13 results on '"Modi, Riddhi"'
Search Results
2. Effects of an intervention on internalized HIV-related stigma for individuals newly entering HIV care.
- Author
-
Yigit, Ibrahim, Modi, Riddhi A., Weiser, Sheri D., Johnson, Mallory O., Mugavero, Michael J., Turan, Janet M., and Turan, Bulent
- Published
- 2020
- Full Text
- View/download PDF
3. HIV-related stigma, depression, and social support are associated with health-related quality of life among patients newly entering HIV care.
- Author
-
Chapman Lambert, Crystal, Westfall, Andrew, Modi, Riddhi, Amico, Rivet K., Golin, Carol, Keruly, Jeanne, Quinlivan, Evelyn Byrd, Crane, Heidi M., Zinski, Anne, Turan, Bulent, Turan, Janet M., and Mugavero, Michael J.
- Subjects
DIAGNOSIS of mental depression ,HIV infections & psychology ,PSYCHOLOGICAL adaptation ,AFFECT (Psychology) ,HIV infections ,OUTPATIENT services in hospitals ,PAIN ,QUALITY of life ,RESEARCH ,SEX distribution ,SOCIAL stigma ,SOCIAL support ,BODY movement ,HEALTH equity ,CROSS-sectional method ,ODDS ratio ,ATTITUDES toward illness - Abstract
Entering HIV care is a vulnerable time for newly diagnosed individuals often exacerbating psychosocial difficulties, which may contribute to poor health-related quality of life (HRQOL) ultimately influencing health behaviors including ART adherence, the driver of viral load suppression. Understanding HRQOL in people newly entering HIV care is critical and has the potential to guide practice and research. This exploratory cross-sectional study examined demographic, clinical, and psychosocial factors associated with limitations in four specific domains of HRQOL among persons initially entering outpatient HIV care at four sites in the United States (n = 335). In the unadjusted analysis, female gender was significantly associated with sub-optimal HRQOL with women having increased odds of reporting HRQOL challenges with pain, mood, mobility, and usual activity when compared to men. The adjusted models demonstrated attenuation of parameter estimates and loss of statistical significance for the associations with impaired HRQOL observed among women in unadjusted analyses, suggesting psychosocial factors related to HRQOL are complex and interrelated. Findings are consistent with a robust literature documenting gender-related health disparities. Programs aimed at improving HRQOL for persons initially entering HIV care are warranted generally, and specifically for women, and must address modifiable psychosocial factors via mechanisms including coping and social support. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
4. Factors Associated with HIV Disclosure Status Among iENGAGE Cohort of New to HIV Care Patients.
- Author
-
Modi, Riddhi A., McGwin, Gerald L., Willig, James H., Westfall, Andrew O., Griffin, Russell L., Amico, Rivet, Martin, Kimberly D., Raper, James L., Keruly, Jeanne C., Golin, Carol E., Zinski, Anne, Napravnik, Sonia, Crane, Heidi M., and Mugavero, Michael J.
- Subjects
HIV infections & psychology ,PSYCHOLOGICAL adaptation ,BLACK people ,EMOTIONS ,HIV-positive persons ,LONGITUDINAL method ,RACE ,DISCLOSURE ,MULTIPLE regression analysis ,SOCIAL support ,RANDOMIZED controlled trials ,CROSS-sectional method - Abstract
HIV disclosure is an important behavior with implications for HIV treatment and prevention but understudied among new to HIV care patients who face unique challenges adjusting to a new diagnosis. This study evaluated the factors associated with HIV disclosure status and patterns of HIV disclosure among new to HIV care patients. A cross-sectional study was conducted evaluating the iENGAGE (integrating ENGagement and Adherence Goals upon Entry) cohort. Participants were enrolled in this randomized behavioral trial between December 2013 and June 2016. The primary and secondary outcomes included HIV disclosure status (Yes/No) and patterns of disclosure (Broad, Selective and Nondisclosure), respectively. Logistic and Multinomial Logistic Regression were used to evaluate the association of participant factors with HIV disclosure and patterns of HIV disclosure, respectively. Of 371 participants, the average age was 37 ± 12 years, 79.3% were males, and 62.3% were African Americans. A majority of participants (78.4%) disclosed their HIV status at baseline, 63.1% were broad disclosers and 15.2% were selective disclosers. In multivariable regression, black race, emotional support, and unmet needs predicted any HIV and broad disclosure, whereas males, emotional support, active coping, and acceptance were associated with selective disclosure. Interventions to promote early disclosure should focus on coping strategies and unmet needs, particularly among black and male people living with HIV initiating care. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
5. Complexities of HIV Disclosure in Patients Newly Entering HIV Care: A Qualitative Analysis.
- Author
-
Lambert, Crystal Chapman, Tarver, Will L., Musoke, Pamela L., Stringer, Kristi L., Whitfield, Samantha, Turan, Bulent, Modi, Riddhi, Mugavero, Michael J., Fredericksen, Rob J., Weiser, Sheri, Johnson, Mallory O., and Turan, Janet M.
- Published
- 2020
- Full Text
- View/download PDF
6. HIV Standard of Care for ART Adherence and Retention in Care Among HIV Medical Care Providers Across Four CNICS Clinics in the US.
- Author
-
Shaw, Sarah, Modi, Riddhi, Mugavero, Michael, Golin, Carol, Quinlivan, Evelyn Byrd, Smith, Laramie R., Roytburd, Katya, Crane, Heidi, Keruly, Jeanne, Zinski, Anne, and Amico, K. Rivet
- Subjects
ATTITUDE (Psychology) ,CONTINUUM of care ,DRUGS ,HIV infections ,INTERPROFESSIONAL relations ,MEDICAL care ,MEDICAL personnel ,PATIENT compliance ,PATIENT satisfaction ,PATIENTS ,HUMAN sexuality ,ANTIRETROVIRAL agents ,PATIENTS' attitudes ,SEXUAL partners - Abstract
Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
- Full Text
- View/download PDF
7. The Depression Treatment Cascade: Disparities by Alcohol Use, Drug Use, and Panic Symptoms Among Patients in Routine HIV Care in the United States.
- Author
-
DiPrete, Bethany L., Pence, Brian W., Bengtson, Angela M., Moore, Richard D., Grelotti, David J., O'Cleirigh, Conall, Modi, Riddhi, and Gaynes, Bradley N.
- Subjects
ALCOHOLISM treatment ,PANIC disorder treatment ,SUBSTANCE abuse treatment ,ANTIDEPRESSANTS ,ATTENTION ,CONFIDENCE intervals ,MENTAL depression ,DRUGS of abuse ,HEALTH services accessibility ,HEALTH status indicators ,HIV infections ,PSYCHOLOGY of HIV-positive persons ,LONGITUDINAL method ,MENTAL illness ,MULTIVARIATE analysis ,PROBABILITY theory ,SUBSTANCE abuse ,COMORBIDITY ,DRUG abusers ,TREATMENT effectiveness ,DISEASE remission ,CROSS-sectional method - Abstract
Little is known about disparities in depression prevalence, treatment, and remission by psychiatric comorbidities and substance use among persons living with HIV (PLWH). We conducted a cross-sectional analysis in a large cohort of PLWH in routine care and analyzed conditional probabilities of having an indication for depression treatment, receiving treatment, receiving indicated treatment adjustments, and achieving remission, stratified by alcohol use, illicit drug use, and panic symptoms. Overall, 34.7% (95% CI 33.9-35.5%) of participants had an indication for depression treatment and of these, 55.3% (53.8-56.8%) were receiving antidepressants. Among patients receiving antidepressants, 33.0% (31.1-34.9%) had evidence of remitted depression. In a subsample of sites with antidepressant dosage data, only 8.8% (6.7-11.5%) of patients received an indicated treatment adjustment. Current drug users (45.8%, 95% CI 43.6-48.1%) and patients reporting full symptoms of panic disorder (75.0%, 95% CI 72.9-77.1%) were most likely to have an indication for antidepressant treatment, least likely to receive treatment given an indication (current drug use: 47.6%, 95% CI 44.3-51.0%; full panic symptoms: 50.8%, 95% CI 48.0-53.6%), or have evidence of remitted depression when treated (22.3%, 95% CI 18.5-26.6%; and 7.3%, 95% CI 5.5-9.6%, respectively). In a multivariable model, drug use and panic symptoms were independently associated with poorer outcomes along the depression treatment cascade. Few differences were evident by alcohol use. Current drug users were most likely to have an indication for depression treatment, but were least likely to be receiving treatment or to have remitted depression. These same disparities were even more starkly evident among patients with co-occurring symptoms of panic disorder compared to those without. Achieving improvements in the depression treatment cascade will likely require attention to substance use and psychiatric comorbidities. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
8. Suicidal Ideation is Associated with Limited Engagement in HIV Care.
- Author
-
Quinlivan, E., Gaynes, Bradley, Lee, Jennifer, Heine, Amy, Shirey, Kristen, Edwards, Malaika, Modi, Riddhi, Willig, James, and Pence, Brian
- Subjects
DIAGNOSIS of HIV infections ,HIV infections ,THERAPEUTICS ,MENTAL depression ,MEDICAL screening ,SUICIDAL ideation - Abstract
PHQ-9 data from persons living with HIV (PLWH, n = 4099) being screened for depression in three clinics in the southeastern USA were used to determine the prevalence of suicidal ideation (SI). SI was reported by 352 (8.6 %); associated with <3 years since HIV diagnosis (1.69; 95 %CI 1.35, 2.13), and HIV RNA >50 copies/ml (1.70, 95 %CI 1.35, 2.14). Data from PLWH enrolled in a depression treatment study were used to determine the association between moderate-to-high risk SI (severity) and SI frequency reported on PHQ-9 screening. Over forty percent of persons reporting that SI occurred on 'more than half the days' (by the PHQ-9) were assessed as having a moderate-to-high risk for suicide completion during the Mini International Neuropsychiatric Interview. SI, including moderate-to-high risk SI, remains a significant comorbid problem for PLWH who are not fully stabilized in care (as indicated by detectable HIV RNA or HIV diagnosis for less than 3 years). [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
9. Using Patient Perspectives to Inform the Development of a Behavioral Intervention for Chronic Pain in Patients with HIV: A Qualitative Study.
- Author
-
Merlin, Jessica S., Young, Sarah R., Johnson, Mallory O., Saag, Michael, Demonte, William, Modi, Riddhi, Shurbaji, Sally, Anderson, William A., Kerns, Robert, Bair, Matthew J., Kertesz, Stefan, Davies, Susan, and Turan, Janet M.
- Subjects
CHRONIC pain treatment ,BEHAVIOR therapy ,FOCUS groups ,HIV infections ,INTERVIEWING ,MEDICAL care ,PATIENT participation ,QUALITATIVE research ,THEMATIC analysis - Abstract
Background. Chronic pain is a common and disabling comorbidity in individuals living with HIV. Behavioral interventions are among the most effective and safe nonpharmacologic treatments for chronic pain. However, the success of a behavioral intervention is influenced by how well it is tailored to the target population's biological, psychological, and social context. Given well-documented psychosocial vulnerabilities among persons with HIV, it is critical to develop a behavioral intervention for chronic pain tailored to this population. Objective. To use qualitative methods to investigate patient preferences for the structure and delivery of a behavioral intervention for chronic pain in individuals with HIV. Methods. Interviews and focus groups were used to elicit participant preferences. A thematic analysis approach, with an initial round of open coding, was used to develop the codebook and analyze the data. Results. Qualitative data from 12 interviews and 3 focus groups with patients living with HIV and chronic pain (total N524) were analyzed. Emergent themes fell into four major categories: perceived value of group sessions, incorporating peer leadership, and two key elements of how the intervention should be delivered: the HIV status of group participants and views on phone-delivered intervention content. Discussion. This study provides a framework for the structure and delivery of a behavioral intervention for chronic pain in individuals with HIV based on patient preferences. We will use these results to design our intervention, and hope that our approach informs the work of investigators in other disciplines who seek to incorporate patient preferences during intervention development. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
10. Venous thromboembolism among HIV-positive patients and anticoagulation clinic outcomes integrated within the HIV primary care setting.
- Author
-
Modi, Riddhi A., McGwin, Gerald, Westfall, Andrew O., Powell, Deon W., Burkholder, Greer A., Raper, James L., and Willig, James H.
- Subjects
HIV infection complications ,DRUG therapy ,ANTICOAGULANTS ,CLINICS ,COMPARATIVE studies ,HOSPITAL pharmacies ,RESEARCH methodology ,MEDICAL cooperation ,MULTIVARIATE analysis ,PHARMACISTS ,PRIMARY health care ,RESEARCH ,THROMBOEMBOLISM ,VEINS ,WARFARIN ,LOGISTIC regression analysis ,EVALUATION research ,TREATMENT effectiveness ,RETROSPECTIVE studies ,CASE-control method ,INTERNATIONAL normalized ratio - Abstract
The purpose of this study was to explore factors associated with venous thromboembolism (VTE) among a cohort of HIV-infected patients and to describe early outcomes of warfarin anticoagulation therapy treated in a pharmacist-based anticoagulation clinic (ACC). A nested case-control study was conducted using the University of Alabama at Birmingham 1917 HIV Clinic Cohort. Conditional logistic regression was used to estimate factors associated with VTE. Among HIV-infected VTE cases, ACC-managed patients were compared to primary care provider (PCP)-managed patients to determine Time within Therapeutic INR Range (TTR). CD4 < 200 cells/µl (OR = 4.50; 95% CI = 1.52, 13.37; p = 0.007) and prior surgical procedures (13.20; 1.56; 111.4; p = 0.018) demonstrated positive associations with VTE, whereas longer HIV duration demonstrated a negative association (0.87; 0.78, 0.98; p = 0.019). TTR was 56.2% among ACC-managed patients compared to 30.5% of PCP-managed patients (p = 0.174). Overall, prior surgical procedures and low CD4 count were associated with an increased risk of VTE among HIV-infected patients. Despite small sample size, patients managed in ACC tend to achieve greater proportion of TTR compared to those managed by PCPs, suggesting that this model of therapy may provide additional benefits to HIV-infected patients. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
11. Improvements in depression and changes in quality of life among HIV-infected adults.
- Author
-
Bengtson, Angela M., Pence, Brian W., O'Donnell, Julie, Thielman, Nathan, Heine, Amy, Zinski, Anne, Modi, Riddhi, McGuinness, Teena, and Gaynes, Bradley
- Subjects
CONFIDENCE intervals ,MENTAL depression ,HAMILTON Depression Inventory ,PSYCHOLOGICAL tests ,QUALITY of life ,QUESTIONNAIRES ,REGRESSION analysis ,RESEARCH funding ,STATISTICS ,PSYCHOLOGY of AIDS patients ,DATA analysis ,RANDOMIZED controlled trials ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Improving quality of life (QOL) for HIV-infected individuals is an important objective of HIV care, given the considerable physical and emotional burden associated with living with HIV. Although worse QOL has been associated with depression, no research has quantified the potential of improvement in depression to prospectively improve QOL among HIV-infected adults. We analyzed data from 115 HIV-infected adults with depression enrolled in a randomized controlled trial to evaluate the effectiveness of improved depression care on antiretroviral drug adherence. Improvement in depression, the exposure of interest, was defined as the relative change in depression at six months compared to baseline and categorized as full response (≥50% improvement), partial response (25–49% improvement), and no response (<25% improvement). Multivariable linear regression was used to investigate the relationship between improvement in depression and four continuous measures of QOL at six months: physical QOL, mental QOL, HIV symptoms, and fatigue intensity. In multivariable analyses, physical QOL was higher among partial responders (mean difference [MD] = 2.51, 95% CI: −1.51, 6.54) and full responders (MD = 3.68, 95% CI: −0.36, 7.72) compared to individuals who did not respond. Mental QOL was an average of 4.01 points higher (95% CI: −1.01, 9.03) among partial responders and 14.34 points higher (95% CI: 9.42, 19.25) among full responders. HIV symptoms were lower for partial responders (MD = −0.69; 95% CI: −1.69, 0.30) and full responders (MD = −1.51; 95% CI: −2.50, −0.53). Fatigue intensity was also lower for partial responders (MD = −0.94; 95% CI: −1.94, 0.07) and full responders (MD = −3.00; 95% CI: −3.98, −2.02). Among HIV-infected adults with depression, improving access to high-quality depression treatment may also improve important QOL outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
12. Implementation of PHQ-9 Depression Screening for HIV-Infected Patients in a Real-World Setting.
- Author
-
Edwards, Malaika, Quinlivan, Evelyn Byrd, Bess, Kiana, Gaynes, Bradley N., Heine, Amy, Zinski, Anne, Modi, Riddhi, and Pence, Brian W.
- Published
- 2014
- Full Text
- View/download PDF
13. Treating Depression Within the HIV 'Medical Home': A Guided Algorithm for Antidepressant Management by HIV Clinicians.
- Author
-
Adams, Julie L., Gaynes, Bradley N., Mcguinness, Teena, Modi, Riddhi, Willig, James, and Pence, Brian W.
- Subjects
MENTAL depression ,AFFECTIVE disorders ,ALGORITHMS ,ANTIDEPRESSANTS ,DECISION trees ,DRUG interactions ,HEALTH care teams ,PSYCHOLOGY of HIV-positive persons ,MEDICAL quality control ,QUESTIONNAIRES ,RESEARCH funding ,SUPERVISION of employees ,EVIDENCE-based medicine ,ANTIRETROVIRAL agents ,THEORY-practice relationship ,MENTAL illness risk factors - Abstract
People living with HIV/AIDS (PLWHA) suffer increased depression prevalence compared to the general population, which negatively impacts antiretroviral (ART) adherence and HIV-related outcomes leading to morbidity and mortality. Yet depression in this population often goes undiagnosed and untreated. The current project sought to design an evidence-based approach to integrate depression care in HIV clinics. The model chosen, measurement-based care (MBC), is based on existing guidelines and the largest randomized trial of depression treatment. MBC was adapted to clinical realities of HIV care for use in a randomized controlled effectiveness trial of depression management at three academic HIV clinics. The adaptation accounts for drug-drug interactions critical to ongoing ART effectiveness and can be delivered by a multidisciplinary team of nonmental health providers. A treatment algorithm was developed that enables clinically supervised, nonphysician depression care managers (DCMs) to track and monitor antidepressant tolerability and treatment response while supporting nonpsychiatric prescribers with antidepressant choice and dosing. Quality of care is ensured through weekly supervision of DCMs by psychiatrists. Key areas of flexibility that have been important in implementation have included flexibility in timing of assessments, accommodation of divergence between algorithm recommendations and provider decisions, and accommodation of delays in implementing treatment plans. This adaptation of the MBC model to HIV care has accounted for critical antidepressant-antiretroviral interactions and facilitated the provision of quality antidepressant management within the HIV medical home. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.