Observational studyBMJ global health2026
Lingering sex and age disparities in dolutegravir uptake among adults with HIV: a multicountry observational cohort study.
Observational study in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Documenting HIV service delivery and adoption of evidence-based practices in HIV care programs: A protocol for a cross-sectional survey of HIV clinics participating in the International epidemiology Databases to Evaluate AIDS (IeDEA).medRxiv : the preprint server for health sciences · 2026Article
- Characterization of human immunodeficiency virus drug-resistance mutations among individuals with low-level-viremia in low-income and middle-income countries: A meta-analysis.World journal of virology · 2026Article
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15 authors.
Funding
Abstract
introductionSince July 2019, the WHO has recommended dolutegravir (DTG)-based regimens as preferred first-line antiretroviral therapy (ART) for adults and adolescents living with HIV (DTG-for-All), a reversal of a 2018 safety alert on use of DTG-based regimens by women of reproductive age (WRA). We examined sex and age disparities in DTG uptake before and after DTG-for-All in the International epidemiology Databases to Evaluate AIDS.
methodsWe included patients ≥16 years on or initiating treatment between January 2017 and July 2021 in 14 low- and middle-income countries where initial guidelines on DTG-based regimens for first-line ART either restricted use by WRA or had no such restrictions. We estimated the cumulative incidence of DTG uptake (CI-DTG) by sex and age group (aged 16-49 years vs 50+ years), stratified by patient, clinic and setting characteristics.
resultsAmong 177 706 patients on ART during the study period, 51% were females aged 16-49 years, with 25% males aged 16-49 and 13% and 11%, respectively, females and males aged 50+. At the time of DTG-for-All, overall CI-DTG was 29.6% (95% CI 29.4% to 29.8%); it was lower among females aged 16-49 (16.2%; 95% CI 16.0% to 16.5%) than males (41.1%; 95% CI 40.6% to 41.5%), with no sex disparities among patients aged 50+ (females: 46.0%; males: 47.0%). While DTG uptake subsequently increased among all groups, by July 2021, it remained substantially lower among females 16-49 (66.4%; 95% CI 66.1% to 66.7%), compared with males 16-49 and older females and males (75.8% to 77.5%). Concentrated in countries where initial guidelines on DTG restricted use by WRA, disparities in DTG uptake persisted at all health system levels and in both low-income and lower-middle-income countries.
conclusionsWhile sex-age differentials in DTG uptake narrowed after WHO's DTG-for-All recommendation, lingering disparities in uptake underscore the difficulty of policy de-implementation when new evidence emerges.
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