Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam
Identifieur interne : 002930 ( Pmc/Curation ); précédent : 002929; suivant : 002931Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam
Auteurs : Bach Xuan Tran [Viêt Nam, États-Unis] ; Jongnam Hwang [Corée du Sud] ; Long Hoang Nguyen [Viêt Nam] ; Anh Tuan Nguyen [Viêt Nam] ; Noah Reed Knowlton Latkin [États-Unis] ; Ngoc Kim Tran [Viêt Nam] ; Vu Thi Minh Thuc [Viêt Nam] ; Huong Lan Thi Nguyen [Viêt Nam] ; Huong Thu Thi Phan [Viêt Nam] ; Huong Thi Le [Viêt Nam] ; Tho Dinh Tran [Viêt Nam] ; Carl A. Latkin [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality.
A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART.
Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes
The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes.
Url:
DOI: 10.1371/journal.pone.0168687
PubMed: 28005937
PubMed Central: 5179124
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wicri:step="Curation">002930</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam</title><author><name sortKey="Tran, Bach Xuan" sort="Tran, Bach Xuan" uniqKey="Tran B" first="Bach Xuan" last="Tran">Bach Xuan Tran</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea></affiliation></author><author><name sortKey="Hwang, Jongnam" sort="Hwang, Jongnam" uniqKey="Hwang J" first="Jongnam" last="Hwang">Jongnam Hwang</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Department of Health Promotion, Daegu University, Gyeongsan, Republic of Korea</addr-line></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Health Promotion, Daegu University, Gyeongsan</wicri:regionArea></affiliation></author><author><name sortKey="Nguyen, Long Hoang" sort="Nguyen, Long Hoang" uniqKey="Nguyen L" first="Long Hoang" last="Nguyen">Long Hoang Nguyen</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>School of Medicine and Pharmacy, Vietnam National University, Hanoi</wicri:regionArea></affiliation></author><author><name sortKey="Nguyen, Anh Tuan" sort="Nguyen, Anh Tuan" uniqKey="Nguyen A" first="Anh Tuan" last="Nguyen">Anh Tuan Nguyen</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Institute for Global Health Innovations, Duy Tan University, Da Nang</wicri:regionArea></affiliation></author><author><name sortKey="Latkin, Noah Reed Knowlton" sort="Latkin, Noah Reed Knowlton" uniqKey="Latkin N" first="Noah Reed Knowlton" last="Latkin">Noah Reed Knowlton Latkin</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea></affiliation></author><author><name sortKey="Tran, Ngoc Kim" sort="Tran, Ngoc Kim" uniqKey="Tran N" first="Ngoc Kim" last="Tran">Ngoc Kim Tran</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Woolcock Medical Research Institute, Hanoi, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Woolcock Medical Research Institute, Hanoi</wicri:regionArea></affiliation></author><author><name sortKey="Minh Thuc, Vu Thi" sort="Minh Thuc, Vu Thi" uniqKey="Minh Thuc V" first="Vu Thi" last="Minh Thuc">Vu Thi Minh Thuc</name><affiliation wicri:level="1"><nlm:aff id="aff007"><addr-line>Department of Immunology and Allergy, National Otolaryngology Hospital, Hanoi, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Department of Immunology and Allergy, National Otolaryngology Hospital, Hanoi</wicri:regionArea></affiliation></author><author><name sortKey="Nguyen, Huong Lan Thi" sort="Nguyen, Huong Lan Thi" uniqKey="Nguyen H" first="Huong Lan Thi" last="Nguyen">Huong Lan Thi Nguyen</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Institute for Global Health Innovations, Duy Tan University, Da Nang</wicri:regionArea></affiliation></author><author><name sortKey="Phan, Huong Thu Thi" sort="Phan, Huong Thu Thi" uniqKey="Phan H" first="Huong Thu Thi" last="Phan">Huong Thu Thi Phan</name><affiliation wicri:level="1"><nlm:aff id="aff008"><addr-line>Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Authority of HIV/AIDS Control, Ministry of Health, Hanoi</wicri:regionArea></affiliation></author><author><name sortKey="Le, Huong Thi" sort="Le, Huong Thi" uniqKey="Le H" first="Huong Thi" last="Le">Huong Thi Le</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi</wicri:regionArea></affiliation></author><author><name sortKey="Tran, Tho Dinh" sort="Tran, Tho Dinh" uniqKey="Tran T" first="Tho Dinh" last="Tran">Tho Dinh Tran</name><affiliation wicri:level="1"><nlm:aff id="aff009"><addr-line>Department of Hepatobiliary Surgery, Vietnam-Germany Hospital, Hanoi, Vietnam</addr-line></nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Department of Hepatobiliary Surgery, Vietnam-Germany Hospital, Hanoi</wicri:regionArea></affiliation></author><author><name sortKey="Latkin, Carl A" sort="Latkin, Carl A" uniqKey="Latkin C" first="Carl A." last="Latkin">Carl A. Latkin</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality.</p></sec><sec id="sec002"><title>Methods</title><p>A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART.</p></sec><sec id="sec003"><title>Results</title><p>Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes</p></sec><sec id="sec004"><title>Conclusion</title><p>The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Jain, Mk" uniqKey="Jain M">MK Jain</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Castelnuovo, B" uniqKey="Castelnuovo B">B Castelnuovo</name></author><author><name sortKey="Manabe, Yc" uniqKey="Manabe Y">YC Manabe</name></author><author><name sortKey="Kiragga, A" uniqKey="Kiragga A">A Kiragga</name></author><author><name sortKey="Kamya, M" uniqKey="Kamya M">M Kamya</name></author><author><name sortKey="Easterbrook, P" uniqKey="Easterbrook P">P Easterbrook</name></author><author><name sortKey="Kambugu, A" uniqKey="Kambugu A">A Kambugu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zwahlen, M" uniqKey="Zwahlen M">M Zwahlen</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28005937</article-id><article-id pub-id-type="pmc">5179124</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0168687</article-id><article-id pub-id-type="publisher-id">PONE-D-16-34513</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Health Care</subject><subj-group><subject>Socioeconomic Aspects of Health</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Public and Occupational Health</subject><subj-group><subject>Socioeconomic Aspects of Health</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Immunology</subject><subj-group><subject>Vaccination and Immunization</subject><subj-group><subject>Antiviral Therapy</subject><subj-group><subject>Antiretroviral Therapy</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Immunology</subject><subj-group><subject>Vaccination and Immunization</subject><subj-group><subject>Antiviral Therapy</subject><subj-group><subject>Antiretroviral Therapy</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Public and Occupational Health</subject><subj-group><subject>Preventive Medicine</subject><subj-group><subject>Vaccination and Immunization</subject><subj-group><subject>Antiviral Therapy</subject><subj-group><subject>Antiretroviral Therapy</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Social Sciences</subject><subj-group><subject>Sociology</subject><subj-group><subject>Social Stratification</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Microbiology</subject><subj-group><subject>Medical Microbiology</subject><subj-group><subject>Microbial Pathogens</subject><subj-group><subject>Viral Pathogens</subject><subj-group><subject>Immunodeficiency Viruses</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pathology and Laboratory Medicine</subject><subj-group><subject>Pathogens</subject><subj-group><subject>Microbial Pathogens</subject><subj-group><subject>Viral Pathogens</subject><subj-group><subject>Immunodeficiency Viruses</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Organisms</subject><subj-group><subject>Viruses</subject><subj-group><subject>Viral Pathogens</subject><subj-group><subject>Immunodeficiency Viruses</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Organisms</subject><subj-group><subject>Viruses</subject><subj-group><subject>Immunodeficiency Viruses</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and life sciences</subject><subj-group><subject>Organisms</subject><subj-group><subject>Viruses</subject><subj-group><subject>RNA viruses</subject><subj-group><subject>Retroviruses</subject><subj-group><subject>Lentivirus</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Microbiology</subject><subj-group><subject>Medical Microbiology</subject><subj-group><subject>Microbial Pathogens</subject><subj-group><subject>Viral Pathogens</subject><subj-group><subject>Retroviruses</subject><subj-group><subject>Lentivirus</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pathology and Laboratory Medicine</subject><subj-group><subject>Pathogens</subject><subj-group><subject>Microbial Pathogens</subject><subj-group><subject>Viral Pathogens</subject><subj-group><subject>Retroviruses</subject><subj-group><subject>Lentivirus</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Organisms</subject><subj-group><subject>Viruses</subject><subj-group><subject>Viral Pathogens</subject><subj-group><subject>Retroviruses</subject><subj-group><subject>Lentivirus</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject><subj-group><subject>Geographical Locations</subject><subj-group><subject>Asia</subject><subj-group><subject>Vietnam</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and health sciences</subject><subj-group><subject>Epidemiology</subject><subj-group><subject>HIV epidemiology</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Health Care</subject><subj-group><subject>Quality of Life</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pharmaceutics</subject><subj-group><subject>Drug Therapy</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam</article-title><alt-title alt-title-type="running-head">Socioeconomic Inequality in Antiretroviral Treatment</alt-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Tran</surname><given-names>Bach Xuan</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="aff" rid="aff002"><sup>2</sup></xref><xref ref-type="corresp" rid="cor001">*</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Hwang</surname><given-names>Jongnam</given-names></name><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nguyen</surname><given-names>Long Hoang</given-names></name><xref ref-type="aff" rid="aff004"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nguyen</surname><given-names>Anh Tuan</given-names></name><xref ref-type="aff" rid="aff005"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Latkin</surname><given-names>Noah Reed Knowlton</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tran</surname><given-names>Ngoc Kim</given-names></name><xref ref-type="aff" rid="aff006"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Minh Thuc</surname><given-names>Vu Thi</given-names></name><xref ref-type="aff" rid="aff007"><sup>7</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nguyen</surname><given-names>Huong Lan Thi</given-names></name><xref ref-type="aff" rid="aff005"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Phan</surname><given-names>Huong Thu Thi</given-names></name><xref ref-type="aff" rid="aff008"><sup>8</sup></xref></contrib><contrib contrib-type="author"><name><surname>Le</surname><given-names>Huong Thi</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tran</surname><given-names>Tho Dinh</given-names></name><xref ref-type="aff" rid="aff009"><sup>9</sup></xref></contrib><contrib contrib-type="author"><name><surname>Latkin</surname><given-names>Carl A.</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib></contrib-group><aff id="aff001"><label>1</label><addr-line>Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam</addr-line></aff><aff id="aff002"><label>2</label><addr-line>Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America</addr-line></aff><aff id="aff003"><label>3</label><addr-line>Department of Health Promotion, Daegu University, Gyeongsan, Republic of Korea</addr-line></aff><aff id="aff004"><label>4</label><addr-line>School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam</addr-line></aff><aff id="aff005"><label>5</label><addr-line>Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam</addr-line></aff><aff id="aff006"><label>6</label><addr-line>Woolcock Medical Research Institute, Hanoi, Vietnam</addr-line></aff><aff id="aff007"><label>7</label><addr-line>Department of Immunology and Allergy, National Otolaryngology Hospital, Hanoi, Vietnam</addr-line></aff><aff id="aff008"><label>8</label><addr-line>Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam</addr-line></aff><aff id="aff009"><label>9</label><addr-line>Department of Hepatobiliary Surgery, Vietnam-Germany Hospital, Hanoi, Vietnam</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Goldenberg</surname><given-names>Shira M</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Simon Fraser University, CANADA</addr-line></aff><author-notes><fn fn-type="COI-statement" id="coi001"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con"><p><list list-type="simple"><list-item><p><bold>Conceptualization:</bold> BXT HTTP CAL HTL TDT JH.</p></list-item><list-item><p><bold>Data curation:</bold> BXT HTTP CAL HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item><list-item><p><bold>Formal analysis:</bold> BXT HTTP CAL HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item><list-item><p><bold>Funding acquisition:</bold> BXT HTTP CAL.</p></list-item><list-item><p><bold>Investigation:</bold> BXT HTTP HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item><list-item><p><bold>Methodology:</bold> BXT HTTP CAL HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item><list-item><p><bold>Project administration:</bold> BXT HTTP CAL HTL TDT JH.</p></list-item><list-item><p><bold>Resources:</bold> BXT HTTP CAL HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item><list-item><p><bold>Software:</bold> BXT HTTP CAL HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item><list-item><p><bold>Supervision:</bold> BXT HTTP CAL HTL TDT JH.</p></list-item><list-item><p><bold>Validation:</bold> BXT HTTP CAL HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item><list-item><p><bold>Visualization:</bold> JH LHN ATN.</p></list-item><list-item><p><bold>Writing – original draft:</bold> BXT HTTP CAL HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item><list-item><p><bold>Writing – review & editing:</bold> BXT HTTP CAL HTL TDT JH LHN ATN VTMT HLTN NRKL NKT.</p></list-item></list></p></fn><corresp id="cor001">* E-mail: <email>bach@hmu.edu.vn</email></corresp></author-notes><pub-date pub-type="epub"><day>22</day><month>12</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>11</volume><issue>12</issue><elocation-id>e0168687</elocation-id><history><date date-type="received"><day>29</day><month>8</month><year>2016</year></date><date date-type="accepted"><day>5</day><month>12</month><year>2016</year></date></history><permissions><copyright-statement>© 2016 Tran et al</copyright-statement><copyright-year>2016</copyright-year><copyright-holder>Tran et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="pone.0168687.pdf"></self-uri><abstract><sec id="sec001"><title>Background</title><p>Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality.</p></sec><sec id="sec002"><title>Methods</title><p>A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART.</p></sec><sec id="sec003"><title>Results</title><p>Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes</p></sec><sec id="sec004"><title>Conclusion</title><p>The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes.</p></sec></abstract><funding-group><funding-statement>The authors received no specific funding for this work.</funding-statement></funding-group><counts><fig-count count="1"></fig-count><table-count count="4"></table-count><page-count count="13"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>Data are owned by the Vietnam Authority of HIV/AIDS Control; therefore, the dataset cannot be shared publicly. Requests for data can be sent to Dr. Phan Thi Thu Huong, Vice Director of the Vietnam Authority of HIV/AIDS Control (<email>huongphanmoh@gmail.com</email>).</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>Data are owned by the Vietnam Authority of HIV/AIDS Control; therefore, the dataset cannot be shared publicly. Requests for data can be sent to Dr. Phan Thi Thu Huong, Vice Director of the Vietnam Authority of HIV/AIDS Control (<email>huongphanmoh@gmail.com</email>).</p></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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