Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.

<h4>Background</h4>In the context of scaling up free antiretroviral therapy (ART), healthcare equality is essential for people living with HIV. We aimed to assess socioeconomic-related inequalities in uptake of continuous care for people living with HIV receiving ART, including retention...

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Autores principales:	Yongmei Jin, Sawitri Assanangkornchai, Yingrong Du, Jun Liu, Jingsong Bai, Yongrui Yang
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1edb06dd99444414976f0c0f34860fa2
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spelling	oai:doaj.org-article:1edb06dd99444414976f0c0f34860fa22021-12-02T20:11:20ZMeasuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.1932-620310.1371/journal.pone.0251252https://doaj.org/article/1edb06dd99444414976f0c0f34860fa22021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251252https://doaj.org/toc/1932-6203<h4>Background</h4>In the context of scaling up free antiretroviral therapy (ART), healthcare equality is essential for people living with HIV. We aimed to assess socioeconomic-related inequalities in uptake of continuous care for people living with HIV receiving ART, including retention in care in the last six months, routine toxicity monitoring, adequate immunological and virological monitoring, and uptake of mental health assessment in the last 12 months. We also determined the contributions of socioeconomic factors to the degree of inequalities.<h4>Methods</h4>A hospital-based cross-sectional survey was conducted among consecutive clients visiting an HIV treatment center in Kunming, China in 2019. Participants were 702 people living with HIV aged ≥18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1-5 years. Socioeconomic-related inequality and its contributing factors were assessed by a normalized concentration index (CIn) with a decomposition approach.<h4>Results</h4>The uptake of mental health assessment was low (15%) but significantly higher among the rich (CIn 0.1337, 95% CI: 0.0140, 0.2534). Retention in care, toxicity, and immunological monitoring were over 80% but non-significant in favor of the rich (CIn: 0.0117, 0.0315, 0.0736, respectively). The uptake of adequate virological monitoring was 15% and higher among the poor (CIn = -0.0308). Socioeconomic status positively contributed to inequalities of all care indicators, with the highest contribution for mental health assessment (124.9%) and lowest for virological monitoring (2.7%).<h4>Conclusions</h4>These findings suggest virological monitoring and mental health assessment be given more attention in long-term HIV care. Policies allocating need-oriented resources geared toward improving equality of continuous care should be developed.Yongmei JinSawitri AssanangkornchaiYingrong DuJun LiuJingsong BaiYongrui YangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251252 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yongmei Jin Sawitri Assanangkornchai Yingrong Du Jun Liu Jingsong Bai Yongrui Yang Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.
description	<h4>Background</h4>In the context of scaling up free antiretroviral therapy (ART), healthcare equality is essential for people living with HIV. We aimed to assess socioeconomic-related inequalities in uptake of continuous care for people living with HIV receiving ART, including retention in care in the last six months, routine toxicity monitoring, adequate immunological and virological monitoring, and uptake of mental health assessment in the last 12 months. We also determined the contributions of socioeconomic factors to the degree of inequalities.<h4>Methods</h4>A hospital-based cross-sectional survey was conducted among consecutive clients visiting an HIV treatment center in Kunming, China in 2019. Participants were 702 people living with HIV aged ≥18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1-5 years. Socioeconomic-related inequality and its contributing factors were assessed by a normalized concentration index (CIn) with a decomposition approach.<h4>Results</h4>The uptake of mental health assessment was low (15%) but significantly higher among the rich (CIn 0.1337, 95% CI: 0.0140, 0.2534). Retention in care, toxicity, and immunological monitoring were over 80% but non-significant in favor of the rich (CIn: 0.0117, 0.0315, 0.0736, respectively). The uptake of adequate virological monitoring was 15% and higher among the poor (CIn = -0.0308). Socioeconomic status positively contributed to inequalities of all care indicators, with the highest contribution for mental health assessment (124.9%) and lowest for virological monitoring (2.7%).<h4>Conclusions</h4>These findings suggest virological monitoring and mental health assessment be given more attention in long-term HIV care. Policies allocating need-oriented resources geared toward improving equality of continuous care should be developed.
format	article
author	Yongmei Jin Sawitri Assanangkornchai Yingrong Du Jun Liu Jingsong Bai Yongrui Yang
author_facet	Yongmei Jin Sawitri Assanangkornchai Yingrong Du Jun Liu Jingsong Bai Yongrui Yang
author_sort	Yongmei Jin
title	Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.
title_short	Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.
title_full	Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.
title_fullStr	Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.
title_full_unstemmed	Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.
title_sort	measuring and explaining inequality of continuous care for people living with hiv receiving antiretroviral therapy in kunming, china.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/1edb06dd99444414976f0c0f34860fa2
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Measuring and explaining inequality of continuous care for people living with HIV receiving antiretroviral therapy in Kunming, China.

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