Risk factors affecting adherence to antiretroviral therapy among HIV patients in Manila, Philippines: a baseline cross-sectional analysis of the Philippines Connect for Life Study.

Background The Philippines HIV epidemic is one of the fastest growing, globally. Infections among men who have sex with men (MSM) are rising at an alarming rate, necessitating targeted evidence-based interventions to reach epidemic control. Treatment as prevention is a key strategy to end AIDS, making it a priority to explore novel approaches to retain people living with HIV (PLHIV) in care, support adherence, and reach viral suppression. METHODS: This cross-sectional analysis describes HIV-related risk behaviours and adherence to antiretroviral therapy (ART) in a population of HIV-positive patients at a clinic in Metro Manila, Philippines participating in the Philippines Connect for LifeTM cohort study. RESULTS: Among 426 HIV-positive adults taking ART, 79% reported ≥95% adherence over the prior 30 days. Longer time on treatment was associated with reduced adherence to ART (adjusted odds ratio (AOR) = 0.87 per year, P = 0.027). Being in a serodiscordant relationship, in which the subject's primary partner was HIV negative, increased adherence (AOR = 3.19, P = 0.006). Inconsistent condom use (AOR = 0.50, P = 0.103) and injection drug use (AOR = 0.54, P = 0.090) are potentially associated with reduced adherence to ART. Patients used drugs and alcohol at significantly higher rates than the general population.? CONCLUSIONS: The study found that patients in this setting require intervention to address treatment fatigue. Interventions to improve social support of PLHIV, as well as harm-reduction approaches for drug and alcohol use, could improve adherence in this population, strengthening the test-and-treat strategy to control the epidemic.

The listening project: A qualitative study on the experiences of pre-registered nurses during the Covid-19 pandemic in Scotland.

Background: During the COVID 19 pandemic academic institutes worldwide were forced to shift to online or socially distanced learning. Nursing students faced unique challenges due to the limited practical learning environment and removal of supernumerary status to meet increased pressure on health care resources. Aim: To explore the experiences and perceptions of pre-registered nurses in relation to their university education during the COVID-19 pandemic. Methods: Underpinned by Lizzio (2006) [1] five senses of student success model, a novel qualitative approach using peer-to-peer discussion was utilized to explore the experiences of pre-registered nurses during the COVID-19 pandemic. Students who were on their second and final year in the nursing program were invited to participate. Interviews were conducted and transcribed using an online meeting platform. Data were analyzed using the five main stages of framework analysis. Results: Eleven peer-to-peer discussion with 22 students were conducted. The five themes were linked with the five senses student success model: capability, connectedness, purpose, resourcefulness, and culture. Six sub-themes emerged in the data: confidence and learning process, building relationships, communication, student as health professional and mental health consequences of COVID-19 pandemic. Conclusion: Whilst there was strength in university provision, the pandemic was an opportunity for students and academics to reflect and learn about how to further programme resilience and enhance student support processes. We recommend that nursing programmes should include concepts of transition, pandemic preparedness, collaboration with professional partners, and provision of catch-up sessions to analyse gaps on their skills and knowledge.