Literature Review On HIV

“The odds of having good health outcomes are 2.88 % higher when patients are adherent” ( DiMatteo, Haskard-Zolnierek & Martin, 2012, p. 75). Nonadherence occurs for many reasons and may or may not be intentional. Nonadherence is defined as the failure to follow prescribed medical advice. Examples of actions considered to be medical advice are: to take medication as prescribed, make behavioral changes such as diet and exercise, keep appointments, and have screenings/testing done. Nonadherence, also called noncompliance also causes frustration of providers and patients, and wastes resources. Rates of nonadherence can be as high as 70% with complex regimens (Martin, Williams & DiMatteo, 2005). Factors in compliance with medical advice include: severity of disease, complexity of regimen, patient knowledge and beliefs, costs incurred by the patient, resource availability, availability of social support, psychological problems, and rapport and communication with healthcare providers.

The data suggested that people 65 years old and older were more adherent with their ART prescription in comparison to their younger counterparts and managed to suppress their viral load. To further add the data also stated that male to male sexual contact had the highest rate of new diagnosis in 2011. However, as the continuum of care progressed the number of men engaged in treatment decreased by nearly 50% and hence reducing the chances of nearly half of newly diagnosed men adhering to the task of acquiring a suppressed viral load. The authors research stated that “of 15,449 people newly diagnosed with HIV in the 19

When referring to M.M.’s treatment regime, adherence is an area where continued encouragement is needed. M.M. has a medication schedule that is PRN except for the three days leading up to her treatment. During those three days a steroid and antiemetic are given prophylactically to decrease side effects. However, because of the complexity of her treatment plan she does not take them because she is not nauseous or in pain. This has led to postponement of treatments and continued reiteration on her treatment plan, which she seems to support fully. M.M.’s adherence issue I feel is attributed to the complexity of her situation. According to Richards (2014) noncompliance can be related to many issues some of which including knowledge, side effects, lifestyle and even motivation (p.221). It is important to avoid pressuring, guilt tripping, or coercing a patient into following a treatment plan. Sometimes continued reeducation can be a form of coercing a patient so I must be cautious and considerate in my approach (Richards, 2014, p. 221). Most of my education is patient led therefore they decide what they would like to discuss. Medications just happen to be a common

Pharmacologic treatment for HIV-infected patients consists of antiretroviral (ARV) medications which cover six classes of drugs including nucleoside/nucleotide reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), protease inhibitors (PT), a fusion inhibitor (FI), a CCR5 antagonist, and integrase

will look at reason behind non-adherence and take an emphasis on patient’s motivation. The paper

Medication is vital in keeping the immune system as healthy as possible however many patients do not adhere to their medication. Chesney, Morin and Sherr (2000) claim that side effects of medication, forgetfulness and access to a pharmacy are all reasons for non-adherence. Also some patients will stop taking prescribed medication because their symptoms have gone, then restart when the symptoms return. Jaquet et al (2010) conducted a study in West Africa on 2920 HIV patients to see how many were adherent. The results showed that 91.8% were taking over 95% of their medication however 16.3% admitted that they had occasionally forgot to take their medications, 12.2% didn't take their medication when they were away from home and 7.0% said the pharmacy had been out of stock. Nurses need to monitor adherence and assess any causes for non adherence. Information on the importance of medication and about the consequences of non adherence will help ensure the patient understands why they are required to adhere.

Dr. C. Everett Koop said: “Drugs don't work in patients who don't take them.” Medication adherence is one of many important factors that determines the success of a therapeutic regimen. The World Health Organization defined medication adherence as “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider.”1 However, many patients do not understand this concept and use medications disregarding the instructions. These non-adherent behaviors accidentally cause serious consequences that affect our health care system such as wasting medications and increasing the cost of treatment.2, 3 They are also associated with worsening

Adequate and useful knowledge about patient adherence has yet not been acquired. Interventions to improve adherence do exist, but only about half of them seem to be effective (Haynes, 2008). Similarly, adherence theories also exist, but are incapable of sufficiently explaining the concept. Thus, the widespread challenge of non adherence to medical treatment persists, leading to negative health outcomes and deterioration of quality of life of a substantial number of patients (Burke et. al., 2001; Einarson,

Our chosen article is titled “HIV and AIDS News and Updates: New Strain of HIV Found in Cuba Which Can Develop Into a Full-Blown AIDS in a Span of Only 3 Years” written by Steff Lyn Smetham. It was published on November 5th, 2015 on the Crossmap online website. The article was written to inform the readers on a newly discovered strain of HIV, which develops faster than the average known types of HIV. This article mentioned many recently studied concepts including, the rate of disease progression, CRF19’s involvement in the AID’s rapid progression (AID’s-RP), the adverse effects of RANTES defense molecules, and proper HIV treatment. The general consensus is that the average rate of disease progression takes approximately 5 to 10 years to progress into AIDS, however, it is quite complicated to pinpoint the rate due to many factors. Based on many clinical studies done with a diverse group of patients in Cuba, CRF19 has shown to be one of the main recombinant subtype responsible for AIDs-RP. In addition, CCL5 and CCL2 of the RANTES family, have proven to be two specific chemokines that display the adverse effects . Finally, regardless of CD4+ count, treatment should be started immediately preferably with the common therapies Isoniazid preventive therapy (IPT) and Co-trimoxazole preventive therapy (CPT). The authors have used information through studies being done at the University of Leuven located in Belgium, and Professor Anne-Mieke Vandamme and a team

People already living with HIV in Sub Saharan Africa, can find treatment. Although it is not a cure; it is a treatment to stop the spread of the virus. Antiretroviral therapy (ART), stated by the world health organization “ART involves taking a combination of HIV medicines (called an HIV regimen) every day, exactly as prescribed.” Medication taken prevents HIV from multiplying, the anesthetic gives the immune system a chance to recover from the virus. Though the virus will not leave the body, very few of it will be left. The treatment helps CD4 cells fight off infection as well as HIV related cancers. Reducing the amount of HIV in the body through medication, ART diminishes the risk of transmitting the virus as well. Expanding ART to Sub Saharan Regions will not only help stop the development of AIDS, but also help stop the spread of HIV. Thou ART is just a treatment, there is ways Human Immunodeficiency Virus can be prevented.

According to Günthard et al., "antiretroviral agents remain the cornerstone of HIV treatment. All HIV-infected individuals with detectable plasma virus should receive treatment with recommended initial regimens consisting of an InSTI plus 2 NRTIs" (2016, p.192). Current antiretroviral HIV treatments focus on blocking HIV viruses at different stages of the virus life cycles. The most common classes of medications include entry inhibitors, fusion inhibitors, reverse transcriptase inhibitors, integrase strand transfer inhibitor and protease inhibitors. Multi-drug therapy including medications from at least 2 or 3 different classes is normally used to slow the progression of the diseases and to increases life expectancy of those patients (Chereshenev et al., 2013).

A sophisticated research indicates that approximately “50,000 people including men and women in Unites States are diagnosed with HIV every year”. There are countless distinctive strains of the popular disease known to be HIV and therefore t is classified in two types. “Type 1 HIV is most common worldwide but controversy. HIV type 2 is found mostly in Africa, with some cases in India and Europe” (Nordqvist). With the proper level of treatment and care, many people with HIV are capable of living a long and active life.

In a sample of 140 participants who were selected for TFV quantification after PrEP was dispensed, 81% (n=113) had TFV detected. Data from MEMS indicated consistency with high adherence. According to the pharmacy pill counts,87% and 96% of the bottles had more than 80% and 50% respectively of the expected doses taken.

The FDA has currently approved 31 different anti-retrviral drugs that are able to treat HIV, but none of them

By the year of 1994, only 72 percent of patients were prescribed with antiretroviral therapy, the number increased to 95 percent in 1997 and now every patient is recommended to start the treatment with antiretroviral therapy (Palella, 1998). The struggle with HIV is life long and even though ART can suppress the virus to eliminate mutation, there is currently no cure for HIV.