dc.contributor.author | Katz, Ingrid T. | |
dc.contributor.author | Musinguzi, Nicholas | |
dc.contributor.author | Bell, Kathleen | |
dc.contributor.author | Cross, Anna | |
dc.contributor.author | Bwana, Mwebesa B. | |
dc.contributor.author | Amanyire, Gideon | |
dc.contributor.author | Asiimwe, Stephen | |
dc.contributor.author | Orrell, Catherine | |
dc.contributor.author | . Bangsberg, David R | |
dc.contributor.author | Haberer, Jessica E. | |
dc.date.accessioned | 2022-01-13T08:52:01Z | |
dc.date.available | 2022-01-13T08:52:01Z | |
dc.date.issued | 2021-04-15 | |
dc.identifier.citation | Katz, I. T., Musinguzi, N., Bell, K., Cross, A., Bwana, M. B., Amanyire, G., ... & Haberer, J. E. (2021). Brief Report: The Impact of Disease Stage on Early Gaps in ART in the “Treatment for All” Era—A Multisite Cohort Study. Journal of Acquired Immune Deficiency Syndromes (1999), 86(5), 562. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/1147 | |
dc.description.abstract | Background: Adoption of “Treat All” policies has increased antiretroviral therapy (ART) initiation in sub-Saharan Africa; however, unexplained early losses continue to occur. More information is needed to understand why treatment discontinuation continues at this vulnerable stage in care.
Methods: The Monitoring Early Treatment Adherence Study involved a prospective observational cohort of individuals initiating
ART at early-stage versus late-stage disease in South Africa and
Uganda. Surveys and HIV-1 RNA levels were performed at baseline,
6, and 12 months, with adherence monitored electronically. This analysis included nonpregnant participants in the first 6 months of follow-up; demographic and clinical factors were compared across groups with x2, univariable, and multivariable models.
Results: Of 669 eligible participants, 91 (14%) showed early gaps of $30 days in ART use (22% in South Africa and 6% in Uganda) with the median time to gap of 77 days (interquartile range: 43–101) and 87 days (74, 105), respectively. Although 71 (78%) ultimately resumed care, having an early gap was still significantly associated with detectable viremia at 6 months (P # 0.01). Multivariable modeling, restricted to South Africa, found secondary education and higher physical health score protected against early gaps [adjusted odds ratio (aOR) 0.4, 95% confidence interval (CI): 0.2 to 0.8 and
(aOR 0.93, 95% CI: 0.9 to 1.0), respectively]. Participants reporting clinics as “too far” had double the odds of early gaps (aOR 2.2: 95%
CI: 1.2 to 4.1).
Discussion: Early gaps in ART persist, resulting in higher odds of detectable viremia, particularly in South Africa. Interventions targeting health management and access to care are critical to reducing earl | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Wolters Kluwer Health, Inc. | en_US |
dc.subject | Impact | en_US |
dc.subject | Disease Stage | en_US |
dc.subject | Early Gaps | en_US |
dc.subject | ART | en_US |
dc.subject | Treatment for All | en_US |
dc.title | The Impact of Disease Stage on Early Gaps in ART in the “Treatment for All” Era—A Multisite Cohort Study | en_US |
dc.type | Technical Report | en_US |