“It’s only fatness, it doesn’t kill”: a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Uganda

dc.contributor.authorAlhassan, Yussif
dc.contributor.authorTwimukye, Adelline
dc.contributor.authorMalaba, Thokozile
dc.contributor.authorMyer, Landon
dc.contributor.authorWaitt, Catriona
dc.contributor.authorLamorde, Mohammed
dc.contributor.authorColbers, Angela
dc.contributor.authorReynolds, Helen
dc.contributor.authorKhoo, Saye
dc.contributor.authorTaegtmeyer, Miriam
dc.date.accessioned2022-09-16T11:28:24Z
dc.date.available2022-09-16T11:28:24Z
dc.date.issued2022-06-21
dc.date.updated2022-06-26T03:12:53Z
dc.description.abstractBackground Dolutegravir (DTG)-based regimens have been recommended by the WHO as the preferred first-line and second-line HIV treatment in all populations. Evidence suggests an association with weight gain, particularly among black women. Our study investigated perceptions of weight gain from DTG-based regimen use on body image and adherence of antiretroviral therapy in women living with HIV (WLHIV) in Uganda. Methods Between April and June 2021, we conducted semi-structured interviews involving 25 WLHIV (adolescents, women of reproductive potential and post-menopausal women) and 19 healthcare professionals (clinicians, nurses, ART managers and counsellors) purposively selected from HIV clinics in Kampala. The interviews explored perceptions of body weight and image; experiences and management of weight related side effects associated with DTG; and knowledge and communication of DTG-related risks. Data was analysed thematically in NVivo 12 software. Results Our findings indicate WLHIV in Uganda commonly disliked thin body size and aspired to gain moderate to high level body weight to improve their body image, social standing and hide their sero-positive status. Both WLHIV and healthcare professionals widely associated weight gain with DTG use, although it was rarely perceived as an adverse event and was unlikely to be reported or to alter medication adherence. Clinical management and pharmacovigilance of DTG-related weight gain were hampered by the limited knowledge of WLHIV of the health risks of being over-weight and obesity; lack of diagnostic equipment and resources; and limited clinical guidance for managing weight gain and associated cardiovascular and metabolic comorbidities. Conclusions The study highlights the significance of large body-size in promoting psychosocial wellbeing in WLHIV in Uganda. Although weight gain is recognized as a side effect of DTG, it may be welcomed by some WLHIV. Healthcare professionals should actively talk about and monitor for weight gain and occurrence of associated comorbidities to facilitate timely interventions. Improved supply of diagnostic equipment and support with sufficient guidance for managing weight gain for healthcare professionals in Uganda are recommended.en_US
dc.identifier.apacitationAlhassan, Y., Twimukye, A., Malaba, T., Myer, L., Waitt, C., Lamorde, M., ... Taegtmeyer, M. (2022). “It’s only fatness, it doesn’t kill”: a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Uganda. <i>BMC Women's Health</i>, 22(1), 246. http://hdl.handle.net/11427/36820en_ZA
dc.identifier.chicagocitationAlhassan, Yussif, Adelline Twimukye, Thokozile Malaba, Landon Myer, Catriona Waitt, Mohammed Lamorde, Angela Colbers, Helen Reynolds, Saye Khoo, and Miriam Taegtmeyer "“It’s only fatness, it doesn’t kill”: a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Uganda." <i>BMC Women's Health</i> 22, 1. (2022): 246. http://hdl.handle.net/11427/36820en_ZA
dc.identifier.citationAlhassan, Y., Twimukye, A., Malaba, T., Myer, L., Waitt, C., Lamorde, M., Colbers, A. & Reynolds, H. et al. 2022. “It’s only fatness, it doesn’t kill”: a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Uganda. <i>BMC Women's Health.</i> 22(1):246. http://hdl.handle.net/11427/36820en_ZA
dc.identifier.ris TY - Journal Article AU - Alhassan, Yussif AU - Twimukye, Adelline AU - Malaba, Thokozile AU - Myer, Landon AU - Waitt, Catriona AU - Lamorde, Mohammed AU - Colbers, Angela AU - Reynolds, Helen AU - Khoo, Saye AU - Taegtmeyer, Miriam AB - Background Dolutegravir (DTG)-based regimens have been recommended by the WHO as the preferred first-line and second-line HIV treatment in all populations. Evidence suggests an association with weight gain, particularly among black women. Our study investigated perceptions of weight gain from DTG-based regimen use on body image and adherence of antiretroviral therapy in women living with HIV (WLHIV) in Uganda. Methods Between April and June 2021, we conducted semi-structured interviews involving 25 WLHIV (adolescents, women of reproductive potential and post-menopausal women) and 19 healthcare professionals (clinicians, nurses, ART managers and counsellors) purposively selected from HIV clinics in Kampala. The interviews explored perceptions of body weight and image; experiences and management of weight related side effects associated with DTG; and knowledge and communication of DTG-related risks. Data was analysed thematically in NVivo 12 software. Results Our findings indicate WLHIV in Uganda commonly disliked thin body size and aspired to gain moderate to high level body weight to improve their body image, social standing and hide their sero-positive status. Both WLHIV and healthcare professionals widely associated weight gain with DTG use, although it was rarely perceived as an adverse event and was unlikely to be reported or to alter medication adherence. Clinical management and pharmacovigilance of DTG-related weight gain were hampered by the limited knowledge of WLHIV of the health risks of being over-weight and obesity; lack of diagnostic equipment and resources; and limited clinical guidance for managing weight gain and associated cardiovascular and metabolic comorbidities. Conclusions The study highlights the significance of large body-size in promoting psychosocial wellbeing in WLHIV in Uganda. Although weight gain is recognized as a side effect of DTG, it may be welcomed by some WLHIV. Healthcare professionals should actively talk about and monitor for weight gain and occurrence of associated comorbidities to facilitate timely interventions. Improved supply of diagnostic equipment and support with sufficient guidance for managing weight gain for healthcare professionals in Uganda are recommended. DA - 2022-06-21 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Women's Health KW - Dolutegravir KW - Weight gain KW - Body image KW - Women KW - HIV KW - Uganda LK - https://open.uct.ac.za PY - 2022 T1 - “It’s only fatness, it doesn’t kill”: a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Uganda TI - “It’s only fatness, it doesn’t kill”: a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Uganda UR - http://hdl.handle.net/11427/36820 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12905-022-01814-x
dc.identifier.urihttp://hdl.handle.net/11427/36820
dc.identifier.vancouvercitationAlhassan Y, Twimukye A, Malaba T, Myer L, Waitt C, Lamorde M, et al. “It’s only fatness, it doesn’t kill”: a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Uganda. BMC Women's Health. 2022;22(1):246. http://hdl.handle.net/11427/36820.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Public Health and Family Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Women's Healthen_US
dc.source.journalissue1en_US
dc.source.journalvolume22en_US
dc.source.pagination246en_US
dc.source.urihttps://bmcwomenshealth.biomedcentral.com/
dc.subjectDolutegraviren_US
dc.subjectWeight gainen_US
dc.subjectBody imageen_US
dc.subjectWomenen_US
dc.subjectHIVen_US
dc.subjectUgandaen_US
dc.title“It’s only fatness, it doesn’t kill”: a qualitative study on perceptions of weight gain from use of dolutegravir-based regimens in women living with HIV in Ugandaen_US
dc.typeJournal Articleen_US
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