High prevalence of undisclosed antiretroviral drug use among individuals initiating HIV treatment in Gaborone, Botswana

Bibliographic Data

ID22088751
AuthorsNatasha O Moraka (0000-0001-5333-4010, University of Botswana), Sikhulile Moyo (0000-0003-3821-4592, Harvard University), Terence Mohammed (Botswana Harvard AIDS Institute Partnership), Kesaobaka Molebatsi (0000-0002-9293-4470, Botswana Harvard AIDS Institute Partnership), Lubbe Wiesner (0000-0002-9070-8699, University of Cape Town), Patrick T Mokgethi, Patrick Mokgethi (Botswana Harvard AIDS Institute Partnership), Irene Gobe (0000-0003-3679-6509, University of Botswana), Margaret Mokomane (0000-0002-4406-3594, University of Botswana), Salang T Moutswi (Botswana Harvard AIDS Institute Partnership), Laone Rabatoko (Botswana Harvard AIDS Institute Partnership), Queen Leteemane (Botswana Harvard AIDS Institute Partnership), Vanessa Strachan-Amaro (Botswana Harvard AIDS Institute Partnership), Phenyo Sabone (Botswana Harvard AIDS Institute Partnership), Simani Gaseitsiwe (0000-0002-7089-3735, Harvard University, corresponding author)
Year2025
Volume13
Pages1582940-1582940
Publication date2025-06-05
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1582940
PMID40538686
OpenAlexW4411075617
LanguageEN
References cited9

Background: Antiretroviral therapy (ART) uptake is critical for evaluating the effectiveness of HIV epidemic control. We evaluated the extent of undisclosed ARV drug use among individuals newly diagnosed and initiating ART in greater Gaborone, Botswana. Methodology: Plasma samples from an ongoing longitudinal cohort study were screened for antiretroviral drug (ARV) traces using the liquid chromatography with tandem mass spectrometry assay. The ARV drug screening panel used detects 4 ARV drugs: Integrase Strand Transfer Inhibitor [INSTI]-dolutegravir (DTG), two non-nucleoside reverse transcriptase inhibitors [NNRTIs]-Efavirenz (EFV), Nevirapine (NVP), and a protease inhibitor [PI]-Lopinavir. We estimated adjusted prevalence ratios (aPR) for factors associated with undisclosed ART use using modified Poisson regression. Results: We enrolled 192 participants, between October 2023 and January 2024, and a total of 120 (63.4%) were screened for plasma ARV drug traces. Participants were of median age 32 (IQR 26, 39), mostly female (66.7%) and of Botswana nationality (75.0%). Among those screened for ARV drug traces 36 (30.0%; 95%CI: 30-39) participants had at least one of the ARVs in the panel detected. One participant (0.8%) was positive for EFV, and 35 (29%) had DTG traces at baseline. Undisclosed ART use was associated with lower viral load (aPR = 0.84; 95%CI: 0.70-1.00) and being of non-Motswana nationality (aPR = 2.6; 95%CI: 1.5-4.5). Conclusion: We report a relatively high proportion of individuals with undisclosed drug use in their baseline plasma. Our results suggest the need to implement pre-drug screening for routine HIV incidence surveillance, including pre-treatment drug resistance evaluations before ART initiation

Antiretroviral therapy · Atazanavir · Dolutegravir · Drug · Efavirenz · Integrase inhibitor · Lopinavir · Nevirapine · Viral load · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Medicine · Pharmaceutical Quality and Counterfeiting · Internal Medicine · Pharmacology · Virology

Tools

Open DOIOpen Access