1045. Treatment-Related Physical, Emotional, and Psychosocial Challenges and their Impact on Indicators of Quality of Life
Bibliographic record
Abstract
Abstract Background Despite effectiveness of antiretroviral therapy (ART), some people living with HIV (PLHIV) still face barriers to daily oral ART adherence, including inconvenient scheduling, food requirements, adverse effects, and privacy concerns. We characterized treatment-related physical, emotional, and psychosocial challenges among PLHIV from 25 countries. Methods 2389 PLHIV adults on ART were surveyed in the 2019 Positive Perspectives Study, a standardized, self-reported survey of HIV patients aged 18-84 years on treatment. Data were collected on ART-related perceptions and behaviors. Descriptive and multivariable analyses were performed. Results Most participants were male (67.9%), aged < 50 years (70.7%), and reported viral suppression (74.1%). ART-related challenges included cueing of bad memories (58.4%), disguising HIV pills (57.9%), stress (33.3%), and difficulty swallowing pills (33.1%). Privacy and emotional challenges were generally similar between the USA and Canada (Figure 1). In the pooled sample, those who felt limited by their ART had higher odds of reporting suboptimal overall health (AOR 1.90, 95%CI:1.57-2.29), treatment dissatisfaction (AOR 2.21, 95%CI:1.82-2.69), and suboptimal adherence (AOR 1.90, 95%CI:1.57-2.29). Difficulty swallowing, any side effects, and privacy concerns were associated with increased odds of suboptimal overall health (AOR 2.10, 1.88, and 1.43, respectively) and suboptimal adherence (AOR 2.51, 1.50, and 1.87, respectively; all P< 0.05); results for other outcomes are in Figure 2. Overall, 12.6% (302/2389) had shared their HIV status solely with their primary HIV provider, whereas 6.8% (163/2389) “always” shared their HIV status. Only 52.0% were comfortable discussing ART-related privacy concerns with providers, although 29.0% overall missed ≥1 ART dose in the past month from privacy concerns. Overall, 54.7% preferred a nondaily regimen if their HIV stays suppressed, while 72.3% were open to ART with fewer therapies. Figure 1 Figure 2 Conclusion This study identified several challenges with ART among PLHIV, underscoring the need for increased flexibility of ART delivery to meet diverse patient needs. Addressing these needs may improve overall health outcomes for more PLHIV on therapy. Disclosures Patricia De Los Rios, MSc, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Chinyere Okoli, PharmD, MSc, DIP, ViiV Healthcare (Employee) Benjamin Young, MD, PhD, ViiV Healthcare (Employee) Garry Brough, BA Joint Hons in French/Italian, ViiV Healthcare (Employee, Independent Contractor, Other Financial or Material Support, Speakers Fees and Honoraria) Anton Eremin, MD, ViiV Healthcare (Advisor or Review Panel member) Marvelous Muchenje, BSW, MSc. in Global Health, ViiV Healthcare Canada (Employee) Nicolas Van de Velde, PhD, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".