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Title: Early suboptimal ART adherence was associated with missed clinical visits in HIV-infected patients in Asia
Authors: Awachana Jiamsakul
Stephen J. Kerr
Sasisopin Kiertiburanakul
Iskandar Azwa
Fujie Zhang
Romanee Chaiwarith
Wingwai Wong
Penh Sun Ly
Nagalingeswaran Kumarasamy
Rossana Ditangco
Sanjay Pujari
Evy Yunihastuti
Cuong Duy Do
Tuti Parwati Merati
Kinh Van Nguyen
Man Po Lee
Jun Yong Choi
Shinichi Oka
Pacharee Kantipong
Benedict L. H Sim
Oon Tek Ng
Jeremy Ross
Matthew Law
Hospital Sungai Buloh
Beijing Ditan Hospital
VHS Medical Centre India
Bach Mai Hospital
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Kirby Institute
National Center for Global Health and Medicine
The HIV Netherlands Australia Thailand Research Collaboration
Yonsei University College of Medicine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
University of Malaya Medical Centre
Veterans General Hospital-Taipei
Tan Tock Seng Hospital
Chiang Mai University
University of Health Sciences
National Hospital for Tropical Diseases
Queen Elizabeth Hospital
Foundation for AIDS Research
Institute of Infectious Diseases
Chiangrai Prachanukroh Hospital
National Center for HIV/AIDS
Keywords: Medicine;Psychology;Social Sciences
Issue Date: 2-Dec-2018
Citation: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. Vol.30, No.12 (2018), 1560-1566
Abstract: © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Missed clinic visits can lead to poorer treatment outcomes in HIV-infected patients. Suboptimal antiretroviral therapy (ART) adherence has been linked to subsequent missed visits. Knowing the determinants of missed visits in Asian patients will allow for appropriate counselling and intervention strategies to ensure continuous engagement in care. A missed visit was defined as having no assessments within six months. Repeated measures logistic regression was used to analyse factors associated with missed visits. A total of 7100 patients were included from 12 countries in Asia with 2676 (37.7%) having at least one missed visit. Patients with early suboptimal self-reported adherence <95% were more likely to have a missed visit compared to those with adherence ≥95% (OR = 2.55, 95% CI(1.81–3.61)). Other factors associated with having a missed visit were homosexual (OR = 1.45, 95%CI(1.27–1.66)) and other modes of HIV exposure (OR = 1.48, 95%CI(1.27–1.74)) compared to heterosexual exposure; using PI-based (OR = 1.33, 95%CI(1.15–1.53) and other ART combinations (OR = 1.79, 95%CI(1.39–2.32)) compared to NRTI+NNRTI combinations; and being hepatitis C co-infected (OR = 1.27, 95%CI(1.06–1.52)). Patients aged >30 years (31–40 years OR = 0.81, 95%CI(0.73–0.89); 41–50 years OR = 0.73, 95%CI(0.64–0.83); and >50 years OR = 0.77, 95%CI(0.64–0.93)); female sex (OR = 0.81, 95%CI(0.72–0.90)); and being from upper middle (OR = 0.78, 95%CI(0.70–0.80)) or high-income countries (OR = 0.42, 95%CI(0.35–0.51)), were less likely to have missed visits. Almost 40% of our patients had a missed clinic visit. Early ART adherence was an indicator of subsequent clinic visits. Intensive counselling and adherence support should be provided at ART initiation in order to optimise long-term clinic attendance and maximise treatment outcomes.
ISSN: 13600451
Appears in Collections:Scopus 2018

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