Including the Household

Individual, Community and Household Factors Affecting Antiretroviral Therapy Adherence After ART Initiation in Cape Town, South Africa

Datos Bibliográficos

ID15334952
AutoresLinda Campbell (0000-0002-8872-9626, autor de correspondencia), Linda S Campbell (0000-0003-3391-4370, University of Antwerp, autor de correspondencia), Lucia Knight (0000-0001-9938-6887, University of Cape Town), Caroline Masquillier (0000-0003-1748-5967, University of Antwerp), Edwin Wouters (0000-0003-2268-3829, University of Antwerp)
Año2024
Volumen28
Número11
Páginas3733-3747
Fecha de publicación2024-08-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaAIDS and Behavior (JOURNAL)
Identificadores de la revistaISSN: 1090-7165 • E-ISSN: 1573-3254
EditorialSpringer Science+Business Media (PUBLISHER • DE)
DOI10.1007/s10461-024-04447-3
PMID39090458
OpenAlexW4401208318
IdiomaEN
Citas recibidas4
Referencias citadas82

Antiretroviral therapy (ART) adherence is crucial for health outcomes of people living with HIV (PLHIV), influenced by a complex interplay of individual, community, and household factors. This article focuses on the influence of household factors, as well as individual and community factors, on ART adherence among PLHIV in Cape Town who have recently initiated ART. Baseline data for a cluster-randomized controlled trial were collected from 316 PLHIV in 12 districts in Cape Town between 6th May 2021 and 22nd May 2022. Zero-inflated Poisson models, with cluster-adjusted standard errors, were used to analyse the association between individual, household, and community factors and ART adherence measures. At the household-level, household support was associated with both better self-rated adherence (exp(β) = 0.81, z = - 4.68, p < 0.001) and fewer days when pills were missed (exp(β) = 0.65, z = - 2.92, p = 0.003). Psychological violence (exp(β) = 1.37, z = 1.97, p = 0.05) and higher household asset scores (exp(β) = 1.29, z = - 2.83, p = 0.05) were weakly associated with poorer ART adherence. At the individual-level, male gender (exp(β) = 1.37, z = 3.95, p < 0.001) and reinitiating ART (exp(β) = 1.35, z = 3.64, p < 0.001) were associated with worse self-rated ART adherence; higher education levels (exp(β) = 0.30 times, z = - 3.75, p < 0.001) and better HIV knowledge (exp(β) = 0.28, z = - 2.83, p = 0.005) were associated with fewer days where pills were missed. At the community-level, community stigma was associated with worse self-rated ART adherence (exp(β) = 1.24, z = 3.01, p = 0.003). When designing interventions to improve ART adherence, household, individual and community factors should all be considered, particularly in addressing gender-based disparities, reducing stigma, tackling violence, and enhancing household support.Clinical Trial Number: Pan African Clinical Trial Registry, PACTR201906476052236. Registered on 24 June 2019

Antiretroviral therapy · Cape · Cluster (spacecraft · Community health · Environmental health · Family medicine · Geography · Human immunodeficiency virus (HIV · Pill · Poisson regression · Population · Public health · Sociology · Viral load · Adolescent Sexual and Reproductive Health · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Gerontology