Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in Kenya
Objective: The aim of this study is to estimate the proportion of virologically suppressed People living with HIV on second-line ART and to identify factors associated with virologic suppression. With an increasing population of patients on complex second-line anti retroviral therapy (ART), understa...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-03-01
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| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121231162354 |
| _version_ | 1797858525299343360 |
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| author | Rose Nyaboke Habib Omari Ramadhani Taylor Lascko Patrick Awuor Elvis Kirui Emily Koech Immaculate Mutisya Carol Ngunu Rebecca Wangusi |
| author_facet | Rose Nyaboke Habib Omari Ramadhani Taylor Lascko Patrick Awuor Elvis Kirui Emily Koech Immaculate Mutisya Carol Ngunu Rebecca Wangusi |
| author_sort | Rose Nyaboke |
| collection | DOAJ |
| description | Objective: The aim of this study is to estimate the proportion of virologically suppressed People living with HIV on second-line ART and to identify factors associated with virologic suppression. With an increasing population of patients on complex second-line anti retroviral therapy (ART), understanding the factors associated with viral suppression and adherence is critical for ensured longevity of ART. Methods: A retrospective study was conducted of patients on second-line ART in 17 facilities supported by University of Maryland, Baltimore, in Nairobi, Kenya, covering the period beginning October 2016 up to August 2019. Viral suppression was defined as viral load <1000 copies/mL in a test conducted in the last 12 months. Adherence was assessed through self-reports and classified as optimal (good) or suboptimal (inadequate/poor). Associations were presented as adjusted risk ratios with 95% confidence intervals. Statistical significance was considered when p value ⩽0.05. Results: Of 1100 study participants with viral load data, 974 (88.5%) reported optimal adherence while on first-line ART and 1029 (93.5%) reported optimal adherence to second-line ART. Overall, viral load suppression on second-line ART was 90%. Optimal adherence ((adjusted risk ratio) 1.26; 95% confidence interval 1.09–1.46)) and age 35–44 versus 15–24 years ((adjusted risk ratio) 1.06; 95% confidence interval 1.01–1.13)) were associated with viral suppression . Adherence to first-line ART ((adjusted risk ratio) 1.19; 95% confidence interval 1.02–1.40)) was associated with adherence to second-line ART. Conclusion: Viral suppression remains high and adherence was strongly associated with viral suppression, underscoring the need to adequately address the barriers to adherence before switching regimens. |
| first_indexed | 2024-04-09T21:14:45Z |
| format | Article |
| id | doaj.art-07e586df2ff942698f638ca854996d23 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-04-09T21:14:45Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-07e586df2ff942698f638ca854996d232023-03-28T11:04:12ZengSAGE PublishingSAGE Open Medicine2050-31212023-03-011110.1177/20503121231162354Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in KenyaRose Nyaboke0Habib Omari Ramadhani1Taylor Lascko2Patrick Awuor3Elvis Kirui4Emily Koech5Immaculate Mutisya6Carol Ngunu7Rebecca Wangusi8CIHEB Kenya, Nairobi, KenyaIHV, University of Maryland School of Medicine, Baltimore, MD, USAIHV, University of Maryland School of Medicine, Baltimore, MD, USACIHEB Kenya, Nairobi, KenyaAmref Health Africa, Nairobi, KenyaCIHEB Kenya, Nairobi, KenyaCDC Kenya, Division of Global HIV & TB (DGHT), US Centers for Disease Control and Prevention (CDC), Nairobi, KenyaNairobi County-MOH, Nairobi Metropolitan Services, Nairobi, KenyaCIHEB Kenya, Nairobi, KenyaObjective: The aim of this study is to estimate the proportion of virologically suppressed People living with HIV on second-line ART and to identify factors associated with virologic suppression. With an increasing population of patients on complex second-line anti retroviral therapy (ART), understanding the factors associated with viral suppression and adherence is critical for ensured longevity of ART. Methods: A retrospective study was conducted of patients on second-line ART in 17 facilities supported by University of Maryland, Baltimore, in Nairobi, Kenya, covering the period beginning October 2016 up to August 2019. Viral suppression was defined as viral load <1000 copies/mL in a test conducted in the last 12 months. Adherence was assessed through self-reports and classified as optimal (good) or suboptimal (inadequate/poor). Associations were presented as adjusted risk ratios with 95% confidence intervals. Statistical significance was considered when p value ⩽0.05. Results: Of 1100 study participants with viral load data, 974 (88.5%) reported optimal adherence while on first-line ART and 1029 (93.5%) reported optimal adherence to second-line ART. Overall, viral load suppression on second-line ART was 90%. Optimal adherence ((adjusted risk ratio) 1.26; 95% confidence interval 1.09–1.46)) and age 35–44 versus 15–24 years ((adjusted risk ratio) 1.06; 95% confidence interval 1.01–1.13)) were associated with viral suppression . Adherence to first-line ART ((adjusted risk ratio) 1.19; 95% confidence interval 1.02–1.40)) was associated with adherence to second-line ART. Conclusion: Viral suppression remains high and adherence was strongly associated with viral suppression, underscoring the need to adequately address the barriers to adherence before switching regimens.https://doi.org/10.1177/20503121231162354 |
| spellingShingle | Rose Nyaboke Habib Omari Ramadhani Taylor Lascko Patrick Awuor Elvis Kirui Emily Koech Immaculate Mutisya Carol Ngunu Rebecca Wangusi Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in Kenya SAGE Open Medicine |
| title | Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in Kenya |
| title_full | Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in Kenya |
| title_fullStr | Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in Kenya |
| title_full_unstemmed | Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in Kenya |
| title_short | Factors associated with adherence and viral suppression among patients on second-line antiretroviral therapy in an urban HIV program in Kenya |
| title_sort | factors associated with adherence and viral suppression among patients on second line antiretroviral therapy in an urban hiv program in kenya |
| url | https://doi.org/10.1177/20503121231162354 |
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