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Journal Article
|Research

Gender differences in retention and survival on antiretroviral therapy of HIV-1 infected adults in Malawi

Tayler-Smith K, Tweya H, Harries AD, Schoutene E, Jahn A
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Gender differences in retention and survival on antiretroviral therapy of HIV-1 infected adults in Malawi | Journal Article / Research | MSF Science Portal
Abstract
BACKGROUND
There is currently a dearth of knowledge on gender differences in mortality among patients on ART in Africa.

METHODS
Using data from the national ART monitoring and evaluation system, a survival analysis of all healthcare workers, teachers, and police/army personnel who accessed ART in Malawi by June, September and December 2006 respectively, was undertaken. Gender differences in survival were analysed using Kaplan-Meier estimates and rate ratios were derived from Poisson regression adjusting for confounding.

RESULTS
4670 ART patients (49.8% female) were followed up for a median of 8.7 months after starting ART. Probability of death was significantly higher for men than women (p < 0.001). Controlling for age, WHO clinical stage and occupation, men experienced nearly 2 times the mortality of women RR 1.90 [95% CI: 1.57-2.29]. A higher proportion of men initiated ART in WHO stage 4 (p < 0.001).

CONCLUSION
Among healthcare workers, teachers, police/army personnel, men have higher mortality on ART than women. Possible reasons are unclear but could be biological or because men present for ART at a later clinical stage or have poorer adherence to therapy. Improving early access to ART may reduce mortality, especially among men. A gender difference in adherence to therapy needs further investigation.

Countries

South Africa

Subject Area

women's healthHIV/AIDS

Languages

English
DOI
10.1371/journal.pmed.1001304
Published Date
01 Jun 2010
PubMed ID
21614882
Journal
Malawi Medical Journal
Volume | Issue | Pages
Volume 9, Issue 9, Pages 49-56
Issue Date
2012-09-04
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