Brion, JM (John M)
John M Brion, Carol Dawson Rose, Patrice K Nicholas, Rick Sloane, Inge B Corless, Teri G Lindgren, Dean J Wantland, Jeanne K Kemppainen, Elizabeth F Sefcik, Kathleen M Nokes, Kenn M Kirksey, Lucille Eller, Mary Jane Hamilton, William L Holzemer, Carmen J Portillo, Marta Rivero Mendez, Linda M Robinson, Shahnaz Moezzi, Maria Rosa, Sarie Human, Mary Maryland, John Arudo, Ana Viamonte Ros, Thomas P Nicholas, Yvette Cuca, Emily Huang, Catherine Bain, Lynda Tyer-Viola, Sheryl M Zang, Maureen Shannon, Angelleen Peters-Lewis, Suzanne Willard
Schools of Nursing, Duke University, Durham, USA.
Unhealthy substance-use behaviors, including a heavy alcohol intake, illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage their disease-related symptoms. This study, based on data from a larger randomized controlled trial of an HIV/AIDS symptom management manual, examines the prevalence and characteristics of unhealthy behaviors in relation to HIV/AIDS symptoms. The mean age of the sample (n = 775) was 42.8 years and 38.5% of the sample was female. The mean number of years living with HIV was 9.1 years. The specific self-reported unhealthy substance-use behaviors were the use of marijuana, cigarettes, a large amount of alcohol, and illicit drugs. A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance-use behaviors, including amphetamine and injection drug use, heavy alcohol use, cigarette smoking, and marijuana use. The implications for clinical practice include the assessment of self-care behaviors, screening for substance abuse, and education of persons regarding the self-management of HIV.
Prevalence, self-care behaviors, and self-care activities for peripheral neuropathy symptoms of HIV/AIDS.
Patrice K Nicholas, Joachim Voss, Dean Wantland, Teri Lindgren, Emily Huang, William L Holzemer, Yvette Cuca, Shahnaz Moezzi, Carmen Portillo, Suzanne Willard, John Arudo, Kenn Kirksey, Inge B Corless, María E Rosa, Linda Robinson, Mary J Hamilton, Elizabeth Sefcik, Sarie Human, Marta Rivero-Mendez, Mary Maryland, Kathleen M Nokes, Lucille Eller, Jeanne Kemppainen, Carol Dawson-Rose, John M Brion, Elli H Bunch, Maureen Shannon, Thomas P Nicholas, Ana Viamonte-Ros, Catherine A Bain
Division of Global Health Equity, Brigham and Women's Hospital and MGH Institute of Health Professions, Boston, MA, USA.
Abstract As part of a larger randomized controlled trial examining the efficacy of an HIV/AIDS symptom management manual (n = 775), this study examined the prevalence of peripheral neuropathy in HIV-infected individuals at 12 sites in the USA, Puerto Rico, and Africa. Neuropathy was reported by 44% of the sample; however, only 29.4% reported initiating self-care behaviors to address the neuropathy symptoms. Antiretroviral therapy was found to increase the frequency of neuropathy symptoms, with an increased mean intensity of 28%. A principal axis factor analysis with Promax rotation was used to assess the relationships in the frequency of use of the 18 self-care activities for neuropathy, revealing three distinct factors:(i) an interactive self-care factor;(ii) a complementary medicine factor; and (iii) a third factor consisting of the negative health items of smoking, alcohol, and street drugs. The study's results suggest that peripheral neuropathy is a common symptom and the presence of neuropathy is associated with self-care behaviors to ameliorate HIV symptoms. The implications for nursing practice include the assessment and evaluation of nursing interventions related to management strategies for neuropathy.
Duke University School of Nursing, Durham, North Carolina, USA.
Focus group methodology was used to describe the medication adherence experience of 24 HIV-infected gay men who reported being adherent to their medication regimens. A conceptualization of medication adherence as an evolving process consisted of challenges to adherence (learning the diagnosis, starting the medications, struggling with the medications, dealing with side effects, coping with stigma) as well as those factors supportive of adherence (believing in medications, finding motivating factors, using reminders, depending on others, owning the disease). Themes associated with challenges to adherence focused on diagnosis and the physical and emotional adjustments individuals made to incorporate antiretroviral medications into their daily lives and move toward medication adherence. The factors supportive of adherence were related to the ongoing behaviors identified with establishing and maintaining adherence behaviors. What can be taken from the study is that adherence is a complex and dynamic process rather than a static behavior.