Association between antiretroviral therapy adherence and employment status: systematic review and meta-analysis
Identifieur interne : 000213 ( Canada/Analysis ); précédent : 000212; suivant : 000214Association between antiretroviral therapy adherence and employment status: systematic review and meta-analysis
Auteurs : Jean B. Nachega ; Olalekan A. Uthman ; Karl Peltzer [Afrique du Sud] ; Lindsey A. Richardson [Canada] ; Edward J. Mills [États-Unis] ; Kofi Amekudzi [Suisse] ; Alice Ouédraogo [Suisse]Source :
- Bulletin of the World Health Organization [ 0042-9686 ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
- administration et posologie : Agents antiVIH.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Agents antiVIH.
- Emploi, Humains, Observance du traitement médicamenteux, Pays développés, Pays en voie de développement.
English descriptors
- KwdEn :
- MESH :
- chemical , administration & dosage : Anti-HIV Agents.
- chemical , therapeutic use : Anti-HIV Agents.
- drug therapy : HIV Infections.
- statistics & numerical data : Employment, Medication Adherence.
- Developed Countries, Developing Countries, Humans.
Abstract
To assess the association between the employment status of human immunodeficiency virus (HIV)-infected individuals and adherence to antiretroviral therapy (ART).
We searched the Medline, Embase and Cochrane Central Register of Controlled Trials databases for studies reporting ART adherence and employment status published between January 1980 and September 2014. Information from a wide range of other sources, including the grey literature, was also analysed. Two independent reviewers extracted data on treatment adherence and study characteristics. Study data on the association between being employed and adhering to ART were pooled using a random-effects model. Between-study heterogeneity and sources of bias were evaluated.
The meta-analysis included 28 studies published between 1996 and 2014 that together involved 8743 HIV-infected individuals from 14 countries. The overall pooled odds ratio (OR) for the association between being employed and adhering to ART was 1.27 (95% confidence interval, CI: 1.04–1.55). The association was significant for studies from low-income countries (OR: 1.85, 95% CI: 1.58–2.18) and high-income countries (OR: 1.33, 95% CI: 1.02–1.74) but not middle-income countries (OR: 0.94, 95% CI: 0.62–1.42). In addition, studies published after 2011 and larger studies showed less association between employment and adherence than earlier and small studies, respectively.
Employed HIV-infected individuals, particularly those in low- and high-income countries, were more likely to adhere to ART than unemployed individuals. Further research is needed on the mechanisms by which employment and ART adherence affect each other and on whether employment-creation interventions can positively influence ART adherence, HIV disease progression and quality of life.
Url:
DOI: 10.2471/BLT.14.138149
PubMed: 25558105
PubMed Central: 4271680
Affiliations:
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PMC:4271680Le document en format XML
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Nachega</name><affiliation><nlm:aff id="aff1">Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 503 Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261, United States of America (USA).</nlm:aff><wicri:noCountry code="subfield">United States of America (USA).</wicri:noCountry></affiliation></author><author><name sortKey="Uthman, Olalekan A" sort="Uthman, Olalekan A" uniqKey="Uthman O" first="Olalekan A" last="Uthman">Olalekan A. Uthman</name><affiliation><nlm:aff id="aff2">Warwick Centre for Applied Health Research and Delivery, University of Warwick, Coventry,<country>England</country>.</nlm:aff><wicri:noCountry code="nlm country">England</wicri:noCountry></affiliation></author><author><name sortKey="Peltzer, Karl" sort="Peltzer, Karl" uniqKey="Peltzer K" first="Karl" last="Peltzer">Karl Peltzer</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Psychology, University of Limpopo, Turfloop,<country>South Africa</country>.</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Richardson, Lindsey A" sort="Richardson, Lindsey A" uniqKey="Richardson L" first="Lindsey A" last="Richardson">Lindsey A. 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Mills</name><affiliation wicri:level="1"><nlm:aff id="aff5">Stanford Prevention Research Center, Stanford University, Stanford,<country>USA</country>.</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Amekudzi, Kofi" sort="Amekudzi, Kofi" uniqKey="Amekudzi K" first="Kofi" last="Amekudzi">Kofi Amekudzi</name><affiliation wicri:level="1"><nlm:aff id="aff6">HIV/AIDS and the World of Work Branch (ILOAIDS), International Labour Organization, Geneva,<country>Switzerland</country>.</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ouedraogo, Alice" sort="Ouedraogo, Alice" uniqKey="Ouedraogo A" first="Alice" last="Ouédraogo">Alice Ouédraogo</name><affiliation wicri:level="1"><nlm:aff id="aff6">HIV/AIDS and the World of Work Branch (ILOAIDS), International Labour Organization, Geneva,<country>Switzerland</country>.</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Bulletin of the World Health Organization</title><idno type="ISSN">0042-9686</idno><idno type="eISSN">1564-0604</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-HIV Agents (administration & dosage)</term><term>Anti-HIV Agents (therapeutic use)</term><term>Developed Countries</term><term>Developing Countries</term><term>Employment (statistics & numerical data)</term><term>HIV Infections (drug therapy)</term><term>Humans</term><term>Medication Adherence (statistics & numerical data)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Agents antiVIH (administration et posologie)</term><term>Agents antiVIH (usage thérapeutique)</term><term>Emploi ()</term><term>Humains</term><term>Infections à VIH (traitement médicamenteux)</term><term>Observance du traitement médicamenteux ()</term><term>Pays développés</term><term>Pays en voie de développement</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-HIV Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Agents antiVIH</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Employment</term><term>Medication Adherence</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agents antiVIH</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Developed Countries</term><term>Developing Countries</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Emploi</term><term>Humains</term><term>Observance du traitement médicamenteux</term><term>Pays développés</term><term>Pays en voie de développement</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec><title>Objective</title><p>To assess the association between the employment status of human immunodeficiency virus (HIV)-infected individuals and adherence to antiretroviral therapy (ART).</p></sec><sec><title>Methods</title><p>We searched the Medline, Embase and Cochrane Central Register of Controlled Trials databases for studies reporting ART adherence and employment status published between January 1980 and September 2014. Information from a wide range of other sources, including the grey literature, was also analysed. Two independent reviewers extracted data on treatment adherence and study characteristics. Study data on the association between being employed and adhering to ART were pooled using a random-effects model. Between-study heterogeneity and sources of bias were evaluated.</p></sec><sec><title>Findings</title><p>The meta-analysis included 28 studies published between 1996 and 2014 that together involved 8743 HIV-infected individuals from 14 countries. The overall pooled odds ratio (OR) for the association between being employed and adhering to ART was 1.27 (95% confidence interval, CI: 1.04–1.55). The association was significant for studies from low-income countries (OR: 1.85, 95% CI: 1.58–2.18) and high-income countries (OR: 1.33, 95% CI: 1.02–1.74) but not middle-income countries (OR: 0.94, 95% CI: 0.62–1.42). In addition, studies published after 2011 and larger studies showed less association between employment and adherence than earlier and small studies, respectively.</p></sec><sec><title>Conclusion</title><p>Employed HIV-infected individuals, particularly those in low- and high-income countries, were more likely to adhere to ART than unemployed individuals. Further research is needed on the mechanisms by which employment and ART adherence affect each other and on whether employment-creation interventions can positively influence ART adherence, HIV disease progression and quality of life.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Canada</li><li>Suisse</li><li>États-Unis</li></country></list><tree><noCountry><name sortKey="Nachega, Jean B" sort="Nachega, Jean B" uniqKey="Nachega J" first="Jean B" last="Nachega">Jean B. Nachega</name><name sortKey="Uthman, Olalekan A" sort="Uthman, Olalekan A" uniqKey="Uthman O" first="Olalekan A" last="Uthman">Olalekan A. Uthman</name></noCountry><country name="Afrique du Sud"><noRegion><name sortKey="Peltzer, Karl" sort="Peltzer, Karl" uniqKey="Peltzer K" first="Karl" last="Peltzer">Karl Peltzer</name></noRegion></country><country name="Canada"><noRegion><name sortKey="Richardson, Lindsey A" sort="Richardson, Lindsey A" uniqKey="Richardson L" first="Lindsey A" last="Richardson">Lindsey A. Richardson</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Mills, Edward J" sort="Mills, Edward J" uniqKey="Mills E" first="Edward J" last="Mills">Edward J. Mills</name></noRegion></country><country name="Suisse"><noRegion><name sortKey="Amekudzi, Kofi" sort="Amekudzi, Kofi" uniqKey="Amekudzi K" first="Kofi" last="Amekudzi">Kofi Amekudzi</name></noRegion><name sortKey="Ouedraogo, Alice" sort="Ouedraogo, Alice" uniqKey="Ouedraogo A" first="Alice" last="Ouédraogo">Alice Ouédraogo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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