ArticleBMJ open2019
Uptake of routine viral load testing among people living with HIV and its implementation challenges in Yangon region of Myanmar: a mixed-methods study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Viral load monitoring for people living with HIV in the era of test and treat: progress made and challenges ahead - a systematic review.BMC public health · 2022Pooled it
- Examining and classifying reasons for missing viral loads among adults living with HIV: An extended outcome investigation and ascertainment approach in Western Kenya.PLOS global public health · 2025Article
- Healthcare practitioners' experiences in managing HIV among young people in Namibia.Curationis · 2024Article
- Compliance to Viral Load Monitoring Schedules Among Women Attending Prevention of Vertical HIV Transmission Services Before and During the COVID-19 Pandemic in Ehlanzeni District, Mpumalanga, South Africa.AIDS and behavior · 2024Article
- Can social support mediate stigma and perceived stress in people live with human immunodeficiency virus?AIDS care · 2024Article
- Patient reported experience measures on HIV viral load testing at public health facilities in Dar es Salaam, Tanzania: A convergent mixed method study.PLOS global public health · 2023Article
- Near point-of-care HIV viral load testing: Cascade after high viral load in suburban Yangon, Myanmar.PloS one · 2023Article
- Psychometric Evaluation of a Myanmar Version of the Perceived Stress Scale for People Living with HIV/AIDS.Journal of nursing measurement · 2022Article
- Adherence to viral load testing guidelines, barriers, and associated factors among persons living with HIV on ART in Southwestern Uganda: a mixed-methods study.BMC public health · 2022Article
- Article
- Improving Quality of Service Among Antiretroviral Therapy Users Through Strategic Problem-Solving Approach at Bure Primary Hospital, Northwest Ethiopia.Patient preference and adherence · 2021Article
- Non-uptake of viral load testing among people receiving HIV treatment in Gomba district, rural Uganda.BMC infectious diseases · 2020Article
- An expanded HIV care cascade: ART uptake, viral load suppression and comorbidity monitoring among adults living with HIV in Asia.Antiviral therapy · 2020Article
- The Mediating Effects of Mindfulness on Perceived Stress From HIV Stigma in People Living With HIV in Myanmar: A Cross-sectional Study.The Journal of the Association of Nurses in AIDS Care : JANACArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIn 2017, Myanmar implemented routine viral load (VL) monitoring for assessing the response to antiretroviral therapy (ART) among people living with HIV (PLHIV). The performance of routine VL testing and implementation challenges has not yet assessed. We aimed to determine the uptake of VL testing and factors associated with it among PLHIV initiated on ART during 2017 in ART clinics of Yangon region and to explore the implementation challenges as perceived by the healthcare providers.
designAn explanatory mixed-methods study was conducted. The quantitative component was a cohort study, and the qualitative part was a descriptive study with in-depth interviews.
settingSix ART clinics operated by AIDS/sexually transmitted infection teams under the National AIDS Programme. PRIMARY OUTCOME MEASURES: (1) The proportion who underwent VL testing by 30 March 2019 and the proportion with virological suppression (plasma VL <1000 copies/mL); (2) association between patient characteristics and 'not tested' was assessed using log binomial regression and (3) qualitative codes on implementation challenges.
resultsOf the 567 PLHIV started on ART, 498 (87.8%) retained in care for more than 6 months and were eligible for VL testing. 288 (57.8%, 95% CI: 53.3% to 62.2%) PLHIV underwent VL testing, of which 263 (91.3%, 95% CI: 87.1% to 94.4%) had virological suppression. PLHIV with WHO clinical stage 4 had significantly higher rates of 'not being tested' for VL. Collection of sample for VL testing only twice a month, difficulties in sample collection and transportation, limited trained workforce, wage loss and out-of-pocket expenditure for patients due to added visits were major implementation challenges.
conclusionsThe VL test uptake was low, with only six out of ten PLHIV tested. The VL testing uptake needs to be improved by strengthening sample collection and transportation, adopting point-of-care VL tests, increasing trained workforce, providing compensation to patients for wage loss and travel costs for additional visits.
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