logo
Science Portal
Copyright © Médecins Sans Frontières
v2.1.5153.produseast1
About MSF Science Portal
About
Contact Us
Frequently Asked Questions (FAQs)
Privacy Policy
Terms of Use
Copyright © Médecins Sans Frontières
v2.1.5153.produseast1
Revisiting long-term adherence to highly active antiretroviral therapy in Senegal using latent class analysis | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Revisiting long-term adherence to highly active antiretroviral therapy in Senegal using latent class analysis

Bastard M, Fall MB, Laniece I, Taverne B, Desclaux A, Ecochard R, Sow PS, Delaporte E, Etard JF
Download

Similar Content
Loading...
Loading...
Loading...
Abstract
BACKGROUND
Adherence is one of the main predictors of antiretroviral treatment success. A governmental initiative was launched in 1998 for HIV-infected patients in Senegal to provide access to highly active antiretroviral therapy.

METHODS
Between August 1998 and April 2002, 404 adult patients were enrolled. Adherence measurements, defined as pills taken/pills prescribed, were assessed between November 1999 and April 2009 using a pill count along with a questionnaire for 330 patients. Predictors of adherence were explored through a random-intercept Tobit model and a latent class analysis (LCA) was performed to identify adherence trajectories. We also performed a survival analysis taking into account gender and latent adherence classes.

RESULTS
Median treatment duration was 91 months (interquartile range, 84-101). On average, adherence declined by 7% every year, was 30% lower for patients taking indinavir, and 12% higher for those receiving cotrimoxazole prophylaxis. Based on the predicted probability of having an adherence ≥ 95%, LCA revealed 3 adherence behaviors and a better adherence for women. A quarter of patients had a high adherence trajectory over time and half had an intermediate one. Male gender and low adherence behavior over time were independently associated with a higher mortality rate.

CONCLUSIONS
This study shows that an overall good adherence can be obtained in the long term in Senegal. LCA suggests a better adherence for women and points out a large subsample of patients with intermediate level of adherence behavior who are at risk for developing resistance to antiretroviral drugs. This study warrants further research into gender issues.

Countries

Senegal

Languages

English
DOI
10.1097/QAI.0b013e318211b43b
Published Date
01 May 2011
PubMed ID
21775934
Journal
Journal of Acquired Immune Deficiency Syndromes (1999)
Volume | Issue | Pages
Volume 57, Issue 1, Pages 55-61
Issue Date
2011-05-01
Dimensions Badge