"It's a burden, it's a nuisance. I wish I didn't have these other ailments": a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia.
"It's a burden, it's a nuisance. I wish I didn't have these other ailments": a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia.
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DOI：
10.1002/jia2.25785
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发表时间：
2021-10
影响因子：
6
通讯作者：
McNeil R
中科院分区：
文献类型：
--
作者：
Chayama KL;Ng C;Small W;Ivsins A;McNeil R
使用非法药物（除大麻外或除大麻外）的艾滋病毒感染者由于抗逆转录病毒治疗而延长了寿命。使用药物的老年艾滋病毒感染者患合并症的风险增加，管理多种健康状况是这一人群日益关注的问题。然而，对使用药物的老年艾滋病毒感染者的生活现实和复杂性以及合并症的深入了解仍然有限。我们试图探索在普遍获得抗逆转录病毒治疗的情况下，使用药物的老年艾滋病毒感染者如何管理其合并症。2019年1月至2020年3月期间，在加拿大温哥华对42名使用药物且至少有一种合并症的老年hiv患者进行了半结构化的深度访谈。所有参与者目前都在接受抗逆转录病毒治疗，并在访谈前至少2年开始接受治疗。数据分析使用归纳和演绎的方法。通过这一分析确定了几个主题。首先，合并症被认为是更为紧迫的健康问题，优先于艾滋病毒。第二，污名化和歧视阻碍了获得合并症护理。第三，由于未管理或管理不善的合并症，同时管理艾滋病毒和合并症往往具有挑战性。第四，抗逆转录病毒治疗对并发疾病的潜在影响令人担忧和沮丧。最后，综合治疗方法促进了艾滋病毒和合并症护理的参与。我们的研究结果强调了艾滋病毒护理需要从主要关注艾滋病毒管理转向以患者为中心的综合方法，以解决艾滋病毒和非艾滋病毒相关的健康需求，以及为使用药物的老年艾滋病毒感染者提供公平和非判断性的护理。
People living with HIV (PLHIV) who use illicit drugs (other than or in addition to cannabis) are living longer due to antiretroviral therapy (ART). Older PLHIV who use drugs have an increased risk for comorbidities, and managing multiple health conditions is a growing concern among this population. However, in‐depth understandings of the lived realities and complexities of living with HIV alongside comorbidities among older PLHIV who use drugs remain limited. We sought to explore how older PLHIV who use drugs manage their comorbid conditions in a setting with universal ART access. Between January 2019 and March 2020, semi‐structured, in‐depth interviews were conducted in Vancouver, Canada with 42 older PLHIV who use drugs and were living with at least one comorbidity. All participants were currently on ART, and had initiated treatment at least 2 years prior to the interviews. Data were analysed using inductive and deductive approaches. Several themes were identified through this analysis. First, comorbidities were perceived as more urgent health concerns and prioritized over HIV. Second, stigma and discrimination hindered access to care for comorbidities. Third, the concurrent management of HIV and comorbidities was often challenging due to unmanaged or poorly managed comorbidities. Fourth, the potential impact of ART on the development of comorbidities was a source of concern and frustration. Finally, integrated treatment approaches facilitated engagement with HIV and comorbidities care. Our findings underscore the need for HIV care to shift from a primary focus on managing HIV to an integrated, patient‐centred approach that addresses both HIV and non‐HIV‐related health needs, as well as an equitable and non‐judgemental delivery of such care for an ageing population of PLHIV who use drugs.
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DOI：
10.1080/13691058.2017.1312530
发表时间：
2017-12
期刊：
Culture, health & sexuality
影响因子：
--
作者：
Sangaramoorthy T;Jamison A;Dyer T
通讯作者：
Dyer T
影响因子：
39
作者：
Freiberg MS;Chang CC;Kuller LH;Skanderson M;Lowy E;Kraemer KL;Butt AA;Bidwell Goetz M;Leaf D;Oursler KA;Rimland D;Rodriguez Barradas M;Brown S;Gibert C;McGinnis K;Crothers K;Sico J;Crane H;Warner A;Gottlieb S;Gottdiener J;Tracy RP;Budoff M;Watson C;Armah KA;Doebler D;Bryant K;Justice AC
通讯作者：
Justice AC
影响因子：
11.8
作者：
Guaraldi, Giovanni;Orlando, Gabriella;Palella, Frank
通讯作者：
Palella, Frank
DOI：
10.1016/s0140-6736(10)60829-x
发表时间：
2010-07-31
期刊：
Lancet (London, England)
影响因子：
--
作者：
Altice FL;Kamarulzaman A;Soriano VV;Schechter M;Friedland GH
通讯作者：
Friedland GH
影响因子：
5.4
作者：
Davis, M;Rhodes, T;Martin, A
通讯作者：
Martin, A