Comparisons of Adherence to Antiretroviral Therapy in a High- Risk Population in China: A Systematic Review and Meta-Analysis

Zhou, Huan; Wang, Fuzhi; Lü, Ling; Zhang, Min; Chen, Xingzhi; Shiyang, Jin

doi:10.1371/journal.pone.0146659

Cited by 18 publications

(20 citation statements)

References 20 publications

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“…(2013) in a meta‐analysis of adherence to ART in India (8 studies; 1666 participants), found similar estimates for other low/middle income regions (77%; 95% CI: 68–85; I 2 = 98.4% and 70%; 95% CI: 59–81, I 2 = 96.3% respectively) than that found by our study. Pooled proportion of adherence has also been estimated by other researchers for North America (55%); Spain (55%); worldwide (62%); and for high‐risk subgroups living with HIV such as drug users (60%), pregnant women (73.5%); female sex workers (76%) , adolescents (62%) , prisoners (54.6%) and different high‐risk populations living with HIV in China (77.61%) .…”

Section: Discussionmentioning

confidence: 74%

Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta‐analysis

et al. 2018

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IntroductionOptimal adherence to antiretroviral therapy is closely related with suppression of the HIV viral load in plasma, slowing disease progression and decreasing HIV transmission rates. Despite its importance, the estimated proportion of people living with HIV in Latin America and the Caribbean with optimal adherence has not yet been reported in a meta‐analysis. Moreover, little is known of the factors leading to poor adherence which may be setting‐specific. We present a pooled estimate of adherence to antiretroviral therapy (ART) of people living with HIV in Latin America and Caribbean, report the methods used to measure adherence and describe the factors associated with poor adherence among the selected studies.MethodsWe electronically searched published studies up to July 2016 on the PubMed, Web of Science and Virtual Health Library (Latin America and the Caribbean Regional Portal); considering the following databases: MEDLINE, LILACS, PAHO and IBECS. Two independent reviewers selected and extracted data on ART adherence and study characteristics. Pooled estimate of adherence was derived using a random‐effects model. Risk of bias in individual studies was assessed independently by two investigators using the Risk of Bias Assessment tool for Non‐randomized Studies (RoBANS).Results and discussionThe meta‐analysis included 53 studies published between 2005 and 2016, which analysed 22,603 people living with HIV in 25 Latin America and Caribbean countries. Overall adherence in Latin America and Caribbean was 70% (95% CI: 63–76; I 2 = 98%), similar to levels identified by studies conducted in high‐income regions. Self‐report was the most frequently used method to measure adherence. Subgroup analysis showed that adherence was higher for the shortest recall time frame used, as well as in countries with lower income level, Gross National Income (GNI) per capita and Human Development Index (HDI). Studies reported diverse adherence barriers, such as alcohol and substance misuse, depression, unemployment and pill burden.ConclusionsOur study suggests that adherence to ART in Latin America and Caribbean may be below the sufficient levels required for a successful long‐term viral load suppression.

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Section: Discussionmentioning

confidence: 74%

Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta‐analysis

et al. 2018

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“…However, it was higher than a globally meta-analyzed report (62%) [41], China (77.6%) [30], Africa (77%) [61], India (70%) [29], West Africa (42%) [31]. These discrepancies might be due to the difference in socio-demographic characteristics, healthcare systems, the adherence report method and/or date, study population and study design.…”

Section: Discussionmentioning

confidence: 87%

“…Accordingly, the prevalence of optimal adherence of children to HAART is 90.9% in South India [28], 77% in India [29], 77% in China [30], 42% in West Africa [31] and 76.1% in Nigeria [32]. …”

Section: Introductionmentioning

confidence: 99%

Adherence to Highly Active Antiretroviral Therapy Among Children in Ethiopia: A Systematic Review and Meta-analysis

et al. 2018

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Adherence to highly active antiretroviral therapy (HAART) is the mainstay of the strategy in reducing morbidity and mortality of HIV-infected children. Different primary studies were conducted in Ethiopia. Thus, we aimed to conduct a meta-analysis of the national prevalence of optimal adherence to HAART in children. In addition, associated factors of HAART adherence were reviewed. A weighted inverse variance random-effects model was applied. The 88.7 and 93.7% of children were adhering to HAART at 07 and 03 days prior to an interview respectively. The subgroup analysis showed that HAART adherence was 93.4% in Amhara, 90.1% in Addis Ababa and 87.3% in Tigray at 07 days prior to an interview. Our study suggests that, within short window reported time, adherence to HAART in Ethiopian children may be in a good progress. Emphasis on specific adherence interventions need further based on individual predictors to improve overall HAART adherence of children.Electronic supplementary materialThe online version of this article (10.1007/s10461-018-2152-z) contains supplementary material, which is available to authorized users.

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“…A meta-analysis of 111 studies from both developed and developing countries reported an average of 71% of patients had “good” (80% or more doses taken) adherence (95% confidence interval [CI]: 66.0%–75.3%) [4]. In China, recent reports suggest that about 77.6% (95% CI, 71.6%–83.1%) of people living with HIV (PLHIV) on ART report adequate adherence (≥90%) [5]. Although the evidence is somewhat mixed with some reports of 80–90% of MSM reporting adequate adherence [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Effects of depression and anxiety on antiretroviral therapy adherence among newly diagnosed HIV-infected Chinese MSM

Tao

Qian

Kipp

et al. 2017

Aids

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Objective To explore the effect of depression and anxiety on adherence to antiretroviral therapy (ART) among men who have sex with men (MSM) with newly diagnosed HIV infections. Design We conducted a prospective study of Chinese MSM with newly diagnosed HIV infections. Methods The Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety at baseline, 6 and 12 months, separately. ART adherence was self-reported once every three months (“perfect” or no missing dose in the past three months vs. “imperfect” adherence or at least one missing dose in the past three months). We utilized a priori substantial knowledge guided by causal models to identify confounding covariates, and performed mixed-effect logistic regression to assess the effects of depression and anxiety on ART adherence. Results We included 228 participants who initiated ART after HIV diagnosis and before the end of study. A one-unit increase in the depression and anxiety score was associated with a 16% increase (adjusted odds ratio [aOR], 1.16; 95% confidence interval [CI], 1.02–1.32) and a 17% increase (aOR, 1.17; 95% CI, 1.03–1.33) in the odds of reporting imperfect ART adherence, respectively. When depression and anxiety were categorized (normal, borderline, and likely), only likely anxiety had a significant association with ART adherence (aOR, 4.79; 95% CI, 1.12–20.50). Conclusions Depression and anxiety are risk factors for imperfect ART adherence among Chinese MSM with newly diagnosed HIV infections. Intensive intervention on depression and/or anxiety beyond regular post HIV-testing counseling may increase adherence to ART, and improve HIV treatment outcomes.

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Comparisons of Adherence to Antiretroviral Therapy in a High- Risk Population in China: A Systematic Review and Meta-Analysis

Cited by 18 publications

References 20 publications

Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta‐analysis

Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta‐analysis

Adherence to Highly Active Antiretroviral Therapy Among Children in Ethiopia: A Systematic Review and Meta-analysis

Effects of depression and anxiety on antiretroviral therapy adherence among newly diagnosed HIV-infected Chinese MSM

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