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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Adherence to PI-based 2nd-line regimens in Cambodia is not simply a question of individual behaviour: the ANRS 12276 2PICAM study
Tropical Medicine and International Health, Volume 22, No. 11, Year 2017
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Description
Objectives: To investigate whether adherence to antiretroviral treatment (ART) can be explained not only by individual factors but also by health care facilities' characteristics, among a sample of people living with HIV (PLWH) treated with PI-based regimens in Cambodia. Methods: The ANRS 12276 2PICAM cross-sectional survey was conducted between February 2013 and April 2014 among PLWH followed up in 13 health care facilities. The 1316 patients in this analysis corresponded to 90% of the total number of adult patients treated with 2nd-line PI-based regimens in Cambodia in the study period. A variable indicating whether patients were non-adherent (=1) or completely adherent (=0) was constructed. Health care facilities and individual characteristics were included in a two-level logistic model to investigate their influence on patients' adherence to ART. Results: A total of 17% of participants did not adhere to ART. Patients in health care facilities outside the capital Phnom Penh were six times more likely to be non-adherent than those treated in health care facilities in the capital (OR: 6.15, 95% CI [1.47, 25.79]). Providing psychosocial care (provided by psychologist counsellors and/or full-time coaches) was found to be a structural facilitator of adherence, as the probability of non-adherence fell by 38.5% per each additional psychological worker present in health care facilities (OR: 0.62, 95% CI [0.43, 0.89]). Financial constraints were the main individual factor preventing adherence. Conclusions: Our results suggest that inefficiencies in health care delivery are detrimental to PLWH health and to the exceptional progress currently being made by Cambodia in response to HIV. Policy makers should focus on increasing the number of psychosocial workers, especially in areas outside the capital. © 2017 John Wiley & Sons Ltd
Authors & Co-Authors
Sagaon-Teyssier, Luis
France, Paris
Inserm
France, Marseille
Observatoire Regional de la Sante Provence-alpes-cote D'azur
M’madi Mrenda, Bakridine
France, Paris
Inserm
France, Marseille
Observatoire Regional de la Sante Provence-alpes-cote D'azur
Khol, Vohith
Cambodia, Phnom Penh
National Center for Hiv/aids
Ferradini, Laurent L.F.
Cambodia, Phnom Penh
Who
Ngin, Sopheak
Cambodia, Phnom Penh
National Center for Hiv/aids
Mora, Marion
France, Paris
Inserm
France, Marseille
Observatoire Regional de la Sante Provence-alpes-cote D'azur
Maradan, Gwenaelle
France, Paris
Inserm
France, Marseille
Observatoire Regional de la Sante Provence-alpes-cote D'azur
Ségéral, Olivier
Cambodia, Phnom Penh
University of Health Sciences
France, Paris
French National Agency for Research on Aids and Viral Hepatitis
Nerrienet, Eric
France, Paris
Institut Pasteur, Paris
Saphonn, Vonthanak
Cambodia, Phnom Penh
National Center for Hiv/aids
Cambodia, Phnom Penh
University of Health Sciences
Spire, Bruno
France, Paris
Inserm
France, Marseille
Observatoire Regional de la Sante Provence-alpes-cote D'azur
Statistics
Citations: 4
Authors: 11
Affiliations: 7
Identifiers
Doi:
10.1111/tmi.12975
ISSN:
13602276
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative