Evidence map›Paper›PMID 25686684›Full record

ArticleAIDS (London, England)2015

Incomplete adherence among treatment-experienced adults on antiretroviral therapy in Tanzania, Uganda and Zambia.

Julie A Denison, Olivier Koole, Sharon Tsui, Joris Menten, Kwasi Torpey, Eric van Praag, Ya Diul Mukadi, Robert Colebunders, Andrew F Auld, Simon Agolory and 5 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 3 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 87 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 6 countries.

Julie A DenisonaFHI 360, Social and Behavioral Health Sciences, Durham, North Carolina, USA bJohns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, Maryland, USA cInstitute of Tropical Medicine, Antwerp, Belgium dLondon School of Hygiene and Tropical Medicine, London, UK eUniversity of Antwerp, Antwerp, Belgium fCenters for Disease Control and Prevention, Atlanta, Georgia, USA gTropical Diseases Research Centre, Ndola, Zambia hMuhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania iThe Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda jMassachusetts General Hospital, Boston, Massachusetts, USA.
Olivier Koole
Sharon Tsui
Joris Menten
Kwasi Torpey
Eric van Praag
Ya Diul Mukadi
Robert Colebunders
Andrew F Auld
Simon Agolory
Jonathan E Kaplan
Modest Mulenga
Gideon P Kwesigabo
Fred Wabwire-Mangen
David R Bangsberg
Family Health International 360 · USCenters for Disease Control and Prevention · USInstituut voor Tropische Geneeskunde · BEHarvard University Press · USInfectious Diseases Institute · UGMakerere University · UGMuhimbili University of Health and Allied Sciences · TZTropical Diseases Research Centre · ZMUniversity of Antwerp · BE

Funding

Task-Shifting of Antiretroviral Therapy Services in Tanzania, Uganda, and ZambiaF31MH095665 · NIMH · JOHNS HOPKINS UNIVERSITY · PI TSUI, SHARON · 2011 to 2015
$210k
Intramural CDC HHS CC999999NIMH NIH HHS F31 MH095665
6 · The paper itself

Abstract

objectivesTo characterize antiretroviral therapy (ART) adherence across different programmes and examine the relationship between individual and programme characteristics and incomplete adherence among ART clients in sub-Saharan Africa.

designA cross-sectional study.

methodsSystematically selected ART clients (≥18 years; on ART ≥6 months) attending 18 facilities in three countries (250 clients/facility) were interviewed. Client self-reports (3-day, 30-day, Case Index ≥48 consecutive hours of missed ART), healthcare provider estimates and the pharmacy medication possession ratio (MPR) were used to estimate ART adherence. Participants from two facilities per country underwent HIV RNA testing. Optimal adherence measures were selected on the basis of degree of association with concurrent HIV RNA dichotomized at less than or greater/equal to 1000 copies/ml. Multivariate regression analysis, adjusted for site-level clustering, assessed associations between incomplete adherence and individual and programme factors.

resultsA total of 4489 participants were included, of whom 1498 underwent HIV RNA testing. Nonadherence ranged from 3.2% missing at least 48 consecutive hours to 40.1% having an MPR of less than 90%. The percentage with HIV RNA at least 1000 copies/ml ranged from 7.2 to 17.2% across study sites (mean = 9.9%). Having at least 48 consecutive hours of missed ART was the adherence measure most strongly related to virologic failure. Factors significantly related to incomplete adherence included visiting a traditional healer, screening positive for alcohol abuse, experiencing more HIV symptoms, having an ART regimen without nevirapine and greater levels of internalized stigma.

conclusionResults support more in-depth investigations of the role of traditional healers, and the development of interventions to address alcohol abuse and internalized stigma among treatment-experienced adult ART patients.

Indexed as

Medication AdherenceAdolescentAdultAlcoholismAnti-Retroviral AgentsCross-Sectional StudiesFemaleHIV InfectionsHumansMaleMedicine, TraditionalMiddle AgedRNA, ViralSocial StigmaTanzaniaUgandaAnti-Retroviral AgentsRNA, Viral

Identifiers

PMID25686684
PMCPMC4728173
OpenAlexW2040780706

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.