Browsing by Author "Alibhai, Arif"

Now showing 1 - 7 of 7
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    Antiretroviral Treatment for HIV in Rural Uganda: Two Year Treatment Outcomes of a Prospective Health Centre/Community-Based and Hospital-Based Cohort
    (PloS one, 2012) Kipp, Walter; Konde-Lule, Joseph; Saunders, L. Duncan; Alibhai, Arif; Houston, Stan; Rubaale, Tom; Senthilselvan, Ambikaipakan; Okech-Ojony, Joa
    In sub-Saharan Africa, a shortage of trained health professionals and limited geographical access to health facilities present major barriers to the expansion of antiretroviral therapy (ART). We tested the utility of a health centre (HC)/community-based approach in the provision of ART to persons living with HIV in a rural area in western Uganda.
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    Comparing antiretroviral treatment outcomes between a prospective community-based and hospital-based cohort of HIV patients in rural Uganda
    (BMC international health and human rights, 2011) Kipp, Walter; Konde-Lule, Joseph; Rubaale, Tom; Okech-Ojony, Joa; Alibhai, Arif; Saunders, Duncan L.
    Improved availability of antiretroviral therapy in sub-Saharan Africa is intended to benefit all eligible HIV-infected patients; however in reality antiretroviral services are mainly offered in urban hospitals. Poor rural patients have difficulty accessing the drugs, making the provision of antiretroviral therapy inequitable. Initial tests of community-based treatment programs in Uganda suggest that home-based treatment of HIV/AIDS may equal hospital-based treatment; however the literature reveals limited experiences with such programs.
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    Gender-related mortality for HIV-infected patients on highly active antiretroviral therapy (HAART) in rural Uganda
    (International journal of women's health, 2010) Alibhai, Arif; Kipp, Walter; Senthilselvan, Ambikaipakan; Konde-Lule, Joseph; Okech-Ojony, Joa; Rubaale, Tom
    The purpose of this study was to examine gender differences in mortality for human immunodeficiency virus (HIV) patients in rural Western Uganda after six months of highly active antiretroviral therapy (HAART). Three hundred eighty five patients were followed up for six months after initiating HAART. Statistical analysis included descriptive, univariate and multivariate methods, using Kaplan–Meier estimates of survival distribution and Cox proportional hazards regression. Mortality in female patients (9.0%) was lower than mortality in males (13.5%), with the difference being almost statistically significant (adjusted hazard ratio for females 0.55; 95% confidence interval [CI]: 0.28–1.07; P = 0.08). At baseline, female patients had a significantly higher CD4+ cell count than male patients (median 147 cells/μL vs 120 cells/μL; P < 0.01). A higher CD4+ cell count and primary level education were strongly associated with better survival. The higher CD4+ cell count in females may indicate that they accessed HAART services at an earlier stage of their disease progression than males. A borderline statistically significant lower mortality rate in females shows that females fare better on treatment in this context than males. The association between lower mortality and higher CD4+ levels suggest that males are not accessing treatment early enough and that more concerted efforts need to be made by HAART programs to reach male HIV patients.
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    Hear our voices: A Photovoice project with children who are orphaned and living with HIV in a Ugandan group home
    (Children and Youth Services Review, 2014) Fournier, Bonnie; Bridge, Andrea; Kennedy, Andrea Pritchard; Alibhai, Arif; Konde-Lule, Joseph
    In June 2010, we conducted a qualitative participatory research study to explore the experience of orphaned, HIV seropositive children who live in a group home in semi-urban western Uganda. Photovoice was used as a participatory method to enhance storytelling with children between 12 and 18years (n=5 girls; n=8 boys). In previous project work done by the research team in Uganda, children's affirming experiences in their group home suggested an extension to the dominant view that favors extended family placements, and raises the need for further inquiry regarding institutional care. Children in this study revealed how the group home supported key protective factors in their everyday lives that promote well-being, and resilience for coping with challenges such as stigma. Children expressed how their group home fostered a sense of belonging and appreciation for nature, home, resources and community. Children also described their hardships stemming from stigma, including associated psychological, emotional and social challenges. This forces us to re-think the role of institutional care for orphaned children who are HIV seropositive, guided by the unique perspective of children themselves. This research extends our understanding of key protective factors, while also challenging the dominant view to include institutional care as an effective placement option for those that require specialized care and support. Moreover, findings demonstrate that HIV seropositive orphaned children who live in a group home setting experience protective factors supporting their psychological, emotional and social well-being.
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    “Living by the hoe” in the age of treatment: perceptions of household well-being after antiretroviral treatment among family members of persons with AIDS
    (AIDS care, 2010) Kaler, Amy; Alibhai, Arif; Kipp, Walter; Rubaale, Tom; Konde-Lule, Joseph
    This paper considers the effects of antiretroviral treatment on the households of person with AIDS in western Uganda. Interviews were carried out with 110 co-resident “treatment partners” of people receiving treatment. We discuss these family members' accounts of the impact of sickness, followed by treatment, on their household's livelihood, defined as the activities needed to obtain and process the resources required to sustain the households. The household's ability to muster labour for subsistence agriculture was of paramount concern when family members considered what treatment meant for the households. While they were very happy with the treatment, they said that households have not yet recovered from the shock of AIDS sicknesses.
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    Public knowledge and attitudes toward HIV/AIDS and antiretroviral therapy in Kabarole district, western Uganda
    (AIDS care, 2009) Kipp, Walter Eigen; Alibhai, Arif; Saunders, Duncan; Konde-Lule, Joseph; Ruhunda, Alex
    A study on knowledge about HIV/AIDS and antiretroviral therapy (ART) was conducted in the general population of a rural district in western Uganda. Three hundred seventy-two participants were selected by random cluster sampling and interviewed with an interview-administered questionnaire. Data were analyzed quantitatively with descriptive, univariate and linear multivariate statistical analysis with the knowledge score about ART as the dependent variable. The results indicate that the mean knowledge was 7.7 in a scale from 0 to 13. Predictor for better ART knowledge was a higher educational status of the participants. Older participants over 50 years were less ART knowledgeable. Only 19% of the participants have been tested for HIV. The conclusions are that the ART knowledge in this population is remarkably high which is reaffirming and important for achieving a high adherence to ART. Of concern is the low proportion of persons tested for HIV in this general population. Kabarole district seems to be receptive and capable for intensifying HIV testing which is a precondition for the ART roll-out.
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    Quality of Life of HIV Patients in a Rural Area of Western Uganda: Impact of a Community-Based Antiretroviral Treatment Program
    (Current HIV research, 2010) Alibhai, Arif; Martin, Leah J.; Kipp, Walter; Konde-Lule, Joseph; Rubaale, Tom; Okech-Ojony, Joa
    Community-based antiretroviral treatment (CBART) programs should aim to achieve positive quality of life outcomes. The purpose of this study was to investigate changes in the health related quality of life (HRQOL) outcomes of patients in a CBART program supported by community volunteers in one sub-county in western Uganda located 50 km from the nearest urban centre. We administered a translated version of the MOS-HIV survey and collected clinical data at baseline and after one year from 130 patients. Inclusion criteria included residency in the sub-county, eighteen years of age or, treatmentnaive, eligible for ART based on CD4 cell count <200 cells/mm3 or WHO clinical stage 3 or 4, and willing to accept daily treatment support by family/friends and to be visited by a community volunteer weekly. We assessed changes in physical health (PHS) and mental health (MHS) summary scores and examined associations between patient characteristics and changes in HRQOL. After one year, we observed significant increases in mean PHS (42.7 to 50.1; p<0.01) and MHS (43.5 to 49.5; p<0.01) scores. Lower age (p<0.01) and lower baseline PHS scores (p<0.01) were associated with increases in PHS scores and lower age (p=0.03) and lower baseline MHS scores (p<0.01) were associated with increases in MHS scores. Fifteen patients (12%) had reductions in their HRQOL after one year which were not associated with patient or clinical characteristics, including virological suppression. The observed improvements in HRQOL demonstrate that positive treatment outcomes can be achieved in CBART programs in rural Uganda. However, some patients appear to experience declines in their overall well-being, despite achieving virological suppression. HRQOL surveys can be useful in identifying these patients, who may require additional attention and support to achieve the full benefits of ART.