Antiretroviral treatment adherence and associated factors among people living with HIV in developing country, Myanmar

Thandar, Mya; Mon, Aye Sandar; Boonyaleepun, Suwanna; Laohasiriwong, Wongsa

doi:10.18203/2394-6040.ijcmph20161405

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…For behaviour variables of moderating factors, tobacco users were significantly associated with non-adherence in our study which is consistent with previous Myanmar study findings where non-smokers were more likely to adhere to ART [ 34 ]. We found an increased risk of non-adherence among individuals who had disclosed their HIV status to others and this finding was inconsistent with other studies [ 41 ].…”

Section: Discussionsupporting

confidence: 92%

“…Among the 300 PLHIV in the study, 16% reported a failure to adhere to ART during the past month. The proportion of adherence was found to be different than the results of the most recent ART adherence study in Myanmar which reported 76.2% adherence in 2016 [ 34 ]. The discrepancy might be due to adherence measurement tools (pill identification test versus VAS within 30 days).…”

Section: Discussioncontrasting

confidence: 76%

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Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar

2017

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BackgroundThe provision of Anti-Retroviral Therapy (ART) was started in Myanmar in 2005 in collaboration with the National AIDS Program and the private sector. Successful clinical management of HIV-infected patients is subject to optimal adherence. The aim of the study was to determine the prevalence of adherence to ART and identify factors associated with non-adherence to ART among HIV infected adults registered in a private sector setting in Mon State, Myanmar.MethodsThis cross-sectional study was conducted with adults living with HIV receiving ART at an HIV outpatient clinic between April and May 2016. A total of three hundred People Living with HIV(PLHIV) were interviewed using a pretested and structured questionnaire. The 30 days Visual Analog Scale (VAS) adherence instrument was used to assess the level of adherence. Multivariable logistic regression analysis was used to determine factors associated with non-adherence to ART.ResultsAmong 300 patients (male 37.7% and female 62.3%, with a mean age of 41.3 years, standard deviation 8.7), 84% reported ≥95% adherence to ART in the past month. Among 16% of those reporting non-adherence, major reasons for skipping the medication were being busy (23%), being away from home (17.7%) and being forgetful (12.3%). In multivariable logistic rgeression, low behavioural skills on ART adherence (OR = 0.31, 95% CI: 0.10-0.94), tobacco use (OR = 3.22, 95% CI:1.28-8.12), having disclosed their HIV status (OR = 0.07, 95% CI: 0.01-0.69), having a partner who was not on ART (OR = 4.25, 95% CI: 1.70-10.64) and among men, having erectile dysfunction (OR = 15.14, 95% CI: 1.41-162.66) were significant associated with ART non-adherence.ConclusionNon-adherence to ART was associated with individual moderating factors and behavioral skills. Priority measures such as addressing risk behaviour and behavioural change communication tailored to individual patients’ lifestyles requires comprehensive interventions to improve adherence.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 76%

Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar

2017

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“…The overall proportion of viral rebound among the adolescents in this study was 31.5% which continues to confirm that a considerable number of patients who achieve viral suppression are unable to maintain it. This proportion is slightly higher than that reported by Palmer et al (5) and Henri et al, (18) among adolescents in Canada and Central African Republic respectively. Additionally, according to Ng'ambi et al (19), the proportion of viral rebound decreased with increase in age.…”

Section: Discussioncontrasting

confidence: 54%

Predictors of Viral Rebound Among Adolescents at an Urban Clinic in Kampala Using Repeated Events Survival Analysis

Kirabira,

Bukenya,

Ssenkusu

et al. 2024

Preprint

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BackgroundA suppressed HIV viral load below 1000 copies/ml is mark of HIV treatment success because it is associated with reduced risk of transmission of HIV. However, following viral suppression, some people experience viral rebound which may occur multiple times. We used repeated events survival analysis to assess the predictors of viral rebound among adolescents (aged 10-19 years) at an urban clinic in Kampala, Uganda.MethodsThe study was a retrospective cohort design conducted at Baylor-Uganda, an HIV care facility. The Lognormal model was used to estimate time from viral suppression to viral rebound (in months) and to determine factors associated with time to first viral rebound. The Prentice, Williams, and Peterson (PWP) model was used to determine the factors associated with repetitive viral rebound.ResultsData from 219 participants were included in the study; 160 (73.06%) were female, 117 (53.42%) were aged 15-19 years whereas 102(46.58%) were aged 10-14 years. The overall proportion of viral rebound was 31.5% (31.51/100); 23.29% (23.29/100) experienced one rebound whereas 8.22% (8.22/100) had multiple rebounds. The probability of viral rebound did not reach 50%, so the median time from viral suppression to viral rebound could not be estimated. The 25thpercentile survival time to first viral rebound was 34.1 months. The incidence rate of first viral rebound was 84.7 (95%CI, 66.9 - 107.2) per 10,000-person months of observation. The predictors of first viral rebound included; duration on ART (adjusted Time Ratio (TR), 1.04; 95%CI, 1.04-1.05; p<0.001), psychosocial issues (adjusted TR, 0.67; 95%CI, 0.58-0.77; p<0.001), baseline viral load (adjusted TR, 0.85; 95%CI, 0.72-0.99; p=0.008) and protease inhibitors (PI) based ART regimens (adjusted TR, 0.67; 95%CI, 0.49- 0.92; p=0.012). The predictors of multiple rebounds included duration on ART (adjusted Hazard Ratio (HR), 0.86, 95%CI, 0.84-0.89; p<0.001), psychosocial issues (adjusted HR, 11.04, 95%CI, 6.09-20.0; p<0.001), WHO clinical stage II (adjusted HR, 2.28, 95%CI, 1.22-4.25; p=0.002), and WHO clinical stage III (adjusted HR, 2.17, 95%CI, 1.14-4.14; p=0.005)ConclusionIn an urban HIV care facility in Kampala, we found an overall proportion of viral rebound among the adolescents of 31.51%. Occurrence of multiple viral rebounds was associated with duration on ART, psychosocial issues, and WHO clinical staging. Therefore, there is need to incorporate screening of adolescents for psychosocial challenges into the routine programming of HIV care and treatment so as identify and appropriately support those affected in time.

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“…They volunteer as clinic registration staff or as peer-to-peer counselors. No study has yet assessed how self-help groups dealt with depressive symptoms among people living with HIV, and previous studies focused mainly on factors associated with ART adherence rates and the retention and attrition rates in ART programs in Myanmar [34][35][36][37]. Only one study has reported that the prevalence of depressive symptoms was (30.1%) among people living with HIV in Yangon city, Myanmar [31].…”

Section: Introductionmentioning

confidence: 99%

Assessing depressive symptoms among people living with HIV in Yangon city, Myanmar: Does being a member of self-help group matter?

Than

Zaw²,

Minn

et al. 2021

PLoS ONE

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Background While self-help groups have been formed among people living with HIV, few studies have been conducted to assess the role of self-help groups in mitigating depressive symptoms. This study investigated the association between self-help group membership and depressive symptoms among people living with HIV in Yangon, Myanmar. Methods In this cross-sectional study, data were collected from people living with HIV at three antiretroviral therapy clinics in 2017. Multiple logistic regression analyses were carried out to examine the associations between having self-help group membership and depressive symptoms. Three ART clinics were purposively selected based on the recommendation from the National AIDS Program in Myanmar. At these clinics, people living with HIV were recruited by a convenience sampling method. Results Among people living with HIV recruited in this study (n = 464), 201 (43.3%) were members of a self-help group. The membership was not associated with having depressive symptoms (adjusted odds ratio [AOR] 1.59, 95% confidence interval [CI] 0.98–2.59). Factors associated with having depressive symptoms were female (AOR 3.70, 95% CI 1.54–8.88) and lack of social support (AOR 0.97, 95% CI 0.96–0.98) among self-help group members, and female (AOR 3.47, 95% CI 1.70–7.09), lack of social support (AOR 0.98, 95% CI 0.97–0.99), and internalized stigma (AOR 1.28, 95% 1.08–1.53) among non-members. Conclusions This study did not find evidence on the association between membership in self-help groups and depressive symptoms among people living with HIV. Social support was a protective factor against depressive symptoms both self-help group members and non-members, although the level of social support was lower among members than non-members. The activities of self-help groups and care provided by the ART clinics should be strengthened to address mental health problems among people living with HIV in the study site.

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Antiretroviral treatment adherence and associated factors among people living with HIV in developing country, Myanmar

Cited by 3 publications

References 19 publications

Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar

Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar

Predictors of Viral Rebound Among Adolescents at an Urban Clinic in Kampala Using Repeated Events Survival Analysis

Assessing depressive symptoms among people living with HIV in Yangon city, Myanmar: Does being a member of self-help group matter?

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