Gender differences in antiretroviral treatment outcomes of HIV patients in rural Uganda

Abstract

Gender differences in treatment outcomes of 305 persons living with HIV receiving antiretroviral treatment (ART) in Kabarole district, western Uganda, were evaluated. The primary treatment outcome was virological suppression defined as HIV-1 RNA viral load (VL) <400 copies/ml and the secondary outcome measure was the increase in the CD4 cell count after six months on ART. Statistical analysis included descriptive, univariate, and multivariate methods. Proportionally, more females chose to seek treatment compared to males. After six months of treatment, females were more likely to have viral suppression (VL > 400 copies/ml) as compared to males (odds ratio 2.14, 95% confidence interval 0.99-4.63, p=0.05). While females had a significantly higher baseline CD4 cell count at initiation of treatment compared to males, the increase in CD4 cell count after six months on ART was similar in males and females. The reasons for better ART outcomes for females should be further investigated. Ideally, ART programs should work toward equitable treatment outcomes for men and women, if the cause of the gender differential lies in patient behavior and the way ART services are delivered.

Outcomes of antiretroviral therapy among younger versus older adolescents and adults in an urban clinic, Zimbabwe

“…These findings are in line with previous studies from Zimbabwe and elsewhere, where men tend to present late for HIV care. [26][27][28] Attrition from HIV care was associated with late presentation, advanced HIV disease and low CD4 counts, similar to previous studies. 8 We also found greater attrition amongst younger adults.…”

Gender Differences in Adverse Drug Reactions during HAART Therapy in HIV/AIDS Patients at a Tertiary Care Hospital Penang, Malaysia

“…Majority of the male patients (62.8%) that had experienced ADRs were unemployed and 54.1% of female patients are housewives. This result is supported by the previous study conducted in Uganda [10] which is in contrast with the study conducted in Malaysia [25].…”

“…In the present study a similar results (80.8%) were observed, though there was not any significant association (p=0.78) observed between the gender and treatment outcome. In two similar studies from rural Uganda, women were more likely to have a lower mortality than men as well a higher rate of viral suppression, although the findings did not quite reach statistical significance [10,34]. In countries where there is considerably more data on the relationship between sex and HAART outcomes, most studies have found no sex differences in response to treatment [14,15] with a few showing more favorable responses in women [35,36].…”

“…Researchers evaluated 305 patients with HIV/AIDS and found that females were more likely to have viral suppression as compared to male patients. Females had a significantly higher baseline CD4 cell count at initiation of treatment compared to male gender [10].…”

“…In resource limited settings, worse outcomes have been more consistently observed in men, including a higher risk of incident opportunistic infections, mortality, immunologic and virologic failure [15,16]. In developing settings, men are more likely to have more advanced HIV at disease presentation, which is thought to place them at higher risk of adverse outcomes and less likely to respond well to ART [10]. To our knowledge, there has been no published data regarding adverse drug reactions and improvement of CD4 cells outcomes associated with HAART in Malaysian HIV/AIDS patients among genders.…”