Evidence map›Paper›PMID 38190403›Full record

ArticlePLOS global public health2024

Association between water insecurity and antiretroviral therapy adherence among pregnant and postpartum women in Greater Accra region of Ghana.

Jerry John Nutor, Jaffer Okiring, Isaac Yeboah, Rachel G A Thompson, Pascal Agbadi, Edward Kwabena Ameyaw, Monica Getahun, Wisdom Agbadi, Thomas J Hoffmann, Sheri D Weiser

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

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 20% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

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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

10 authors at 4 institutions in 3 countries.

Jerry John NutorDepartment of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, United States of America.ORCID https://orcid.org/0000-0002-7562-6281
Jaffer OkiringInfectious Diseases Research Collaboration, Kampala, Uganda.
Isaac YeboahInstitute of Work Employment and Society, University of Professional Studies, Accra, Ghana.
Rachel G A ThompsonLanguage Center, College of Humanities, University of Ghana, Accra, Ghana.
Pascal AgbadiDepartment of Sociology and Social Science Policy, Lingnan University, Hong Kong, China.
Edward Kwabena AmeyawInstitute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong, China.ORCID https://orcid.org/0000-0002-6617-237X
Monica GetahunInstitute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America.
Wisdom AgbadiAfrica Interdisciplinary Research Institute, Accra, Ghana.
Thomas J HoffmannDepartment of Epidemiology and Biostatistics, and Office of Research, School of Nursing, University of California, San Francisco, San Francisco, California, United States of America.
Sheri D WeiserDivision of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco California, United States of America.
University of California, San Francisco · USInfectious Diseases Research Collaboration · UGUniversity of Ghana · GHUniversity of Professional Studies · GH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdherence to antiretroviral therapy (ART) can substantially reduce morbidity and mortality among women living with HIV (WLWH) and prevent vertical transmission of HIV. However, in sub-Saharan Africa (SSA), more than 50% of new mothers discontinue ART and HIV care after childbirth. The role of water insecurity (WI) in ART adherence is not well-explored. We examined the relationship between WI and ART adherence among pregnant and postpartum WLWH in Greater Accra region of Ghana.

methodsUsing a cross-sectional survey, we recruited 176 pregnant and postpartum WLWH on ART across 11 health facilities. We examined the association between WI (measured using the Household Water Insecurity Experience Scale, and categorized as moderate and severe WI compard to low WI) and poor ART adherence (defined as scoring a below average observed CASE index score). Bivariate analysis was performed using chi-square test followed by multivariate logistic regression models. We included all variables with p-values less than 0.20 in the multivariate analysis.

resultsMost (79.5%) of the pregnant and postpartum WLWH enrolled on ART, were urban residents. Over 2/3 were aged 30 years and older. Overall, 33.5% of respondents had poor ART adherence. Proportion of poor ART adherence was 19.4% among those with low WI, 44.4% in those with moderate WI, and 40.0% among those with high WI. Respondents with moderate household water insecurity had a greater odds of reporting poor ART adherence, as compared to those with low water insecurity (adjusted Odds ratio (aOR) = 2.76, 95%CI: 1.14-6.66, p = 0.024), even after adjusting for food insecurity. Similarly, respondents with high WI had a greater odds of reporting poor ART adherence, as compared to those with low water insecurity (aOR = 1.49, 95%CI: 0.50-4.48, p = 0.479), even after adjusting for food insecurity.

conclusionWater insecurity is prevalent among pregnant and postpartum WLWH and is a significant risk factor for poor ART adherence. Governments and other stakeholders working in HIV care provision should prioritize water security programming for WLWH along the HIV care continuum.

Identifiers

PMID38190403
PMCPMC10773961
OpenAlexW4390660631

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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.