Investigating Self-Management of the Dual Diagnosis of HIV and Diabetes
University Of Texas At Austin, Austin TX
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Abstract
Abstract Type 2 diabetes mellitus (T2DM) is common among persons living with HIV (PLWH), with a prevalence of 10%-15%. This rate may be higher in racial and ethnic minority populations. For PLWH who have T2DM (PLWH+T2DM), sub-par self-management of either condition can lead to serious complications. Patients can improve morbidity and mortality by engaging in effective self-management27 but the regimens for managing both HIV and T2DM are complex and extensive. At minimum, patients with T2DM must learn to manage a diabetic diet, take DM medications, monitor blood glucose, perform daily physical activity, and monitor foot problems.28 PLWH must take HIV medications, monitor for opportunistic infections, and prevent transmission to others.29 Factors that influence T2DM self-management can be contextual (gender, race/ethnicity), motivational (self-efficacy, social support, depression), psychological (stress, anxiety, depression), and behavioral (diet, self-monitoring, adherence to exercise and treatment regimen). In this mixed-methods study, using a simplified diabetes management model, we will examine (1) factors that predict self-management behaviors and outcomes in PLWH+T2DM and clinical outcomes, using a de-identified patient medical records dataset, and (2) patients? perspectives of self-management challenges. The Center for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) will provide the quantitative data for ~3,100 PLWH+T2DM within a larger cohort of >31,000 PLWH. To verify significant variables in this cohort and to address variables not included in the dataset, we will conduct 30 qualitative semi-structured interviews with PLWH+T2DM recruited from local HIV care clinics and volunteer organizations regarding their perspectives on barriers and facilitators related to self-management.
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