HIV viral load suppression following intensive adherence counseling among people living with HIV on treatment at military-managed health facilities in Uganda.
HIV
Intensive adherence counselling
Low and middle-income countries
Military
Viral load
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
20
04
2021
revised:
22
08
2021
accepted:
23
08
2021
pubmed:
6
9
2021
medline:
15
12
2021
entrez:
5
9
2021
Statut:
ppublish
Résumé
Uniformed service personnel have an increased risk of poor viral load suppression (VLS). This study was performed to evaluate the outcomes of interventions to improve VLS in the 28 military health facilities in Uganda. This operational research was conducted between October 2018 and September 2019, among people living with HIV (PLHIV) in the 28 health facilities managed by the military in Uganda. Patients with a viral load (VL) >1000 copies/ml received three sessions of intensive adherence counselling (IAC), 1 month apart, after which a repeat VL was done. The main outcome was the proportion with a suppressed VL following IAC. Of the 965 participants included in this analysis, 592 (61.4%) were male and 367 (38.3%) were female. Average age was 35.5 ± 13.7 years, and 87.8% had at least one IAC session. At least 48.2% had a suppressed repeat VL. IAC increased the odds of VLS by 82% (P = 0.004), with adjusted OR of 1.56 (P = 0.054). An initial VL >10 000 copies/ml, being on antiretroviral therapy for at least 2 years, being male, and being <18 years of age were associated with repeat VL non-suppression. IAC marginally improved VL suppression. There is a need to improve IAC in military health facilities.
Sections du résumé
BACKGROUND
BACKGROUND
Uniformed service personnel have an increased risk of poor viral load suppression (VLS). This study was performed to evaluate the outcomes of interventions to improve VLS in the 28 military health facilities in Uganda.
METHODS
METHODS
This operational research was conducted between October 2018 and September 2019, among people living with HIV (PLHIV) in the 28 health facilities managed by the military in Uganda. Patients with a viral load (VL) >1000 copies/ml received three sessions of intensive adherence counselling (IAC), 1 month apart, after which a repeat VL was done. The main outcome was the proportion with a suppressed VL following IAC.
RESULTS
RESULTS
Of the 965 participants included in this analysis, 592 (61.4%) were male and 367 (38.3%) were female. Average age was 35.5 ± 13.7 years, and 87.8% had at least one IAC session. At least 48.2% had a suppressed repeat VL. IAC increased the odds of VLS by 82% (P = 0.004), with adjusted OR of 1.56 (P = 0.054). An initial VL >10 000 copies/ml, being on antiretroviral therapy for at least 2 years, being male, and being <18 years of age were associated with repeat VL non-suppression.
CONCLUSIONS
CONCLUSIONS
IAC marginally improved VL suppression. There is a need to improve IAC in military health facilities.
Identifiants
pubmed: 34481969
pii: S1201-9712(21)00690-1
doi: 10.1016/j.ijid.2021.08.057
pii:
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
45-51Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.