Risk factors for interruption in treatment among HIV-infected adolescence attending health care and treatment clinics in Tanzania
Abstract Background Interruption in Treatment (IIT) is a challenge in HIV care and treatment programs in sub- Saharan Africa. High IIT among HIV adolescents has both individual and potential public health consequences including discontinuation of treatment, increased HIV transmission and risk of dea...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | AIDS Research and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12981-023-00512-4 |
| _version_ | 1797853575259357184 |
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| author | Expeditho L. Mtisi Stella E. Mushy Simon G. Mkawe Antony Ndjovu Eric Mboggo Boniface S. Mlay Frida Ngalesoni Aisa Muya |
| author_facet | Expeditho L. Mtisi Stella E. Mushy Simon G. Mkawe Antony Ndjovu Eric Mboggo Boniface S. Mlay Frida Ngalesoni Aisa Muya |
| author_sort | Expeditho L. Mtisi |
| collection | DOAJ |
| description | Abstract Background Interruption in Treatment (IIT) is a challenge in HIV care and treatment programs in sub- Saharan Africa. High IIT among HIV adolescents has both individual and potential public health consequences including discontinuation of treatment, increased HIV transmission and risk of death. In this era of test and treat policy it is important to ensure that patients remain connected to HIV clinics to enable achieve UNAIDS 95-95-95 targets timely. This study aimed to assess risk factors for IIT among HIV-positive adolescence in Tanzania. Methods We conducted retrospective longitudinal cohort study using secondary data of adolescent patients enrolled in care and treatment clinics in Tanga from October 2018 to December 2020. We defined Interuption in Treatment as missing clinic visits for 90 consecutive days after the last scheduled appointment date on anti-retroviral therapy (ART). Cox proportional hazard regression models were employed to identify risk factors of the outcome variable. Results Among 2,084 adolescents of age between 15 and 19 years were followed for two years, whereby 546 (26.2%) had interrupted treatment. The median age of the participants was 14.6 years (interquartile range, IQR: 12.6–16.6 years), with age between 15 and 19 years, male sex, with advanced HIV disease and were not on Dolutegravir (DTG) related regimens were associated with interruption in treatment; (Hazard ratio (HR) 1.43, 95% CI: 1.23–1.66, p < 0.0001, HR 2.47, 95% CI: 1.62–3.77, p < 0.0001, HR: 2.47, 95% CI: 1.91– 3.21, p < 0.0001 and HR: 6.67, 95% CI: 3.36– 7.04, p < 0.0001 respectively). Adolescents who were on ART for less or equal one year compared to those on ART for more than one year were protective toward interruption in treatment (HR: 0.68, 95% CI: 0.54–0.87, p = 0.002). Conclusions The risk of interruption in treatment was high among adolescents in HIV care and treatment facilities in Tanga. This might lead to poor clinical outcomes, and increased drug resistance among ART-initiated adolescents. Placing more adolescents with DTG based drug, strengthening access to care and treatment and rapid tracking of patients is recommended to improve patient outcomes. |
| first_indexed | 2024-04-09T19:51:45Z |
| format | Article |
| id | doaj.art-45a6df82641543d694f6197c74afc2cb |
| institution | Directory Open Access Journal |
| issn | 1742-6405 |
| language | English |
| last_indexed | 2024-04-09T19:51:45Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj.art-45a6df82641543d694f6197c74afc2cb2023-04-03T05:41:28ZengBMCAIDS Research and Therapy1742-64052023-03-012011910.1186/s12981-023-00512-4Risk factors for interruption in treatment among HIV-infected adolescence attending health care and treatment clinics in TanzaniaExpeditho L. Mtisi0Stella E. Mushy1Simon G. Mkawe2Antony Ndjovu3Eric Mboggo4Boniface S. Mlay5Frida Ngalesoni6Aisa Muya7Amref Health AfricaDepartment of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied SciencesDepartment of General Studies, Dar es Salaam Institute of TechnologyAmref Health AfricaAmref Health AfricaDepartment of Care and Treatment, National AIDS Control Program (NACP), Ministry of HealthAmref Health AfricaAmref Health AfricaAbstract Background Interruption in Treatment (IIT) is a challenge in HIV care and treatment programs in sub- Saharan Africa. High IIT among HIV adolescents has both individual and potential public health consequences including discontinuation of treatment, increased HIV transmission and risk of death. In this era of test and treat policy it is important to ensure that patients remain connected to HIV clinics to enable achieve UNAIDS 95-95-95 targets timely. This study aimed to assess risk factors for IIT among HIV-positive adolescence in Tanzania. Methods We conducted retrospective longitudinal cohort study using secondary data of adolescent patients enrolled in care and treatment clinics in Tanga from October 2018 to December 2020. We defined Interuption in Treatment as missing clinic visits for 90 consecutive days after the last scheduled appointment date on anti-retroviral therapy (ART). Cox proportional hazard regression models were employed to identify risk factors of the outcome variable. Results Among 2,084 adolescents of age between 15 and 19 years were followed for two years, whereby 546 (26.2%) had interrupted treatment. The median age of the participants was 14.6 years (interquartile range, IQR: 12.6–16.6 years), with age between 15 and 19 years, male sex, with advanced HIV disease and were not on Dolutegravir (DTG) related regimens were associated with interruption in treatment; (Hazard ratio (HR) 1.43, 95% CI: 1.23–1.66, p < 0.0001, HR 2.47, 95% CI: 1.62–3.77, p < 0.0001, HR: 2.47, 95% CI: 1.91– 3.21, p < 0.0001 and HR: 6.67, 95% CI: 3.36– 7.04, p < 0.0001 respectively). Adolescents who were on ART for less or equal one year compared to those on ART for more than one year were protective toward interruption in treatment (HR: 0.68, 95% CI: 0.54–0.87, p = 0.002). Conclusions The risk of interruption in treatment was high among adolescents in HIV care and treatment facilities in Tanga. This might lead to poor clinical outcomes, and increased drug resistance among ART-initiated adolescents. Placing more adolescents with DTG based drug, strengthening access to care and treatment and rapid tracking of patients is recommended to improve patient outcomes.https://doi.org/10.1186/s12981-023-00512-4Risk factorsInterruption in treatment (IIT)HIV-infectedAntiretroviral therapy (ART)AdolescenceCare and treatment |
| spellingShingle | Expeditho L. Mtisi Stella E. Mushy Simon G. Mkawe Antony Ndjovu Eric Mboggo Boniface S. Mlay Frida Ngalesoni Aisa Muya Risk factors for interruption in treatment among HIV-infected adolescence attending health care and treatment clinics in Tanzania AIDS Research and Therapy Risk factors Interruption in treatment (IIT) HIV-infected Antiretroviral therapy (ART) Adolescence Care and treatment |
| title | Risk factors for interruption in treatment among HIV-infected adolescence attending health care and treatment clinics in Tanzania |
| title_full | Risk factors for interruption in treatment among HIV-infected adolescence attending health care and treatment clinics in Tanzania |
| title_fullStr | Risk factors for interruption in treatment among HIV-infected adolescence attending health care and treatment clinics in Tanzania |
| title_full_unstemmed | Risk factors for interruption in treatment among HIV-infected adolescence attending health care and treatment clinics in Tanzania |
| title_short | Risk factors for interruption in treatment among HIV-infected adolescence attending health care and treatment clinics in Tanzania |
| title_sort | risk factors for interruption in treatment among hiv infected adolescence attending health care and treatment clinics in tanzania |
| topic | Risk factors Interruption in treatment (IIT) HIV-infected Antiretroviral therapy (ART) Adolescence Care and treatment |
| url | https://doi.org/10.1186/s12981-023-00512-4 |
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