Evidence map›Paper›PMID 34407133›Full record

ArticlePloS one2021

Food insecurity, drug resistance and non-disclosure are associated with virologic non-suppression among HIV pregnant women on antiretroviral treatment.

Bhavna H Chohan, Keshet Ronen, Brian Khasimwa, Daniel Matemo, Lusi Osborn, Jennifer A Unger, Alison L Drake, Ingrid A Beck, Lisa M Frenkel, John Kinuthia and 1 more

Open access · goldAbstract read
In one paragraph

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 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 25% 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

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. 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

11 authors at 3 institutions in 2 countries.

Bhavna H ChohanDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID 0000-0002-2125-6799
Keshet RonenDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Brian KhasimwaDepartment of Pediatrics, University of Nairobi, Nairobi, Kenya.
Daniel MatemoDepartment of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya.
Lusi OsbornDepartment of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya.
Jennifer A UngerDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Alison L DrakeDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID 0000-0002-4178-7706
Ingrid A BeckCenter for Infectious Diseases Research, Seattle Children's Research Institute, Seattle, Washington, United States of America.
Lisa M FrenkelDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID 0000-0001-9566-8959
John KinuthiaDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Grace John-StewartDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
University of Washington · USKenyatta National Hospital · KEUniversity of Nairobi · KE

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
WOMEN'S REPRODUCTIVE HEALTH RESEARCH CAREER DEVELOPMENTK12HD001264 · NICHD · UNIVERSITY OF WASHINGTON · PI Barbara Ann Goff · 1998 to 2026
$8.6M
Evaluation of mHealth strategies to optimize adherence and efficacy of PMTCT/ARTR01HD080460 · NICHD · UNIVERSITY OF WASHINGTON · PI JOHN-STEWART, GRACE C. · 2014 to 2018
$3.5M
Pediatric HIV-1 in Africa: Pathogenesis and ManagementK24HD054314 · NICHD · UNIVERSITY OF WASHINGTON · PI JOHN-STEWART, GRACE C. · 2006 to 2016
$1.2M
Optimizing repeat HIV testing during pregnancy and postpartum for PMTCTK01AI116298 · NIAID · UNIVERSITY OF WASHINGTON · PI DRAKE, ALISON L · 2015 to 2019
$632k
Leveraging interactive SMS messaging to monitor and support maternal mental health in KenyaK18MH122978 · NIMH · UNIVERSITY OF WASHINGTON · PI RONEN, KESHET · 2020 to 2021
$256k
NIAID NIH HHS K01 AI116298NIAID NIH HHS P30 AI027757NICHD NIH HHS K12 HD001264NICHD NIH HHS K24 HD054314NICHD NIH HHS R01 HD080460NIMH NIH HHS K18 MH122978
6 · The paper itself

Abstract

We determined social and behavioral factors associated with virologic non-suppression among pregnant women receiving Option B+ antiretroviral treatment (ART). Baseline data was used from women in Mobile WAChX trial from 6 public maternal child health (MCH) clinics in Kenya. Virologic non-suppression was defined as HIV viral load (VL) ≥1000 copies/ml. Antiretroviral resistance testing was performed using oligonucleotide ligation (OLA) assay. ART adherence information, motivation and behavioral skills were assessed using Lifewindows IMB tool, depression using PHQ-9, and food insecurity with the Household Food Insecurity Access Scale. Correlates of virologic non-suppression were assessed using Poisson regression. Among 470 pregnant women on ART ≥4 months, 57 (12.1%) had virologic non-suppression, of whom 65% had HIV drug resistance mutations. In univariate analyses, risk of virologic non-suppression was associated with moderate-to-severe food insecurity (RR 1.80 [95% CI 1.06-3.05]), and varied significantly by clinic site (range 2%-22%, p <0.001). In contrast, disclosure (RR 0.36 [95% CI 0.17-0.78]) and having higher adherence skills (RR 0.70 [95% CI 0.58-0.85]) were associated with lower risk of virologic non-suppression. In multivariate analysis adjusting for clinic site, disclosure, depression symptoms, adherence behavior skills and food insecurity, disclosure and food insecurity remained associated with virologic non-suppression. Age, side-effects, social support, physical or emotional abuse, and distance were not associated with virologic non-suppression. Prevalence of virologic non-suppression among pregnant women on ART was appreciable and associated with food insecurity, disclosure and frequent drug resistance. HIV VL and resistance monitoring, and tailored counseling addressing food security and disclosure, may improve virologic suppression in pregnancy.

Indexed as

Food InsecurityAdultAge FactorsAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveConfidentialityDrug MonitoringDrug Resistance, ViralFemaleHIV-1HIV InfectionsHumansKenyaMedication AdherencePregnancyRNA, ViralAnti-HIV AgentsRNA, Viral

Identifiers

PMID34407133
PMCPMC8372899
OpenAlexW3195173750

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.