Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020

Abstract Background Patient interruption of antiretroviral therapy (ART) continues to limit HIV programs’ progress toward epidemic control. Multiple factors have been associated with client interruption in treatment (IIT)— including age, gender, CD4 count, and education level. In this paper, we expl...

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Autores principales:	Silviu Tomescu, Thomas Crompton, Jonathan Adebayo, Constance Wose Kinge, Francis Akpan, Marcus Rennick, Charles Chasela, Evans Ondura, Dauda Sulaiman Dauda, Pedro T. Pisa
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Retention Loss to follow up (LTFU) Interruption in treatment (IIT) Multi-month dispensing (MMD) Antiretroviral treatment (ART) Nigeria Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/181832d58fcf409b83dd6a814e841522
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spelling	oai:doaj.org-article:181832d58fcf409b83dd6a814e8415222021-12-05T12:09:47ZFactors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–202010.1186/s12889-021-12264-91471-2458https://doaj.org/article/181832d58fcf409b83dd6a814e8415222021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12264-9https://doaj.org/toc/1471-2458Abstract Background Patient interruption of antiretroviral therapy (ART) continues to limit HIV programs’ progress toward epidemic control. Multiple factors have been associated with client interruption in treatment (IIT)— including age, gender, CD4 count, and education level. In this paper, we explore the factors associated with IIT in people living with HIV (PLHIV) in United States Agency for International Development (USAID)-supported facilities under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program in Nigeria. Methods We conducted cross-sectional analyses on data obtained from Nigeria’s National Data Repository (NDR), representing a summarized record of 573 630 ART clients that received care at 484 PEPFAR/USAID-supported facilities in 16 states from 2000–2020. IIT was defined as no clinical contact for 28 days or more after the last expected clinical contact. Univariate and multivariate logistic regression models were computed to explore the factors associated with IIT. The variables included in the analysis were sex, age group, zone, facility level, regimen line, multi-month dispensing (MMD), and viral load category. Results Of the 573 630 clients analysed in this study, 32% have been recorded as having interrupted treatment. Of the clients investigated, 66% were female (32% had interrupted treatment), 39% were aged 25–34 at their last ART pick-up date (with 32% of them interrupted treatment), 59% received care at secondary level facilities (37% interrupted treatment) and 38% were last receiving between three- to five-month MMD (with 10% of these interrupted treatment). Those less likely to interrupt ART were males (aOR = 0.91), clients on six-month MMD (aOR = 0.01), adults on 2nd line regimen (aOR = 0.09), and paediatrics on salvage regimen (aOR = 0.02). Clients most likely to interrupt ART were located in the South West Zone (aOR = 1.99), received treatment at a tertiary level (aOR = 12.34) or secondary level facilities (aOR = 4.01), and had no viral load (VL) on record (aOR =10.02). Age group was not significantly associated with IIT. Conclusions Sex, zone, facility level, regimen line, MMD, and VL were significantly associated with IIT. MMD of three months and longer (especially six months) had better retention on ART than those on shorter MMD. Not having a VL on record was associated with a considerable risk of IIT.Silviu TomescuThomas CromptonJonathan AdebayoConstance Wose KingeFrancis AkpanMarcus RennickCharles ChaselaEvans OnduraDauda Sulaiman DaudaPedro T. PisaBMCarticleRetentionLoss to follow up (LTFU)Interruption in treatment (IIT)Multi-month dispensing (MMD)Antiretroviral treatment (ART)NigeriaPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Retention Loss to follow up (LTFU) Interruption in treatment (IIT) Multi-month dispensing (MMD) Antiretroviral treatment (ART) Nigeria Public aspects of medicine RA1-1270
spellingShingle	Retention Loss to follow up (LTFU) Interruption in treatment (IIT) Multi-month dispensing (MMD) Antiretroviral treatment (ART) Nigeria Public aspects of medicine RA1-1270 Silviu Tomescu Thomas Crompton Jonathan Adebayo Constance Wose Kinge Francis Akpan Marcus Rennick Charles Chasela Evans Ondura Dauda Sulaiman Dauda Pedro T. Pisa Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020
description	Abstract Background Patient interruption of antiretroviral therapy (ART) continues to limit HIV programs’ progress toward epidemic control. Multiple factors have been associated with client interruption in treatment (IIT)— including age, gender, CD4 count, and education level. In this paper, we explore the factors associated with IIT in people living with HIV (PLHIV) in United States Agency for International Development (USAID)-supported facilities under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program in Nigeria. Methods We conducted cross-sectional analyses on data obtained from Nigeria’s National Data Repository (NDR), representing a summarized record of 573 630 ART clients that received care at 484 PEPFAR/USAID-supported facilities in 16 states from 2000–2020. IIT was defined as no clinical contact for 28 days or more after the last expected clinical contact. Univariate and multivariate logistic regression models were computed to explore the factors associated with IIT. The variables included in the analysis were sex, age group, zone, facility level, regimen line, multi-month dispensing (MMD), and viral load category. Results Of the 573 630 clients analysed in this study, 32% have been recorded as having interrupted treatment. Of the clients investigated, 66% were female (32% had interrupted treatment), 39% were aged 25–34 at their last ART pick-up date (with 32% of them interrupted treatment), 59% received care at secondary level facilities (37% interrupted treatment) and 38% were last receiving between three- to five-month MMD (with 10% of these interrupted treatment). Those less likely to interrupt ART were males (aOR = 0.91), clients on six-month MMD (aOR = 0.01), adults on 2nd line regimen (aOR = 0.09), and paediatrics on salvage regimen (aOR = 0.02). Clients most likely to interrupt ART were located in the South West Zone (aOR = 1.99), received treatment at a tertiary level (aOR = 12.34) or secondary level facilities (aOR = 4.01), and had no viral load (VL) on record (aOR =10.02). Age group was not significantly associated with IIT. Conclusions Sex, zone, facility level, regimen line, MMD, and VL were significantly associated with IIT. MMD of three months and longer (especially six months) had better retention on ART than those on shorter MMD. Not having a VL on record was associated with a considerable risk of IIT.
format	article
author	Silviu Tomescu Thomas Crompton Jonathan Adebayo Constance Wose Kinge Francis Akpan Marcus Rennick Charles Chasela Evans Ondura Dauda Sulaiman Dauda Pedro T. Pisa
author_facet	Silviu Tomescu Thomas Crompton Jonathan Adebayo Constance Wose Kinge Francis Akpan Marcus Rennick Charles Chasela Evans Ondura Dauda Sulaiman Dauda Pedro T. Pisa
author_sort	Silviu Tomescu
title	Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020
title_short	Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020
title_full	Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020
title_fullStr	Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020
title_full_unstemmed	Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020
title_sort	factors associated with an interruption in treatment of people living with hiv in usaid-supported states in nigeria: a retrospective study from 2000–2020
publisher	BMC
publishDate	2021
url	https://doaj.org/article/181832d58fcf409b83dd6a814e841522
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Factors associated with an interruption in treatment of people living with HIV in USAID-supported states in Nigeria: a retrospective study from 2000–2020

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