Assessing eligibility for differentiated service delivery, HIV services utilization and virologic outcomes of adult HIV-infected patients in Sierra Leone
A pre-implementation analysis
Dados Bibliográficos
| ID | 19529741 |
|---|---|
| Autores | Sulaiman Lakoh (0000-0002-7639-0004, University of Sierra Leone), Darlinda F Jiba (0000-0002-1595-4742, Ministry of Health and Sanitation), Alren O Vandy (0000-0003-3004-2052, Ministry of Health and Sanitation), Eva Poveda (0000-0003-4835-9875, Galicia Sur Biomedical Foundation), Olukemi Adekanmbi (0000-0002-0290-9563, University College Hospital), Mariama J S Murray (Ministry of Health and Sanitation), Gibrilla F Deen (0000-0001-6567-4821, University of Sierra Leone), Foday Sahr (0000-0001-9816-4502, University of Sierra Leone), Christopher J Hoffmann (0000-0002-9422-0519, Johns Hopkins University), Jeffrey M Jacobson (0000-0001-7250-1208, University Hospitals of Cleveland), Robert A Salata (0000-0001-8464-0918, University Hospitals of Cleveland), George A Yendewa (0000-0002-8474-1812, Johns Hopkins University, autor correspondente) |
| Ano | 2021 |
| Volume | 14 |
| Fascículo | 1 |
| Páginas | 1947566-1947566 |
| Data de publicação | 2021-01-01 |
| Peer Reviewed | Sim |
| Open Access | Sim |
| Tipo | ARTICLE |
| Periódico | Global Health Action (JOURNAL) |
| Identificadores do periódico | ISSN: 1654-9716 • E-ISSN: 1654-9880 |
| Editora | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/16549716.2021.1947566 |
| PMID | 34404330 |
| OpenAlex | W3193861828 |
| Idioma | EN |
| Referências citadas | 16 |
Background There are limited data to help guide implementation of differentiated HIV service delivery (DSD) in resource-limited settings in sub-Saharan Africa.Objectives This pre-implementation study sought to assess the proportion of patients eligible for DSD and HIV services utilization, as well as risk factor analysis of virologic failure in Sierra Leone.Methods We conducted a retrospective study of adult HIV-infected patients aged 18 years and older receiving care at the largest HIV treatment center in Sierra Leone 2019–2020. Multiple logistic regression was used to identify predictors of virologic failure.Results Of 586 unique patients reviewed, 210 (35.8%) qualified as ‘stable’ for antiretroviral therapy (ART) delivery. There was high utilization of certain HIV service programs (e.g. HIV status disclosure to partners (83%) and treatment ‘buddy’ program participation (62.8%)), while other service programs (e.g. partner testing and community HIV support group participation) had low utilization (<50%). Of 429 patients with available viral load, 277 (64.6%) were virologically suppressed. In the multivariate logistic regression analysis of risk factors of virologic failure, CD4 < 350 cells/mm3 (p = 0.009), atazanavir-based ART (p = 0.032), once monthly versus once two- or three-monthly ART dispensing (p = 0.028), history of ART switching (p = 0.02), poor adherence (p = 0.001) and not having received adherence support (p < 0.001) were independent predictors of virologic failure.Conclusion Approximately one in three HIV-infected patients on ART were eligible for DSD. We identified gaps in HIV care (i.e. low partner testing, treatment ‘buddy’, program participation and a substantially high rate of virologic failure) that need to be addressed in preparation for full implementation of DSD in Sierra Leone
Business · Expanded access · Family medicine · Logistic regression · Multivariate analysis · Retrospective cohort study · Service delivery framework · Sierra leone · Viral load · Adolescent Sexual and Reproductive Health · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Medicine · Internal Medicine
| Velocidade de citação | historical |
|---|---|
| Altamente citado | Não |