Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.

Autor: Gabster A; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama.; National Research System, National Secretariat of Science, Technology and Innovation, Panama City, Panama.; Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States of America.; Instituto de Investigaciones Científicas y Servicios de Alta Tecnología AIP, Panama City, Panama., Díaz Fernández F; Hospital Santo Tomás, Panama City, Panama., Pascale JM; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama.; Universidad de Panamá, Facultad de Medicina, Campus Universitario, Panama City, Panama., Orillac A; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama., Moreno-Wynter S; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama., Xavier Hall CD; Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States of America.; Instituto de Investigaciones Científicas y Servicios de Alta Tecnología AIP, Panama City, Panama.; College of Social Work, Florida State University, Tallahassee, FL, United States of America., Flores Millender E; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama.; Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States of America.; Instituto de Investigaciones Científicas y Servicios de Alta Tecnología AIP, Panama City, Panama.; Florida State University-Republic of Panama campus, Panama City, Panama., Wong FF; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama.; Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States of America.; Instituto de Investigaciones Científicas y Servicios de Alta Tecnología AIP, Panama City, Panama.; Florida State University-Republic of Panama campus, Panama City, Panama., Jhangimal M; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama., Yu-Pon A; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama., Rodríguez-Vargas C; Hospital Santo Tomás, Panama City, Panama., Arjona-Miranda D; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama., Fuentes B; Universidad Interamericana de Panama, Facultad de Medicina, Panama City, Panama., Henostroza G; Division of Infectious Diseases, University of Alabama Birmingham, Birmingham, AL, United States of America., Araúz AB; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama.; National Research System, National Secretariat of Science, Technology and Innovation, Panama City, Panama.; Hospital Santo Tomás, Panama City, Panama.; Universidad de Panamá, Facultad de Medicina, Campus Universitario, Panama City, Panama.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Nov 27; Vol. 19 (11), pp. e0311048. Date of Electronic Publication: 2024 Nov 27 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0311048
Abstrakt: Background: The prevalence of HIV in Panama is estimated to be 1.0%; only 71% of individuals on antiretroviral treatment (ART) were virally suppressed in 2022. This study aimed to describe the prevalence of suboptimal adherence (≥1 missed doses in previous four weeks) and limited retention in HIV care (≥1 missed HIV care appointments in previous 12 months) among adults (aged ≥18 years) who attended the most populous urban ART Clinic in Panama City.
Methods: In this cross-sectional study, participants completed a self-administered questionnaire. Univariable and bivariable analyses were used to describe the prevalence of suboptimal adherence and limited retention in HIV care. Multivariable logistic regression identified factors associated with suboptimal adherence at p<0.05.
Results: We included 375 participants (209 identified as men, 158 as women, 8 another gender). Of those who responded, 37.3% (n = 125/335) reported suboptimal adherence: 28.6% (n = 53/185) of men, 49.0% (n = 71/145) women, 20.0% (n = 1/5) another gender; p<0.01; 18.6% (n = 69/371) reported limited retention in care:13.6% (n = 28/206) men, 24.2% (n = 38/157) women, 37.5% (n = 3/8) another gender, p = 0.01. In multivariable analyses, suboptimal adherence was associated with gender (49.0%women vs. 28.6% men, AOR = 1.86, 95%CI:0.97-3.57), depressive symptoms:46.2% severe symptoms vs. 28.1% minimal-mild, AOR = 2.19,95%CI:0.96-5.04), and lifetime intimate partner emotional violence (IPV) 48.2% vs.no emotional IPV 32.2%, OR = 1.96,95%CI:1.15-2.90, and lifetime physical IPV 46.9% vs.no physical IPV 32.6%, OR = 1.82, 95%CI:1.15-2.90. In unadjusted analyses, limited retention in care was associated with gender (24.2%women vs.13.6% men OR = 2.03, 95%CI:1.18-3.49), difficulty paying rent/mortgage/utilities (22.6% vs.14.9% no difficulty paying, OR = 1.67,95%CI = 0.98-2.83); no variables were associated in the multivariable model.
Conclusions: This study found high prevalence of suboptimal ART adherence and limited retention in care, especially among women; these factors were associated with severe depressive symptoms, as well as lifetime emotional and physical IPV. These results show the need for integrated mental health and IPV intervention for all individuals, including focused support for women.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Gabster et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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