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Kawuki J, Nuwabaine L, Namulema A, Asiimwe JB, Sserwanja Q, Gatasi G, Donkor E. Prevalence of risk factors for human immunodeficiency virus among sexually active women in Rwanda: a nationwide survey. BMC Public Health 2023; 23:2222. [PMID: 37950175 PMCID: PMC10638791 DOI: 10.1186/s12889-023-17148-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The Human Immunodeficiency Virus (HIV) remains a global health burden, and despite the advancements in antiretroviral therapy and various strategies employed to curb HIV infections, the incidence of HIV remains disproportionately high among women. Therefore, this study aimed to determine the prevalence of the risk factors for the acquisition of HIV among sexually active women in Rwanda. METHODS Secondary data from the 2020 Rwanda Demographic Health Survey, comprising 10,684 sexually active women, was used. Multistage stratified sampling was employed to select the study participants. Multivariable logistic regression was conducted to determine the associated risk factors using the SPSS (version 25). RESULTS Of the 10,684 sexually active women, 28.7% (95% confidence interval (CI): 27.5-29.4) had at least one risk factor for HIV acquisition. Having no education (AOR = 3.65, 95%CI: 2.16-6.16), being unmarried (AOR = 4.50, 95%CI: 2.47-8.21), being from female-headed households (AOR = 1.75, 95%CI: 1.42-2.15), not having health insurance (AOR = 1.34, 95%CI: 1.09-1.65), no HIV test history (AOR = 1.44, 95%CI: 1.01-2.08), being from the poorest wealth quintile (AOR = 1.61, 95%CI: 1.14-2.27) and lack of exposure to mass media (AOR = 1.30, 95%CI: 1.07-1.58) were associated with higher odds of exposure to at least one HIV acquisition risk factor. In contrast, age groups of 25-34 (AOR = 0.56, 95%CI: 0.44-0.71) and 35-44 years (AOR = 0.62, 95%CI: 0.48-0.80), rural residence (AOR = 0.63, 95%CI: 0.49-0.81) and being from the western region (AOR = 0.67, 95%CI: 0.48-0.94) were associated with less odds of exposure to at least one HIV acquisition risk factor. CONCLUSION More than a quarter of sexually active women in Rwanda had exposure to at least one risk factor for HIV acquisition. There is a need to maximize the use of mass media in disseminating HIV prevention and behavioral change messages. Engagement of religious leaders and promotion of HIV testing, especially among the never-testers, may be vital strategies in successful HIV prevention programs.
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Affiliation(s)
- Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Lilian Nuwabaine
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.
| | | | | | | | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Elorm Donkor
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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Kintu TM, Kaggwa MM, Namagembe R, Muganzi DJ, Kihumuro BR, Luyinda GS, Nabwana BW, Moses M, Nnyombi M, Kirega A, Kabakyenga JK, Maling S. Alcohol use disorder among healthcare professional students: a structural equation model describing its effect on depression, anxiety, and risky sexual behavior. BMC Psychiatry 2023; 23:505. [PMID: 37438721 DOI: 10.1186/s12888-023-04989-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Mental health problems such as depression, anxiety and alcohol use disorders are among the leading causes of disability worldwide. Among university students, alcohol use and poor mental health are associated with risky sexual behavior. Given the syndemic occurrence of these disorders most especially in young adults, we describe the relationship between them so as to guide and intensify current interventions on reducing their burden in this population. METHODS This was a cross-sectional study based on an online survey among healthcare professional university students that captured sociodemographic characteristics, risky sexual behavior, alcohol use disorder, generalized anxiety disorder, and depression. Structural equation modelling was used to describe the relationship between these variables using RStudio. RESULTS We enrolled a total of 351 participants of which 11% (37/351) had Alcohol Use Disorder, 33% (117/351) had depressive symptoms and 32% (111/351) had symptoms of anxiety. A model describing the relationship between these variables was found to fit well both descriptively and statistically [χ2 = 44.437, df = 21, p-value = 0.01, CFI = 0.989, TFI = 0.980, RMSEA = 0.056]. All observed variables were found to fit significantly and positively onto their respective latent factors (AUD, anxiety, depression and risky sexual behavior). AUD was found to be significantly associated with risky sexual behavior (β = 0.381, P < 0.001), depression (β = 0.152, P = 0.004), and anxiety (β = 0.137, P = 0.001). CONCLUSION AUD, depression and anxiety are a significant burden in this health professional student population and there's need to consider screening for anxiety and depression in students reporting with AUD so as to ensure appropriate interventions. A lot of attention and efforts should be focused on the effect of AUD on risky sexual behavior and continued health education is still required even among health professional students.
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Affiliation(s)
- Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Robinah Namagembe
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - David Jolly Muganzi
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Bernard Raymond Kihumuro
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Garvin Ssali Luyinda
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | | | - Muwanguzi Moses
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Marvin Nnyombi
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Alex Kirega
- Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda
| | - Jerome Kahuma Kabakyenga
- Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Samuel Maling
- Department of Psychiatry, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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Ramalingam A, Pasupuleti SSR, Nagappa B, Sarin SK. Health and economic burden due to alcohol-associated liver diseases in the Union Territory of Delhi: A Markov probabilistic model approach. Indian J Gastroenterol 2022; 41:84-95. [PMID: 35226293 DOI: 10.1007/s12664-021-01221-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/22/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Nearly one-fifth of all deaths attributable to alcohol are due to liver diseases. METHODS The study employs a Markov Probabilistic Modeling approach considering various clinical spectrum of alcohol-associated liver diseases (ALD), to gauge the health and economic burden due to ALD for the national capital territory of Delhi, from March 2017 to February 2018. The health impact was estimated through Disability Adjusted Life Years (DALYs), years of life lost (YLL), and total deaths due to ALD. The economic burden of ALD was assessed assuming the current health-seeking preferences and assuming that all the diseased individuals are cared for in the public health systems. Sensitivity analysis was done by Monte Carlo simulations. RESULTS Total number of estimated deaths due to ALD in the national capital territory of Delhi for one year period from March 2017 was 8367. The DALYs due to ALD were estimated to be 0.247 million life years; this includes 0.178 million YLL and 0.069 million life years lost due to disability. The total cost of treating ALD was estimated to be 92.94 billion Indian rupees, if patients sought care based on current preferences and 55.52 billion Indian rupees if all diseased individuals were cared for in public health systems. The total excise revenue due to alcohol to the Government is being Indian rupees 43.1 billion in the said year. CONCLUSION The high burden of ALD in terms of lives lost, DALYs lost, and more than two times higher estimated expense for care than the revenue generation due to alcohol clearly indicates that it would be prudent to initiate social engineering and preventive strategies to lessen the growing burden of ALD in India. The Delhi model for health and economic burden of ALD could help the country develop policies for better health outcomes of these patients.
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Affiliation(s)
- Archana Ramalingam
- Department of Epidemiology and Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, 110 070, India.,National Institute of Epidemiology, Chennai, India
| | - Samba Siva Rao Pasupuleti
- Department of Epidemiology and Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, 110 070, India.,Department of Statistics, Mizoram University, Pachhunga University College Campus, Aizawl, 796 001, India
| | - Bharathnag Nagappa
- Department of Epidemiology and Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, 110 070, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110 070, India.
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Reis RK, Sousa LRM, Melo ES, Fernandes NM, Sorensen W, Gir E. Predictors of HIV Status Disclosure to Sexual Partners Among People Living with HIV in Brazil. AIDS Behav 2021; 25:3538-3546. [PMID: 34173896 DOI: 10.1007/s10461-021-03362-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/26/2022]
Abstract
The objective of this study was to identify the factors associated with the non-disclosure of HIV seropositivity among people living with HIV/AIDS undergoing antiretroviral treatment. A cross-sectional study was carried out in five HIV clinics in the interior of the state of São Paulo, Brazil. Logistic regression analysis was used to determine independent predictors of HIV status disclosure. It was found that 68.5% revealed their HIV seropositivity to their most recent sexual partner. The variables "casual partner" [OR 19.08, 95% CI (4.08, 20.23), p = 0.001], "sexual partners with negative HIV or unknown HIV" [OR 4.54, 95% CI (1.58, 1.01), p = 0.005], "multiple sexual partners" [OR = 3.17, 95% CI (1.34, 7.35), p = 0.009], and "lack of communication with the partner on HIV prevention"[OR = 8.3, 95% CI (3.88, 16.61), p = 0.001] were independently associated with non-disclosure of the diagnosis. Future HIV prevention interventions should encourage open communication between sexual partners.
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Affiliation(s)
- Renata Karina Reis
- Department of General and Specialized Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo At Ribeirão Preto College of Nursing, Avenida: Bandeirantes, 3900 Campus Universitário - Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil.
| | - Laelson Rochelle Milanês Sousa
- Department of General and Specialized Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo At Ribeirão Preto College of Nursing, Avenida: Bandeirantes, 3900 Campus Universitário - Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil
| | - Elizabete Santos Melo
- Department of General and Specialized Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo At Ribeirão Preto College of Nursing, Avenida: Bandeirantes, 3900 Campus Universitário - Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil
| | | | - William Sorensen
- Department of Health and Kinesiology, University of Texas, Tyler, TX, USA
| | - Elucir Gir
- Department of General and Specialized Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo At Ribeirão Preto College of Nursing, Avenida: Bandeirantes, 3900 Campus Universitário - Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil
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Antonini M, Pontes PS, Melo ES, de Souza Alves R, Gir E, Sorensen W, Reis RK. Serodiscordance predictors among couples in the HIV context: implications for health care. BMC Public Health 2021; 21:1849. [PMID: 34645401 PMCID: PMC8513240 DOI: 10.1186/s12889-021-11835-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background After HIV diagnosis, people maintain, reestablish their sexual lives, or build new relationships, often with HIV seronegative partners. Therefore, understanding the factors concerning couple-vulnerability is essential in order to design effective HIV preventive strategies. We examined HIV serodiscordant couples prevalence and their associated factors from a Brazilian city. Methods This is a cross-sectional analytical study carried out with people living with HIV (PLHIV) who had an active sex life and were engagement in HIV health care follow-up. Data were collected using a semi-structured questionnaire during individual interviews. We analyzed data using bivariate and multiple logistic regression analyses. Results There was 72.0% of HIV serodiscordant partnerships. Those who inconsistently used condoms (aOR: 0.3[0.13–0.7]) and/or had HIV detectable viral load (aOR: 0.29 [0.12–0.7]) were less likely to have an HIV serodiscordant sexual partner. On other hand, the lack of HIV transmission counseling by the health service (aOR: 5.08 [2.02–12.76]), or those who had a casual partner (aOR: 8.12 [1.7–38.8]) or a steady and casual one concomitantly (aOR: 24.82 [1.46–420.83]), were more likely to indicate an HIV serodiscordant partnership. Conclusion The findings showed a high prevalence of serodiscordant partnerships in PLHIV. Greater visibility among couples in the health services is needed as well as a reassessment in order to provide PLHIV and their sexual partners with care strategies, by the health professionals. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11835-0.
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Affiliation(s)
- Marcela Antonini
- Department of General and Specialized Nursing, University of São Paulo, Ribeirão Preto College of Nursing, Bandeirantes Ave, 3900, Vila Monte Alegre SP, CEP, Ribeirão Preto, 14040-902, Brazil.
| | - Priscila Silva Pontes
- Department of General and Specialized Nursing, University of São Paulo, Ribeirão Preto College of Nursing, Bandeirantes Ave, 3900, Vila Monte Alegre SP, CEP, Ribeirão Preto, 14040-902, Brazil
| | - Elizabete Santos Melo
- Paulista University at São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
| | - Regina de Souza Alves
- Department of General and Specialized Nursing, University of São Paulo, Ribeirão Preto College of Nursing, Bandeirantes Ave, 3900, Vila Monte Alegre SP, CEP, Ribeirão Preto, 14040-902, Brazil
| | - Elucir Gir
- Department of General and Specialized Nursing, University of São Paulo, Ribeirão Preto College of Nursing, Bandeirantes Ave, 3900, Vila Monte Alegre SP, CEP, Ribeirão Preto, 14040-902, Brazil
| | - William Sorensen
- Department of Health and Kinesiology, University of Texas at Tyler, Tyler, TX, USA
| | - Renata Karina Reis
- Department of General and Specialized Nursing, University of São Paulo, Ribeirão Preto College of Nursing, Bandeirantes Ave, 3900, Vila Monte Alegre SP, CEP, Ribeirão Preto, 14040-902, Brazil
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Jabr AM, Di Stefano M, Greco P, Santantonio T, Fiore JR. Errors in Condom Use in the Setting of HIV Transmission: A Systematic Review. Open AIDS J 2020. [DOI: 10.2174/1874613602014010016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The efficacy of condom use in declining HIV transmission may be compromised by their incorrect usage. Much focus has been paid on the regularity of condom usage but consumer mistakes and challenges must be considered. Breakage, slipping, leakage, incomplete use and other problems during the sexual event may compromise the protective role of the condom.
Objective:
To evaluate through a systematic review of published data, the type, and incidence of error and problems in condom use, and their possible role in reducing the preventive action of condoms.
Methods:
A systematic literature search for peer-reviewed articles published between January 2000 and January 2019, issued in English in peer-reviewed journals, and reporting the occurrence of condom errors/problems among HIV high-risk populations.
Results:
Twenty studies representing nine countries met the inclusion criteria. The most predominant mistakes associated with condom use included condom breakage, slippage, delayed condom application, early removal, issues related to erection loss and difficulties with fit and feel were reported, failure to squeeze out air, use of expired condoms, reuse of condom, and wearing the condom outside out were other issues noticed.
Conclusions:
Condom use problems and mistakes are prevalent across the globe. Educational efforts are needed to empower HIV the at-risk population with confidence and knowledge to improve correct condom use and increase preventive activity
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Reis RK, Melo ES, Fernandes NM, Antonini M, Neves LADS, Gir E. Inconsistent condom use between serodifferent sexual partnerships to the human immunodeficiency virus. Rev Lat Am Enfermagem 2019; 27:e3222. [PMID: 31826163 PMCID: PMC6896812 DOI: 10.1590/1518-8345.3059.3222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 09/03/2019] [Indexed: 01/08/2023] Open
Abstract
Objective: to analyze predictors of inconsistent condom use among HIV-positive people with sexual immunodeficiency virus serodifferent sexual partnership. Method: cross-sectional, analytical study with a consecutive non-probabilistic sample consisting of people living with the human immunodeficiency virus with serodifferent sexual partnership and who were in outpatient clinical follow-up. Data were collected through individual interviews guided by a semi-structured questionnaire and subsequently analyzed with bivariate analysis and logistic regression. Results: Seven variables were independently associated with inconsistent condom use. Schooling less than 11 years of schooling (4.9 [2.4-10.1]), having multiple partnerships (5.0 [1.3-19.6]), using alcohol (2.1 [1.1 -4.4]) or other drugs (2.8 [1.2-6.3]), do not receive advice from a healthcare professional (2.0 [1.1-3.9]), have no knowledge of treatment as prevention (3.0 [1,2-6,9]) and not knowing that undetectable viral load reduces the risk of human immunodeficiency virus transmission (3.8 [1,1-13,7]) were predictors for inconsistent condom use. Conclusion: The study showed that psychosocial factors interfere with consistent condom use between serodifferent partnerships. Thus, it is highlighted that there is a need for comprehensive interventions that include the integration of clinical and psychosocial care.
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Affiliation(s)
- Renata Karina Reis
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Colaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Elizabete Santos Melo
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Colaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Nilo Martinez Fernandes
- Fundação Oswaldo Cruz, Instituto de Pesquisa Clínica Evandro Chagas, Rio de Janeiro, RJ, Brazil
| | - Marcela Antonini
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Colaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Programa Institucional de Bolsas de Iniciação Científica (PIBIC), Brazil
| | - Lis Aparecida de Souza Neves
- Prefeitura Municipal de Ribeirão Preto, Programa de Doenças Sexualmente Transmissíveis, Aids, Tuberculose e Hepatites Virais, Ribeirão Preto, SP, Brazil
| | - Elucir Gir
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Colaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Abate A, Tareke M, Tirfie M, Semachew A, Amare D, Ayalew E. Chewing khat and risky sexual behavior among residents of Bahir Dar City administration, Northwest Ethiopia. Ann Gen Psychiatry 2018; 17:26. [PMID: 29942341 PMCID: PMC5996492 DOI: 10.1186/s12991-018-0194-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/25/2018] [Indexed: 03/07/2023] Open
Abstract
INTRODUCTION Khat is a well-known natural stimulant and is widely used in Ethiopia, particularly in Bahir Dar city. Khat chewing is linked with risky sexual behaviors. OBJECTIVE The study was aimed to determine the prevalence of chewing khat and its relation with risky sexual behaviors among residents of Bahir Dar City administration, Northwest Ethiopia. METHODS A community based cross-sectional study was conducted from January to February, 2016. The data were collected using an interviewer administered structured questionnaire. Logistic regression analysis was applied to assess association between dependent and explanatory variables. RESULTS The proportion of lifetime and current chewing khat among the study participants were 25.7 and 19.5%, respectively. Males (AOR 5.0; 95% CI 3.0-8.2) than females, merchants (AOR 4.9; 95% CI 2.6-9.3) than government employees, and those with average monthly income of ≥ 3001 Ethiopian birr (AOR 2.4; 95% CI 1.2-4.8) than ≤ 1000 had an increased current chewing khat prevalence. Having lifetime history of chewing khat was significantly associated with ever had sexual intercourse, having extra sexual partners, watching pornographic film and self-reported sexually transmitted infections. CONCLUSION Chewing khat is associated with increment of having risky sexual behaviors and self-reported sexually transmitted infections. Harm reduction measures are needed to prevent the community from engaging in khat use and risky sexual behaviors.
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Affiliation(s)
- Andargie Abate
- College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Minale Tareke
- College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulat Tirfie
- College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ayele Semachew
- College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desalegne Amare
- College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Emiru Ayalew
- College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Miyada S, Garbin AJÍ, Gatto RCJ, Garbin CAS. Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil. Rev Soc Bras Med Trop 2017; 50:607-612. [PMID: 29160506 DOI: 10.1590/0037-8682-0266-2017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/19/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients. METHODS This was a cross-sectional, exploratory study with a quantitative approach that was conducted over 8 months. The target population contained patients who were assisted at the ambulatory care facility specialized in STD/AIDS of a medium-size city located in Northwest São Paulo. In order to verify the level of adherence to ART, a validated CEAT-VIH (Assessment of Adherence to Antiretroviral Therapy Questionnaire) questionnaire was used. Sociodemographic aspects and clinical/laboratory data were obtained from the medical records. The results were analyzed using the Student's t-test and Pearson's coefficient. RESULTS Herein, 109 patients were interviewed, 56% of whom were male. The age of the population ranged 18-74 years (mean 45.67 years). Adherence to ART was classified as insufficient in 80.7% of cases. There was an association between ART adherence and presence of symptoms and/or opportunistic infection (p=0.008) and economic status (p<0.001). CONCLUSIONS Adherence to ART among HIV carriers cared for by the public health system is low. Patients who reported a favorable economic status and those without symptoms and/or opportunistic infection demonstrated greater treatment adherence than those who needed to take more than 3 pills a day.
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Affiliation(s)
- Simone Miyada
- Programa de Pós-graduação Stricto Sensu em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Artênio José Ísper Garbin
- Programa de Pós-graduação Stricto Sensu em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Renata Colturato Joaquim Gatto
- Programa de Pós-graduação Stricto Sensu em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Cléa Adas Saliba Garbin
- Programa de Pós-graduação Stricto Sensu em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil
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