ArticleJournal of the International AIDS Society2017
Virological outcomes of antiretroviral therapy in Zomba central prison, Malawi; a cross-sectional study.
Article in Journal of the International AIDS Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review and meta-analyses on initiation, adherence and outcomes of antiretroviral therapy in incarcerated people.PloS one · 2020Pooled it
- Imprisonment for South Ethiopian people living with HIV presents a double health burden: lived experiences of prisoners.BMC health services research · 2024Article
- Experiences of Justice-Involved People Transitioning to HIV Care in the Community After Prison Release in Lusaka, Zambia: A Qualitative Study.Global health, science and practice · 2023Article
- Factors affecting optimal adherence to antiretroviral therapy and viral suppression amongst HIV-infected prisoners in South Ethiopia: a comparative cross-sectional study.AIDS research and therapy · 2022Article
- Costs of implementing universal test and treat in three correctional facilities in South Africa and Zambia.PloS one · 2022Article
- Prisoners' access to HIV services in southern Malawi: a cross-sectional mixed methods study.BMC public health · 2021Article
- Adherence to antiretroviral therapy among HIV infected pregnant women in public health sectors: a pilot of Chilenje level one Hospital Lusaka, Zambia.The Pan African medical journal · 2020Article
- Prisons: ignore them at our peril.Current opinion in HIV and AIDS · 2019Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
introductionAntiretroviral therapy (ART) outcomes that include viral suppression rates are rarely reported among African prison populations. Prisoners deal with specific challenges concerning adherence to ART. We aimed to describe virological outcomes of ART in a large prison in Malawi.
methodsA cross-sectional study of ART outcomes was conducted at the Zomba Central Prison HIV clinic, Malawi, following the introduction of routine viral load monitoring. All prisoners on ART for at least 6 months were eligible for a viral load test. Patients with ≥1,000 copies/ml received adherence support for 3 months, after which a second VL sample was taken. Patients with ≥5,000 copies/ml on the second sample had virological failure and started 2nd line ART. We describe demographics and patient characteristics and report prevalence of potential- and documented virological failure. In the potential virological failure rate, those who could not be sampled after 3 months adherence support are included as virological failures. Logistic regression analysis was used to determine factors associated with potential ART failure. RESULTS AND DISCUSSION: Viral load testing was started at the end of 2014, when 1054 patients had ever registered on ART. Of those, 501 (47.5%) had transferred out to another clinic, 96 (9.1%) had died, 11 defaulted (1.0%) and 3 (0.3%) stopped ART. Of 443 (42.0%) remaining alive in care, an estimated 322 prisoners were on ART >6 months, of whom 262 (81.4%) were sampled. Their median age was 35 years (IQR 31-40) and 257 (98.1%) were male. Self-reported adherence was good in 258 (98.5%). The rate of potential ART failure was 8.0%, documented ART failure was 4.6% and documented HIV suppression 95.0%. No patient characteristics were independently associated with potential ART failure, possibly due to low numbers with this outcome.
conclusionsGood virological suppression rates can be achieved among Malawian prisoners on ART, under challenging circumstances.
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