Evidence map›Paper›PMID 30908522›Full record

ArticlePloS one2019

Individual factors associated with time to non-adherence to ART pick-up within HIV care and treatment services in three health facilities of Zambézia Province, Mozambique.

Dércio B C Filimão, Troy D Moon, Jorge F Senise, Ricardo S Diaz, Mohsin Sidat, Adauto Castelo

Abstract read
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

6 authors.

Dércio B C FilimãoProvincial Directorate of Health, Zambézia Province, Quelimane, Mozambique.ORCID 0000-0002-8325-5767
Troy D MoonVanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Jorge F SeniseDepartment of Medicine, Federal University of São Paulo, São Paulo, Brazil.
Ricardo S DiazRetrovirology Laboratory, Federal University of São Paulo, São Paulo, Brazil.
Mohsin SidatFaculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique.
Adauto CasteloDepartment of Medicine, Federal University of São Paulo, São Paulo, Brazil.

Funding

UEM-Vanderbilt Partnership for Research in Implementation Science Mozambique (PRISM)D43TW009745 · FIC · VANDERBILT UNIVERSITY MEDICAL CENTER · PI D. Troy Moon, Mohsin Sidat · 2015 to 2026
$3.3M
FIC NIH HHS D43 TW009745PEPFAR
6 · The paper itself

Abstract

introductionMozambique has made significant gains in addressing its HIV epidemic, yet adherence to visit schedules remains a challenge. HIV programmatic gains to date could be impaired if adherence and retention to ART remains low. We investigate individual factors associated with non-adherence to ART pick-up in Mozambique.

methodsThis was a retrospective cohort of patients initiating ART between January 2013 and June 2014. Non-adherence to ART pick-up was defined as a delay in pick-up ≥ 15 days. Descriptive statistics were used to calculate socio-demographic and clinical characteristics. Adherence to ART pick-up was assessed using Kaplan Meier estimates. Cox proportional hazards model was used to determine factors associated with non-adherence.

results1,413 participants were included (77% female). Median age was 30.4 years. 19% of patients remained adherent to ART pick-up during the evaluation period, while 81% of patients were non-adherent to ART pick-up. Probability of being non-adherent to ART pick-up by 166 days following initiation was 50%. In univariate analysis, being widowed was associated with higher adherence to ART pick-up than other marital status groups (p = 0.01). After adjusting, being ≥35 years (aHR: 0.843, 95% CI: 0.738-0.964, p = 0.012); receiving efavirenz (aHR: 0.932, 95% CI: 0.875-0.992, p = 0.026); and being urban (aHR: 0.754, 95% CI: 0.661-0.861, p<0.0001) were associated with improved adherence. Non-participation in a Community ART Support Group (CASG) was associated with a 43% increased hazard of non-adherence to ART pick-up (aHR 1.431, 1.192-1.717, p<0.0001).

conclusionsInterventions should focus on the first 6 months following ARV initiation for improvements. Younger persons and widows are two target groups for better understanding facilitators and barriers to visit schedule adherence. Future strategies should explore the benefits of joining CASGs earlier in one´s treatment course. Finally, greater efforts should be made to accelerate the scale-up of viral load capacity and HIV resistance monitoring.

Indexed as

Drug MonitoringAdultAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveFemaleHealth FacilitiesHIVHIV InfectionsHumansMaleMedication AdherenceMozambiqueRetrospective StudiesViral LoadAnti-HIV Agents

Identifiers

PMID30908522
PMCPMC6433271

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LicenceCC BY
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Registered trials

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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.