Adherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study

Ismael Ahmed,1 Meaza Demissie,2 Alemayehu Worku,3 Salem Gugsa,4 Yemane Berhane2 1University of Gondar, Gondar, Ethiopia; 2Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; 3Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa Universi...

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Autores principales:	Ahmed I, Demissie M, Worku A, Gugsa S, Berhane Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	same-day antiretroviral therapy rapid art adherence test and treat africa ethiopia Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/cf8c1422b71742799b07087bd91a807c
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spelling	oai:doaj.org-article:cf8c1422b71742799b07087bd91a807c2021-11-11T18:22:26ZAdherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study1179-1373https://doaj.org/article/cf8c1422b71742799b07087bd91a807c2021-11-01T00:00:00Zhttps://www.dovepress.com/adherence-to-antiretroviral-treatment-among-people-who-started-treatme-peer-reviewed-fulltext-article-HIVhttps://doaj.org/toc/1179-1373Ismael Ahmed,1 Meaza Demissie,2 Alemayehu Worku,3 Salem Gugsa,4 Yemane Berhane2 1University of Gondar, Gondar, Ethiopia; 2Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; 3Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Global Health, University of Washington, Seattle, WA, USACorrespondence: Ismael Ahmed Tel +251911126852Email ismaelahmed2003@gmail.comIntroduction: Since the launch of universal “test and treat” approach in 2016, there has been a significant increase in persons initiated on antiretroviral therapy (ART) on the same-day of human immunodeficiency virus (HIV) diagnosis in low-income settings. However, there are limited studies that investigated the effect of rapid treatment initiation on adherence. In this study, we compared adherence to ART in people who started ART on the same-day of HIV diagnosis and those started more than 7 days after HIV diagnosis.Methods: We conducted a retrospective cohort analysis using routinely collected data from multiple ART clinics. Participants were at least 15 years old, were newly diagnosed and started on ART between October 2016 and July 2018 in the Amhara region of Ethiopia. We used doubly-robust multivariable logistic regression model to estimate the adjusted effects on adherence.Results: A total of 415 individuals who started ART on the same-day of HIV diagnosis and 527 individuals who started 7 days after their HIV diagnosis were included in the analysis. The proportion of participants who reported optimal adherence was significantly lower in the same-day group at 6- and 12-months (absolute risk difference of 6.5%; 95% CI: 1.1%, 11.9% and 6.8%; 95% CI: 1.2%, 12.5%, respectively) compared to the > 7 days group. After adjusting for baseline and non-baseline covariates, the same-day group was less likely to have optimal adherence both at 6- and 12-months (adjusted RR=0.90; 95% CI: 0.86, 0.94 and RR=0.89; 95% CI: 0.83, 0.95, respectively) compared to the > 7 days group.Conclusion: We observed lower optimal adherence among individuals who started ART on the same-day of HIV diagnosis compared to those who started ART > 7 days after their HIV diagnosis. Our findings highlight the importance of identifying adherence barriers, providing support, and ensuring treatment readiness before initiating individuals on same-day ART.Keywords: same-day antiretroviral therapy, rapid ART, adherence, test and treat, Africa, EthiopiaAhmed IDemissie MWorku AGugsa SBerhane YDove Medical Pressarticlesame-day antiretroviral therapyrapid artadherencetest and treatafricaethiopiaImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 13, Pp 983-991 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	same-day antiretroviral therapy rapid art adherence test and treat africa ethiopia Immunologic diseases. Allergy RC581-607
spellingShingle	same-day antiretroviral therapy rapid art adherence test and treat africa ethiopia Immunologic diseases. Allergy RC581-607 Ahmed I Demissie M Worku A Gugsa S Berhane Y Adherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study
description	Ismael Ahmed,1 Meaza Demissie,2 Alemayehu Worku,3 Salem Gugsa,4 Yemane Berhane2 1University of Gondar, Gondar, Ethiopia; 2Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; 3Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Global Health, University of Washington, Seattle, WA, USACorrespondence: Ismael Ahmed Tel +251911126852Email ismaelahmed2003@gmail.comIntroduction: Since the launch of universal “test and treat” approach in 2016, there has been a significant increase in persons initiated on antiretroviral therapy (ART) on the same-day of human immunodeficiency virus (HIV) diagnosis in low-income settings. However, there are limited studies that investigated the effect of rapid treatment initiation on adherence. In this study, we compared adherence to ART in people who started ART on the same-day of HIV diagnosis and those started more than 7 days after HIV diagnosis.Methods: We conducted a retrospective cohort analysis using routinely collected data from multiple ART clinics. Participants were at least 15 years old, were newly diagnosed and started on ART between October 2016 and July 2018 in the Amhara region of Ethiopia. We used doubly-robust multivariable logistic regression model to estimate the adjusted effects on adherence.Results: A total of 415 individuals who started ART on the same-day of HIV diagnosis and 527 individuals who started 7 days after their HIV diagnosis were included in the analysis. The proportion of participants who reported optimal adherence was significantly lower in the same-day group at 6- and 12-months (absolute risk difference of 6.5%; 95% CI: 1.1%, 11.9% and 6.8%; 95% CI: 1.2%, 12.5%, respectively) compared to the > 7 days group. After adjusting for baseline and non-baseline covariates, the same-day group was less likely to have optimal adherence both at 6- and 12-months (adjusted RR=0.90; 95% CI: 0.86, 0.94 and RR=0.89; 95% CI: 0.83, 0.95, respectively) compared to the > 7 days group.Conclusion: We observed lower optimal adherence among individuals who started ART on the same-day of HIV diagnosis compared to those who started ART > 7 days after their HIV diagnosis. Our findings highlight the importance of identifying adherence barriers, providing support, and ensuring treatment readiness before initiating individuals on same-day ART.Keywords: same-day antiretroviral therapy, rapid ART, adherence, test and treat, Africa, Ethiopia
format	article
author	Ahmed I Demissie M Worku A Gugsa S Berhane Y
author_facet	Ahmed I Demissie M Worku A Gugsa S Berhane Y
author_sort	Ahmed I
title	Adherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study
title_short	Adherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study
title_full	Adherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study
title_fullStr	Adherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study
title_full_unstemmed	Adherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study
title_sort	adherence to antiretroviral treatment among people who started treatment on the same-day of hiv diagnosis in ethiopia: a multicenter observational study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/cf8c1422b71742799b07087bd91a807c
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Adherence to Antiretroviral Treatment Among People Who Started Treatment on the Same-Day of HIV Diagnosis in Ethiopia: A Multicenter Observational Study

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