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Title

Revisiting long-term adherence to HAART in Senegal using latent class analysis

Authors

Bastard M, Koita Fall MB, Lanièce I

Network Affiliation

Other

Organization

 

Journal Name

JAIDS

Publication Date

2/4/2011

PubMed Search

http://www.ncbi.nlm.nih.gov/pubmed?term=Revisiting%20Long-Term%20Adherence%20to%20Highly%20Active%20Antiretroviral%20Therapy%20in%20Senegal%20Using%20Latent%20Class%20Analysis

Link to full-text

 

PMID

21297478

Abstract

BACKGROUND: Adherence is one of the main predictors of antiretroviral treatment success. A governmental initiative was launched in 1998 for HIV-infected patients in Senegal to provide access to highly active antiretroviral therapy (HAART).
METHODS: Between August 1998 and April 2002, 404 adult patients were enrolled. Adherence measurements, defined as pills taken/pills prescribed, were assessed between November 1999 and April 2009 using a pill count along with a questionnaire for 330 patients. Predictors of adherence were explored through a random-intercept Tobit model and a latent class analysis (LCA) was performed to identify adherence trajectories. We also carried out a survival analysis taking into account gender and latent adherence classes.
RESULTS: Median treatment duration was 91 months [IQR 84-101]. On average, adherence declined by 7% every year, was 30% lower for patients taking indinavir and 12% higher for those receiving cotrimoxazole prophylaxis. Based on the predicted probability of having an adherence ≥ 95%, LCA revealed three adherence behaviours and a better adherence for women. A quarter of patients had a high adherence trajectory over time and half had an intermediate one. Male gender and low adherence behaviour over time were independently associated with a higher mortality rate.
CONCLUSIONS: This study shows that an overall good adherence can be obtained in the long-term in Senegal. LCA suggests a better adherence for women and points out a large sub-sample of patients with intermediate level of adherence behaviour at risk for developing resistance to antiretroviral drugs. This study warrants further research into gender issues.

Keywords

 

Topic

Adherence

Attachments

Created at 4/14/2011 3:49 PM by Mooney, Jessica L
Last modified at 4/14/2011 3:49 PM by Mooney, Jessica L