per month. Patients spent an average of$95.1 on laboratory tests per month. Subsidized ARV drugs depleted 9.8% of total household expenditure, other drugs (e.g. for opportunistic infections) depleted 9.7%, ARV drugs from elsewhere depleted 105%, investigations depleted 112.9% and total expenditure depleted 243.2%. The level of catastrophe was generally more with females, rural dwellers and most poor patients. Females and urbanites had more benefit incidence than males and rural dwellers. CONCLUSION: Subsidized ART programme lowers the cost of ARV drugs but other major costs are still incurred, which make the overall cost of accessing and consuming ART treatment to be excessive and catastrophic. The costs of laboratory tests and other drugs should be subsidized and there should also be targeting of ART programme to ensure that more rural dwellers and the most-poor people have increased benefit incidence

Modeling long-term longitudinal HIV dynamics with application to an AIDS clinical study

A virologic marker, the number of HIV RNA copies or viral load, is currently used to evaluate antiretroviral (ARV) therapies in AIDS clinical trials. This marker can be used to assess the ARV potency of therapies, but is easily affected by drug exposures, drug resistance and other factors during the long-term treatment evaluation process. HIV dynamic studies have significantly contributed to the understanding of HIV pathogenesis and ARV treatment strategies. However, the models of these studies are used to quantify short-term HIV dynamics ($<$ 1 month), and are not applicable to describe long-term virological response to ARV treatment due to the difficulty of establishing a relationship of antiviral response with multiple treatment factors such as drug exposure and drug susceptibility during long-term treatment. Long-term therapy with ARV agents in HIV-infected patients often results in failure to suppress the viral load. Pharmacokinetics (PK), drug resistance and imperfect adherence to prescribed antiviral drugs are important factors explaining the resurgence of virus. To better understand the factors responsible for the virological failure, this paper develops the mechanism-based nonlinear differential equation models for characterizing long-term viral dynamics with ARV therapy. The models directly incorporate drug concentration, adherence and drug susceptibility into a function of treatment efficacy and, hence, fully integrate virologic, PK, drug adherence and resistance from an AIDS clinical trial into the analysis. A Bayesian nonlinear mixed-effects modeling approach in conjunction with the rescaled version of dynamic differential equations is investigated to estimate dynamic parameters and make inference. In addition, the correlations of baseline factors with estimated dynamic parameters are explored and some biologically meaningful correlation results are presented. Further, the estimated dynamic parameters in patients with virologic success were compared to those in patients with virologic failure and significantly important findings were summarized. These results suggest that viral dynamic parameters may play an important role in understanding HIV pathogenesis, designing new treatment strategies for long-term care of AIDS patients.Comment: Published in at http://dx.doi.org/10.1214/08-AOAS192 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

A Drug Dosage Table is a Useful Tool to Facilitate Prescriptions of Antiretroviral Drugs for Children in Thailand.

Scaling up of antiretroviral treatment (ART) for children in countries like Thailand will require decentralization and management by non-specialist doctors. We describe (a) the formulation of a standardized drug dosage table to facilitate antiretroviral drug (ARV) prescriptions for children, (b) the acceptability of such a table among doctors and (c) the safety and efficacy of drug doses in the table. Acceptability was assessed using a questionnaire. Safety and efficacy were assessed on the basis of incidence of adverse effects and virological response to treatment, respectively. Of all doctors (n=18), 17 (94%) found that the table was practical to use, avoided miscalculations and made them more confident with prescriptions. Of 49 children prescribed ARVs, less than 5% had adverse side-effects. All ARV-naïve children achieved undetectable viral loads within six months of ART. In our setting, a standardized drug dosage table provided a simple and reliable tool that facilitated ARV prescriptions for children

Religion and HIV in Tanzania: Influence of Religious Beliefs on HIV stigma, Disclosure, and Treatment Attitudes.

Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment. A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p < 0.01) or that people living with HIV/AIDS (PLWHA) have not followed the Word of God (p < 0.001). Most participants (84.2%) said that they would disclose their HIV status to their pastor or congregation if they became infected. Although the majority of respondents (80.8%) believed that prayer could cure HIV, almost all (93.7%) said that they would begin ARV treatment if they became HIV-infected. The multivariate analysis found that respondents' hypothetical willingness to begin ARV treatme was not significantly associated with the belief that prayer could cure HIV or with other religious factors. Refusal of ARV treatment was instead correlated with lack of secondary schooling and lack of knowledge about ARVs. The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups

U.S. Strategy for Rapid Scale-Up of ARV Treatment: Advocacy Issues and Concerns

Provides background on international developments concerning anti-retroviral drugs (ARV) and related U.S. policy, and summarizes the presentations and recommendations of representatives from organizations providing ARV treatment in developing countries

AIDS Treatment and Intrahousehold Resource Allocations: Children's Nutrition and Schooling in Kenya

The provision of life-saving antiretroviral (ARV) treatment has emerged as a key component of the global response to HIV/AIDS, but very little is known about the impact of this intervention on the welfare of children in the households of treated persons. We estimate the impact of ARV treatment on children’s schooling and nutrition outcomes using longitudinal household survey data collected in collaboration with a treatment program in western Kenya. We find that children’s weekly hours of school attendance increase by over 20 percent within six months after treatment is initiated for the adult household member. For boys in treatment households, these increases closely follow their reduced market labor supply. Similarly, young children’s short-term nutritional status—as measured by their weight-for-height Z-score—also improves dramatically. We argue that these treatment effects will be considerably larger when compared to the counterfactual scenario of no ARV treatment. The results provide evidence on how intrahousehold resource allocation is altered in response to significant health improvements. Since the improvements in children’s schooling and nutrition at these critical early ages will affect their socio-economic outcomes in adulthood, the widespread provision of ARV treatment is likely to generate significant long-run macroeconomic benefits.

Antiretroviral treatment programmes in Nepal: Problems and barriers

Background: Antiretroviral (ARV) drugs have become the cornerstone of HIV (Human Immunodefi ciency Virus) care and treatment. Its use has led to a marked reduction in AIDS (Acquired Immune Defi ciency Syndrome) related morbidity and mortality. However, more than fi ve years after their introduction few HIV infected people in Nepal are receiving ARVs. Objective: The main aim of this study is to identify barriers and obstacles to providing and expanding ARV programmes in Nepal. Materials and methods: A qualitative approach consisting of in-depth interviews with three groups of stakeholders: policy makers, ARV service providers and ARV recipients were carried out. The transcripts were analysed using a thematic approach. Results: The estimated number of people in need was high compared with people currently receiving ARV in Nepal. With regards to the proper distribution of the ARVs, the main problems identifi ed in the interviews were: lack of infrastructure, lack of human resources, financial constraints, programmatic problems, weak leadership and management at national level, poor cooperation between management structures, geographical barriers, lack of awareness and low uptake of counselling and/or testing, stigmatization and discrimination felt by the health workers and the community, lack of coordination and limited access to services. Conclusion: Limited resources and administrative capacity coupled with strong underlying needs for services pose serious challenges to the government

Analysis of short-term blood pressure variability in pheochromocytoma/paraganglioma patients

Data on short-term blood pressure variability (BPV), which is a well-established cardiovascular prognostic tool, in pheochromocytoma and paraganglioma (PPGL) patients is still lack and conflicting. We retrospectively evaluated 23 PPGL patients referred to our unit from 2010 to 2019 to analyze 24 h ambulatory blood pressure monitoring (24-h ABPM)-derived markers of short-term BPV, before and after surgical treatment. PPGL diagnosis was assessed according to guidelines and confirmed by histologic examination. The 24-h ABPM-derived markers of short-term BPV included: circadian pressure rhythm; standard deviation (SD) and weighted SD (wSD) of 24-h, daytime, and night-time systolic and diastolic blood pressure (BP); average real variability (ARV) of 24-h, daytime, and night-time systolic and diastolic BP. 7 males and 16 females of 53 ± 18 years old were evaluated. After surgical resection of PPGL we found a significant decrease in 24-h systolic BP ARV (8.8 ± 1.6 vs. 7.6 ± 1.3 mmHg, p &lt; 0.001), in 24-h diastolic BP ARV (7.5 ± 1.6 vs. 6.9 ± 1.4 mmHg, p = 0.031), and in wSD of 24-h diastolic BP (9.7 ± 2.0 vs 8.8 ± 2.1 mmHg, p = 0.050) comparing to baseline measurements. Moreover, baseline 24-h urinary metanephrines significantly correlated with wSD of both 24-h systolic and diastolic BP. Our study highlights as PPGL patients, after proper treatment, show a significant decrease in some short-term BPV markers, which might represent a further cardiovascular risk factor