Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study

Abstract Background Increased availability of HIV care over the past decade has dramatically reduced morbidity and mortality among people living with HIV (PLWH) in sub-Saharan Africa. However, perceived and experienced barriers to care, including dissatisfaction with services, may impact adherence a...

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Autores principales:	Nancy Somi, Nicole Dear, Domonique Reed, Ajay Parikh, Anange Lwilla, Emmanuel Bahemana, Samoel Khamadi, Michael Iroezindu, Hannah Kibuuka, Jonah Maswai, Trevor A. Crowell, John Owuoth, Lucas Maganga, Christina Polyak, Julie Ake, Allahna Esber, the AFRICOS Study Group
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	HIV/AIDS Quality of care Viral load Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/adef45d3309b4fec95e18d7c2aa8ce0a
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spelling	oai:doaj.org-article:adef45d3309b4fec95e18d7c2aa8ce0a2021-11-28T12:06:38ZPerceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study10.1186/s12981-021-00414-31742-6405https://doaj.org/article/adef45d3309b4fec95e18d7c2aa8ce0a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12981-021-00414-3https://doaj.org/toc/1742-6405Abstract Background Increased availability of HIV care over the past decade has dramatically reduced morbidity and mortality among people living with HIV (PLWH) in sub-Saharan Africa. However, perceived and experienced barriers to care, including dissatisfaction with services, may impact adherence and viral suppression. We examined the associations between satisfaction with HIV care and antiretroviral therapy (ART) adherence and viral load suppression. Methods The African Cohort Study (AFRICOS) is a prospective observational study conducted at PEPFAR-supported clinics in four African countries. At enrollment and twice-yearly study visits, participants received a clinical assessment and a socio-behavioral questionnaire was administered. Participants were classified as dissatisfied with care if they reported dissatisfaction with any of the following: waiting time, health care worker skills, health care worker attitudes, quality of clinic building, or overall quality of care received. Robust Poisson regression was used to estimate prevalence ratios and 95% confidence intervals (CIs) for associations between satisfaction with care and ART adherence and between satisfaction with care and viral suppression (viral load < 1000 copies/mL). Results As of 1 March 2020, 2928 PLWH were enrolled and 2311 had a year of follow-up visits. At the first annual follow-up visit, 2309 participants responded to questions regarding satisfaction with quality of care, and 2069 (89.6%) reported satisfaction with care. Dissatisfaction with waiting time was reported by 177 (7.6%), building quality by 59 (2.6%), overall quality of care by 18 (0.8%), health care worker attitudes by 16 (0.7%), and health care worker skills by 15 (0.7%). After adjusting for age and site, there was no significant difference in viral suppression between those who were satisfied with care and those who were dissatisfied (aPR: 1.03, 95% CI 0.97–1.09). Satisfaction with HIV care was moderately associated with ART adherence among AFRICOS participants (aPR: 1.09; 95% CI 1.00–1.16). Conclusions While patient satisfaction in AFRICOS was high and the association between perceived quality of care and adherence to ART was marginal, we did identify potential target areas for HIV care improvement, including reducing clinic waiting times.Nancy SomiNicole DearDomonique ReedAjay ParikhAnange LwillaEmmanuel BahemanaSamoel KhamadiMichael IroezinduHannah KibuukaJonah MaswaiTrevor A. CrowellJohn OwuothLucas MagangaChristina PolyakJulie AkeAllahna Esberthe AFRICOS Study GroupBMCarticleHIV/AIDSQuality of careViral loadImmunologic diseases. AllergyRC581-607ENAIDS Research and Therapy, Vol 18, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV/AIDS Quality of care Viral load Immunologic diseases. Allergy RC581-607
spellingShingle	HIV/AIDS Quality of care Viral load Immunologic diseases. Allergy RC581-607 Nancy Somi Nicole Dear Domonique Reed Ajay Parikh Anange Lwilla Emmanuel Bahemana Samoel Khamadi Michael Iroezindu Hannah Kibuuka Jonah Maswai Trevor A. Crowell John Owuoth Lucas Maganga Christina Polyak Julie Ake Allahna Esber the AFRICOS Study Group Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study
description	Abstract Background Increased availability of HIV care over the past decade has dramatically reduced morbidity and mortality among people living with HIV (PLWH) in sub-Saharan Africa. However, perceived and experienced barriers to care, including dissatisfaction with services, may impact adherence and viral suppression. We examined the associations between satisfaction with HIV care and antiretroviral therapy (ART) adherence and viral load suppression. Methods The African Cohort Study (AFRICOS) is a prospective observational study conducted at PEPFAR-supported clinics in four African countries. At enrollment and twice-yearly study visits, participants received a clinical assessment and a socio-behavioral questionnaire was administered. Participants were classified as dissatisfied with care if they reported dissatisfaction with any of the following: waiting time, health care worker skills, health care worker attitudes, quality of clinic building, or overall quality of care received. Robust Poisson regression was used to estimate prevalence ratios and 95% confidence intervals (CIs) for associations between satisfaction with care and ART adherence and between satisfaction with care and viral suppression (viral load < 1000 copies/mL). Results As of 1 March 2020, 2928 PLWH were enrolled and 2311 had a year of follow-up visits. At the first annual follow-up visit, 2309 participants responded to questions regarding satisfaction with quality of care, and 2069 (89.6%) reported satisfaction with care. Dissatisfaction with waiting time was reported by 177 (7.6%), building quality by 59 (2.6%), overall quality of care by 18 (0.8%), health care worker attitudes by 16 (0.7%), and health care worker skills by 15 (0.7%). After adjusting for age and site, there was no significant difference in viral suppression between those who were satisfied with care and those who were dissatisfied (aPR: 1.03, 95% CI 0.97–1.09). Satisfaction with HIV care was moderately associated with ART adherence among AFRICOS participants (aPR: 1.09; 95% CI 1.00–1.16). Conclusions While patient satisfaction in AFRICOS was high and the association between perceived quality of care and adherence to ART was marginal, we did identify potential target areas for HIV care improvement, including reducing clinic waiting times.
format	article
author	Nancy Somi Nicole Dear Domonique Reed Ajay Parikh Anange Lwilla Emmanuel Bahemana Samoel Khamadi Michael Iroezindu Hannah Kibuuka Jonah Maswai Trevor A. Crowell John Owuoth Lucas Maganga Christina Polyak Julie Ake Allahna Esber the AFRICOS Study Group
author_facet	Nancy Somi Nicole Dear Domonique Reed Ajay Parikh Anange Lwilla Emmanuel Bahemana Samoel Khamadi Michael Iroezindu Hannah Kibuuka Jonah Maswai Trevor A. Crowell John Owuoth Lucas Maganga Christina Polyak Julie Ake Allahna Esber the AFRICOS Study Group
author_sort	Nancy Somi
title	Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study
title_short	Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study
title_full	Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study
title_fullStr	Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study
title_full_unstemmed	Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study
title_sort	perceived satisfaction with hiv care and its association with adherence to antiretroviral therapy and viral suppression in the african cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/adef45d3309b4fec95e18d7c2aa8ce0a
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Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study

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