Predictors of treatment interruption among patients on antiretroviral therapy in Akwa Ibom, Nigeria: outcomes after 12 months

Predictors of treatment interruption among patients on antiretroviral therapy in Akwa Ibom, Nigeria: outcomes after 12 months

Understanding the characteristics of people living with HIV who interrupt antiretroviral therapy (ART) is critical for designing client-centered services to ensure optimal outcomes. We assessed predictors of treatment interruption in 22 HIV clinics in Nigeria. We reviewed records of HIV-positive pat...

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Bibliographic Details
Published in:AIDS care Vol. 35; no. 1; pp. 114 - 122
Main Authors: Akpan, Uduak, Kakanfo, Kunle, Ekele, Oche D., Ukpong, Kufre, Toyo, Otoyo, Nwaokoro, Pius, James, Ezekiel, Pandey, Satish, Olatubosun, Kolawole, Bateganya, Moses
Format: Journal Article
Language:English
Published: England Taylor & Francis 2023
Taylor & Francis Ltd
Subjects:
Adult
adults
AIDS
Anti-HIV Agents - therapeutic use
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
Catchment areas
CD4 Lymphocyte Count
Clinics
Drug therapy
Education
Female
Health care facilities
Higher education
HIV
HIV Infections - diagnosis
HIV Infections - drug therapy
Human immunodeficiency virus
Humans
lost to follow-up
Male
Medical diagnosis
Nigeria
Patient-centered care
predictors
Regression analysis
Regression models
Retrospective Studies
Secondary education
Nigeria
predictors
lost to follow-up
AIDS
HIV
antiretroviral therapy
adults
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Summary:Understanding the characteristics of people living with HIV who interrupt antiretroviral therapy (ART) is critical for designing client-centered services to ensure optimal outcomes. We assessed predictors of treatment interruption in 22 HIV clinics in Nigeria. We reviewed records of HIV-positive patients aged ≥15 years who started ART 1 January and 31 March 2019. We determined treatment status over 12 months as either active, or interrupted treatment (defined as interruption in treatment up to 28 days or longer). Potential predictors were assessed using Cox hazard regression models. Overall, 1185 patients were enrolled on ART, 829 (70%) were female, and median age was 32 years. Retention at 1, 3, 6, 9, and 12 months was 85%, 80%, 76%, 72%, and 68%, respectively. Predictors of treatment interruption were post-secondary education (p = 0.04), diagnosis through voluntary counseling and testing (p < 0.001), receiving care at low-volume facilities (p < 0.001), lack of access to a peer counselor (p < 0.001), and residing outside the clinic catchment area (p = 0.03). Treatment interruption was common but can be improved by focusing on lower volume health facilities, providing peer support especially to those with higher education, and client-centered HIV services for those who live further from clinics..
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ISSN:0954-0121
1360-0451
DOI:10.1080/09540121.2022.2093826