Evidence map›Paper›PMID 34265155›Full record

ArticleTropical medicine & international health : TM & IH2021

HIV care and treatment models and their association with medication possession ratio among treatment-experienced adults in three African countries.

Sharon Tsui, Caitlin E Kennedy, Lawrence H Moulton, Larry W Chang, Jason E Farley, Kwasi Torpey, Eric van Praag, Olivier Koole, Nathan Ford, Fred Wabwire-Mangen and 1 more

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

Article in Tropical medicine & international health : TM & IH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 59% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

11 authors at 7 institutions in 8 countries.

Sharon TsuiDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Caitlin E KennedyDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Lawrence H MoultonDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Larry W ChangDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Jason E FarleyDepartment of Medicine - Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kwasi TorpeySchool of Public Health, University of Ghana College of Health Sciences, Accra, Ghana.
Eric van PraagFHI 360, Dar es Salaam, Tanzania.
Olivier KooleClinical Sciences Department, Institute of Tropical Medicine, Antwerp, Belgium.
Nathan FordDepartment HIV, World Health Organization, Geneva, Switzerland.
Fred Wabwire-MangenDepartment of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda.
Julie A DenisonDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Johns Hopkins University · USArdhi University · TZAssociation of Nurses in AIDS Care · USGhana Health Service · GHInstituut voor Tropische Geneeskunde · BEMakerere University · UGWorld Health Organization · CH

Funding

Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Richard E. Chaisson · 2012 to 2026
$67.0M
Task-Shifting of Antiretroviral Therapy Services in Tanzania, Uganda, and ZambiaF31MH095665 · NIMH · JOHNS HOPKINS UNIVERSITY · PI TSUI, SHARON · 2011 to 2015
$210k
NIAID NIH HHS P30 AI094189NIMH NIH HHS F31 MH095665World Health Organization 001
6 · The paper itself

Abstract

objectiveHow clinics structure the delivery of antiretroviral therapy (ART) services may influence patient adherence. We assessed the relationship between models of HIV care delivery and adherence as measured by medication possession ratio (MPR) among treatment-experienced adults in Tanzania, Uganda and Zambia.

methodsEighteen clinics were grouped into three models of HIV care. Model 1-Traditional and Model 2-Mixed represented task-sharing of clinical services between physicians and clinical officers, distinguished by whether nurses played a role in clinical care; in Model 3-Task-Shifted, clinical officers and nurses shared clinical responsibilities without physicians. We assessed MPR among 3,419 patients and calculated clinic-level MPR summaries. We then calculated the mean differences of percentages and adjusted residual ratio (aRR) of the association between models of care and incomplete adherence, defined as a MPR <90%, adjusting for individual-level characteristics.

resultsIn the adjusted analysis, patients in Model 1-Traditional were more likely than patients in Model 2-Mixed to have MPR <90% (aRR = 1.60, 95% CI 1-2.48). Patients in Model 1-Traditional were no more likely than patients in Model 3-Task-Shifted to have a MPR <90% (aRR = 1.58, 95% 0.88-2.85). There was no evidence of differences in MPR <90% between Model 2-Mixed and Model 3-Task-Shifted (aRR = 0.99, 95% CI 0.59-1.66).

conclusionNon-physician-led ART programmes were associated with adherence levels as good as or better than physician-led ART programmes. Additional research is needed to optimise models of care to support patients on lifelong treatment.

Indexed as

Medication AdherenceAdultAmbulatory Care FacilitiesAnti-Retroviral AgentsFemaleHIV InfectionsHumansMaleModels, TheoreticalTanzaniaUgandaZambiaAnti-Retroviral Agentsantiretroviral therapyHIV/AIDSmedication adherenceTanzaniaUgandaZambia

Identifiers

PMID34265155
PMCPMC8563398
OpenAlexW3178838093

What OpenQuestion holds

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LicenceTDM
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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.