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Predictors of non-adherence to antiretroviral therapy among HIV infected patients in northern Tanzania.

Abstract Antiretroviral therapy (ART) has been shown to reduce HIV-related morbidity and mortality amongst those living with HIV and reduce transmission of the virus to those who are yet to be infected. However, these outcomes depend on maximum ART adherence, and HIV programs around the world make efforts to ensure optimal adherence. Predictors of ART non-adherence vary considerably across populations and settings with respect to demographic, psychological, behavioral and economic factors. The objective of this study is to investigate risk factors that predict non-adherence to antiretroviral treatment among HIV-infected individuals in northern Tanzania.
PMID
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Authors

Mayor MeshTerms

Medication Adherence

Keywords
Journal Title plos one
Publication Year Start




PMID- 29252984
OWN - NLM
STAT- MEDLINE
DCOM- 20180108
LR  - 20180108
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 12
DP  - 2017
TI  - Predictors of non-adherence to antiretroviral therapy among HIV infected patients
      in northern Tanzania.
PG  - e0189460
LID - 10.1371/journal.pone.0189460 [doi]
AB  - BACKGROUND: Antiretroviral therapy (ART) has been shown to reduce HIV-related
      morbidity and mortality amongst those living with HIV and reduce transmission of 
      the virus to those who are yet to be infected. However, these outcomes depend on 
      maximum ART adherence, and HIV programs around the world make efforts to ensure
      optimal adherence. Predictors of ART non-adherence vary considerably across
      populations and settings with respect to demographic, psychological, behavioral
      and economic factors. The objective of this study is to investigate risk factors 
      that predict non-adherence to antiretroviral treatment among HIV-infected
      individuals in northern Tanzania. METHODS: At Kilimanjaro Christian Medical
      Centre (KCMC), a tertiary and referral hospital in northern Tanzania, we used an 
      existing ART database to randomly select HIV-infected patients above 18 years of 
      age who have been on triple ART for at least two years. We used interviewer
      administered structured questionnaires to cross-sectionally determine predictors 
      of ART non-adherence. We determined non-adherence through retrospective review of
      pharmacy drug refill (PDR) records of the interviewed participants using a
      pharmacy database. RESULTS: Non-adherence was defined as collecting less than 95%
      of expected monthly refills in the previous 2 years. Multivariable logistic
      regression model was used to determine the predictors of non-adherence. Of the
      256 patients enrolled mean age was 44 years (SD +/- 11) and median CD4 count was 
      499 cells per microliter (IQR 332-690). Median PDR adherence was 71% (IQR
      58%-75%). Non-adherence was associated with younger age and unemployment.
      CONCLUSION: In this setting, adherence strategies could be adapted to address
      issues facing young adults, and those with household challenges such as
      unemployment. Further research is required to better understand the potential
      roles of these factors in suboptimal adherence.
FAU - Semvua, Seleman Khamis
AU  - Semvua SK
AUID- ORCID: http://orcid.org/0000-0002-7660-9192
AD  - Kilimanjaro Christian Medical Centre-Duke Research Collaboration, Moshi,
      Tanzania.
AD  - Desmond Tutu HIV Centre, University Of Cape Town, Cape Town, South Africa.
AD  - Kilimanjaro Christian Medical University College, Moshi, Tanzania.
FAU - Orrell, Catherine
AU  - Orrell C
AD  - Desmond Tutu HIV Centre, University Of Cape Town, Cape Town, South Africa.
FAU - Mmbaga, Blandina Theophil
AU  - Mmbaga BT
AD  - Kilimanjaro Christian Medical Centre-Duke Research Collaboration, Moshi,
      Tanzania.
AD  - Kilimanjaro Christian Medical University College, Moshi, Tanzania.
AD  - Duke Global Health Institute, Durham, North Carolina, United States of America.
AD  - Kilimanjaro Clinical Research Institute-Kilimanjaro Christian Medical Centre,
      Moshi, Tanzania.
FAU - Semvua, Hadija Hamis
AU  - Semvua HH
AD  - Kilimanjaro Christian Medical University College, Moshi, Tanzania.
AD  - Kilimanjaro Clinical Research Institute-Kilimanjaro Christian Medical Centre,
      Moshi, Tanzania.
FAU - Bartlett, John A
AU  - Bartlett JA
AD  - Kilimanjaro Christian Medical University College, Moshi, Tanzania.
AD  - Duke Global Health Institute, Durham, North Carolina, United States of America.
FAU - Boulle, Andrew A
AU  - Boulle AA
AD  - Desmond Tutu HIV Centre, University Of Cape Town, Cape Town, South Africa.
LA  - eng
PT  - Journal Article
DEP - 20171218
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adult
MH  - Anti-HIV Agents/*therapeutic use
MH  - CD4 Lymphocyte Count
MH  - Cross-Sectional Studies
MH  - Female
MH  - HIV Infections/*drug therapy/*epidemiology
MH  - Humans
MH  - Male
MH  - *Medication Adherence
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sample Size
MH  - Self Report
MH  - Surveys and Questionnaires
MH  - Tanzania
MH  - Tertiary Care Centers
MH  - Treatment Outcome
MH  - Viral Load
PMC - PMC5734684
EDAT- 2017/12/19 06:00
MHDA- 2018/01/09 06:00
CRDT- 2017/12/19 06:00
PHST- 2017/04/20 00:00 [received]
PHST- 2017/11/28 00:00 [accepted]
PHST- 2017/12/19 06:00 [entrez]
PHST- 2017/12/19 06:00 [pubmed]
PHST- 2018/01/09 06:00 [medline]
AID - 10.1371/journal.pone.0189460 [doi]
AID - PONE-D-17-15360 [pii]
PST - epublish
SO  - PLoS One. 2017 Dec 18;12(12):e0189460. doi: 10.1371/journal.pone.0189460.
      eCollection 2017.