Impact of antiretroviral therapy (ART) duration on ART adherence among men who have sex with men (MSM) living with HIV in Jinan of China

Jiao, Kedi; Liao, Meizhen; Liu, Guangmei; Bi, Yanmei; Zhao, Xiao‐Fan; Chen, Qian; Ma, Jing; Yan, Yu; Cheng, Chunxiao; Li, Yijun; Jia, Wenwen; Wang, Lina; Cao, Yanwen; Zhao, Zhonghui; Yang, Xuan; Meng, Jing; Li, Jianzhuo; Li, Xinrui; Wang, Chunmei; Kang, Dianmin; Ma, Wei

doi:10.1186/s12981-022-00482-z

Cited by 6 publications

(6 citation statements)

References 34 publications

(36 reference statements)

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“… 44 – 46 However, a large Nigerian study 47 reported associations between longer duration of ART and risk of low-level viraemia, which is similar to our findings. This may be a result of declining ART adherence over time, which has been linked to longer ART duration, 48 , 49 even among members of adherence clubs, 50 and points to the need for continuous person-centred adherence support with increasing ART duration. Previous research has also associated longer ART duration with mental health issues, 51 which may consequently impact ART adherence adversely, 52 , 53 and this underscores the need to integrate mental health services with adherence counselling 54 for individuals with low-level viraemia.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of persistent low-level HIV viraemia: a retrospective cohort study among people receiving dolutegravir-based antiretroviral therapy in Southern Nigeria

Onwah,

Nwanja,

Akpan

et al. 2024

Therapeutic Advances in Infection

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Background: Persistent low-level viraemia (PLLV) is a risk factor for virologic failure among people receiving antiretroviral therapy (ART). Objectives: We assessed the prevalence and predictors of PLLV among individuals receiving Dolutegravir-based ART in southern Nigeria. Design: This retrospective cohort study used routine program data from electronic medical records of persons receiving Dolutegravir-based first-line ART in 154 PEPFAR/USAID-supported health facilities in Akwa Ibom and Cross Rivers states, Nigeria. Methods: Clients on first-line Dolutegravir-based ART ⩾6 months, who had a viral load result in the 12 months preceding October 2021 (baseline), and a second viral load result by September 2022 were included. Persons with low-level viraemia (LLV) (viral load 51–999 copies/ml) received additional adherence support. The outcome analysed was PLLV (two consecutive LLV results). Indices were summarized using descriptive statistics, and predictors of PLLV were determined using multivariate logistic regression. Results: In total, 141,208 persons on ART were included, of which 63.3% ( n = 89,944) were females. The median age was 36 [29–44] years, median ART duration was 19 [11–42] months. At the end of the study, 10.5% (14,759/141,208) had initial LLV, 90.1% (13,304/14,759) of which attained undetectable viral load (⩽50 copies/ml), and 1.1% (163/14,759) transitioned to virologic failure (⩾1000 copies/ml) by the end of the study. PLLV prevalence was 0.9% (1292/141,208). Increasing ART duration [adjusted odds ratio (aOR) = 1.0; 95% confidence interval (CI): 1.005–1.008; p < 0.001] and viral suppression (<1000 copies/ml) before initial LLV (aOR = 1.7; 95% CI: 1.50–2.00; p < 0.001) were positively associated with PLLV, while receipt of tuberculosis preventive therapy reduced the likelihood of PLLV (aOR = 0.3; 95% CI: 0.10–0.94; p = 0.039). Conclusion: PLLV was uncommon among individuals receiving dolutegravir-based ART and was associated with longer ART duration, prior viral suppression, and non-receipt of tuberculosis preventive therapy. This strengthens recommendations for continuous adherence support and comprehensive health services with ART, to prevent treatment failure.

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Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of persistent low-level HIV viraemia: a retrospective cohort study among people receiving dolutegravir-based antiretroviral therapy in Southern Nigeria

Onwah,

Nwanja,

Akpan

et al. 2024

Therapeutic Advances in Infection

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“…Consequently, the association we found between social support and ART adherence/retention is driven by how we conceptualized it. Additionally, data on “duration on ART” was not collected and yet it is known to influence ART adherence [ 38 ]. The study relied on self-reported data other than hospital records, hence there is the possibility that the data was affected by some biases such as social desirability bias.…”

Section: Discussionmentioning

confidence: 99%

The role of social support in antiretroviral therapy uptake and retention among pregnant and postpartum women living with HIV in the Greater Accra region of Ghana

Ameyaw,

Nutor,

Okiring

et al. 2024

BMC Public Health

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Introduction The role of social support in antiretroviral therapy (ART) uptake and retention among pregnant and postpartum women in Ghana’s capital, Accra, has received limited attention in the literature. This cross-sectional study extends existing knowledge by investigating the role of social support in ART adherence and retention among pregnant and postpartum women in Accra. Methods We implemented a cross-sectional study in eleven (11) public health facilities. Convenience sampling approach was used to recruit 180 participants, out of which 176 with completed data were included in the study. ART adherence in the three months preceding the survey (termed consistent uptake), and ART retention were the outcomes of interest. Initial analysis included descriptive statistics characterized by frequencies and percentages to describe the study population. In model building, we included all variables that had p-values of 0.2 or lesser in the bivariate analysis to minimize negative confounding. Overall, a two-sided p-value of < 0.05 was considered statistically significant. Data were analyzed using Stata version 14.1 (College Station, TX). Results In the multivariate model, we realized a lower odds trend between social support score and consistent ART adherence, however, this was insignificant. Similarly, both the univariate and multivariate models showed that social support has no relationship with ART retention. Meanwhile, urban residents had a higher prevalence of ART adherence (adjusted Prevalence ratio (aPR) = 2.04, CI = 1.12–3.73) relative to rural/peri-urban residents. As compared to those below age 30, women aged 30–34 (aPR = 0.58, CI = 0.34–0.98) and above 35 (aPR = 0.48, CI = 0.31–0.72) had lower prevalence of ART adherence Women who knew their partner’s HIV status had lower prevalence of ART adherence compared to those who did not know (aPR = 0.62, CI = 0.43–0.91). Also, having a rival or co-wife was significantly associated with ART retention such that higher prevalence of ART adherence among women with rivals relative to those without rivals (aOR = 1.98, CI = 1.16–3.36). Conclusion Our study showed that social support does not play any essential role in ART adherence among the surveyed pregnant and postpartum women. Meanwhile, factors such as having a rival and being under the age of thirty play an instrumental role. The study has signaled the need for ART retention scale-up interventions to have a multi-pronged approach in order to identify the multitude of underlying factors, beyond social support, that enhance/impede efforts to achieve higher uptake and retention rates.

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“…It is postulated that longer treatment duration leads to better quality of life; hence patients become more motivated to follow healthcare providers’, advice including adhering to their medications [ 39 ]. In contrast, a study in Eastern China found men with longer ART duration were less likely to be adherent [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Association of coping mechanisms with medication adherence among young People living with HIV (PLHIV) in Klang Valley

Zainal-Abidin,

Miptah,

Ariffin

et al. 2024

Heliyon

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Impact of antiretroviral therapy (ART) duration on ART adherence among men who have sex with men (MSM) living with HIV in Jinan of China

Cited by 6 publications

References 34 publications

Prevalence and predictors of persistent low-level HIV viraemia: a retrospective cohort study among people receiving dolutegravir-based antiretroviral therapy in Southern Nigeria

Prevalence and predictors of persistent low-level HIV viraemia: a retrospective cohort study among people receiving dolutegravir-based antiretroviral therapy in Southern Nigeria

The role of social support in antiretroviral therapy uptake and retention among pregnant and postpartum women living with HIV in the Greater Accra region of Ghana

Association of coping mechanisms with medication adherence among young People living with HIV (PLHIV) in Klang Valley

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