HIV Linkage to Care and Retention in Care Rate Among MSM in Guangzhou, China

Wong, Ngai Sze; Mao, Jessica; Cheng, Weibin; Tang, Weiming; Cohen, Myron S.; Tucker, Joseph D.; Xu, Huifang

doi:10.1007/s10461-017-1893-4

Cited by 19 publications

(19 citation statements)

References 39 publications

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“…In 2013, HIV treatment retention for 12, 24, and 60 months was 66%, 62%, and 44%, respectively [ 17 ]. These drop-out levels are comparable to the treatment retention of HIV-positive MSM and transwomen populations in other countries [ 18 , 19 ]. However, specific data about how HIV-positive MSM and waria in Indonesia are linked to and retained in care is scarce.…”

Section: Introductionsupporting

confidence: 60%

Driving factors of retention in care among HIV-positive MSM and transwomen in Indonesia: A cross-sectional study

et al. 2018

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Little is known about the prevalence of and factors that influence retention in HIV-related care among Indonesian men who have sex with men (MSM) and transgender women (transwomen, or waria in Indonesian term). Therefore, we explored the driving factors of retention in care among HIV-positive MSM and waria in Indonesia. This cross-sectional study involved 298 self-reported HIV-positive MSM (n = 165) and waria (n = 133). Participants were recruited using targeted sampling and interviewed using a structured questionnaire. We applied a four-step model building process using multivariable logistic regression to examine how sociodemographic, predisposing, enabling, and reinforcing factors were associated with retention in care. Overall, 78.5% of participants were linked to HIV care within 3 months after diagnosis or earlier, and 66.4% were adequately retained in care (at least one health care visit every three months once a person is diagnosed with HIV). Being on antiretroviral therapy (adjusted odds ratio [AOR] = 6.00; 95% confidence interval [CI]: 2.93–12.3), using the Internet to find HIV-related information (AOR = 2.15; 95% CI: 1.00–4.59), and having medical insurance (AOR = 2.84; 95% CI: 1.27–6.34) were associated with adequate retention in care. Involvement with an HIV-related organization was associated negatively with retention in care (AOR = 0.47; 95% CI: 0.24–0.95). Future interventions should increase health insurance coverage and utilize the Internet to help MSM and waria to remain in HIV-related care, thereby assisting them in achieving viral suppression.

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Section: Introductionsupporting

confidence: 60%

Driving factors of retention in care among HIV-positive MSM and transwomen in Indonesia: A cross-sectional study

et al. 2018

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“…Socio-demographic characteristics. Several socio-demographic factors associated with disparities in access to care may also be associated with inequalities in the HIV care continuum [11,14,16,[25][26][27][28]30]. We investigated biological sex, age (at the time of the survey), ethnicity (Han and other), religious beliefs, marital status, education level (primary school or below, secondary school, high school, and university or above), employment status (employed and unemployed), and type of medical insurance (none, New Rural Cooperative Medical Insurance (NRCMI), Urban Employees Basic Medical Insurance (UEBMI), and Urban Residents Basic Medical Insurance (URBMI)).…”

Section: Data Collectionmentioning

confidence: 99%

“…Previous studies have indicated that socioeconomic status (SES), younger or older age, employment, education, area of residence, and health insurance were associated with HIV epidemics, HIV testing, maternal care, delays in HIV treatment, access to ART, attrition of ART, and even poorer treatment outcomes [11,14,[25][26][27][28]. However, there is a paucity of studies measuring the socioeconomic-related inequality in care for people living with HIV who are stable on ART, especially in the Asia-Pacific region.…”

Section: Introductionmentioning

confidence: 99%

Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China

Jin

Assanangkornchai

et al. 2021

PLoS ONE

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Background In the context of scaling up free antiretroviral therapy (ART), healthcare equality is essential for people living with HIV. We aimed to assess socioeconomic-related inequalities in uptake of continuous care for people living with HIV receiving ART, including retention in care in the last six months, routine toxicity monitoring, adequate immunological and virological monitoring, and uptake of mental health assessment in the last 12 months. We also determined the contributions of socioeconomic factors to the degree of inequalities. Methods A hospital-based cross-sectional survey was conducted among consecutive clients visiting an HIV treatment center in Kunming, China in 2019. Participants were 702 people living with HIV aged ≥18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1–5 years. Socioeconomic-related inequality and its contributing factors were assessed by a normalized concentration index (CIn) with a decomposition approach. Results The uptake of mental health assessment was low (15%) but significantly higher among the rich (CIn 0.1337, 95% CI: 0.0140, 0.2534). Retention in care, toxicity, and immunological monitoring were over 80% but non-significant in favor of the rich (CIn: 0.0117, 0.0315, 0.0736, respectively). The uptake of adequate virological monitoring was 15% and higher among the poor (CIn = -0.0308). Socioeconomic status positively contributed to inequalities of all care indicators, with the highest contribution for mental health assessment (124.9%) and lowest for virological monitoring (2.7%). Conclusions These findings suggest virological monitoring and mental health assessment be given more attention in long-term HIV care. Policies allocating need-oriented resources geared toward improving equality of continuous care should be developed.

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“…Men who have sex with men (MSM) have been identified as one of the key populations in the HIV epidemic. The prevalence of HIV among MSM in China has been rapidly and continuously increasing, especially in metropolitan cities such as Beijing, Guangzhou, and Chengdu [1][2][3]. The pooled prevalence of HIV infection among MSM soared from 1.4% in 2001 to 9.0% in 2013 [4], and transmissions between MSM accounted for 25.5% of the new HIV infections in 2017 [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of smartphone APP-based case-management services among antiretroviral treatment-naïve HIV-positive men who have sex with men: a randomized controlled trial protocol

et al. 2020

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Background: Men who have sex with men (MSM) are disproportionally affected by HIV in China. 'Treatment as Prevention' is a promising strategy for HIV prevention but requires adequate adherence. Mobile health (mHealth) may be an acceptable and feasible approach for service delivery, but there is little evidence supporting mHealth intervention for improving antiretroviral treatment adherence among HIV-infected MSM in low-and middle-income countries, including China. This study will aim to develop a smartphone application-based case-management service and compare its efficacy to standard care with regards to adherence, CD4, HIV viral load and psychosocial outcomes among MSM patients in Guangzhou, China.Methods: A non-blinded 1:1 parallel-group randomised controlled trial will be conducted in Guangzhou Eighth People's Hospital, with 300 MSM enrolled in each arm. Eligible MSM who are newly initiating ART will be randomly assigned to an intervention group (standard-of-care case management plus mHealth intervention) or a control group (standard-of-care case management). The development of the mHealth intervention will be based on the information-motivation-behavioural skills theory of ART adherence, and comprise four components: educational articles, one-to-one online communication with case managers, support-service information and hospital-visit reminders. Outcome measures will be collected at baseline and at months 1, 3, 6, and 12. The primary outcomes will be ART adherence and CD4 count at month 6. Secondary outcomes include HIV RNA, sexual behaviours, mental health status, illness perceptions, and quality of life. χ 2 test and t-test will be used for between-group comparisons. Intervention effects will be evaluated using General estimating equation performed by SAS 9.0, on the principle of intention-to-treat. Structural equation modelling will be used to test potential mechanisms of intervention effect.

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HIV Linkage to Care and Retention in Care Rate Among MSM in Guangzhou, China

Cited by 19 publications

References 39 publications

Driving factors of retention in care among HIV-positive MSM and transwomen in Indonesia: A cross-sectional study

Driving factors of retention in care among HIV-positive MSM and transwomen in Indonesia: A cross-sectional study

Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China

Evaluation of smartphone APP-based case-management services among antiretroviral treatment-naïve HIV-positive men who have sex with men: a randomized controlled trial protocol

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