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Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Association of knowledge on ART line of treatment, scarcity of treatment options and adherence

Authors: Habib O. Ramadhani, Charles Muiruri, Venance P. Maro, Michael Omondi, Julian B. Mushi, Eileen S. Lirhunde, John A. Bartlett

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

Adherence to Antiretroviral Therapy (ART) is critical piece in the management of HIV infected patients. Despite the benefits of ART, non-adherence to ART persists. This study explores association between patient’s knowledge of the ART line of treatment, availability of future treatment options and adherence.

Methods

A cross sectional survey of HIV infected adolescent and adults was conducted. Cumulative optimal and sub-optimal adherence was defined as percentage adherence of ≥ 95 % and < 95 %, respectively. Binomial regression models were used to assess the association of patient’s knowledge of the ART line of treatment, availability of future treatment options and adherence.

Results

Of the 402 patients reviewed, 101 (25.1 %) patients knew their ART line of treatment and were aware that future treatment options are limited. Compared to those who were not aware of the ART line of treatment and/or scarcity of future treatment options, those who were aware were more likely to be adherent (adjusted prevalence ratio [APR], 1.1; 95 % CI, 1.0–1.3).

Conclusion

The study reports knowledge of patient’s ART line of treatment and future treatment options is important indicator of adherence to ART. Although majority of the patients did not have the knowledge, those who had the knowledge demonstrated to be more adherent. It is critical for the physicians/health care providers in these settings to clearly educate patients about ART line of treatment and limited availability of future treatment options as such information is likely to influence individual behavior and improve patient’s adherence to ART.
Literature
1.
go back to reference Safren SA, Mayer KH, Ou SS, McCauley M, Grinsztejn B, Hosseinipour MC, et al. Adherence to early antiretroviral therapy: results from HPTN 052, a phase III, multinational randomized trial of ART to prevent HIV-1 sexual transmission in serodiscordant couples. J Acquir Immune Defic Syndr. 2015;69(2):234–40.CrossRefPubMedPubMedCentral Safren SA, Mayer KH, Ou SS, McCauley M, Grinsztejn B, Hosseinipour MC, et al. Adherence to early antiretroviral therapy: results from HPTN 052, a phase III, multinational randomized trial of ART to prevent HIV-1 sexual transmission in serodiscordant couples. J Acquir Immune Defic Syndr. 2015;69(2):234–40.CrossRefPubMedPubMedCentral
2.
go back to reference Koss CA, Natureeba P, Mwesigwa J, Cohan D, Nzarubara B, Bacchetti P, et al. Hair concentrations of antiretrovirals predict viral suppression in HIV-infected pregnant and breastfeeding Ugandan women. AIDS (London, England). 2015;29(7):825–30.CrossRef Koss CA, Natureeba P, Mwesigwa J, Cohan D, Nzarubara B, Bacchetti P, et al. Hair concentrations of antiretrovirals predict viral suppression in HIV-infected pregnant and breastfeeding Ugandan women. AIDS (London, England). 2015;29(7):825–30.CrossRef
3.
go back to reference Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, et al. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS (London, England). 2000;14(4):357–66.CrossRef Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, et al. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS (London, England). 2000;14(4):357–66.CrossRef
4.
go back to reference Ramadhani HO, Bartlett JA, Thielman NM, Pence BW, Kimani SM, Maro VP, et al. Association of first-line and second-line antiretroviral therapy adherence. Open forum Infectious Dis. 2014;1(2):ofu079.CrossRef Ramadhani HO, Bartlett JA, Thielman NM, Pence BW, Kimani SM, Maro VP, et al. Association of first-line and second-line antiretroviral therapy adherence. Open forum Infectious Dis. 2014;1(2):ofu079.CrossRef
5.
go back to reference Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.CrossRefPubMedPubMedCentral Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.CrossRefPubMedPubMedCentral
6.
go back to reference Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21–30.CrossRefPubMed Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21–30.CrossRefPubMed
7.
go back to reference Bangsberg DR, Kroetz DL, Deeks SG. Adherence-resistance relationships to combination HIV antiretroviral therapy. Current HIV/AIDS Rep. 2007;4(2):65–72.CrossRef Bangsberg DR, Kroetz DL, Deeks SG. Adherence-resistance relationships to combination HIV antiretroviral therapy. Current HIV/AIDS Rep. 2007;4(2):65–72.CrossRef
8.
go back to reference Parienti JJ, Das-Douglas M, Massari V, Guzman D, Deeks SG, Verdon R, et al. Not all missed doses are the same: sustained NNRTI treatment interruptions predict HIV rebound at low-to-moderate adherence levels. PLoS One. 2008;3(7):e2783.CrossRefPubMedPubMedCentral Parienti JJ, Das-Douglas M, Massari V, Guzman D, Deeks SG, Verdon R, et al. Not all missed doses are the same: sustained NNRTI treatment interruptions predict HIV rebound at low-to-moderate adherence levels. PLoS One. 2008;3(7):e2783.CrossRefPubMedPubMedCentral
9.
go back to reference Zachariah R, Van Engelgem I, Massaquoi M, Kocholla L, Manzi M, Suleh A, et al. Payment for antiretroviral drugs is associated with a higher rate of patients lost to follow-up than those offered free-of-charge therapy in Nairobi, Kenya. Trans R Soc Trop Med Hyg. 2008;102(3):288–93.CrossRefPubMed Zachariah R, Van Engelgem I, Massaquoi M, Kocholla L, Manzi M, Suleh A, et al. Payment for antiretroviral drugs is associated with a higher rate of patients lost to follow-up than those offered free-of-charge therapy in Nairobi, Kenya. Trans R Soc Trop Med Hyg. 2008;102(3):288–93.CrossRefPubMed
10.
go back to reference Senkomago V, Guwatudde D, Breda M, Khoshnood K. Barriers to antiretroviral adherence in HIV-positive patients receiving free medication in Kayunga, Uganda. AIDS care. 2011;23(10):1246–53.CrossRefPubMed Senkomago V, Guwatudde D, Breda M, Khoshnood K. Barriers to antiretroviral adherence in HIV-positive patients receiving free medication in Kayunga, Uganda. AIDS care. 2011;23(10):1246–53.CrossRefPubMed
11.
go back to reference Ramadhani HO, Thielman NM, Landman KZ, Ndosi EM, Gao F, Kirchherr JL, et al. Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Clin Infect Dis. 2007;45(11):1492–8.CrossRefPubMed Ramadhani HO, Thielman NM, Landman KZ, Ndosi EM, Gao F, Kirchherr JL, et al. Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Clin Infect Dis. 2007;45(11):1492–8.CrossRefPubMed
12.
go back to reference Mbonye M, Seeley J, Ssembajja F, Birungi J, Jaffar S. Adherence to antiretroviral therapy in Jinja, Uganda: a Six-year follow-Up study. PLoS One. 2013;8(10):e78243.CrossRefPubMedPubMedCentral Mbonye M, Seeley J, Ssembajja F, Birungi J, Jaffar S. Adherence to antiretroviral therapy in Jinja, Uganda: a Six-year follow-Up study. PLoS One. 2013;8(10):e78243.CrossRefPubMedPubMedCentral
13.
go back to reference Wilson IB, Bangsberg DR, Shen J, Simoni JM, Reynolds NR, Goggin K, et al. Heterogeneity among studies in rates of decline of ART adherence over time: results from the MACH14 study. J Acquir Immune Defic Syndr. 2013;64:448–54.CrossRefPubMedPubMedCentral Wilson IB, Bangsberg DR, Shen J, Simoni JM, Reynolds NR, Goggin K, et al. Heterogeneity among studies in rates of decline of ART adherence over time: results from the MACH14 study. J Acquir Immune Defic Syndr. 2013;64:448–54.CrossRefPubMedPubMedCentral
14.
go back to reference Bangsberg DR. Less than 95 % adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006;43(7):939–41.CrossRefPubMed Bangsberg DR. Less than 95 % adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006;43(7):939–41.CrossRefPubMed
15.
go back to reference El-Khatib Z, Katzenstein D, Marrone G, Laher F, Mohapi L, Petzold M, et al. Adherence to drug-refill is a useful early warning indicator of virologic and immunologic failure among HIV patients on first-line ART in South Africa. PLoS One. 2011;6(3):e17518.CrossRefPubMedPubMedCentral El-Khatib Z, Katzenstein D, Marrone G, Laher F, Mohapi L, Petzold M, et al. Adherence to drug-refill is a useful early warning indicator of virologic and immunologic failure among HIV patients on first-line ART in South Africa. PLoS One. 2011;6(3):e17518.CrossRefPubMedPubMedCentral
16.
go back to reference Slaymaker E, Todd J, Marston M, Calvert C, Michael D, Nakiyingi-Miiro J, et al. How have ART treatment programmes changed the patterns of excess mortality in people living with HIV? Estimates from four countries in East and Southern Africa. Glob Health Action. 2014;7:22789.PubMed Slaymaker E, Todd J, Marston M, Calvert C, Michael D, Nakiyingi-Miiro J, et al. How have ART treatment programmes changed the patterns of excess mortality in people living with HIV? Estimates from four countries in East and Southern Africa. Glob Health Action. 2014;7:22789.PubMed
17.
go back to reference Kanjala C, Michael D, Todd J, Slaymaker E, Calvert C, Isingo R, et al. Using HIV-attributable mortality to assess the impact of antiretroviral therapy on adult mortality in rural Tanzania. Glob Health Action. 2014;7:21865.PubMed Kanjala C, Michael D, Todd J, Slaymaker E, Calvert C, Isingo R, et al. Using HIV-attributable mortality to assess the impact of antiretroviral therapy on adult mortality in rural Tanzania. Glob Health Action. 2014;7:21865.PubMed
18.
go back to reference Thompson MA, Mugavero MJ, Amico KR, Cargill VA, Chang LW, Gross R, et al. Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an international association of physicians in AIDS care panel. Ann Intern Med. 2012;156(11):817–294.CrossRefPubMedPubMedCentral Thompson MA, Mugavero MJ, Amico KR, Cargill VA, Chang LW, Gross R, et al. Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an international association of physicians in AIDS care panel. Ann Intern Med. 2012;156(11):817–294.CrossRefPubMedPubMedCentral
19.
go back to reference Bärnighausen T, Chaiyachati K, Chimbindi N, Peoples A, Haberer J, Newell ML. Interventions to increase antiretroviral adherence in sub-Saharan Africa: a systematic review of evaluation studies. Lancet Infect Dis. 2011;11(12):942–51.CrossRefPubMedPubMedCentral Bärnighausen T, Chaiyachati K, Chimbindi N, Peoples A, Haberer J, Newell ML. Interventions to increase antiretroviral adherence in sub-Saharan Africa: a systematic review of evaluation studies. Lancet Infect Dis. 2011;11(12):942–51.CrossRefPubMedPubMedCentral
20.
go back to reference Terblanche LM, Stellenberg EL. Patient knowledge of HIV and its treatment in South Africa. African J Prim Health care Family Med. 2014;6(1):E1–7. Terblanche LM, Stellenberg EL. Patient knowledge of HIV and its treatment in South Africa. African J Prim Health care Family Med. 2014;6(1):E1–7.
22.
go back to reference Potchoo Y, Tchamdja K, Balogou A, Pitche VP, Guissou IP, Kassang EK. Knowledge and adherence to antiretroviral therapy among adult people living with HIV/AIDS treated in the health care centers of the association “Espoir Vie Togo” in Togo, West Africa. BMC Clin Pharmacol. 2010;10:11.CrossRefPubMedPubMedCentral Potchoo Y, Tchamdja K, Balogou A, Pitche VP, Guissou IP, Kassang EK. Knowledge and adherence to antiretroviral therapy among adult people living with HIV/AIDS treated in the health care centers of the association “Espoir Vie Togo” in Togo, West Africa. BMC Clin Pharmacol. 2010;10:11.CrossRefPubMedPubMedCentral
23.
go back to reference Boateng D, Kwapong GD, Agyei-Baffour P. Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Womens Health. 2013;13:2.CrossRefPubMedPubMedCentral Boateng D, Kwapong GD, Agyei-Baffour P. Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Womens Health. 2013;13:2.CrossRefPubMedPubMedCentral
24.
go back to reference Demessie R, Mekonnen A, Amogne W, Shibeshi W. Knowledge and adherence to antiretroviral therapy among adult people living with HIV/AIDS at Tikur Anbessa Specialized Hospital, Ethiopia. Int J Basic Clin Pharmacol. 2014;3(2):320–30. Demessie R, Mekonnen A, Amogne W, Shibeshi W. Knowledge and adherence to antiretroviral therapy among adult people living with HIV/AIDS at Tikur Anbessa Specialized Hospital, Ethiopia. Int J Basic Clin Pharmacol. 2014;3(2):320–30.
25.
go back to reference Wasti SP, Simkhada P, Randall J, Freeman JV, van Teijlingen E. Factors influencing adherence to antiretroviral treatment in Nepal: a mixed-methods study. PLoS One. 2012;7(5):e35547.CrossRefPubMedPubMedCentral Wasti SP, Simkhada P, Randall J, Freeman JV, van Teijlingen E. Factors influencing adherence to antiretroviral treatment in Nepal: a mixed-methods study. PLoS One. 2012;7(5):e35547.CrossRefPubMedPubMedCentral
26.
go back to reference Sasaki Y, Kakimoto K, Dube C, Sikazwe I, Moyo C, Syakantu G, et al. Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients. Ann Clin Microbiol Antimicrob. 2012;11:34.CrossRefPubMedPubMedCentral Sasaki Y, Kakimoto K, Dube C, Sikazwe I, Moyo C, Syakantu G, et al. Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients. Ann Clin Microbiol Antimicrob. 2012;11:34.CrossRefPubMedPubMedCentral
27.
go back to reference Gare J, Kelly-Hanku A, Ryan CE, David M, Kaima P, Imara U, et al. Factors influencing antiretroviral adherence and virological outcomes in people living with HIV in the highlands of Papua New Guinea. PLoS One. 2015;10(8):e0134918.CrossRefPubMedPubMedCentral Gare J, Kelly-Hanku A, Ryan CE, David M, Kaima P, Imara U, et al. Factors influencing antiretroviral adherence and virological outcomes in people living with HIV in the highlands of Papua New Guinea. PLoS One. 2015;10(8):e0134918.CrossRefPubMedPubMedCentral
Metadata
Title
Association of knowledge on ART line of treatment, scarcity of treatment options and adherence
Authors
Habib O. Ramadhani
Charles Muiruri
Venance P. Maro
Michael Omondi
Julian B. Mushi
Eileen S. Lirhunde
John A. Bartlett
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1483-6

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