Barriers to antiretroviral therapy initiation for HIV-positive children aged 2-18 months in Swaziland
| Autor: | Pauline E. Jolly, Luz A. Padilla, Florence Naluyinda-Kitabire, Raina Brooks, Peter Preko, Inessa Ba, Sarah Perry Hope, Megha Jha, Amy Styles, Chantal Harris, Charisse Ahmed, Nobuhle Mthethwa, Makhosini Mamba |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Art initiation Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Logistic regression Health Services Accessibility Article 03 medical and health sciences 0302 clinical medicine Virology Intervention (counseling) Medicine Humans 030212 general & internal medicine Child 030505 public health business.industry Public Health Environmental and Occupational Health Case-control study HIV Infant General Medicine Priority areas Antiretroviral therapy Infectious Diseases Anti-Retroviral Agents Caregivers Case-Control Studies Child Preschool Patient Compliance Female 0305 other medical science business Healthcare providers Eswatini ART initiation clinic visits HIV HIV-positive infants healthcare providers immunisation predictors |
| Zdroj: | African Journal of AIDS Research; Vol 17, No 2 (2018) |
| ISSN: | 1727-9445 1608-5906 |
| Popis: | Although early antiretroviral therapy (ART) reduces HIV-related mortality in children by up to 75%, almost half of HIV-positive children younger than 1 year old in Swaziland do not initiate ART. This study was conducted to identify barriers to early ART initiation among HIV-positive infants. This was a case-control study among HIV-positive infants, aged 2 to 18 months, who either did not initiate ART (cases), or initiated ART (controls), during 18 months after testing. Multivariable logistic regression showed that infants who visited the clinic every month, or every 2 months, were 5.78 and 6.20 times more likely to initiate ART than those who visited less often (OR 5.78, 95% CI 1.82–18.33 and OR 6.20, 95% CI 1.30–29.60 respectively). Children who lived ≤30 and 31–60 minutes from the nearest clinic were 84% and 79% less likely respectively to initiate ART (OR 0.16, 95% CI 0.03–0.78 and OR 0.21, 95% CI 0.04–0.98) compared with those who lived more than 60 minutes away. Children who received immunisation after 6 months were 22.59 times more likely to initiate ART (OR 22.59, 95% CI 7.00–21.72) than those who did not. Infants of caregivers who had excellent or good relationships with their healthcare provider were 4.32 times more likely to initiate ART (OR 4.32, 95% CI 1.01–18.59) than those of caregivers who had average or poor relationships with healthcare providers. The significant predictors of ART initiation identified in this study should be regarded as priority areas for intervention among HIV-positive women in Swaziland.Keywords: ART initiation, clinic visits, HIV, HIV-positive infants, healthcare providers, immunisation, predictors |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|