ArticlePloS one2021
Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- Disparities in healthcare access and utilization among people living with HIV in China: A scoping review and meta-analysis.HIV medicine · 2023Pooled it
- Disparities in healthcare access and utilization among people living with HIV in China: a scoping review and meta-analysis.Research square · 2023Article
- Socioeconomic inequalities in the 90-90-90 target, among people living with HIV in 12 sub-Saharan African countries - Implications for achieving the 95-95-95 target - Analysis of population-based surveys.EClinicalMedicine · 2022Article
- Measuring the uptake of continuous care among people living with HIV receiving antiretroviral therapy and social determinants of the uptake of continuous care in the southwest of China: a cross-sectional study.BMC infectious diseases · 2021Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the context of scaling up free antiretroviral therapy (ART), healthcare equality is essential for people living with HIV. We aimed to assess socioeconomic-related inequalities in uptake of continuous care for people living with HIV receiving ART, including retention in care in the last six months, routine toxicity monitoring, adequate immunological and virological monitoring, and uptake of mental health assessment in the last 12 months. We also determined the contributions of socioeconomic factors to the degree of inequalities.
methodsA hospital-based cross-sectional survey was conducted among consecutive clients visiting an HIV treatment center in Kunming, China in 2019. Participants were 702 people living with HIV aged ≥18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1-5 years. Socioeconomic-related inequality and its contributing factors were assessed by a normalized concentration index (CIn) with a decomposition approach.
resultsThe uptake of mental health assessment was low (15%) but significantly higher among the rich (CIn 0.1337, 95% CI: 0.0140, 0.2534). Retention in care, toxicity, and immunological monitoring were over 80% but non-significant in favor of the rich (CIn: 0.0117, 0.0315, 0.0736, respectively). The uptake of adequate virological monitoring was 15% and higher among the poor (CIn = -0.0308). Socioeconomic status positively contributed to inequalities of all care indicators, with the highest contribution for mental health assessment (124.9%) and lowest for virological monitoring (2.7%).
conclusionsThese findings suggest virological monitoring and mental health assessment be given more attention in long-term HIV care. Policies allocating need-oriented resources geared toward improving equality of continuous care should be developed.
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