ArticleBMC research notes2013
Patients' worries before starting antiretroviral therapy and their association with treatment adherence and outcomes: a prospective study in rural Uganda, 2004 - 2009.
Article in BMC research notes, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Living in Fear: Severe HIV-Associated Stigma Persists in Senegal, West Africa.AIDS and behavior · 2026Article
- Codeveloping a community-based, peer-led psychosocial support intervention to reduce stigma and depression among people with tuberculosis and their households in Indonesia: a mixed-methods participatory action study.NPJ primary care respiratory medicine · 2025Article
- Willingness by people living with HIV/AIDS to utilize HIV services provided by Village Health team workers in Kalungu district, central Uganda.African health sciences · 2017Article
- Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa: a systematic review.BMJ global health · 2016Article
- The dynamic relationship between social support and HIV-related stigma in rural Uganda.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2014Article
- Psychological Well-Being Challenges and Associated Coping Mechanisms of HIV/AIDS Counselors in the Volta Region of Ghana: A Descriptive Phenomenological Study.Journal of the International Association of Providers of AIDS CareArticle
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Authors and funding
5 authors.
Funding
Abstract
backgroundIn HIV-infected persons, good adherence to antiretroviral therapy (ART) is essential for successful treatment outcomes. Patients' worries before starting ART may affect their ART adherence and treatment outcomes.
methodsBetween 2004 and 2009, HIV-infected individuals in a prospective cohort study in rural Uganda were assessed for ART eligibility. A counsellor explained the ART eligibility criteria, adherence and side effects, and recorded the patients' worries related to ART. Every quarter, patients who initiated ART had clinical, immunological (CD4 cell counts) and virological (viral loads) assessments, and data were collected on ART adherence using patients' self-reports and pill counts. We describe the patients' worries and examine their association with ART adherence, and immunological and virological outcomes.
resultsWe assessed 421 patients, 271 (64%) were females, 318 (76%) were aged 30 years and above and 315 (75%) were eligible for ART. 277 (66%) reported any worry, and the proportions were similar by sex, age group and ART eligibility status. The baseline median CD4 counts and viral loads were similar among patients with any worry and those with no worry. The commonest worries were: fear of HIV serostatus disclosure; among 69 (16%) participants, lack of food when appetite improved after starting ART; 50 (12%), concurrent use of other medications; 33 (8%), adherence to ART; 28 (7%) and problems concerning condom use; 27 (6%). After 24 months or more on ART, patients who reported any worry had made more scheduled ART refill visits than patients who reported no worry (p<0.01), but the annual CD4 cell increases were similar (p=0.12). After one year on ART, patients who reported any worry had greater virological suppression than patients who reported no worry (p<0.05).
conclusionsDespite the lack of significant associations of worries with unfavourable ART outcomes, physicians and counsellors should assist patients in overcoming their worries that can cause stress and discomfort. Food supplements may be desirable for some patients initiating ART.
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