28 results on '"Sinha, Sanjeev"'
Search Results
2. Lean Mass Improvement from Nutrition Education and Protein Supplementation among Rural Indian Women Living with HIV/AIDS: Results from Cluster Randomized Factorial Trial at 18-Month Follow-Up
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Carpenter, Catherine L, Kapur, Kavita, Ramakrishna, Padma, Pamujula, Suresh, Yadav, Kartik, Giovanni, Jennifer E, Julian, Olivia, Ekstrand, Maria L, Sinha, Sanjeev, and Nyamathi, Adeline M
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Clinical Research ,Clinical Trials and Supportive Activities ,Prevention ,Behavioral and Social Science ,Nutrition ,HIV/AIDS ,Infectious Diseases ,Acquired Immunodeficiency Syndrome ,Body Composition ,Counseling ,Dietary Proteins ,Dietary Supplements ,Female ,Follow-Up Studies ,Health Education ,Humans ,India ,Nutrition Therapy ,Nutritional Physiological Phenomena ,Rural Population ,Time Factors ,lean mass ,HIV ,AIDS ,protein ,nutrition ,cluster-randomized trial ,Food Sciences ,Nutrition and Dietetics ,Clinical sciences ,Nutrition and dietetics ,Public health - Abstract
Loss of lean muscle mass impairs immunity and increases mortality risk among individuals with HIV/AIDS. We evaluated the relative contributions of protein supplementation and nutrition education on body composition among 600 women living with HIV/AIDS in rural Andhra Pradesh, India. We conducted a cluster randomized controlled 2 × 2 factorial trial lasting six months with follow up at twelve and eighteen months. Interventions occurred in the Nellore and Prakasam regions of Andhra Pradesh by trained village women, ASHA (Accredited Social Health Activists), and included: (1) the usual supportive care from ASHA (UC); (2) UC plus nutrition education (NE); (3) UC plus nutritional protein supplementation (NS); (4) combined UC plus NE plus NS. A Bioimpedance Analyzer Model 310e measured body composition. SAS 9.4 analyzed all data. Mixed models using repeated measures evaluated lean mass change from baseline as primary and fat weight and total weight as secondary outcomes. Lean mass change was significantly associated with NS (p = 0.0001), NE (p = 0.0001), and combined NS plus NE (p = 0.0001), with similar associations for secondary outcomes. Stronger associations for total weight were observed with greater ART adherence. Nutritional interventions may improve physiologic response to HIV. Significant increases in lean mass resulted from independent and combined protein supplementation and nutrition education.
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- 2022
3. Mental health of women living with HIV and its impact on child development in Andhra Pradesh, India.
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Satyanarayana, Veena A, Burroughs, Hadley R, Heylen, Elsa, Yadav, Kartik, Sinha, Sanjeev, Nyamathi, Adeline, and Ekstrand, Maria L
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Child development ,Depression ,HIV ,India ,Stigma ,Women ,Mental Health ,Clinical Research ,Nutrition ,Infectious Diseases ,Behavioral and Social Science ,Pediatric ,Pediatric AIDS ,Prevention ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Prevention of disease and conditions ,and promotion of well-being ,Mental health ,Good Health and Well Being ,stigma ,women ,child development ,Psychology - Abstract
Global literature examining the association between mental health of women living with HIV (WLWH) and child development is scarce. In this study, we examined the relationship between mothers' mental health and their children's social development outcomes 6 months later. Data for these analyses come from several waves of interviews of 600 WLWH in the South Indian state of Andhra Pradesh, India. These women were enrolled in a 2×2 factorial clinical trial designed to assess the impact of food supplementation and nutrition education, both in addition to ASHA support, on adherence to ART and improved health outcomes for the women and one of their children. They were assessed on food security, stigma, social support, quality of life, depressive symptoms and child development outcomes. Results of longitudinal GEE regression analysis indicate that mother's depressive symptoms were significantly negatively associated with child's social quotient 6 months later. These findings have important implications for targeted health interventions, integrating mental health, both for WLWH and their children in India.
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- 2021
4. The Effect of Community-Based Nutritional Interventions on Children of Women Living With Human Immunodeficiency Virus in Rural India: A 2 × 2 Factorial Intervention Trial.
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Shin, Sanghyuk S, Satyanarayana, Veena A, Ekstrand, Maria L, Carpenter, Catherine L, Wang, Qiao, Yadav, Kartik, Ramakrishnan, Padma, Pamujula, Suresh, Sinha, Sanjeev, and Nyamathi, Adeline M
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Obesity ,Pediatric ,Clinical Research ,Prevention ,Infectious Diseases ,Pediatric AIDS ,Nutrition ,Clinical Trials and Supportive Activities ,HIV/AIDS ,Prevention of disease and conditions ,and promotion of well-being ,3.3 Nutrition and chemoprevention ,Zero Hunger ,CD4 Lymphocyte Count ,Child ,Female ,HIV ,HIV Infections ,Humans ,India ,Infant ,Rural Population ,malnutrition ,body weight ,community intervention ,longitudinal follow-up ,Biological Sciences ,Medical and Health Sciences ,Microbiology - Abstract
BackgroundMalnutrition is a common clinical concern among children in low-income communities affected by human immunodeficiency virus (HIV). We examined the effect of a community-based nutritional intervention on anthropometric and clinical outcomes of children of women living with HIV in rural India.MethodsWe assigned women living with HIV and their child (oldest 3-8 years) to 1 of 4 programs: (1) community-based HIV care program, (2) program 1 + nutrition education, (3) program 1 + food supplement, and (4) all elements of programs 1-3. Study data were collected at baseline and months 6, 12, and 18. We applied mixed-effects modeling with restricted maximum likelihood estimation to examine changes in weight (all children) and CD4+ T-cell counts (children with HIV only).ResultsOverall, 600 mother-child pairs were enrolled (150/group) with 100% retention at follow-up visits. Approximately 20% of children were living with HIV. Children in program 4 had higher weight gain than those in programs 1, 2, and 3 at all time points (adjusted P < .001). We found a higher increase in CD4+ T cells across all time points among participants in programs 3 and 4 compared with program 1 (adjusted P < .001). Factorial analysis suggested a synergistic effect of combining nutrition education and food supplements for weight gain but not for increase in CD4+ T cells.ConclusionsA combination of nutrition education and food supplements provided to women living with HIV significantly increased weight and CD4+ T cells, and such interventions can be integrated into HIV-care programs in low-income settings.
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- 2020
5. Sustained Effect of a Community-based Behavioral and Nutrition Intervention on HIV-related Outcomes Among Women Living With HIV in Rural India: A Quasi-experimental Trial.
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Nyamathi, Adeline M, Shin, Sanghyuk S, Sinha, Sanjeev, Carpenter, Catherine L, Garfin, Dana Rose, Ramakrishnan, Padma, Yadav, Kartik, and Ekstrand, Maria L
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Clinical Sciences ,Prevention ,Behavioral and Social Science ,HIV/AIDS ,Clinical Research ,Clinical Trials and Supportive Activities ,Nutrition ,Good Health and Well Being ,Adult ,Behavior Therapy ,Behavioral Medicine ,Body Mass Index ,CD4 Lymphocyte Count ,Child ,Preschool ,Community Health Workers ,Counseling ,Diet Therapy ,Dietary Supplements ,Female ,HIV Infections ,Hemoglobins ,Humans ,India ,Middle Aged ,Non-Randomized Controlled Trials as Topic ,Nutrition Assessment ,Nutritional Status ,Patient Education as Topic ,Rural Population ,Serum Albumin ,Treatment Outcome ,infectious diseases/HIV-AIDS ,clinical trial ,nutrition ,nursing ,health education ,community health workers ,behavioral medicine ,CD4 lymphocyte count ,body mass index ,Public Health and Health Services ,Virology ,Clinical sciences ,Epidemiology ,Public health - Abstract
BackgroundWomen living with HIV (WLH) in rural communities face challenges to obtaining treatment and accurate disease-related information. Nutritional deficits exacerbate disease progression.SettingWLH were recruited from primary health centers in rural India.MethodA quasi-experimental trial of a comprehensive Accredited Social Health Activist (Asha)-supported intervention compared 4 distinct Asha-based programs [(1) standard education (SE) alone; (2) nutrition education (+NE); (3) nutrition supplements (+NS); or (4) nutrition education and nutrition supplements (+NENS)] on key disease and nutrition-related outcomes [CD4 count, body mass index (BMI), serum albumin, and hemoglobin]. Assessments occurred at baseline, and months 6 (immediately after intervention), 12, and 18. Multilevel modeling examined effects of program (group) over time.FindingsAmong 600 WLH enrolled (n = 150 per arm), mean age, CD4 count, and BMI (kg/m) were 34.31, 447.42, and 20.09, respectively, at baseline. At 18-month follow-up, program 4 (+NENS) experienced greatest improvements in CD4 counts compared with program 1 (+SE) [adjusted difference = 223.81, 95% confidence interval (CI): 170.29 to 277.32]. For BMI, programs 3 (+NS; adjusted difference = 2.33, 95% CI: 1.39 to 3.26) and 4 (+NENS; adjusted difference = 2.14, 95% CI: 1.17 to 3.12) exhibited greater gains compared with program 1 (+SE). Programs 3 and 4 were not significantly different from each other (adjusted difference = -0.18, 95% CI: -1.12 to 0.76). Hemoglobin and serum albumin also improved over time; program 4 (+NENS) exhibited the greatest gains.ConclusionsA low-cost Asha-supported behavioral and nutritional intervention improved outcomes for WLH. Gains were sustained at 18-month follow-up. Similar approaches may help improve HIV and other infectious disease-related outcomes in vulnerable populations.
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- 2019
6. Cervical cancer awareness and presence of abnormal cytology among HIV-infected women on antiretroviral therapy in rural Andhra Pradesh, India.
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Shin, Sanghyuk S, Carpenter, Catherine L, Ekstrand, Maria L, Wang, Qiao, Grover, Surbhi, Zetola, Nicola M, Yadav, Kartik, Sinha, Sanjeev, and Nyamathi, Adeline M
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Humans ,Papillomaviridae ,Papillomavirus Infections ,HIV Infections ,Carcinoma ,Squamous Cell ,Vaginal Smears ,Prevalence ,Risk Factors ,Health Knowledge ,Attitudes ,Practice ,Adolescent ,Adult ,Middle Aged ,Rural Population ,India ,Uterine Cervical Dysplasia ,Uterine Cervical Neoplasms ,Female ,Young Adult ,Papanicolaou Test ,Squamous Intraepithelial Lesions of the Cervix ,Surveys and Questionnaires ,cytology ,lesion ,prevalence ,prevention ,Sexually Transmitted Infections ,Cancer ,Cervical Cancer ,HIV/AIDS ,Infectious Diseases ,Prevention ,Clinical Research ,Infection ,Good Health and Well Being ,Cervical Intraepithelial Neoplasia ,Clinical Sciences ,Medical Microbiology ,Public Health and Health Services ,Public Health - Abstract
Cervical cancer is a leading cause of death among women in low- and middle-income countries, and women living with HIV are at high risk for cervical cancer. The objective of this study was to estimate the prevalence and correlates of cervical cancer and pre-cancer lesions and to examine cervical cancer knowledge among women living with HIV receiving antiretroviral therapy in rural Andhra Pradesh, India. We conducted cytology-based screening and administered a standardized questionnaire among 598 HIV-infected women. We found 5 (0.8%), 39 (6.5%), 29 (4.9%), and 4 (0.7%) had atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), and squamous cervical carcinoma (SCC), respectively. In multivariable logistic regression analysis, ASCUS/LSIL was independently associated with age >16 years old at first sexual encounter and smokeless tobacco use. We found no factors associated with HSIL/SCC. In total, 101 women (16.9%) had heard of cervical cancer and 28 (27.7%) of them correctly identified HIV infection as a risk factor. In light of the high prevalence of pre-cancer lesions and low level of cervical cancer knowledge in our study population, focused interventions are needed to improve cervical cancer literacy and prevention among rural women living with HIV.
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- 2019
7. Depression, social support, and stigma as predictors of quality of life over time: results from an Asha-based HIV/AIDS intervention in India.
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Garfin, Dana Rose, Shin, Sanghyuk S, Ekstrand, Maria L, Yadav, Kartik, Carpenter, Catherine L, Sinha, Sanjeev, and Nyamathi, Adeline M
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Humans ,HIV Infections ,Antiretroviral Therapy ,Highly Active ,Depression ,Quality of Life ,Social Support ,Adult ,Middle Aged ,India ,Female ,Male ,Social Stigma ,Self Report ,AIDS ,HIV ,Latent Class Analysis ,depression ,quality of life ,social support ,stigma ,Clinical Research ,HIV/AIDS ,Mental Health ,Infectious Diseases ,Behavioral and Social Science ,Good Health and Well Being ,Public Health and Health Services ,Psychology ,Public Health - Abstract
Quality of life (QOL) is associated with better outcomes in HIV/AIDS populations. We explored predictors of improved QOL over time in 600 Women Living with HIV/AIDS (WLH/A) in India [mean age = 34.31, SD = 6.97], enrolled in a nurse-led-Asha (Accredited Social Health Activist) intervention. Trained local interviewers ascertained self-report data at baseline and six-month follow-up (post-intervention). Latent Class Analysis (LCA) identified constellations of responses on psychosocial indicators (depression, social support, internalized stigma and stigma fears); their relationship with QOL over time was examined. We identified three classes: Class 1) Highest Social Resources/Lowest Depression; Class 2) Some Social Resources/Highest Depression; and Class 3) Lowest Social Resources/Higher Depression. At baseline, Class 3 reported the lowest QOL (M = 0.25, SD = 0.26); Class 1 reported the highest (M = 0.37, SD = 0.33). Class 2's QOL did not differ from Class 3's QOL, likely due to the potent effects of high depression. At six-month follow-up, all groups reported improved QOL; class membership no longer predicted variability (contrast between Class 2 and 1 = -0.05, 95% CI = -0.14, 0.04; contrast between Class 3 and 1 = 0.01, 95% CI = -0.03, 0.05; contrast between Class 3 and 2 = 0.07, 95% CI = -0.02, 0.16). Psychosocial indicators are important predictors of QOL; an Asha-supported approach may have broad applicability to improve QOL in WLH/A in India.
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- 2019
8. Household Food Insecurity as Mediator of the Association Between Internalized Stigma and Opportunistic Infections.
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Shin, Sanghyuk S, Carpenter, Catherine L, Ekstrand, Maria L, Yadav, Kartik, Shah, Saanchi V, Ramakrishnan, Padma, Pamujula, Suresh, Sinha, Sanjeev, and Nyamathi, Adeline M
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Humans ,Opportunistic Infections ,HIV Infections ,Skin Diseases ,Cross-Sectional Studies ,Social Support ,Socioeconomic Factors ,Food Supply ,Adult ,Middle Aged ,Rural Population ,India ,Female ,Male ,Social Stigma ,Adherence ,Antiretroviral therapy ,Dermatoses ,Fungal infections ,Nutrition ,Infectious Diseases ,Clinical Research ,HIV/AIDS ,Behavioral and Social Science ,Infection ,Zero Hunger ,Public Health and Health Services ,Social Work ,Public Health - Abstract
Internalized HIV stigma can affect health outcomes, but the mechanism underlying this relationship is poorly understood. We investigated the potential pathways for the association between internalized stigma and opportunistic infections (OIs) among women living with HIV in rural India. We conducted a cross-sectional study involving in-person interviews with 600 participants. We modeled two outcome variables, total number of OIs and fungal dermatoses, which was the most frequently reported OI. Causal mediation analysis was performed to estimate the total effect, direct effect, and indirect effect through mediators while controlling for confounders. Food insecurity was a strong mediator of the association between internalized stigma and the number of OIs (70% of the total effect) and fungal dermatoses (83% of the total effect), while the indirect effect of stigma through adherence was minimal for both outcomes. Household food insecurity may be an important mediator of the impact of HIV-related stigma on opportunistic infections.
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- 2018
9. The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India.
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Ekstrand, Maria L, Heylen, Elsa, Mazur, Amanda, Steward, Wayne T, Carpenter, Catherine, Yadav, Kartik, Sinha, Sanjeev, and Nyamathi, Adey
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Humans ,HIV Infections ,Adaptation ,Psychological ,Loneliness ,Quality of Life ,Social Support ,Adult ,Middle Aged ,Rural Population ,India ,Female ,Male ,Medication Adherence ,Social Stigma ,Adherence ,HIV stigma ,Quality of life ,Rural women ,Public Health ,Public Health and Health Services ,Social Work - Abstract
HIV stigma continues to be a barrier to physical and mental health among people living with HIV globally, especially in vulnerable populations. We examined how stigma is associated with health outcomes and quality of life among rural women living with HIV in South India (N = 600). Interviewer-administered measures assessed multiple dimensions of stigma, as well as loneliness, social support, ART adherence, time since diagnosis, and quality of life. Internalized stigma and a lack of social support were associated with a lower quality of life, while the association between internalized stigma and adherence was mediated by the use of stigma-avoidant coping strategies, suggesting that keeping one's diagnosis a secret may make it more difficult to take one's medications. These findings suggest that these women constitute a vulnerable population who need additional services to optimize their health and who might benefit from peer support interventions and stigma-reduction programs for family and community members.
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- 2018
10. Randomized controlled trial of a community-based intervention on HIV and nutritional outcomes at 6 months among women living with HIV/AIDS in rural India
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Nyamathi, Adeline M, Carpenter, Catherine L, Ekstrand, Maria L, Yadav, Kartik, Garfin, Dana Rose, Muniz, Lisa C, Kelley, Mariko, and Sinha, Sanjeev
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HIV/AIDS ,Clinical Trials and Supportive Activities ,Clinical Research ,Prevention ,Nutrition ,Adolescent ,Adult ,Behavior Therapy ,Body Mass Index ,CD4 Lymphocyte Count ,Community Health Workers ,Diet Therapy ,Female ,HIV Infections ,Humans ,India ,Middle Aged ,Rural Population ,Treatment Outcome ,Young Adult ,BMI ,body weight ,cluster randomized control trial ,community interventions ,food insecurity ,social support ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology - Abstract
ObjectiveTo assess the impact of nurse-led Asha (Accredited Social Health Activist)-support behavioral and nutritional intervention among women living with HIV/AIDS (WLH/A) in rural India.DesignCluster randomized controlled trial.MethodsSixteen Primary Health Centers serving WLH/A in Andhra Pradesh were grouped into four regional clusters that were randomly allocated into one of four arms. All four groups included Asha-support and consisted of: Asha-support only (control group); nutrition education; nutrition supplementation; and the combination of supplementation and education. Differences between baseline and 6-month follow-up for key physiological outcomes (BMI, CD4 cell count) were analyzed using factorial mixed models that accounted for geographic clustering.ResultsAt 6 months, all groups improved CD4 cell count: Asha only [mean difference score (D) = 343.97, standard deviation (SD) = 106.94], nutrition education (D = 356.15, SD = 0.69), nutrition supplement (D = 469.66, SD = 116.0), and nutrition supplement and education (D = 530.82, SD = 128.56). In multivariable models, Asha-support and nutrition, and Asha-support and nutrition supplement interventions demonstrated independent significant improvements in CD4 cell count; the interaction term was significant [estimate = 529.9; 95% confidence interval (CI) 512.0, 547.8; P = 0.006]. BMI also increased for all groups: Asha only (D = 0.95, SD = 0.82), Asha and nutrition education (D = 1.28, SD = 0.53), Asha and nutrition supplement (D = 2.38, SD = 0.60), nutrition supplement, and nutrition supplement and education (D = 2.72, SD = 0.84). Nutrition supplementation and nutrition education demonstrated independent effects on BMI; the interaction term was not significant (estimate = 0.27; 95% CI = 2.5, 2.7; P = 0.80).ConclusionInterventions supported by community workers were efficacious at improving physiological outcomes and may be beneficial at meeting critical healthcare needs of vulnerable WLH/A in India.
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- 2018
11. Effect of kidney transplantation on sleep-disordered breathing in patients with End Stage Renal Disease: a polysomnographic study
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Mahajan, Sanjiv, Gupta, Kartik, Sinha, Sanjeev, Malhotra, Atul, and Mahajan, Sandeep
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Transplantation ,Clinical Research ,Kidney Disease ,Behavioral and Social Science ,Lung ,Sleep Research ,Organ Transplantation ,Renal and urogenital ,Adult ,Female ,Humans ,Hypertension ,India ,Kidney Failure ,Chronic ,Kidney Transplantation ,Male ,Polysomnography ,Prevalence ,Renal Dialysis ,Sleep Apnea Syndromes ,Sleep-disordered breathing ,ESRD ,Renal transplant ,Desaturation index ,AHI ,Psychology ,Neurology & Neurosurgery ,Clinical sciences ,Clinical and health psychology - Abstract
BackgroundSleep-disordered breathing (SDB) is common in patients with end-stage renal disease (ESRD). SDB is associated with comorbidities such as hypertension, diabetes mellitus, and obesity, interplaying with metabolic derangements in the form of uremia, acidosis, and hypervolemia. Renal transplant has been observed to correct most of these metabolic derangements and to control progression of comorbidities. While SDB is highly prevalent among patients in the pretransplant stage, it remains to be seen whether the beneficial aspects of transplant are extended to improvement in SDB in patients with ESRD.MethodsEighteen patients undergoing thrice-weekly hemodialysis (HD) for ESRD at the transplant clinic of All India Institute of Medical Sciences (AIIMS), New Delhi, underwent detailed clinical, laboratory, and polysomnographic evaluation. The average number of apneas and hypopneas per hour of sleep, ie, Apnea-Hypopnea Index (AHI), was used to define the severity of sleep apnea. All patients underwent polysomnography (PSG) within 24 h of the last HD and after three months of living-donor transplant.ResultsOf 18 patients, there were 14 males and four females. The median age was 28 years (range 19-50 years). They had already spent a median period of six months (range 3-31 months) on HD before inclusion. The prevalence of SDB (AHI ≥ 5/h) was 44.4% (8/18) before transplant, which decreased to 5.6% (1/18) after transplant (p = 0.016). The oxygen desaturation index had a median value of 5.8 events/h (range 0.1-35.4) in the pretransplant stage, which decreased to 0 events/h (range 0-6.6) in the post-transplant stage (p = 0.035).ConclusionThere was a significant improvement in the prevalence and severity of SDB after transplant. Whether improvement in SDB is sustained on a long-term follow-up remains to be seen.
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- 2018
12. Relationships Among Adherence and Physical and Mental Health Among Women Living with HIV in Rural India
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Nyamathi, Adeline, Ekstrand, Maria, Heylen, Elsa, Ramakrishna, Padma, Yadav, Kartik, Sinha, Sanjeev, Hudson, Angela, Carpenter, Catherine L, and Arab, Lenore
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Health Services and Systems ,Public Health ,Health Sciences ,Behavioral and Social Science ,Mind and Body ,Infectious Diseases ,Clinical Research ,HIV/AIDS ,Prevention ,Mental Health ,Good Health and Well Being ,Zero Hunger ,Adult ,Anti-Retroviral Agents ,CD4 Lymphocyte Count ,Cross-Sectional Studies ,Depression ,Female ,Food Supply ,HIV Infections ,Health Status ,Humans ,India ,Male ,Medication Adherence ,Middle Aged ,Quality of Life ,Rural Population ,Social Stigma ,Women ,AIDS ,Opportunistic infections ,Public Health and Health Services ,Social Work ,Public health - Abstract
We conducted a cross-sectional examination of the physical and psychological factors related to ART adherence among a sample of 400 women living with HIV/AIDS in rural India. Interviewer-administered measures assessed adherence, internalized stigma, depressive symptoms, quality of life, food insecurity, health history and sociodemographic information. CD4 counts were measured using blood collected at screening. Findings revealed that adherence to ART was generally low, with 94% of women taking 50% or less of prescribed medication in past month. Multivariate analyses showed a non-linear association between numbers of self-reported opportunistic infections (OIs) in past 6 months (p = 0.016) and adherence, with adherence decreasing with each additional OI for 0-5 OIs. For those reporting more than 5 OIs, the association reversed direction, with increasing OIs beyond 5 associated with greater adherence.
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- 2018
13. Prevalence of HIV in Patients with Malignancy and of Malignancy in HIV Patients in a Tertiary Care Center from North India
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Sinha, Sanjeev, Agarwal, Ashish, Gupta, Kartik, Mandal, Dibyakanti, Jain, Mitul, Detels, Roger, Nandy, Karabi, DeVos, Michelle A, Sharma, SK, Manoharan, N, Julka, PK, Rath, GK, Ambinder, Richard F, and Mitsuyasu, Ronald T
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Biomedical and Clinical Sciences ,Health Services and Systems ,Health Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Cancer ,Hematology ,Prevention ,HIV/AIDS ,Infectious Diseases ,Rare Diseases ,Clinical Research ,2.4 Surveillance and distribution ,Aetiology ,Infection ,Good Health and Well Being ,Adult ,Aged ,Cross-Sectional Studies ,Female ,HIV Infections ,Humans ,India ,Male ,Middle Aged ,Neoplasms ,Prevalence ,Risk Factors ,Tertiary Care Centers ,AIDS-defining cancer ,cancer ,HIV ,invasive cervical cancer ,non-Hodgkin's lymphoma ,ART ,non-Hodgkin's lymphoma. ,Medical and Health Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
Background and objectivesPeople living with HIV/AIDS are at an increased risk of developing cancer. The goals of this study were to obtain data on the prevalence of HIV in the cancer population and vice versa at a major tertiary cancer and HIV center in North India.MethodsThis cross-sectional study was conducted over a 3-year period from July 2013 to June 2016, wherein successive HIV positive patients from an anti-retroviral therapy (ART) center were screened for malignancy. Simultaneously, successive cancer patients at the cancer center were screened for HIV. Baseline demographic details, risk factors, and laboratory investigations were obtained for all the patients.ResultsAmong the 999 HIV-positive patients at the ART center, the prevalence of malignancy was 2% (n=20; 95% confidence interval (CI) 1.13, 2.87). Among the 998 patients with a malignancy, the prevalence of HIV infection was 0.9% (n=9; 95% CI 0.31, 1.49). Weight loss, loss of appetite, and fever were the most common symptoms in patients with HIV and cancer. Among 29 patients with HIV and cancer, AIDS-defining cancer was found in 19 patients; non-Hodgkin's lymphoma was the most common malignancy reported (n=13).Interpretation and conclusionThere is a low prevalence of HIV in cancer patients as well as a low prevalence of cancer in HIV patients. AIDS-defining cancers remain much more common than non-AIDS-defining cancers. With the increased coverage of ART, it is expected that non-AIDSdefining cancers will increase, as is evident from data from more developed countries.
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- 2018
14. Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study.
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Salem, Benissa E, Bustos, Yvita, Shalita, Chidyaonga, Kwon, Jordan, Ramakrishnan, Padma, Yadav, Kartik, Ekstrand, Maria L, Sinha, Sanjeev, and Nyamathi, Adeline M
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Humans ,HIV Infections ,Acquired Immunodeficiency Syndrome ,Chronic Disease ,Anti-Retroviral Agents ,Diet ,Qualitative Research ,Social Support ,Socioeconomic Factors ,Adult ,Middle Aged ,Rural Population ,Health Services Accessibility ,India ,Female ,Medication Adherence ,Self-Management ,HIV/AIDS ,antiretroviral therapy ,rural women ,self-management ,Pediatric ,Rural Health ,Clinical Research ,Behavioral and Social Science ,Infectious Diseases ,Pediatric AIDS ,7.1 Individual care needs ,8.1 Organisation and delivery of services ,Health and social care services research ,Management of diseases and conditions ,Infection ,Good Health and Well Being ,Zero Hunger - Abstract
Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future. Chronic disease self-management in rural locales is challenging, given the number of barriers which rural women experience on a daily basis. These findings suggest a need for individual- and structural-level supports that will aid in assisting rural WLHA to self-manage HIV/AIDS as a chronic illness.
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- 2018
15. Quality of Life Among Women Living With HIV in Rural India.
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Nyamathi, Adeline M, Ekstrand, Maria, Yadav, Kartik, Ramakrishna, Padma, Heylen, Elsa, Carpenter, Catherine, Wall, Sarah, Oleskowicz, Tanya, Arab, Lenore, and Sinha, Sanjeev
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Humans ,HIV Infections ,Cross-Sectional Studies ,Depression ,Quality of Life ,Social Support ,Socioeconomic Factors ,Adult ,Rural Population ,India ,Female ,Social Stigma ,Surveys and Questionnaires ,HIV ,quality of life ,women ,Public Health ,Nursing - Abstract
A cross-sectional examination was conducted on quality of life (QOL) among women living with HIV (WLWH) in rural Andhra Pradesh, India. Baseline data were collected from 400 WLWH and their children. QOL was measured with 10 items from the Quality of Life Enjoyment and Satisfaction Questionnaire. Findings revealed low QOL scores; on a scale from 0 to 3, the mean QOL score was 0.38 (SD = 0.30). Depression symptoms were reported by 25.5%, internalized stigma was high, and most reported little to no social support. Multivariable analysis revealed positive associations between QOL and CD4+ T cells (b = .0011, p = .021) and social support (b = .260, p
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- 2017
16. Women living with AIDS in rural Southern India: Perspectives on mental health and lay health care worker support
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Srivastava, Neha, Nyamathi, Adeline M, Sinha, Sanjeev, Carpenter, Catherine, Satyanarayana, Veena, Ramakrishnan, Padma, and Ekstrand, Maria
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Health Services and Systems ,Health Sciences ,Mental Health ,Clinical Research ,Behavioral and Social Science ,7.1 Individual care needs ,Management of diseases and conditions ,Mental health ,Good Health and Well Being ,AIDS ,coping resources ,India ,mental health ,women ,Women ,Public Health and Health Services ,Social Work ,Public Health ,Public health ,Social work - Abstract
In this study, focus groups were conducted with 16 rural Women Living with AIDS (WLA) from Andhra Pradesh, India who had previously participated in a clinical trial wherein 68 WLA were randomized into either an Accredited Social Health Activists (ASHA) - Life (AL) intervention or a Usual Care program. Findings are discussed in terms of: a) mental health issues, b) perceived stressors, c) individual resources for coping with mental health issues, and d) role of Asha support in coping with mental health issues. These findings highlight the salience of mental health issues in the lives of WLA and the role played by Asha in addressing some of these issues. The discussion section makes a case for increased emphasis on mental health care in future community-based interventions for this population.
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- 2017
17. ASHA-Life Intervention Perspectives Voiced by Rural Indian Women Living With AIDS
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Nyamathi, Adeline, Ekstrand, Maria, Srivastava, Neha, Carpenter, Catherine L, Salem, Benissa E, Al-Harrasi, Shawana, Ramakrishnan, Padma, and Sinha, Sanjeev
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Health Services and Systems ,Health Sciences ,Prevention ,Clinical Research ,Behavioral and Social Science ,Nutrition ,7.1 Individual care needs ,Management of diseases and conditions ,Adaptation ,Psychological ,Adolescent ,Adult ,Anti-Retroviral Agents ,Female ,Focus Groups ,HIV Infections ,Health Services Accessibility ,Humans ,India ,Medication Adherence ,Middle Aged ,Rural Population ,Social Support ,Socioeconomic Factors ,Young Adult ,Nursing ,Public Health and Health Services ,Public Health ,Health sciences ,Psychology - Abstract
In this focus group study, we explored the experiences of 16 rural women living with AIDS (WLA) who participated in the Asha-Life (AL) intervention to gain an understanding of the environmental, psychosocial, and cultural impact of the AL on their lives. Four themes emerged among AL participants: (a) the importance of tangible support, (b) need for social support, (c) ongoing challenges to accessing antiretroviral therapy (ART), and (d) perspectives on future programs. Our research findings support the development of future programs targeting mother-child dyads which emphasize nutritional knowledge, while reducing barriers to receiving ART, and physical, emotional, and financial support.
- Published
- 2016
18. Physical and Mental Health of Rural Southern Indian Women Living with AIDS
- Author
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Nyamathi, Adeline, Heravian, Anisa, Salem, Benissa, Suresh, P, Sinha, Sanjeev, Ganguly, Kalyan, Carpenter, Catherine, Ramakrishnan, Padma, Marfisee, Mary, and Liu, Yihang
- Subjects
Health Services and Systems ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Rural Health ,Depression ,Behavioral and Social Science ,Mental Health ,Prevention ,Management of diseases and conditions ,7.1 Individual care needs ,Health and social care services research ,8.1 Organisation and delivery of services ,Good Health and Well Being ,Adult ,Cross-Sectional Studies ,Female ,HIV Infections ,Health Services Accessibility ,Humans ,India ,Medication Adherence ,Rural Population ,Socioeconomic Factors ,Surveys and Questionnaires ,HIV/AIDS ,rural and urban women living with AIDS in India - Abstract
The purpose of this descriptive study is to highlight the physical and mental health symptoms of 68 rural women living with AIDS (WLA) in India, their compliance to antiretroviral therapy (ART) medication, and barriers to accessing health care within the past 6 months. Physical and mental health status was obtained by self-report, administered by questionnaire and physician-determined clinical assessment, as well as selected objective parameters. Findings revealed that while rural WLA had been on antiretroviral therapy for just under 2 years, they self-reported a high prevalence of physical symptoms, and more than half reported high levels of depressive symptoms and major barriers to accessing health care. CD4 levels, body weight, and basal metabolic rate were also low. While the rural and urban WLA faced similar health care challenges, the demographic characteristics of the rural women may make them more vulnerable, as they are less adherent to ART and slimmer than their urban counterparts.
- Published
- 2013
19. Impact of Asha Intervention on Stigma Among Rural Indian Women With AIDS
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Nyamathi, Adeline, Ekstrand, Maria, Salem, Benissa E, Sinha, Sanjeev, Ganguly, Kalyan K, and Leake, Barbara
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Health Services and Systems ,Health Sciences ,Infectious Diseases ,Rural Health ,Behavioral and Social Science ,Mental Health ,HIV/AIDS ,Clinical Research ,Pediatric AIDS ,Prevention ,Pediatric ,Management of diseases and conditions ,7.1 Individual care needs ,Good Health and Well Being ,Acquired Immunodeficiency Syndrome ,Adaptation ,Psychological ,Adolescent ,Adult ,Anti-HIV Agents ,Female ,Humans ,Middle Aged ,Pilot Projects ,Prospective Studies ,Rural Population ,Stereotyping ,Young Adult ,HIV ,AIDS ,health care delivery ,women's health ,India ,women’s health ,Nursing - Abstract
Rural women living with HIV/AIDS (WLA) in India face multifarious challenges which affect access to antiretroviral regimens and management of HIV/AIDS. The purpose of this pilot study, using cluster randomization, is to compare the effectiveness of the Asha-Life (AL) intervention, delivered by HIV-trained village women, Asha (Accredited Social Health Activists), with a usual care group on reduction of internalized stigma and avoidant coping among 68 WLA in rural India over a 6-month period. The findings demonstrated that participation in the AL intervention was associated with significant reductions in internalized stigma and the use of avoidant coping strategies at follow-up. The findings of our study are promising in terms of the role rural village women (Asha) may play in reducing internalized stigma and avoidant coping in the lives of rural WLA in India.
- Published
- 2013
20. Impact of Protein Supplementation and Care and Support on Body Composition and CD4 Count Among HIV-Infected Women Living in Rural India: Results from a Randomized Pilot Clinical Trial
- Author
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Nyamathi, Adeline, Sinha, Sanjeev, Ganguly, Kalyan K, Ramakrishna, Padma, Suresh, P, and Carpenter, Catherine L
- Subjects
Health Services and Systems ,Health Sciences ,HIV/AIDS ,Clinical Research ,Prevention ,Infectious Diseases ,Clinical Trials and Supportive Activities ,Behavioral and Social Science ,Nutrition ,Metabolic and endocrine ,Adult ,Anti-HIV Agents ,Body Composition ,CD4 Lymphocyte Count ,Depression ,Dietary Proteins ,Dietary Supplements ,Female ,Food Supply ,HIV Infections ,Humans ,India ,Medication Adherence ,Patient Education as Topic ,Pilot Projects ,Rural Population ,Treatment Outcome ,AIDS in rural women ,ART ,Protein ,Body composition ,Public Health and Health Services ,Social Work ,Public Health ,Public health - Abstract
Body composition in HIV-infected individuals is subject to many influences. We conducted a pilot 6-month randomized trial of 68 women living with AIDS (WLA) from rural India. High protein intervention combined with education and supportive care delivered by HIV-trained village women (activated social health activist [Asha] life [AL]) was compared to standard protein with usual care delivered by village community assistants (usual care [UC]). Measurements included CD4 counts, ART adherence, socio-demographics, disease characteristics (questionnaires); and anthropometry (bioimpedance analyzer). Repeated measures analysis of variance modeled associations. AL significantly gained in BMI, muscle mass, fat mass, ART adherence, and CD4 counts compared to UC, with higher weight and muscle mass gains among ART adherent (≥66%) participants who had healthier immunity (CD4 ≥450). BMI of WLA improved through high protein supplementation combined with education and supportive care. Future research is needed to determine which intervention aspect was most responsible.
- Published
- 2013
21. Correlates of Stigma among Rural Indian Women Living with HIV/AIDS
- Author
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Nyamathi, Adeline, Ekstrand, Maria, Zolt-Gilburne, Jessica, Ganguly, Kalyan, Sinha, Sanjeev, Ramakrishnan, Padma, Suresh, P, Marfisee, Mary, and Leake, Barbara
- Subjects
Health Services and Systems ,Health Sciences ,Infectious Diseases ,Rural Health ,Pediatric ,Behavioral and Social Science ,HIV/AIDS ,Mental Health ,Clinical Research ,Pediatric AIDS ,Adaptation ,Psychological ,Adolescent ,Adult ,Attitude of Health Personnel ,Cross-Sectional Studies ,Depression ,Female ,HIV Infections ,Health Knowledge ,Attitudes ,Practice ,Humans ,India ,Models ,Statistical ,Regression Analysis ,Rural Population ,Self Disclosure ,Social Isolation ,Social Stigma ,Social Support ,Socioeconomic Factors ,Surveys and Questionnaires ,Young Adult ,Rural Women ,Stigma ,Public Health and Health Services ,Social Work ,Public Health ,Public health - Abstract
AIDS-related stigma has received increasing attention in the literature; however, little is known about the devastating impact it has on rural women living with AIDS (WLA) in India. This cross-sectional study (N = 68), analyzed from complete baseline data, identified a number of correlates of stigma among rural WLA in South India. Structured instruments were used to capture sociodemographic history, stigma, knowledge of HIV, depressive symptoms along with the recording of CD4 data. A higher level of felt stigma and more AIDS symptoms were related to avoidant coping, while fewer adherence strategies and lower support for antiretroviral therapy (ART) adherence were also associated with avoidant coping. These findings promote the need for support and resources for rural Indian WLA.
- Published
- 2013
22. Challenges experienced by rural women in India living with AIDS and implications for the delivery of HIV/AIDS care.
- Author
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Nyamathi, Adeline M, Sinha, Sanjeev, Ganguly, Kalyan K, William, Ravi Raj, Heravian, Anisa, Ramakrishnan, Padma, Greengold, Barbara, Ekstrand, Maria, and Rao, Pantangi Venkata Rama
- Subjects
Humans ,HIV Infections ,Anti-HIV Agents ,Focus Groups ,Health Knowledge ,Attitudes ,Practice ,Patient Compliance ,Stereotyping ,Qualitative Research ,Privacy ,Social Support ,Socioeconomic Factors ,Adult ,Middle Aged ,Rural Population ,Primary Health Care ,Delivery of Health Care ,Health Services Accessibility ,India ,Female ,Interviews as Topic ,Community-Based Participatory Research ,Young Adult ,Health Knowledge ,Attitudes ,Practice ,Public Health ,Nursing ,Public Health and Health Services - Abstract
Researchers explored the barriers to AIDS care for rural women living with AIDS, and they investigated alternative delivery models to increase the women's adherence to antiretroviral therapy (ART). Community-based participatory research focus groups were conducted by the researchers with a convenience sample of 39 women living with AIDS from a primary health center (PHC) near Chennai, India, and with nurses, physicians, and Accredited Social Health Activists (Ashas), who are lay health care workers. The most prevalent barriers expressed by the women were sickness-related, psychological, financial issues with childcare, and distance, or transportation to the site. Women living with AIDS reviewed Ashas favorably.
- Published
- 2011
23. Impact of COVID-19 on the patientsf income and work in Delhi, India.
- Author
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Chandra, Ankit, Sarda, Radhika, Kumar, Arvind, Bir, Megha, Parija, Pragyan, Pal, Aishee, Sinha, Sanjeev, Vikas, H, and Wig, Naveet
- Subjects
COVID-19 ,MEDICAL history taking ,PHYSICIAN services utilization ,DIAGNOSIS ,SOCIAL stigma - Abstract
Background: Currently, there is no data on the impact of COVID-19 on patients' income and work in India. Methods: We conducted a cross-sectional study at a tertiary hospital in New Delhi. We included all the patients who were ≥18 years of age and consecutively diagnosed with COVID-19 between the 1
st of May 2020 to 31st July 2020. Patients were interviewed by a physician using a semi-structure questionnaire. Data were collected on socio-economic status, occupation, income loss, leaves taken, decrease in work efficiency (self-perceived) and about-facing any stigma/discrimination at the workplace. Results: Out of 245 patients, 190 patients were employed. A total of 126 patients (66.3%) self-reported their work was affected due to COVID-19 disease. A total of 30.5% of patients (n = 58/190) reported deduction in their salary. The median amount of salary loss was INR 10,000 (IQR 9000–25000). Decrease in income and work efficiency (self-perceived) was found to be 37.3% (n = 71) and 12.1% (n = 23), respectively. A total of 47 patients (37.3%) took personal leaves (median number – 17 days (IQR 14–25), and discrimination/stigma related to the COVID-19 at the workplace was faced by 22.6% of patients. Conclusion: Income and work of a substantial number of patients was affected due to COVID-19, as there was a decrease in income and work efficiency. Patients also had to take personal leaves and face stigma in the workplace. This will inform the policymakers to formulate strategies to mitigate the impact of COVID-19. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
24. The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India.
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Heylen, Elsa, Mazur, Amanda, Steward, Wayne T., Ekstrand, Maria L., Carpenter, Catherine, Yadav, Kartik, Nyamathi, Adey, and Sinha, Sanjeev
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ANTIRETROVIRAL agents ,DRUGS ,HIV infections ,PSYCHOLOGY of HIV-positive persons ,LONELINESS ,EVALUATION of medical care ,PATIENT compliance ,QUALITY of life ,RURAL conditions ,SOCIAL stigma ,WOMEN'S health ,SOCIAL support - Abstract
HIV stigma continues to be a barrier to physical and mental health among people living with HIV globally, especially in vulnerable populations. We examined how stigma is associated with health outcomes and quality of life among rural women living with HIV in South India (N = 600). Interviewer-administered measures assessed multiple dimensions of stigma, as well as loneliness, social support, ART adherence, time since diagnosis, and quality of life. Internalized stigma and a lack of social support were associated with a lower quality of life, while the association between internalized stigma and adherence was mediated by the use of stigma-avoidant coping strategies, suggesting that keeping one’s diagnosis a secret may make it more difficult to take one’s medications. These findings suggest that these women constitute a vulnerable population who need additional services to optimize their health and who might benefit from peer support interventions and stigma-reduction programs for family and community members. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
25. Quality of Life Among Women Living With HIV in Rural India.
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Nyamathi, Adeline M., Ekstrand, Maria, Yadav, Kartik, Ramakrishna, Padma, Heylen, Elsa, Carpenter, Catherine, Wall, Sarah, Oleskowicz, Tanya, Arab, Lenore, and Sinha, Sanjeev
- Abstract
A cross-sectional examination was conducted on quality of life (QOL) among women living with HIV (WLWH) in rural Andhra Pradesh, India. Baseline data were collected from 400 WLWH and their children. QOL was measured with 10 items from the Quality of Life Enjoyment and Satisfaction Questionnaire. Findings revealed low QOL scores; on a scale from 0 to 3, the mean QOL score was 0.38 ( SD = 0.30). Depression symptoms were reported by 25.5%, internalized stigma was high, and most reported little to no social support. Multivariable analysis revealed positive associations between QOL and CD4+ T cells ( b = .0011, p = .021) and social support ( b = .260, p < .0001), and a negative relationship between QOL and internalized stigma ( b = −.232, p < .0001). Interventions focused on improving QOL for WLWH should incorporate strategies to improve social support and adherence to antiretroviral therapy, while mitigating internalized stigma. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
26. Intestinal Parasitosis in Relation to Anti-Retroviral Therapy, CD4+ T-cell Count and Diarrhea in HIV Patients.
- Author
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Khalil, Shehla, Mirdha, Bijay Ranjan, Sinha, Sanjeev, Panda, Ashutosh, Singh, Yogita, Joseph, Anju, and Deb, Manorama
- Subjects
INTESTINAL parasite treatment ,ANTIRETROVIRAL agents ,CD4 antigen ,T cells ,DIARRHEA ,HIV-positive persons - Abstract
Intestinal parasitic infections are one of the major causes of diarrhea in human immunodeficiency virus (HIV) seropositive individuals. Antiretroviral therapy has markedly reduced the incidence of many opportunistic infections, but parasite-related diarrhea still remains frequent and often underestimated especially in developing countries. The present hospital-based study was conducted to determine the spectrum of intestinal parasitosis in adult HIV/AIDS (acquired immunodeficiency syndrome) patients with or without diarrhea with the levels of CD4+ T-cell counts. A total of 400 individuals were enrolled and were screened for intestinal parasitosis. Of these study population, 200 were HIV seropositives, and the remaining 200 were HIV uninfected individuals with or without diarrhea. Intestinal parasites were identified by using microscopy as well as PCR assay. A total of 130 (32.5%) out of 400 patients were positive for any kinds of intestinal parasites. The cumulative number of parasite positive patients was 152 due to multiple infections. A significant association of Cryptosporidium (P<0.001) was detected among individuals with CD4+ T-cell counts less than 200 cells/µl. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
27. Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study.
- Author
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Salem, Benissa E., Bustos, Yvita, Shalita, Chidyaonga, Kwon, Jordan, Ramakrishnan, Padma, Yadav, Kartik, Ekstrand, Maria L., Sinha, Sanjeev, and Nyamathi, Adeline M.
- Abstract
Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future. Chronic disease self-management in rural locales is challenging, given the number of barriers which rural women experience on a daily basis. These findings suggest a need for individual- and structural-level supports that will aid in assisting rural WLHA to self-manage HIV/AIDS as a chronic illness. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
28. Impact of a Rural Village Women (Asha) Intervention on Adherence to Antiretroviral Therapy in Southern India.
- Author
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Nyamathi, Adeline, Hanson, Alecia Y., Salem, Benissa E., Sinha, Sanjeev, Ganguly, Kalyan K., Leake, Barbara, Yadav, Kartik, and Marfisee, Mary
- Subjects
- *
CLINICAL drug trials , *AIDS , *ANTIVIRAL agents , *CHI-squared test , *CONCEPTUAL structures , *DRUGS , *HELP-seeking behavior , *EVALUATION of medical care , *PATIENT compliance , *PSYCHOLOGICAL tests , *RELIGION , *RESEARCH funding , *RURAL conditions , *STATISTICAL sampling , *SCALE analysis (Psychology) , *SCALES (Weighing instruments) , *STATISTICS , *SOCIAL stigma , *PSYCHOLOGICAL stress , *T-test (Statistics) , *PILOT projects , *THEORY , *DATA analysis , *MULTIPLE regression analysis , *RANDOMIZED controlled trials , *HUMAN research subjects , *PATIENT selection , *PATIENTS' attitudes , *CD4 lymphocyte count ,DRUG therapy for AIDS - Abstract
The article discusses a study assessing the effectiveness of an intervention (Asha-Life) by Accredited Social Health Activists (Asha) to improve antiretroviral therapy adherence of rural women living with AIDS in India compared with that of a usual care group. It focuses on continued low adherence of therapy due to several barriers facing rural women. Findings suggested significant increase in the Asha-Life intervention, which provides awareness and councelling on HIV/AIDS and its therapy.
- Published
- 2012
- Full Text
- View/download PDF
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