Adherence to HIV antiretroviral therapy among pregnant and postpartum women during the Option B+ era: 12-month cohort study in urban South Africa and rural Uganda.
ARV
Africa < Region
Cohort studies
HIV
adherence
cohort studies
gender
women
Journal
Journal of the International AIDS Society
ISSN: 1758-2652
Titre abrégé: J Int AIDS Soc
Pays: Switzerland
ID NLM: 101478566
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
19
12
2019
revised:
18
06
2020
accepted:
01
07
2020
entrez:
22
8
2020
pubmed:
21
8
2020
medline:
14
5
2021
Statut:
ppublish
Résumé
We conducted a cohort study to understand patterns of anti-retroviral therapy (ART) adherence during pregnancy, postpartum and non-pregnancy follow-up among women initiating ART in public clinics offering Option B+ in rural Uganda and urban South Africa. We collected survey data, continuously monitored ART adherence (Wisepill), HIV-RNA and pregnancy tests at zero, six and twelve months from women initiating ART in Uganda and South Africa, 2015 to 2017. The primary predictor of interest was follow-up time categorized as pregnant (pregnancy diagnosis to pregnancy end), postpartum (pregnancy end to study exit) or non-pregnancy-related (neither pregnant nor postpartum). Fractional regression models included demographics and socio-behavioural factors informed by the Behavioral Model for Vulnerable Populations. We evaluated HIV-RNA at 12 months by ever- versus never-pregnant status. In Uganda, 247 women contributed 676, 900 and 1274 months of pregnancy, postpartum and non-pregnancy-related follow-up. Median ART adherence was consistently ≥90%: pregnancy, 94% (interquartile range [IQR] 78,98); postpartum, 90% (IQR 70,97) and non-pregnancy, 90% (IQR 80,98). Poorer adherence was associated with younger age (0.98% [95% CI 0.33%, 1.62%] average increase per year of age) and higher CD4 cell count (1.01% [0.08%, 1.94%] average decrease per 50 cells/mm Women in rural Uganda maintained high adherence with 91% of ever-pregnant and 86% of never-pregnant women suppressing HIV-RNA at 12 months. Women in urban South Africa struggled with adherence, particularly during postpartum follow-up with median adherence of 40% and 57% of women with HIV-RNA suppression at one year, suggesting a crisis for postpartum women with HIV in South Africa. Findings suggest that effective interventions should promote emotional support.
Identifiants
pubmed: 32820622
doi: 10.1002/jia2.25586
pmc: PMC7441010
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25586Subventions
Organisme : Bill & Melinda Gates Foundation
ID : OPP113634
Pays : United States
Investigateurs
Nomakhaya April
(N)
Alienah Mpahleni
(A)
Vivie Situlo
(V)
Speech Mzamo
(S)
Nomsa Ngwenya
(N)
Khosi Tshangela Regina Panda
(KTR)
Teboho Linda
(T)
Christine Atwiine
(C)
Sheila Moonight
(S)
Edna Tindimwebwa
(E)
Nicholas Mugisha
(N)
Peace Atwogeire
(P)
Vian Namana
(V)
Catherine Kyampaire
(C)
Gabriel Nuwagaba
(G)
Annet Kembabazi
(A)
Stephen Mugisha
(S)
Victoria Nanfuka
(V)
Anna Cross
(A)
Nicky Kelly
(N)
Daphne Moralie
(D)
Dolphina Cogill
(D)
Justus Ashaba
(J)
Zoleka Xapa
(Z)
Mathias Orimwesiga
(M)
Elly Tuhanamagyezi
(E)
Don Bosco Mpanga
(DB)
Leonia Kyarisima
(L)
Simone Kigozi
(S)
Edgar October
(E)
Silver Mugisha
(S)
Ibrahim Kiviiri
(I)
Norma Ware
(N)
Tumwesigye Elioda
(T)
Mark J Siedner
(MJ)
Ingrid T Katz
(IT)
Monique Wyatt
(M)
Informations de copyright
© 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.
Références
AIDS Behav. 2015 Feb;19(2):341-51
pubmed: 25096895
AIDS Res Ther. 2017 Apr 4;14(1):20
pubmed: 28376815
Qual Life Res. 2012 Nov;21(9):1655-63
pubmed: 22198741
Reprod Health Matters. 2009 May;17(33):143-51
pubmed: 19523591
J Acquir Immune Defic Syndr. 2019 Dec 15;82(5):443-451
pubmed: 31567551
BMC Public Health. 2013 May 07;13:450
pubmed: 23647555
BMC Pregnancy Childbirth. 2017 Mar 21;17(1):94
pubmed: 28320347
Health Res Policy Syst. 2011 Jan 31;9:6
pubmed: 21276274
AIDS Care. 2020 Apr;32(4):480-485
pubmed: 31455090
AIDS Behav. 2013 Jan;17(1):319-28
pubmed: 23229338
J Acquir Immune Defic Syndr. 2018 Apr 15;77(5):427-438
pubmed: 29287029
AIDS Patient Care STDS. 2017 Apr;31(4):153-166
pubmed: 28358624
J Int AIDS Soc. 2016 Apr 25;19(1):20679
pubmed: 27118443
J Acquir Immune Defic Syndr. 2016 Dec 15;73(5):514-521
pubmed: 27851712
Arch Intern Med. 1998 Sep 14;158(16):1789-95
pubmed: 9738608
Drugs Aging. 2013 Oct;30(10):809-19
pubmed: 23959913
PLoS One. 2017 May 1;12(5):e0176256
pubmed: 28459866
J Acquir Immune Defic Syndr. 2015 Nov 1;70(3):e102-9
pubmed: 26470033
BMJ Open. 2020 Jan 9;10(1):e035465
pubmed: 31924641
BMJ. 2019 Jun 6;365:l1965
pubmed: 31171558
AIDS Behav. 2013 Jan;17(1):434-43
pubmed: 22246514
AIDS Behav. 2019 Feb;23(2):445-458
pubmed: 29971732
J Int AIDS Soc. 2017 Jul 21;20(Suppl 4):21636
pubmed: 28770593
Trials. 2018 Jan 29;19(1):77
pubmed: 29378622
Curr HIV/AIDS Rep. 2015 Mar;12(1):1-5
pubmed: 25620530
Health Serv Res. 2000 Feb;34(6):1273-302
pubmed: 10654830
Int J Environ Res Public Health. 2018 Jan 20;15(1):
pubmed: 29361675
Dev Rev. 2008 Mar;28(1):78-106
pubmed: 18509515
J Int AIDS Soc. 2018 Jul;21 Suppl 4:e25114
pubmed: 30027583
J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S198-S206
pubmed: 28498190
J Dev Orig Health Dis. 2018 Feb;9(1):30-40
pubmed: 28877770
AIDS Behav. 2005 Mar;9(1):103-10
pubmed: 15812617
AIDS Behav. 2019 Dec;23(12):3247-3256
pubmed: 31401739
PLoS Med. 2019 Oct 2;16(10):e1002924
pubmed: 31577792
Acta Psychiatr Scand. 2002 Jul;106(1):9-19
pubmed: 12100343
Int J Gynaecol Obstet. 2010 Feb;108(2):111-4
pubmed: 19892340
J Int AIDS Soc. 2019 Feb;22(2):e25232
pubmed: 30746898
AIDS Behav. 2020 Sep;24(9):2624-2636
pubmed: 32140877
N Engl J Med. 2016 Dec;375(22):2121-2132
pubmed: 26900902
PLoS Med. 2018 Mar 30;15(3):e1002547
pubmed: 29601570
Health Serv Res. 2009 Dec;44(6):2093-105
pubmed: 19732170
AIDS Behav. 2018 May;22(5):1467-1474
pubmed: 28667469
AIDS. 2016 Apr 24;30(7):1121-9
pubmed: 26785125
J Pers Soc Psychol. 1987 Jul;53(1):71-80
pubmed: 3612494
J Int AIDS Soc. 2020 Aug;23(8):e25586
pubmed: 32820622
BMC Med Inform Decis Mak. 2016 Jul 11;16:86
pubmed: 27401475
PLoS Med. 2012;9(5):e1001222
pubmed: 22666181
BMC Public Health. 2018 Jul 31;18(1):935
pubmed: 30064405
Am J Prev Med. 2007 May;32(5 Suppl):S112-8
pubmed: 17466815
J Acquir Immune Defic Syndr. 2015 Dec 1;70(4):386-92
pubmed: 26110445
Contemp Clin Trials. 2017 Jun;57:44-50
pubmed: 28315480
PLoS One. 2019 Oct 30;14(10):e0222959
pubmed: 31665137
AIDS Behav. 2005 Jun;9(2):135-43
pubmed: 15933833
J Acquir Immune Defic Syndr. 2013 Mar 1;62(3):317-21
pubmed: 23242160
J Psychosom Res. 1999 Dec;47(6):555-67
pubmed: 10661603
AIDS. 2017 Jul 17;31(11):1593-1602
pubmed: 28463877
PLoS Med. 2013 Nov;10(11):e1001557
pubmed: 24319400
Am J Public Health. 2008 Oct;98(10):1865-71
pubmed: 18703447
Br J Psychiatry. 1987 Jun;150:782-6
pubmed: 3651732
Lancet HIV. 2016 May;3(5):e202-11
pubmed: 27126487
J Acquir Immune Defic Syndr. 2016 Aug 1;72 Suppl 2:S124-9
pubmed: 27355499
Arch Intern Med. 2003 Apr 14;163(7):821-9
pubmed: 12695273
PLoS One. 2013 Dec 10;8(12):e82521
pubmed: 24340036
AIDS. 2019 Jan 27;33(1):45-54
pubmed: 30289804
Matern Child Health J. 2015 Sep;19(9):2029-37
pubmed: 25656728
HIV Clin Trials. 2011 Jan-Feb;12(1):9-23
pubmed: 21388937
J Int AIDS Soc. 2013 Nov 13;16(3 Suppl 2):18640
pubmed: 24242258
BMC Infect Dis. 2015 Apr 08;15:175
pubmed: 25886277
AIDS Care. 2016;28 Suppl 1:114-8
pubmed: 26922939
Soc Sci Med. 2011 Dec;73(12):1717-24
pubmed: 22019367
PLoS One. 2018 Apr 18;13(4):e0193697
pubmed: 29668725
BMC Pregnancy Childbirth. 2017 May 8;17(1):138
pubmed: 28482821
AIDS. 2014 Sep 24;28(15):2307-12
pubmed: 25313586
J Acquir Immune Defic Syndr. 2009 Nov 1;52(3):406-16
pubmed: 19730269
AIDS. 2012 Oct 23;26(16):2039-52
pubmed: 22951634
Trials. 2018 Oct 30;19(1):594
pubmed: 30376872