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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Early warning indicators for first-line virologic failure independent of adherence measures in a South African Urban clinic
AIDS Patient Care and STDs, Volume 27, No. 12, Year 2013
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Description
We sought to develop individual-level Early Warning Indicators (EWI) of virologic failure (VF) for clinicians to use during routine care complementing WHO population-level EWI. A case-control study was conducted at a Durban clinic. Patients after≥5 months of first-line antiretroviral therapy (ART) were defined as cases if they had VF [HIV-1 viral load (VL)>1000 copies/mL] and controls (2:1) if they had VL≤1000 copies/mL. Pharmacy refills and pill counts were used as adherence measures. Participants responded to a questionnaire including validated psychosocial and symptom scales. Data were also collected from the medical record. Multivariable logistic regression models of VF included factors associated with VF (p<0.05) in univariable analyses. We enrolled 158 cases and 300 controls. In the final multivariable model, male gender, not having an active religious faith, practicing unsafe sex, having a family member with HIV, not being pleased with the clinic experience, symptoms of depression, fatigue, or rash, low CD4 counts, family recommending HIV care, and using a TV/radio as ART reminders (compared to mobile phones) were associated with VF independent of adherence measures. In this setting, we identified several key individual-level EWI associated with VF including novel psychosocial factors independent of adherence measures. © 2013 Mary Ann Liebert, Inc.
Authors & Co-Authors
Marconi, Vincent Charles
United States, Atlanta
Emory University School of Medicine
United States, Atlanta
Rollins School of Public Health
United States, Decatur
Atlanta va Medical Center
Wu, Baohua
United States, Atlanta
Rollins School of Public Health
Hampton, Jane
South Africa, Durban
Mccord Hospital
Ordóñez, Claudia E.
South Africa, Durban
Mccord Hospital
Johnson, Brent Alan
United States, Atlanta
Rollins School of Public Health
Singh, Dinesh Kumar
South Africa, Durban
Mccord Hospital
John, Sally
South Africa, Durban
Mccord Hospital
Gordon, Michelle L.
South Africa, Durban
The Nelson R. Mandela Medical School
Hare, Anna Quinn
United States, Atlanta
Emory University School of Medicine
Murphy, Richard A.
United States, New York
Albert Einstein College of Medicine of Yeshiva University
Nachega, J. B.
United States, Pittsburgh
University of Pittsburgh
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Kuritzkes, Daniel R.D.
United States, Boston
Brigham and Women's Hospital
Del Rio, Carlos D.
United States, Atlanta
Emory University School of Medicine
United States, Atlanta
Rollins School of Public Health
Sunpath, Henry
South Africa, Durban
Mccord Hospital
South Africa, Durban
The Nelson R. Mandela Medical School
Statistics
Citations: 43
Authors: 14
Affiliations: 10
Identifiers
Doi:
10.1089/apc.2013.0263
ISSN:
10872914
e-ISSN:
15577449
Research Areas
Health System And Policy
Infectious Diseases
Mental Health
Study Design
Cross Sectional Study
Case-Control Study
Participants Gender
Male