Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Antiretroviral therapy refusal among newly diagnosed HIV-infected adults
AIDS, Volume 25, No. 17, Year 2011
Notification
URL copied to clipboard!
Description
OBJECTIVE:: To determine rates and predictors of treatment refusal in newly identified HIV-infected individuals in Soweto, South Africa. DESIGN:: It is designed as a cross-sectional study. METHODS:: We analyzed data from adult clients (>18 years) presenting for voluntary counseling and testing (VCT) at the Zazi Testing Center, Perinatal HIV Research Unit to determine rates of antiretroviral therapy (ART) refusal among treatment-eligible, HIV-infected individuals (CD4 cell count < 200 cells/μl or WHO stage 4). Multiple logistic regression models were used to investigate factors associated with refusal. RESULTS:: From December 2008 to December 2009, 7287 adult clients were HIV tested after counseling. Two thousand, five hundred and sixty-two (35%) were HIV-infected, of whom 743 (29%) were eligible for immediate ART. One hundred and forty-eight (20%) refused referral to initiate ART, most of whom (92%) continued to refuse after 2 months of counseling. The leading reason for ART refusal was given as 'feeling healthy' (37%), despite clients having a median CD4 cell count of 110 cells/μl and triple the rate of active tuberculosis as seen in nonrefusers. In adjusted models, single clients [adjusted odds ratio (AOR) 1.80, 95% confidence interval (CI) 1.06-3.06] and those with active tuberculosis (AOR 3.50, 95% CI 1.55-6.61) were more likely to refuse ART. CONCLUSION:: Nearly one in five treatment-eligible HIV-infected individuals in Soweto refused to initiate ART after VCT, putting them at higher risk for early mortality. 'Feeling healthy' was given as the most common reason to refuse ART, despite a suppressed CD4 count and comorbidities such as tuberculosis. These findings highlight the urgent need for research to inform interventions targeting ART refusers. © 2011 Wolters Kluwer Health Lippincott Williams & Wilkins.
Authors & Co-Authors
Katz, Ingrid T.
United States, Boston
Brigham and Women's Hospital
United States, Boston
Harvard Medical School
Essien, Thandekile
South Africa, Johannesburg
Perinatal Hiv Research Unit
Marinda, Edmore T.
South Africa, Johannesburg
Wits School of Public Health
Gray, Glenda E.
South Africa, Johannesburg
Perinatal Hiv Research Unit
Bangsberg, David R.
United States, Boston
Harvard Medical School
Uganda, Mbarara
Mbarara University of Science and Technology
United States, Boston
Massachusetts General Hospital
United States, Cambridge
Massachusetts Institute of Technology
Martinson, Neil Alexander
South Africa, Johannesburg
Perinatal Hiv Research Unit
United States, Baltimore
Johns Hopkins School of Medicine
De Bruyn, Guy
South Africa, Johannesburg
Perinatal Hiv Research Unit
Statistics
Citations: 111
Authors: 7
Affiliations: 8
Identifiers
Doi:
10.1097/QAD.0b013e32834b6464
e-ISSN:
14735571
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Case-Control Study
Study Approach
Quantitative
Study Locations
South Africa