Demographic and Clinical Characteristics Predicting Missed Clinic Visits among Patients Living with HIV on Antiretroviral Treatment in Kinshasa and Haut-Katanga Provinces of the Democratic Republic of Congo.

BACKGROUND: Patients living with HIV (PLHIV) often face challenges that contribute to missed clinical care which can impact their health outcomes. METHODS: This retrospective quantitative study comprised 5338 adults living with HIV who received antiretroviral treatment (ART) for 12 months, from July 2018 to June 2019 in Kinshasa and Haut-Katanga provinces of the Democratic Republic of Congo. Descriptive statistics were computed to show the level of missed appointments for ART. Multivariable associations of clinical and sociodemographic factors with a tendency to miss scheduled visits after adjusting for the covariates were examined using multivariable logistic regression analysis. RESULTS: Six percent of PLHIV experienced at least one missed visit while 94% did not miss any visits. A small proportion (20%) of PLHIV had a viral load ≥1000 copies/mL. PLHIV receiving ART from urban clinics showed significantly higher odds of missed visits compared to those from rural areas (AOR = 4.18, 95% CI [1.84-9.511]; p < 0.0001). Similarly, patients from semi-rural/semi-urban clinics showed significantly higher odds of missed visits compared to those from rural areas. (AOR = 2.57, 95% CI [1.08-6.141]; p = 0.03). Additionally, older PLHIV (18-34 years old) demonstrated increased odds of missed visits (AOR= 1.71, 95% CI [1.0078-2.697]; p = 0.02) compared to those under 18 years old. CONCLUSIONS: The findings from this study strongly suggest that there is a significant association between certain demographic factors, such as age and rurality-urbanicity, and missed visits. The study findings have implications for policy and interventions targeting PLHIV at higher risk of missed visits.

A systematic review of rural community-based mental health interventions in the United States.

BACKGROUND: Mental health impacts a person's quality of life and ability to engage in healthy behaviors. Rural communities in the United States have limited access to mental and behavioral health treatment. AIM: To conduct a systematic review to identify existing rural community-based mental health interventions and identify commonalities and differences by extracting study attributes and intervention components. METHODS: March 2022 CINAHL, EMBASE, PsycInfo, Scopus, and Academic Search Complete were searched for studies that met the inclusion criteria of rural, community-based mental health interventions in the United States. RESULTS: Ten publications satisfied the criteria for this review. The most common intervention components identified were peer interaction, developed coping skills, and activity-based interventions. CONCLUSION: While this review excluded a meta-analysis, it did illuminate the components of existing community-based mental health interventions and highlighted gaps in the current research. Our findings suggest that future community-based mental health interventions would benefit from the inclusion of peer interaction, coping skills development, activity-based, cultural & historical context, service referral, and spirituality.

This review followed PRISMA 2020 guidelines, including the use of the PRISMA flow chart and checklist. The review was not registered with PROSPERO due to having already begun data extraction and registering is not permitted post-data extraction to prevent bias. However, iterative searches were conducted on PROSPERO to determine the relevance of this review.

Courtesy Stigma and HIV Professionals: A Brief Review of Implications for Psychosocial and Professional Well-Being.

The impact of HIV-related stigma on social workers, clinicians, counselors, and advocates working in organizations serving people living with HIV (PLWH), is rarely considered. Professionals experience "courtesy stigma" when working with or on behalf of PLWH, regardless of their personal HIV status. PubMed, Medline, and PsycInfo databases, along with a review of relevant reference lists and referrals, identified 13 studies addressing this phenomenon. Although limited, this brief review suggests that members of the HIV workforce do indeed face challenges that compromise their personal and professional well-being as a result of courtesy stigma. Addressing stigma among professionals is necessary to support the health of those working in the field, and to avoid undermining the efforts of this important workforce. More research is needed to understand the perceptions and experiences of courtesy stigma and how this stigma may adversely impact the psychological well-being, social functioning, and professional practice of HIV professionals.