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Books on the topic 'HIV treatment adherence'

Author: Grafiati
Published: 4 June 2021
Last updated: 4 February 2022

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1

Gupta, Indrani. Determinants of adherence in the antiretroviral treatment programme of the government of India. Delhi: Institute of Economic Growth, 2009.

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2

Ka'opna, Lana Sue, and Nathan L. Linsk, eds. HIV Treatment Adherence. Routledge, 2013. http://dx.doi.org/10.4324/9780203052075.

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3

Sue, Ka'opua Lana, and Linsk Nathan L, eds. HIV treatment adherence: Challenges for social services. New York, NY: Haworth Press, 2007.

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4

Linsk, Nathan L., and Lana Sue Ka'opna. HIV Treatment Adherence: Challenges for Social Services. Taylor & Francis Group, 2016.

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5

Lana Sue, Ph.D. Ka'opua (Editor) and Nathan L. Linsk (Editor), eds. HIV Treatment Adherence: Challenging for Social Services (Journal of HIV/AIDS & Social Services) (Journal of HIV/AIDS & Social Services). Haworth Press, 2007.

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6

Weiss, Jeffrey J., and Michael J. Stirratt. Psychiatric Aspects of Care Engagement and Medication Adherence in Antiretroviral-Based HIV Treatment and Prevention. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0029.

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Care engagement and treatment adherence are directly related to HIV treatment outcomes and to mortality. Active drug use and psychiatric illness such as depressive and addictive disorders are significant barriers to care engagement and treatment adherence among persons living with HIV and those at high risk for HIV infection and eligible for pre-exposure prophylaxis (PrEP). This chapter addresses (1) psychiatric aspects of PrEP for HIV prevention, (2) the care continuum for individuals living with HIV infection, (3) psychiatric determinants of HIV care engagement, (4) behavioral interventions to improve HIV care engagement, (5) psychiatric determinants of antiretroviral (ART) adherence, (6) interventions to improve ART adherence, and (7) implications of research findings for the medical and mental health clinician working with patients with psychiatric illness who are living with HIV or at risk for infection.
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7

Cozza, Kelly L., Gary H. Wynn, Glenn W. Wortmann, Scott G. Williams, and Rita Rein. Psychopharmacological Treatment Issues in HIV/AIDS Psychiatry. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0042.

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Attention to pharmacokinetics and pharmacodynamics and an understanding of intended effects, side effects, toxicities, and drug interactions are imperative when treating persons with HIV/AIDS. This chapter includes an essential review of drug interaction principles and an overview of current antiretroviral treatment (ART) and known side effects, toxicities, and drug interactions, in text and table format. The chapter concludes with a presentation of psychotropic-antiretroviral treatment issues. Most psychotropics are effective in the treatment of persons with HIV, but some, particularly the pan-inducing antiepileptics, are best avoided or at least should be very carefully monitored. Recognizing the potential for drug–drug interactions allows for more careful monitoring and for consideration of alternative treatments or precautions. Being a pharmacologically knowledgeable multidisciplinary team member can reduce morbidity and mortality in patients. An understanding of antiretroviral therapy and psychopharmacological treatment issues prevents morbidity, supports adherence to medications, and improves quality of life for persons with HIV.
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8

David, Elizabeth. Psychiatric Illness and Treatment in HIV Populations. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0037.

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The interaction between HIV and mental illness is complex. For many individuals, the psychiatric condition is a preexisting one, predisposing to HIV infection through behavioral factors and risk environment. The risk factors for HIV are well established and involve blood/bodily fluid contact with infected individuals: unprotected sexual behaviors, needle sharing, multiple sexual partners, and fetal/natal exposure. Individuals with preexisting psychiatric illness often engage in risky behaviors with little thought or fear of consequences. This relates to increased emotional immaturity and impulsivity, poor contact with reality, denial and disinhibition, cognitive dysfunction, active thoughts of self-harm, and victimization or impaired judgment. Barriers to treatment, such as distrust of authority, poor communication skills, limited access, lack of motivation, and unstructured lifestyle, result in poor overall health care and delayed diagnosis of all health issues. Diagnosis of mental health issues is frequently challenging, and adherence to treatment is frequently impacted by these same factors.
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9

Maggi, Julie Diana. The impact of attachment style and the physician-patient relationship on adherence to medication treatment in HIV disease. 2004.

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10

Breitbart, William, and Anna L. Dickerman. Fatigue and HIV. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0024.

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Fatigue is commonly reported by persons with HIV and AIDS and is associated with impaired physical function, reduced quality of life, and suboptimal treatment adherence. Patients regard fatigue as an important condition to be addressed because it is disabling and distressing. In the past, fatigue was overlooked and undertreated by physicians, but clinicians caring for persons with HIV and AIDS have been giving more attention to symptom management and patients’ quality of life. Increased attention to symptom management in HIV and AIDS warrants familiarity with major issues in evaluation and treatment of fatigue. This chapter reviews the definition and assessment of fatigue, prevalence of fatigue in HIV/AIDS and its impact on patients, medical and psychological causes of fatigue, and evidence-based treatment strategies.
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11

Collins, Simon, Tim Horn, Loon Gangte, Emmanuel Trenado, and Vuyiseka Dubula. HIV Advocacy. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0010.

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Community responses to the AIDS crisis have changed traditional approaches to medicine, healthcare, health systems, and research. Earlier approaches were rooted in widespread discrimination against key affected populations who were already socially marginalized. The background of community responses, first in the United States and then in other regions, each has a special history. This chapter provides an overview of historical community responses to HIV and is written by activists from the United States, India, South Africa and Western Europe. Examples of key projects include the role of peer advocacy and treatment literacy, which have enabled people living with HIV to learn more about HIV and treatment, adherence, treatment choice, drug resistance, and pipeline research for better drugs in the future. The outcome of this advocacy is that people living with HIV have been empowered to take an active role in their healthcare. HIV advocacy also provides an example of how the international activism that has changed the face of global healthcare is rooted in similar principles developed by early HIV-positive activists and is just as relevant today.
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12

Alfonso, César A., Eva Stern-Rodríguez, and Mary Ann Cohen. Suicide and HIV. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0025.

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HIV is a risk factor for suicide. Even after developing effective treatments and reducing mortality of HIV in countries with access to care, psychological and medical multimorbidities continue to create distress. This chapter reviews the global epidemiology of suicide in persons with HIV and describes the known predisposing and protective factors, as well as the psychodynamics of suicide. Predisposing factors include course of illness, symptomatic multimorbidities, physical incapacity, history of trauma, past attempts, hopelessness, family suicide, bereavement, poor social support and family relations, unemployment, unstable housing, detectable viral load, and access to lethal means. Protective factors include positive-reappraisal coping skills, treatment adherence, responsibility toward family, having reasons for living, religiosity, higher emotional expression, experiential involvement, and secure attachments. By identifying protective and risk factors clinicians can be more cognizant of persons at risk and better equipped to treat them. Timely application of psychotherapeutic, pharmacological, and psychosocial interventions can treat suicidality and may prevent death by suicide.
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13

David, Elizabeth, and John P. Casas. Substance Abuse in HIV Populations. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0030.

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Mental illness and substance abuse are separate and additive risk factors for HIV infection. A comprehensive approach in the treatment of those with the dual diagnosis of mental illness and substance abuse is very important because these patients are inherently at a higher risk of contracting or transmitting sexually transmitted diseases, including HIV. Problems with adherence to medical treatment seem to be additive in this group. In addition, substance abuse is associated with a host of medical sequelae (liver disease, infection, diabetes, cardiovascular disease, and neurocognitive changes), complicating treatment of the virus in a population already at risk for these problems and leading to increased disease progression.
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14

Letendre, Scott, Jennifer Iudicello, Beau Ances, Thomas D. Marcotte, Serena Spudich, and Mary Ann Cohen. HIV-Associated Neurocognitive Disorders. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0016.

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The human immunodeficiency virus (HIV) enters the central nervous system soon after infection; can infect glia and tissue macrophages in the brain; and can injure neurons, resulting in loss of dendrites. These and other processes underpin a syndrome of cognitive and motor impairment termed HIV-associated neurocognitive disorder (HAND). This chapter principally focuses on HAND, although delirium and other neurocognitive disorders are also discussed and should remain in the differential diagnosis of cognitive impairment in persons with HIV. A differential diagnosis of cognitive impairment in HIV also includes multimorbid conditions that can influence neurocognitive performance, such as metabolic syndrome, vascular disease, medication toxicity, and substance use disorders. When developing treatment recommendations for HAND, initiation of ART and treatment of multimorbid conditions and other neurocognitive disorders should be prioritized. It is important for clinicians to regularly monitor HIV patients for HAND and other neurocognitive disorders since cognitive impairment can affect activities of daily living; quality of life; adherence to risk reduction, medical care, and medication; and survival.
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15

Pahuja, Meera, Jessica S. Merlin, and Peter A. Selwyn. HIV/AIDS. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0151.

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In less than two decades, AIDS has been transformed from a rapidly fatal, untreatable illness to a manageable chronic disease. Early in the AIDS epidemic, HIV care and palliative care were inseparable; over time, these two treatment paradigms diverged. In the developed world, and to a lesser but increasing extent in the developing world, decreasing mortality rates have resulted in growing numbers of HIV-infected patients living with the disease for many years. As this long-surviving population increases, the challenges of chronic disease management, an expanding range of co-morbidities, and a process that has been described as ‘accelerated ageing’, have all emerged to present new needs and opportunities for palliative care expertise. Earlier in the epidemic, palliative care for AIDS focused primarily on end-of-life care and pain and symptom management related to the manifestations of AIDS-specific opportunistic infections and malignancies. Currently, pain and symptoms may be related to these as well as other co-morbid chronic diseases which commonly occur in HIV-infected patients, including cardiovascular, pulmonary, renal, hepatic, metabolic, and neurocognitive complications. Attention to these symptoms, quality of life issues, and psychosocial problems in long-surviving patients over many years will be increasingly important to support engagement with care and effective adherence with antiretroviral therapy over time. End-of-life care, while less frequent, also remains important, as patients may still die from AIDS, or even more commonly, from end-organ failure, non-AIDS defining malignancies, and/or other complications of ageing and chronic co-morbid disease. All these converging factors have now resulted in a new need for the re-integration of HIV care and palliative care, both to help HIV-infected patients live better and longer, as well as manage late-stage and end-of-life issues when they emerge.
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16

Mugavero, Michael J., and J. Michael Kilby. HIV/AIDS in the Fourth Decade. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0002.

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This chapter discusses the maturing HIV/AIDS epidemic, now in its fourth decade, with global scale-up of antiretroviral therapy (ART) and reductions in the number of new HIV cases in many regions in the world. Advances in biomedical prevention with promising clinical trial findings for pre-exposure prophylaxis (PrEP) and microbicides provide a scientific foundation for the prevention of new infections in persons who are HIV uninfected and at risk. Landmark trials identifying the benefits of ART treatment as prevention (TasP) of new HIV infections and demonstrating the benefits of early ART initiation at higher CD4 counts have informed global guidelines. The pendulum has swung back to recommending early ART initiation for all persons living with HIV upon learning of a new diagnosis. However, late diagnosis persists as a formidable challenge, and gaps in engagement in medical care among diagnosed persons, as depicted by the treatment cascade, as well as suboptimal adherence to biomedical prevention and ART threaten the effectiveness of these scientific discoveries. The tools and resources are available to hasten the end of HIV/AIDS around the globe with integration of service delivery to address the medical, psychiatric, psychological, and societal impact the virus poses to individuals and communities living with and at risk for HIV/AIDS.
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17

Chaudoir, Stephenie R., and Jeffrey D. Fisher. Stigma and the “Social Epidemic” of HIV: Understanding Bidirectional Mechanisms of Risk and Resilience. Edited by Brenda Major, John F. Dovidio, and Bruce G. Link. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780190243470.013.28.

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HIV/AIDS is one of the most devastating public health threats facing the modern world, and its eradication relies heavily on the performance of individual risk-reduction and treatment behaviors. In this chapter, a bidirectional lens is applied to consider how stigma systematically and synergistically constrains individual ability to perform behaviors critical to the effective prevention and treatment of HIV (e.g., sexual risk reduction and medication adherence), which ultimately compromises physical health. In addition to producing increased stigma, compromised physical health may further inhibit HIV risk-reduction and treatment behaviors. Interventions capable of mitigating these bidirectional effects are then discussed. Finally, the chapter discusses the implications of the conceptual model in illuminating the causes of persistent disparities in HIV incidence and treatment outcomes.
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18

Douaihy, Antoine, Melanie Grubisha, Maureen Lyon, and Mary Ann Cohen. Trauma and Posttraumatic Stress Disorder—The Special Role in HIV Transmission. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0017.

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The prevalence of posttraumatic stress disorder (PTSD) in persons with HIV is higher than in the general population. Adults with HIV are likely to have experienced traumatic events that place them at risk for developing PTSD. Among women with HIV, PTSD may be more common than depression, suicidality, and substance use. The high prevalence of PTSD is related to increased exposure to traumatic experiences such as physical violence and sexual assault, including intimate partner violence and childhood sexual abuse. The co-occurrence of PTSD and HIV creates complex challenges for both the management of HIV and treatment of PTSD. Individuals with PTSD and HIV experience more rapid illness progression and poorer health-related quality of life, with health-compromising behaviors such as substance use, high-risk sexual behavior, poor utilization of services, and low adherence to antiretroviral therapy. This chapter addresses the complexities of HIV, trauma, and PTSD and recommends trauma-informed care in the treatment of people living with HIV and AIDS.
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19

Haskard-Zolnierek, Kelly B., Tricia A. Miller, and M. Robin DiMatteo. Promoting treatment adherence. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198736134.003.0037.

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Empirical evidence demonstrates that quality healthcare outcomes depend greatly upon patients’ adherence to their recommended treatments. Patient adherence is a patient’s ability to follow his or her treatment recommendations given by a healthcare provider. Rates of adherence, however, can be as poor as 50% or less among patients with certain chronic diseases. For cancer patients, non-adherence can have serious consequences, including increased disease morbidity and mortality. Factors associated with non-adherence in cancer patients include treatment complexity, illness severity, patients’ beliefs and attitudes, lack of social support, and depression. Improving adherence depends upon effective provider–patient communication, trust in the therapeutic relationship, shared decision-making, and a realistic assessment of patients’ knowledge and understanding of their treatment. To assist cancer patients in acquiring appropriate disease and treatment information, to build commitment and motivation, and to assist in the development of strategies to overcome treatment barriers, healthcare professionals can use the Information-Motivation-Strategy model.
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20

Douaihy, Antoine, Matthew Conlon, and Maria Ferrara. Depressive and Bipolar Disorders. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0015.

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Depressive disorders are highly prevalent among persons living with HIV/AIDS. Depressive disorders significantly negatively affects adherence to antiretroviral therapy and HIV viral suppression and is associated with poor quality of life and major impairment in overall functioning. This chapter reviews the prevalence, risk factors, assessment and diagnosis of depressive and bipolar disorders. It also examines the impact of depression on sexual behaviors, adherence to antiretroviral therapy, quality of life, and mortality. This chapter also includes a comprehensive discussion of treatment approaches and considerations for HIV-infected individuals with depressive disorders. Furthermore, it reviews the bipolar disorder spectrum in HIV/AIDS as well as other psychiatric disorders co-occurring with depressive disorders.
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21

Cohen, Mary Ann, Harold Goforth, Joseph Lux, Sharon Batista, Sami Khalife, Kelly Cozza, and Jocelyn Soffer. Handbook of AIDS Psychiatry. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195372571.001.0001.

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The Handbook of AIDS Psychiatry is a practical guide for AIDS psychiatrists and other mental health professionals as well as for other clinicians who work with persons with HIV and AIDS and a companion book to the Comprehensive Textbook of AIDS Psychiatry (Cohen and Gorman, 2008). The Handbook provides insights into the dynamics of adherence to risk reduction and medical care in persons with HIV and AIDS as well as strategies to improve adherence using a biopsychosocial approach. Psychiatric disorders can accelerate the spread of the virus by creating barriers to risk reduction. Risky sexual behaviors and sharing of needles in intravenous drug users account for the majority of new cases each year. Delirium, dementia, depression, substance dependence, PTSD, and other psychiatric disorders complicate the course and add considerably to the pain and suffering of persons with AIDS. HIV infection and AIDS also are risk factors for suicide, and the rate of suicide has been shown to be higher in persons with AIDS. Psychiatric care can help prevent HIV transmission through recognition and treatment of substance-related disorders, dementia, and mood disorders such as mania. Comprehensive, coordinated care by a multidisciplinary AIDS team, including AIDS psychiatrists, can provide a biopsychosocial approach that is supportive to patients, families, and clinicians. Psychiatric interventions are valuable in every phase of infection, from identification of risk behaviors to anticipation about HIV testing; from exposure and initial infection to confirmation with a positive HIV antibody test; from entry into systems of care to managing complex antiretroviral regimen; from healthy seropositive to onset of first AIDS-related illness; from late stage AIDS to end-stage AIDS and death. There is no comprehensive handbook of AIDS psychiatry to guide clinicians in providing much needed care. The Handbook of AIDS Psychiatry is a practical pocket guide that provides protocols for the recognition and treatment of the psychiatric disorders most prevalent in persons with AIDS and most relevant for primary physicians, infectious disease specialists, and other caregivers because of their impact on health, adherence, behavior, and quality of life.
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22

Soffer, Jocelyn, César A. Alfonso, John Grimaldi, and Jack M. Gorman. Psychotherapeutic Interventions. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0037.

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Psychotherapeutic care for persons with HIV is an important component of overall treatment, helping people to cope and decreasing the psychological suffering that may be attendant when navigating the complex array of biopsychosocial stresses and challenges of living with HIV. A combination of psychotherapeutic and psychosocial interventions can effectively address psychological aspects of functioning and reduce psychiatric symptoms, as well as improve adherence to risk reduction and medical care. This chapter reviews several psychotherapeutic interventions, including supportive, psychodynamic, and interpersonal psychotherapy, cognitive-behavioral therapy, and motivational interviewing. Both individual and group settings are discussed, as well as the particular settings of spiritual care, family therapy, and couples therapy.
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23

Al-Darraji, Haider A., and Frederick L. Altice. The Perfect Storm. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199374847.003.0008.

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Globally, tuberculosis (TB) is a major cause of morbidity and mortality among people who use drugs (PWUD), particularly those co-infected with HIV. This chapter describes how TB is prevalent in several prison systems by virtue of the concentration of PWUD and people living with HIV. TB is further amplified within this system through overcrowding, poor ventilation, and delayed access to quality prevention and treatment services. In many countries, individuals cycling through prisons are inadequately screened and treated for TB, and affected individuals may have frequent treatment interruptions. For PWUD, relapse to drug use immediately after release from custody can impede continuity of care, which may contribute to the development of drug-resistant TB. Particularly in countries with high incarceration rates, prisons act as amplifiers of TB and drug-resistant TB in the community. The World Health Organization’s recommendations for integration of TB, HIV, and addiction treatment are seldom achieved, especially within prisons. Other factors contributing to poor TB outcomes among PWUD interfacing with prisons include insufficient support to promote medication adherence and co-morbidities, like viral hepatitis that potentiate hepatic toxicity, both of which are prevalent among PWUD.
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24

Pandit, Neha Sheth, and Emily L. Heil. Principles of Applied Clinical Pharmacokinetics and Pharmacodynamics in Antiretroviral Therapy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0018.

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Systemic concentrations of antiretroviral drugs (ARVs) are influenced by the pharmacokinetic properties of absorption, distribution, metabolism, and excretion. Pharmacokinetics and local drug exposure can differ significantly within anatomical sanctuary sites compared with the systemic compartment. High variability in interpatient ARV concentrations is common, which makes population pharmacokinetics for ARVs very difficult to interpret. HIV replication is dynamic and requires combination antiretroviral therapy with multiple active agents in order to achieve durable virologic suppression. Direct and indirect relationships between drug exposure, efficacy, and/or toxicity are common for most ARVs, which can be used to improve overall treatment success. Suboptimal adherence can result in inadequate concentrations, drug resistance, and virologic failure. Therapeutic drug monitoring can be considered in certain scenarios that should be evaluated on a case-by-case basis.
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25

Meyer, Jaimie P., and Frederick L. Altice. Transition to the community. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0047.

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Re-incarceration of former prisoners is commonly associated with relapse to drug and alcohol use because of ineffective treatment of substance use disorders (SUDs) after release. High entry rates of people who use drugs (PWUDs) into prisons or jails results in the criminal justice system (CJS) bearing a disproportionate burden of the epidemic of people with SUDs. In contrast to 8% of U.S. adults in the general population, up to 65% of prisoners meet DSM-IV criteria for having a SUD and, depending on geographical location, 70% of HIV-infected prisoners meet criteria for opioid dependence. Though substantial efforts have focused on providing support for those with SUDs as they transition back to the community, evidence-based interventions are not commonly deployed. Despite scientific evidence supporting transitional programs for prisoners with SUDs (e.g., medication assisted therapies, contingency management, adherence support strategies), there are significant logistical constraints to introducing evidence-based interventions into correctional systems and delivering them to prisoners prior to release. Innovative solutions are needed that involve partnerships between all existing stakeholders, including individual patients with SUDs, the CJS and communities, in order to overcome existing impediments. This chapter discusses best practice and evidence-based models in use for jails and prisons to support successful community re-entry.
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26

Helzlsouer, Kathy J., and Arti Patel Varanasi. Enhancing Fidelity to Cancer Treatment Guidelines. Edited by David A. Chambers, Wynne E. Norton, and Cynthia A. Vinson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190647421.003.0019.

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Cancer treatment has become increasingly complex with the rapid development of new therapies and treatment modalities. Guidelines for optimum cancer treatment are produced by several organizations, but ensuring that the patient receives the treatment requires both provider awareness and patient support to follow a complex treatment plan. An individual diagnosed with cancer must simultaneously come to terms with the diagnosis, make difficult shared decisions about treatment with his or her provider, and commence treatment in a matter of a few days or weeks. Ensuring optimum treatment is an increasingly complex process that involves multiple people and steps. Well-documented disparities exist in the receipt of and adherence to appropriate treatment by demographic and social factors, such as age, race, ethnicity, socioeconomic status, and geography. This case study provides an example of how the process of providing optimum cancer treatment may be improved through a technology-enhanced navigation program.
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27

Blashill, Aaron J., Janna R. Gordon, Matthew J. Mimiaga, and Steven A. Safren. HIV/AIDS and Depression. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.010.

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Depression is highly prevalent among individuals living with HIV/AIDS. Depression not only affects quality of life for this population but also confers significant barriers to optimizing self-care behaviors, which are essential to medical care. Two of the most important HIV/AIDS care behaviors are medication adherence and safe sex practices; inadequacy in both can be associated with depression. Depression among those living with HIV/AIDS also is associated with substance abuse, which in turn predicts poor self-care. Importantly, there has recently been an emphasis on creating and testing integrative psychosocial interventions that address depression and self-care behaviors among people living with HIV/AIDS. These combination treatments have displayed initial efficacy and appear to be efficient in addressing multiple health behaviors. This chapter briefly reviews the epidemiology of HIV/AIDS and salient biological outcomes in the context of depression. It then discusses the role of depression and self-care behaviors and it concludes with a review of interventions and future research priorities.
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28

Hull, Mark, and Steven C. Reynolds. HIV in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0291.

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It has been over 30 years since the recognition of the acquired immune deficiency syndrome (AIDS), linked to infection with human immunodeficiency virus (HIV). Opportunistic infections arise in the setting of decreases in the CD4+ T-lymphocyte count. Advances in the safety, and effectiveness of combination antiretroviral therapy (cART) have led to substantial improvements in life-expectancy for individuals accessing successful therapy. As such individuals are likely to be admitted to the intensive care unit (ICU) for conditions un-related to HIV, although presentations due to opportunistic infections and malignancies must be considered in those with previously undiagnosed infection or in those patients non-adherent to cART.. Individuals receiving cART must undergo careful evaluation for potential drug–drug interactions with other medications. Treatment interruption of cART is not generally advised due to risk of rebound viraemia and potential development of resistance.. Immune reconstitution inflammatory syndrome may be considered in those with recent cART initiation.
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29

Douaihy, Antoine, Meredith Spada, Nicole Bates, Julia Macedo, and Jack M. Gorman. Anxiety Disorders. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0018.

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HIV practitioners are increasingly confronted with complex co-occurring medical and psychiatric disorders among their patients. Depressive and anxiety disorders are among the most commonly diagnosed in HIV-infected individuals and can complicate the overall management of HIV illness. Anxiety may be experienced as a symptom, as a manifestation of an anxiety disorder, as a consequence of HIV-associated or other illness, or as a result of one of its treatments. It can occur at any stage, from the realization of being at risk, to the anxiety about a possible symptom, to the time of HIV testing and the experience of HIV-associated stigma and discrimination, diagnosis, disclosure, illness progression, late- and end-stage illness, and dying. This chapter explores the complexities of anxiety as it relates to HIV and AIDS and discusses the prevalence, diagnosis, and assessment of anxiety disorders. The impact of anxiety on medical management of HIV is also addressed, including adherence to antiretroviral regimen, psychotherapeutic and pharmacological interventions, and coexisting medical and psychiatric disorders.
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30

Bennell, Kim L., Ans Van Ginckel, Fiona Dobson, and Rana S. Hinman. Exercise for the person with osteoarthritis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0022.

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Because of its beneficial effects on pain and physical dysfunction commonly reported by afflicted individuals, all clinical guidelines of osteoarthritis (OA) advocate exercise therapy as a vital component of conservative management strategies. Although the optimal exercise modalities in terms of dosage, exercise type, or delivery mode are not yet known, clinical benefits can be achieved with a wide range of exercise types. While treatment effect sizes may be considered small to moderate, they are similar to those of common analgesic drugs or oral non-steroidal anti-inflammatories but seem to elicit fewer side effects. To achieve optimal treatment outcomes, programme parameters should be individualized to the patient’s clinical characteristics and preferences. Where validated instruments could assist the clinician in monitoring the progress of an exercise intervention programme, adherence to exercise in the longer term is a prerequisite to maintain symptom relief over time. Whereas the current body of evidence mainly comprises clinical trials in people with knee OA, future studies should continue to address efficacy and safety of exercise therapy in individuals suffering from hand or hip OA and should further determine its ability to postpone the need for costly arthroplasty surgery.
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