Factors for incomplete adherence to antiretroviral therapy including drug refill and clinic visits among older adults living with human immunodeficiency virus – cross‐sectional study in South Africa

Barry, Abbie; Ford, Nathan; El‐Khatib, Ziad

doi:10.1111/tmi.13026

Cited by 10 publications

(14 citation statements)

References 35 publications

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“…The present findings also confirm that older age was a risk factor for each AIDS status [ 28 , 69 , 70 ]. Older PWH have a higher risk of being late presenters due to the lower perception of HIV risk [ 71 ], lack of physician awareness regarding HIV infection [ 72 ], and underestimation of HIV risk behaviors [ 73 ]; moreover, they have a higher risk of AIDS events during follow-up, which is likely due to missed clinic visits [ 70 ].…”

Section: Discussionsupporting

confidence: 87%

Different Trends of Distinct Time Points of AIDS Events Following HIV Diagnosis in Various At-risk Populations: A Retrospective Nationwide Cohort Study in Taiwan

Lee

et al. 2021

Infect Dis Ther

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Introduction: Acquired immune deficiency syndrome (AIDS) events at distinct time points after human immunodeficiency virus (HIV) diagnosis require various AIDS prevention strategies. However, no nationwide epidemiological surveillance studies have been conducted to explore the trends of distinct AIDS event time points in various at-risk populations. The aim of this study was to explore the issues and characterize the determinants of AIDS status after HIV diagnosis. Methods: This nationwide cohort study enrolled HIV-positive Taiwanese during 1984-2016. AIDS events were classified into three time points (B 3, 4-12,[12 months) by their occurrence time after HIV diagnosis. The periods of HIV/AIDS diagnosis were divided into six categories according to the calendar year of HIV/ AIDS diagnosis:

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Section: Discussionsupporting

confidence: 87%

Different Trends of Distinct Time Points of AIDS Events Following HIV Diagnosis in Various At-risk Populations: A Retrospective Nationwide Cohort Study in Taiwan

Lee

et al. 2021

Infect Dis Ther

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“…Similarly, no evidence was found for an association between the education level of the respondent and ART adherence. This is in contrast to other studies in South Africa [ 88 – 90 ], however, assessing the relationship between ART adherence and factors such as education is notoriously complex given the multiple pathways between them [ 36 , 91 ], especially in times of crisis.…”

Section: Discussionmentioning

confidence: 80%

Stay-at-Home: The Impact of the COVID-19 Lockdown on Household Functioning and ART Adherence for People Living with HIV in Three Sub-districts of Cape Town, South Africa

et al. 2022

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In March 2020, the South African government imposed a lockdown to control COVID-19 transmission. Lockdown may affect people living with HIV’s (PLWH) antiretroviral therapy (ART) adherence. Data from a cluster randomised control trial was collected from 152 PLWH in Cape Town sub-districts from October 2019–March 2020 when the lockdown halted collection. Subsequently, 83 PLWH were followed-up in June–July 2020. Random effects models were used to analyse: (1) changes between baseline and follow-up and (2) correlates of adherence during lockdown. At follow-up, there was an increase in the odds of being below the poverty line and the odds of experiencing violence decreased. Measures for well-being, household functioning, stigma and HIV competency improved. Violence, depression, food insecurity, and stigma were associated with poorer ART adherence; higher well-being scores were associated with better adherence. During lockdown, governments need to ensure financial support, access to (mental) health services, and services for those experiencing violence. Clinical Trial Number : Pan African Clinical Trial Registry, PACTR201906476052236. Registered on 24 June 2019. Supplementary Information The online version contains supplementary material available at 10.1007/s10461-021-03541-0.

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“…Evidence from a clinical care setting in Uganda suggests that socio-structural barriers contribute to clinic visit nonadherence, including having to travel far to the clinic, HIV-related stigma, forgetting the appointment or not being able to take time off work, experiencing ART side effects, having an adequate drug supply, and food insecurity [ 2 ]. A cross-sectional study in Johannesburg, South Africa found that older and more educated PLWH were more likely to miss clinic visits, and the most commonly reported reasons for missing clinic visits included transportation costs, being away for work or personal travel, having forgotten the appointment, and not feeling well [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Routine HIV clinic visit adherence in the African Cohort Study

et al. 2022

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Background Retention in clinical care is important for people living with HIV (PLWH). Evidence suggests that missed clinic visits are associated with interruptions in antiretroviral therapy (ART), lower CD4 counts, virologic failure, and overlooked coinfections. We identified factors associated with missed routine clinic visits in the African Cohort Study (AFRICOS). Methods In 2013, AFRICOS began enrolling people with and without HIV in Uganda, Kenya, Tanzania, and Nigeria. At enrollment and every 6 months thereafter, sociodemographic questionnaires are administered and clinical outcomes assessed. Missed clinic visits were measured as the self-reported number of clinic visits missed in the past 6 months and dichotomized into none or one or more visits missed. Logistic regression with generalized estimating equations was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between risk factors and missed visits. Results Between January 2013 and March 2020, 2937 PLWH were enrolled, of whom 2807 (95.6%) had initiated ART and 2771 had complete data available for analyses. Compared to PLWH 50+, missed clinic visits were more common among those 18–29 years (aOR 2.33, 95% CI 1.65–3.29), 30–39 years (aOR 1.59, 95% CI 1.19–2.13), and 40–49 years (aOR 1.42, 95% CI 1.07–1.89). As compared to PLWH on ART for < 2 years, those on ART for 4+ years were less likely to have missed clinic visits (aOR 0.72, 95% CI 0.55–0.95). Missed clinic visits were associated with alcohol use (aOR 1.34, 95% CI 1.05–1.70), a history of incarceration (aOR 1.42, 95% CI 1.07–1.88), depression (aOR 1.47, 95% CI 1.13–1.91), and viral non-suppression (aOR 2.50, 95% CI 2.00–3.12). As compared to PLWH who did not miss any ART in the past month, missed clinic visits were more common among those who missed 1–2 days (aOR 2.09, 95% CI 1.65–2.64) and 3+ days of ART (aOR 7.06, 95% CI 5.43–9.19). Conclusions Inconsistent clinic attendance is associated with worsened HIV-related outcomes. Strategies to improve visit adherence are especially needed for young PLWH and those with depression.

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Factors for incomplete adherence to antiretroviral therapy including drug refill and clinic visits among older adults living with human immunodeficiency virus – cross‐sectional study in South Africa

Abstract: Missing a clinic visit was more common among older PLHIV who were more financially vulnerable. Further studies are needed to verify these findings and identify new risk factors associated with ART adherence.

Cited by 10 publications

References 35 publications

Different Trends of Distinct Time Points of AIDS Events Following HIV Diagnosis in Various At-risk Populations: A Retrospective Nationwide Cohort Study in Taiwan

Different Trends of Distinct Time Points of AIDS Events Following HIV Diagnosis in Various At-risk Populations: A Retrospective Nationwide Cohort Study in Taiwan

Stay-at-Home: The Impact of the COVID-19 Lockdown on Household Functioning and ART Adherence for People Living with HIV in Three Sub-districts of Cape Town, South Africa

Routine HIV clinic visit adherence in the African Cohort Study

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