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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Factors associated with different patterns of non-adherence to HIV care in Dar es Salaam, Tanzania</title><author><name sortKey="Poles, Gabriela" sort="Poles, Gabriela" uniqKey="Poles G" first="Gabriela" last="Poles">Gabriela Poles</name><affiliation><nlm:aff id="A1">Tufts University School of Medicine, Boston, MA</nlm:aff></affiliation></author><author><name sortKey="Li, Michelle" sort="Li, Michelle" uniqKey="Li M" first="Michelle" last="Li">Michelle Li</name><affiliation><nlm:aff id="A2">Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia</nlm:aff></affiliation></author><author><name sortKey="Siril, Hellen" sort="Siril, Hellen" uniqKey="Siril H" first="Hellen" last="Siril">Hellen Siril</name><affiliation><nlm:aff id="A3">Management and Development for Health (MDH), Dar-es-Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Mhalu, Aisa" sort="Mhalu, Aisa" uniqKey="Mhalu A" first="Aisa" last="Mhalu">Aisa Mhalu</name><affiliation><nlm:aff id="A3">Management and Development for Health (MDH), Dar-es-Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Hawkins, Claudia" sort="Hawkins, Claudia" uniqKey="Hawkins C" first="Claudia" last="Hawkins">Claudia Hawkins</name><affiliation><nlm:aff id="A4">Northwestern University Feinberg School of Medicine, Chicago, US</nlm:aff></affiliation></author><author><name sortKey="Kaaya, Sylvia" sort="Kaaya, Sylvia" uniqKey="Kaaya S" first="Sylvia" last="Kaaya">Sylvia Kaaya</name><affiliation><nlm:aff id="A5">Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Aris, Eric" sort="Aris, Eric" uniqKey="Aris E" first="Eric" last="Aris">Eric Aris</name><affiliation><nlm:aff id="A5">Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Chalamilla, Guerino" sort="Chalamilla, Guerino" uniqKey="Chalamilla G" first="Guerino" last="Chalamilla">Guerino Chalamilla</name><affiliation><nlm:aff id="A3">Management and Development for Health (MDH), Dar-es-Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Hirschhorn, Lisa R" sort="Hirschhorn, Lisa R" uniqKey="Hirschhorn L" first="Lisa R." last="Hirschhorn">Lisa R. Hirschhorn</name><affiliation><nlm:aff id="A6">Harvard Medical School, Boston, US</nlm:aff></affiliation><affiliation><nlm:aff id="A7">JSI Research and Training Institute Inc., Boston, US</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23269515</idno><idno type="pmc">3809339</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809339</idno><idno type="RBID">PMC:3809339</idno><idno type="doi">10.1177/1545109712467068</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">001B02</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001B02</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Factors associated with different patterns of non-adherence to HIV care in Dar es Salaam, Tanzania</title><author><name sortKey="Poles, Gabriela" sort="Poles, Gabriela" uniqKey="Poles G" first="Gabriela" last="Poles">Gabriela Poles</name><affiliation><nlm:aff id="A1">Tufts University School of Medicine, Boston, MA</nlm:aff></affiliation></author><author><name sortKey="Li, Michelle" sort="Li, Michelle" uniqKey="Li M" first="Michelle" last="Li">Michelle Li</name><affiliation><nlm:aff id="A2">Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia</nlm:aff></affiliation></author><author><name sortKey="Siril, Hellen" sort="Siril, Hellen" uniqKey="Siril H" first="Hellen" last="Siril">Hellen Siril</name><affiliation><nlm:aff id="A3">Management and Development for Health (MDH), Dar-es-Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Mhalu, Aisa" sort="Mhalu, Aisa" uniqKey="Mhalu A" first="Aisa" last="Mhalu">Aisa Mhalu</name><affiliation><nlm:aff id="A3">Management and Development for Health (MDH), Dar-es-Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Hawkins, Claudia" sort="Hawkins, Claudia" uniqKey="Hawkins C" first="Claudia" last="Hawkins">Claudia Hawkins</name><affiliation><nlm:aff id="A4">Northwestern University Feinberg School of Medicine, Chicago, US</nlm:aff></affiliation></author><author><name sortKey="Kaaya, Sylvia" sort="Kaaya, Sylvia" uniqKey="Kaaya S" first="Sylvia" last="Kaaya">Sylvia Kaaya</name><affiliation><nlm:aff id="A5">Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Aris, Eric" sort="Aris, Eric" uniqKey="Aris E" first="Eric" last="Aris">Eric Aris</name><affiliation><nlm:aff id="A5">Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Chalamilla, Guerino" sort="Chalamilla, Guerino" uniqKey="Chalamilla G" first="Guerino" last="Chalamilla">Guerino Chalamilla</name><affiliation><nlm:aff id="A3">Management and Development for Health (MDH), Dar-es-Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Hirschhorn, Lisa R" sort="Hirschhorn, Lisa R" uniqKey="Hirschhorn L" first="Lisa R." last="Hirschhorn">Lisa R. Hirschhorn</name><affiliation><nlm:aff id="A6">Harvard Medical School, Boston, US</nlm:aff></affiliation><affiliation><nlm:aff id="A7">JSI Research and Training Institute Inc., Boston, US</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of the International Association of Providers of AIDS Care</title><idno type="ISSN">2325-9574</idno><idno type="eISSN">2325-9582</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P2">Health system responsiveness (HSR), a measure of patient healthcare experience, may influence adherence to HIV/AIDS care and be an important predictor of outcomes. We studied the relationship between HSR, patient factors and visit non-adherence in 16 PEPFAR-supported HIV/AIDS clinics in Dar es Salaam.</p><p id="P3">A HSR survey was administered in 2009 and all clinic visits one year following interviews were analyzed for 720 patients on antiretrovirals (ART). Definitions of visit non-adherence were: 1)low visit constancy (VC:no visit in ≥1 quarter), 2)gaps in care (>60 days between visits), 3)no visit in last quarter (VLQ). Relationships between factors were analyzed using multivariate analysis with adjusted odds ratio (AOR) and 95% confidence intervals reported. Few patients were non-adherent using VLQ (14%) and VC (28%). Gaps in care were more common (49.6%) and associated with younger age [AOR:3.86(2.02–7.40)], no explanation of side effects [AOR:2.21(1.49–3.28)], and shorter ART duration [0–3 months AOR:1.49(1.09–2.03); 3–6 months AOR:2.44(1.40–4.25)]. No VLQ was associated with younger age [AOR:3.40(1.63–7.07)], poor HCW communication [AOR:4.83(1.39–16.78)], and less time on ART [0–3 months AOR:5.04(2.47–10.30); 3–6 months AOR:3.09(1.72–5.57)]. Younger age, poor HCW communication and shorter ART duration also predicted lower VC, as did higher patient:HCW ratios.</p><p id="P4">Rates of visit non-adherence differed based on definitions used. Younger age, shorter time on ART and poor HCW communication predicted lower adherence regardless of definition. More work is needed to understand the relationship between HSR, patient factors and different patterns of visit non-adherence and their impact on ART outcomes.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101603896</journal-id><journal-id journal-id-type="pubmed-jr-id">41074</journal-id><journal-id journal-id-type="nlm-ta">J Int Assoc Provid AIDS Care</journal-id><journal-id journal-id-type="iso-abbrev">J Int Assoc Provid AIDS Care</journal-id><journal-title-group><journal-title>Journal of the International Association of Providers of AIDS Care</journal-title></journal-title-group><issn pub-type="ppub">2325-9574</issn><issn pub-type="epub">2325-9582</issn></journal-meta><article-meta><article-id pub-id-type="pmid">23269515</article-id><article-id pub-id-type="pmc">3809339</article-id><article-id pub-id-type="doi">10.1177/1545109712467068</article-id><article-id pub-id-type="manuscript">NIHMS460678</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Factors associated with different patterns of non-adherence to HIV care in Dar es Salaam, Tanzania</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Poles</surname><given-names>Gabriela</given-names></name><degrees>B.A.</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>Michelle</given-names></name><degrees>M.P.H.</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Siril</surname><given-names>Hellen</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Mhalu</surname><given-names>Aisa</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Hawkins</surname><given-names>Claudia</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Kaaya</surname><given-names>Sylvia</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Aris</surname><given-names>Eric</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Chalamilla</surname><given-names>Guerino</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Hirschhorn</surname><given-names>Lisa R.</given-names></name><degrees>M.D., M.P.H.</degrees><xref ref-type="aff" rid="A6">6</xref><xref ref-type="aff" rid="A7">7</xref></contrib></contrib-group><aff id="A1"><label>1</label>Tufts University School of Medicine, Boston, MA</aff><aff id="A2"><label>2</label>Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia</aff><aff id="A3"><label>3</label>Management and Development for Health (MDH), Dar-es-Salaam, Tanzania</aff><aff id="A4"><label>4</label>Northwestern University Feinberg School of Medicine, Chicago, US</aff><aff id="A5"><label>5</label>Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</aff><aff id="A6"><label>6</label>Harvard Medical School, Boston, US</aff><aff id="A7"><label>7</label>JSI Research and Training Institute Inc., Boston, US</aff><author-notes><corresp id="cor1"><bold>Corresponding author:</bold> Lisa Hirschhorn, M.D., M.P.H., Department of Global Health and Social Medicine, Harvard Medical School, 888 Commonwealth Avenue, Boston, MA 02115, Phone: 617-504-5794, Fax number: 617-482-0617,<email>LRH3@hms.harvard.edu</email>, publishable</corresp><fn id="FN1"><p id="P1"><table-wrap id="T4" position="anchor" orientation="portrait"><table frame="box" rules="all"><thead><tr><th align="left" rowspan="1" colspan="1">Names of authors</th><th align="left" rowspan="1" colspan="1">Contact Information</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Gabriela Poles, BA</td><td align="left" rowspan="1" colspan="1">Email: <email>gpoles@gmail.com</email><break></break>phone number: 001-617-821-4304</td></tr><tr><td align="left" rowspan="1" colspan="1">Sylvia Kaaya, M.D.</td><td align="left" rowspan="1" colspan="1">Email: <email>skaaya@gmail.com</email><break></break>Phone number: 255-77-832-5706</td></tr><tr><td align="left" rowspan="1" colspan="1">Michelle Li, MPH</td><td align="left" rowspan="1" colspan="1">Email: <email>michelle.li.9@gmail.com</email><break></break>Phone number: 260-97-400-3498</td></tr><tr><td align="left" rowspan="1" colspan="1">Hellen Siril, M.D.</td><td align="left" rowspan="1" colspan="1">Email: <email>neemasiril@gmail.com</email><break></break>Phone number: 255-71-288-1480</td></tr><tr><td align="left" rowspan="1" colspan="1">Aisa Mhalu, M.D.</td><td align="left" rowspan="1" colspan="1">Email: <email>aisapm@gmail.com</email><break></break>Phone number: 255-75-463-3947</td></tr><tr><td align="left" rowspan="1" colspan="1">Claudia Hawkins, M.D.</td><td align="left" rowspan="1" colspan="1">Email: <email>c-hawkins@md.northwestern.edu</email><break></break>Phone number: 001-312-695-0463</td></tr><tr><td align="left" rowspan="1" colspan="1">Eric Aris, M.D.</td><td align="left" rowspan="1" colspan="1">Email: <email>aeric@mdh-tz.org</email><break></break>Phone number: 255-75-482-4071</td></tr><tr><td align="left" rowspan="1" colspan="1">Guerino Chalamilla, M.D.</td><td align="left" rowspan="1" colspan="1">Email: <email>gchalamilla@gmail.com</email><break></break>Phone number: 255-75-460-0700</td></tr><tr><td align="left" rowspan="1" colspan="1">Lisa Hirschhorn, M.D, MPH</td><td align="left" rowspan="1" colspan="1">Email: <email>LRH3@hms.harvard.edu</email><break></break>Phone: 001-617-504-5794</td></tr></tbody></table></table-wrap></p></fn></author-notes><pub-date pub-type="nihms-submitted"><day>3</day><month>5</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>26</day><month>12</month><year>2012</year></pub-date><pub-date pub-type="ppub"><season>Jan-Feb</season><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>1</month><year>2015</year></pub-date><volume>13</volume><issue>1</issue><fpage>78</fpage><lpage>84</lpage><pmc-comment>elocation-id from pubmed: 10.1177/1545109712467068</pmc-comment>
<abstract><p id="P2">Health system responsiveness (HSR), a measure of patient healthcare experience, may influence adherence to HIV/AIDS care and be an important predictor of outcomes. We studied the relationship between HSR, patient factors and visit non-adherence in 16 PEPFAR-supported HIV/AIDS clinics in Dar es Salaam.</p><p id="P3">A HSR survey was administered in 2009 and all clinic visits one year following interviews were analyzed for 720 patients on antiretrovirals (ART). Definitions of visit non-adherence were: 1)low visit constancy (VC:no visit in ≥1 quarter), 2)gaps in care (>60 days between visits), 3)no visit in last quarter (VLQ). Relationships between factors were analyzed using multivariate analysis with adjusted odds ratio (AOR) and 95% confidence intervals reported. Few patients were non-adherent using VLQ (14%) and VC (28%). Gaps in care were more common (49.6%) and associated with younger age [AOR:3.86(2.02–7.40)], no explanation of side effects [AOR:2.21(1.49–3.28)], and shorter ART duration [0–3 months AOR:1.49(1.09–2.03); 3–6 months AOR:2.44(1.40–4.25)]. No VLQ was associated with younger age [AOR:3.40(1.63–7.07)], poor HCW communication [AOR:4.83(1.39–16.78)], and less time on ART [0–3 months AOR:5.04(2.47–10.30); 3–6 months AOR:3.09(1.72–5.57)]. Younger age, poor HCW communication and shorter ART duration also predicted lower VC, as did higher patient:HCW ratios.</p><p id="P4">Rates of visit non-adherence differed based on definitions used. Younger age, shorter time on ART and poor HCW communication predicted lower adherence regardless of definition. More work is needed to understand the relationship between HSR, patient factors and different patterns of visit non-adherence and their impact on ART outcomes.</p></abstract><funding-group><award-group><funding-source country="United States">National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID</funding-source><award-id>P30 AI060354 || AI</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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