HIV Treatment Satisfaction and Preferences for HIV regimen  among Female Sex Workers

Abstract

Improving patient satisfaction is a vital patient-reported outcome that can enhance healthcare services. There is considerable interest among patients, healthcare professionals, and policymakers in including patients in decision-making processes that affect their overall health. Female sex workers views about their HIV treatment may reflect their priorities that shape their overall quality of life. This study assessed the satisfaction with HIV treatment and preference for HIV regimen. This cross-sectional study comprised of 244 female sex workers who had been on combined antiretroviral therapy for a minimum of one year at the Society for Family Health (SFH) clinic in Mubi, Adamawa State Nigeria. HIV treatment satisfaction scores were also categorised in high (80–100), moderate (60–79) or low (< 60) according to Blooms cut-off points. Chi square test was applied to identify factors, if any, and that may explain association of HIV treatment satisfaction with sociodemographic data while binary logistic regression analysis was carried out to determine predictors of HIV treatment satisfaction. A p-value < 0.05 was considered statistically significant (95% Confidence Interval). The findings from this study showed that the majority of the patients, 140 (57.4%), were between the ages of 25 and 35 and had been on antiretroviral therapy (ART) for less than 3 years, 98 (40.2%), were diagnosed at the age of 18 to 25, 107 (43.9%), and started sex work at the same age, 146 (59.8%). Additionally, nearly half of the FSWs were involved in the use of other substances, 103 (42.2%). Two-thirds of the patients were not diagnosed with AIDS-related tuberculosis, 185 (75.8%), and nearly all were on the tenofovir/lamivudine/dolutegravir regimen, 214 (96.7%). Furthermore, more than two-thirds of the population had a suppressed viral load, 214 (87.7%), and had disclosed their HIV status, 126 (51.6%). While HIV treatment satisfaction is significantly associated with age at HIV diagnosis (p < 0.001), age at commencement of sex work (p = 0.01), highest level of education (p < 0.001), marital status (p < 0.001), use of substance (p < 0.001), HIV regimen at viral load (p < 0.001), virologic status p < 0.001) and HIV disclosure status (p < 0.001). This study also found age at HIV diagnosis (p = 0.005; AOR 0.24; 95% CI 0.09–0.66), lack of formal education (p = 0.02; AOR 0.43; 95%CI 0.20–0.92), married sex workers (p = 0.005; AOR 0.17; 95% CI 0.07–0.39), use of cigarette (p = 0.12–0.79; AOR 0.13; 95% CI 0.12–0.79) and other psychoactive substances (p = 0.005; AOR 0.19; 95% CI 0.09–0.39), unsuppressed virologic status (p = 0.001; AOR 0.07; 95% CI 0.01–0.31) and undisclosed HIV status (p = 0.007; AOR 0.37; 95% CI; 0.18–0.76) to predict satisfaction with HIV treatments. Nearly all of the FSWs 222 (91%) preferred the injectable ART over the conventional oral regimen at a duration of every 4 weeks. Finding from this study revealed that HIV treatment satisfaction was influenced by age at HIV diagnosis and commencement of sex work, education, marital status, HIV regimen and disclosure of HIV status. While the patients preferred the injectable ART over the conventional oral regimen. In view of these, targeted interventions should be focused on these factors