Failure to return pillbox is a predictor of being lost to follow-up among people living with HIV on antiretroviral therapy in rural Tanzania.
HIV treatment outcome
adherence
antiretroviral treatment
lost to follow-up
pillbox
rural
stigma
sub-Saharan Africa
Journal
HIV medicine
ISSN: 1468-1293
Titre abrégé: HIV Med
Pays: England
ID NLM: 100897392
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
revised:
22
11
2021
received:
21
09
2021
accepted:
06
12
2021
pubmed:
30
12
2021
medline:
10
6
2022
entrez:
29
12
2021
Statut:
ppublish
Résumé
Pill count is used to assess drug adherence in people living with HIV (PLHIV). Carrying a pillbox is associated with fear of concealment and stigma and might indicate poor adherence and predict someone who will be lost to follow-up (LTFU). We therefore assessed the association between pillbox return and being LTFU in rural Tanzania. This is a nested study of the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO). We included PLHIV aged ≥ 18 years enrolled in KIULARCO between January 2013 and March 2019 with follow-up through January 2020, who were on antiretroviral treatment (ART) for ≥ 6 months. Baseline was defined as the latest ART initiation or KIULARCO enrolment. We determined the association between time-dependent failed pillbox return updated at every visit and LTFU using Kaplan-Meier estimation and Cox models. Among 2552 PLHIV included in the study, 1735 (68.0%) were female, 959 (40.3%) had a WHO stage III/IV and 1487 (66.4%) had a CD4 cell count < 350 cells/µL. The median age was 38.4 years [interquartile range (IQR): 31.7-46.2]. During a median follow-up of 33.1 months (IQR: 17.5-52.4), 909 (35.6%) participants were LTFU, 43 (1.7%) died and 194 (7.6%) had transferred to another clinic. The probability of being LTFU was higher among PLHIV with failed pillbox return than among those who returned their pillbox [30.0%, 95% confidence interval (CI): 26.8-33.2% vs. 19.4%, 95% CI: 17.4-21.6%, respectively, at 24 months (hazard ratio = 1.67, 95% CI: 1.46-1.90; p < 0.001)]. Failed pillbox return was associated with a higher risk of being LTFU and could be used as a simple tool to identify PLHIV for appropriate interventions to reduce their chance of being LTFU.
Identifiants
pubmed: 34964236
doi: 10.1111/hiv.13223
pmc: PMC9306592
doi:
Substances chimiques
Anti-Retroviral Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
661-672Investigateurs
Aschola Asantiel
(A)
Farida Bani
(F)
Manuel Battegay
(M)
Theonestina Byakuzana
(T)
Adolphina Chale
(A)
Francisca Chuwa
(F)
Anna Eichenberger
(A)
Gideon Francis
(G)
Hansjakob Furrer
(H)
Tracy R Glass
(TR)
Speciosa Hwaya
(S)
Aneth V Kalinjuma
(AV)
Bryson Kasuga
(B)
Andrew Katende
(A)
Namvua Kimera
(N)
Bernard Kivuma
(B)
Yassin Kisunga
(Y)
Olivia Kitau
(O)
Thomas Klimkait
(T)
Ezekiel Luoga
(E)
Herry Mapesi
(H)
Mengi Mkulila
(M)
Julius Mkumbo
(J)
Margareth Mkusa
(M)
Slyakus Mlembe
(S)
Dorcas K Mnzava
(DK)
Gertrud J Mollel
(GJ)
Lilian Moshi
(L)
Germana Mossad
(G)
Dolores Mpundunga
(D)
Athumani Mtandanguo
(A)
Selerine Myeya
(S)
Sanula Nahota
(S)
Regina Ndaki
(R)
Robert C Ndege
(RC)
Agatha Ngulukila
(A)
Amina Nyuri
(A)
James Okuma
(J)
Daniel H Paris
(DH)
Aloyce Sambuta
(A)
Leila Samson
(L)
Elizabeth Senkoro
(E)
George Sikalengo
(G)
Jenifa Tarimo
(J)
Yvan Temba
(Y)
Juerg Utzinger
(J)
Fiona Vanobberghen
(F)
John Wigay
(J)
Herieth Wilson
(H)
Informations de copyright
© 2021 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.
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