Tracing-corrected estimates of disengagement from HIV care and mortality among patients enrolling in HIV care without overt immunosuppression in Tanzania

Tymejczyk, Olga; Vo, Quynh; Kulkarni, Sarah; Antelman, Gretchen; Boshe, Judith; Reidy, William; Parcesepe, Angela M.; Nash, Denis; Elul, Batya

doi:10.1080/09540121.2019.1699642

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…Sixty-eight papers reporting on 56 unique studies with 24,940 participants meeting the inclusion criteria (Fig 1). Eight of these studies did not provide prevalence data on mental health [23][24][25][26][27][28][29][30][31]; authors of these studies were contacted twice for further information, and 2 authors responded, providing prevalence data [23,27]. In total, 86 prevalence estimates from 48 studies were available (depression n = 37; anxiety n = 7; PTSD n = 8; suicide attempt n = 8; suicide ideation n = 17; psychological distress n = 7; mood disorders n = 2) ( Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Forty-four studies examined depression among FSWs, with 37 reporting prevalence estimates (Table 1) [9,10,23,27,[32][33][34][35][36][37]39,. A meta-analysis was conducted with 23 studies (Fig 2).…”

Section: Mental Disorders and Suicidal Behaviourmentioning

confidence: 99%

“…The pooled prevalence of anxiety among FSWs from LMICs is 21.0% (95% CI 4.8%-58.4%). PTSD symptomology was reported in 8 studies [9,10,23,40,43,46,47,50] with 4 studies included in the meta-analysis (Fig 4). The…”

Section: Plos Medicinementioning

confidence: 99%

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Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

et al. 2020

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Background The psychological health of female sex workers (FSWs) has emerged as a major public health concern in many low-and middle-income countries (LMICs). Key risk factors include poverty, low education, violence, alcohol and drug use, human immunodeficiency virus (HIV), and stigma and discrimination. This systematic review and meta-analysis aimed to quantify the prevalence of mental health problems among FSWs in LMICs, and to examine associations with common risk factors. Method and findings The review protocol was registered with PROSPERO, number CRD42016049179. We searched 6 electronic databases for peer-reviewed, quantitative studies from inception to 26 April 2020. Study quality was assessed with the Centre for Evidence-Based Management (CEBM) Critical Appraisal Tool. Pooled prevalence estimates were calculated for depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal behaviour. Meta-analyses examined associations between these disorders and violence, alcohol/drug use, condom use, and HIV/sexually transmitted infection (STI). A total of 1,046 studies were identified, and 68 papers reporting on 56 unique studies were eligible for inclusion. These were geographically diverse (26 countries), representing all LMIC regions, and included 24,940 participants. All studies were cross-sectional and used a range of measurement tools; none reported a mental health intervention. Of the 56 studies, 14 scored as strong quality, 34 scored as moderate, and 8 scored as weak. The average age of participants was 28.9 years (age range: 11-64 years), with just under half (46%) having up to primary education or less. The pooled prevalence rates for mental disorders among FSWs in LMICs were as follows: depression 41.8% (95% CI 35.8%-48.0%), anxiety 21.0% (95% CI: 4.8%-58.4%), PTSD 19.7% (95% CI 3.2%-64.6%), psychological distress 40.8% (95% CI 20.7%-64.4%), recent suicide ideation 22.8% (95% CI 13.2%-36.5%), and recent suicide attempt 6.3% (95% CI 3.4%-11.4%). Meta-analyses found significant associations between violence experience

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Mental Disorders and Suicidal Behaviourmentioning

confidence: 99%

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Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

et al. 2020

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“…The Ugandan Ministry of Health de nes ART Interruption as a PLHIV who disengages from HIV care for more than 3 months (Lost-to-Follow-up) (28). Community-based studies reveal that between 12 -27.2% of PLHIV disengage from care and are at a higher risk of dying (10,15,(29)(30)(31). Thus, strengthening and optimizing Retention-in-care for PLHIV on ART could be an important intervention in reducing HIV-associated mortality.…”

Section: Discussionmentioning

confidence: 99%

HIV Mortality and Associated Factors in Patients Admitted at a Tertiary-care Hospital in Uganda, A Cross-sectional Study

Owachi,

Akatukunda,

Nanyanzi

et al. 2023

Preprint

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Background: Outcomes for Persons living with HIV (PLHIV) admitted to hospitals in Uganda are relatively unknown. We determined the prevalence of mortality and associated factors in PLHIV admitted at a tertiary-level public hospital in Uganda. Methods: We used routinely collected data for PLHIV admitted at Kiruddu National Referral Hospital (KNRH) from March 2020 to March 2023 to perform a cross-sectional analysis for mortality (using proportions) and associated factors using a logistic regression model. Results: Of the 5,827 PLHIV admitted, 3293 (56.51%) were female and the median age was 39 years (interquartile range [IQR] 31-49, range 12-98). CD4+ cell count was documented in 3,715 (63.75%) admitted PLHIV with a median count of 109 cells/µL (IQR 25-343, range 0-1,475). At admission, 3,710 (63.67%) were actively taking their antiretroviral therapy (ART), 1,144 (19.63%) had interrupted ART for more than three months and 973 (16.70%) were not on ART. Functional status impairment (measured using Eastern Cooperative Oncology Group [ECOG] score 3-4) was observed in 2,225 (38.18%) PLHIV. Overall mortality was 26% (1,524) with a median time-to-death of 3 days (IQR 1-7, range 0-88). Factors associated with mortality included Function impairment odds ratio 7.23 (95%CI 6.31-8.29; undocumented CD4+ cell count 1.53 (95%CI 1.33-1.76, P<0.001); distance >20 Km from hospital 1.21 (95%CI 1.03-1.43, P=0.024); ART interruption 1.34 (95%CI 1.14-1.59; P<0.001); being male 1.16 (95%CI 1.02-1.32, P=0.029); severe malnutrition 1.81 (95%CI 1.51-2.16; P<0.001); COVID19 disease 1.74 (95%CI 1.24-2.43; P=0.001); liver disease 1.75 (95%CI 1.35-2.28; P<0.001); kidney disease 1.64 (95%CI 1.31-2.05; P<0.001); non-opportunistic infections 1.52 (95%CI 1.30-1.77, P<0.001); and anaemia 1.25 (95%CI 1.02-1.54, P=0.034). Conclusion: One in every four admitted PLHIV died during hospitalization. Early identification and management of associated risk factors such as ART interruption, function impairment, baseline CD4+ tests and screening for non-communicable diseases, may avert poor hospital outcomes.

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The Intersection of Inequitable Gender Norm Endorsement and HIV Stigma: Implications for HIV Care Engagement for Men in Ugandan Fishing Communities

et al. 2021

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Tracing-corrected estimates of disengagement from HIV care and mortality among patients enrolling in HIV care without overt immunosuppression in Tanzania

Cited by 5 publications

References 18 publications

Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

HIV Mortality and Associated Factors in Patients Admitted at a Tertiary-care Hospital in Uganda, A Cross-sectional Study

The Intersection of Inequitable Gender Norm Endorsement and HIV Stigma: Implications for HIV Care Engagement for Men in Ugandan Fishing Communities

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