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Table 3 Validation comments by HIV health experts and PLHIV

From: Development of a nursing intervention to facilitate optimal antiretroviral-treatment taking among people living with HIV

Sections/Topic

Observations made by HIV health experts

Implications of CD4 count and viral load

"To avoid confusion, I suggest always referring to the CD4 count in terms of a decrease, rather than saying that CD4 should remain 'above' 350 or that the risk of opportunistic infections 'increases' if it falls below 350."

"Explain RNA... For example: each virus has a similar genetic code, which is the virus RNA and which is identifiable through laboratory analysis... Each RNA = 1 virus."

"According to DHHS guidelines, treatment is recommended if the CD4 count is between 200 and 350, regardless of the viral load ... and should be altered if the viral load is >100,000 and particularly if the viral load is very high."

Importance of taking medication effectively

"More and more people are taking treatment only once a day, so the significance of this should be stressed (in terms of missed dosages per month)."

"Add more emphasis and explanation about mutations; for example: some of these errors allow the virus to become resistant to treatment... the virus can then multiply increasingly and the viral load increases again."

Techniques for contending with side-effects

"I advise seeking a consultation if a cutaneous eruption appears right away because there is a lot of syphilis around and it presents with a skin rash."

"Add that it is important to consult a dietician when there is weight loss of more than 5% of the normal weight."

"Instead of recommending avoiding or cutting out dairy product consumption, you could suggest alternatives such as trying lactase."

"Instead of just saying that it is necessary to re-hydrate, be more precise about how to do this: prepare and drink pharmacy re-hydration beverages such as Pédialyte ® or Gastrolyte ® or make their own."

Sections/Topic

Remarks made by PLHIV

Importance of taking medication effectively

"I didn't understand the resistance part, it was difficult to follow; maybe you could add a diagram (sketch) to help us understand it."

"I couldn't follow the material on mutations and resistance... It's all too complicated."

Recognizing oversights

"I thought I had understood, but when I got home and I wanted to make notes, I didn't know how to set about it: there should be more explanations and examples given.

Techniques for solving problems

"It's difficult to keep in mind all the steps: a written version of part should be available."