Failure to return pillbox is a predictor of being lost to follow‐up among people living with HIV on antiretroviral therapy in rural Tanzania
Objectives Pill count is used to assess drug adherence in people living with HIV (PLHIV). Carrying a pillbox is associated with fear of concealment and stigma and might indicate poor adherence and predict someone who will be lost to follow‐up (LTFU). We therefore assessed the association between pil...
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| Veröffentlicht in: | HIV medicine 2022-07, Vol.23 (6), p.661-672 |
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| creator | Ndege, Robert C. Okuma, James Kalinjuma, Aneth V. Mkumbo, Julius Senkoro, Elizabeth Fue, Gideon Samson, Leila Mapesi, Herry Shabani, Siraji Glass, Tracy R. Battegay, Manuel Paris, Daniel H. Vanobberghen, Fiona Weisser, Maja Asantiel, Aschola Bani, Farida Battegay, Manuel Byakuzana, Theonestina Chale, Adolphina Chuwa, Francisca Eichenberger, Anna Francis, Gideon Furrer, Hansjakob Glass, Tracy R. Hwaya, Speciosa Kalinjuma, Aneth V. Kasuga, Bryson Katende, Andrew Kimera, Namvua Kivuma, Bernard Kisunga, Yassin Kitau, Olivia Klimkait, Thomas Luoga, Ezekiel Mapesi, Herry Mkulila, Mengi Mkumbo, Julius Mkusa, Margareth Mlembe, Slyakus Mnzava, Dorcas K. Mollel, Gertrud J. Moshi, Lilian Mossad, Germana Mpundunga, Dolores Mtandanguo, Athumani Myeya, Selerine Nahota, Sanula Ndaki, Regina Ndege, Robert C. Ngulukila, Agatha Nyuri, Amina Okuma, James Paris, Daniel H. Sambuta, Aloyce Samson, Leila Senkoro, Elizabeth Sikalengo, George Tarimo, Jenifa Temba, Yvan Utzinger, Juerg Vanobberghen, Fiona Wigay, John Wilson, Herieth |
| description | Objectives
Pill count is used to assess drug adherence in people living with HIV (PLHIV). Carrying a pillbox is associated with fear of concealment and stigma and might indicate poor adherence and predict someone who will be lost to follow‐up (LTFU). We therefore assessed the association between pillbox return and being LTFU in rural Tanzania.
Methods
This is a nested study of the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO). We included PLHIV aged ≥ 18 years enrolled in KIULARCO between January 2013 and March 2019 with follow‐up through January 2020, who were on antiretroviral treatment (ART) for ≥ 6 months. Baseline was defined as the latest ART initiation or KIULARCO enrolment. We determined the association between time‐dependent failed pillbox return updated at every visit and LTFU using Kaplan–Meier estimation and Cox models.
Results
Among 2552 PLHIV included in the study, 1735 (68.0%) were female, 959 (40.3%) had a WHO stage III/IV and 1487 (66.4%) had a CD4 cell count |
| doi_str_mv | 10.1111/hiv.13223 |
| format | Article |
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Pill count is used to assess drug adherence in people living with HIV (PLHIV). Carrying a pillbox is associated with fear of concealment and stigma and might indicate poor adherence and predict someone who will be lost to follow‐up (LTFU). We therefore assessed the association between pillbox return and being LTFU in rural Tanzania.
Methods
This is a nested study of the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO). We included PLHIV aged ≥ 18 years enrolled in KIULARCO between January 2013 and March 2019 with follow‐up through January 2020, who were on antiretroviral treatment (ART) for ≥ 6 months. Baseline was defined as the latest ART initiation or KIULARCO enrolment. We determined the association between time‐dependent failed pillbox return updated at every visit and LTFU using Kaplan–Meier estimation and Cox models.
Results
Among 2552 PLHIV included in the study, 1735 (68.0%) were female, 959 (40.3%) had a WHO stage III/IV and 1487 (66.4%) had a CD4 cell count < 350 cells/µL. The median age was 38.4 years [interquartile range (IQR): 31.7–46.2]. During a median follow‐up of 33.1 months (IQR: 17.5–52.4), 909 (35.6%) participants were LTFU, 43 (1.7%) died and 194 (7.6%) had transferred to another clinic. The probability of being LTFU was higher among PLHIV with failed pillbox return than among those who returned their pillbox [30.0%, 95% confidence interval (CI): 26.8–33.2% vs. 19.4%, 95% CI: 17.4–21.6%, respectively, at 24 months (hazard ratio = 1.67, 95% CI: 1.46–1.90; p < 0.001)].
Conclusions
Failed pillbox return was associated with a higher risk of being LTFU and could be used as a simple tool to identify PLHIV for appropriate interventions to reduce their chance of being LTFU.</description><identifier>ISSN: 1464-2662</identifier><identifier>EISSN: 1468-1293</identifier><identifier>DOI: 10.1111/hiv.13223</identifier><identifier>PMID: 34964236</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>adherence ; Adult ; Anti-Retroviral Agents - therapeutic use ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; antiretroviral treatment ; CD4 antigen ; CD4 Lymphocyte Count ; Confidence intervals ; Female ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV treatment outcome ; Human immunodeficiency virus ; Humans ; Lost to Follow-Up ; Male ; Original Research ; pillbox ; rural ; Statistical analysis ; stigma ; sub‐Saharan Africa ; Tanzania - epidemiology</subject><ispartof>HIV medicine, 2022-07, Vol.23 (6), p.661-672</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd on behalf of British HIV Association.</rights><rights>2021 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4433-6b3b365551dfa5bbe1ad7616971a0e116e74f8640e2f680beb0562d3ec3f692f3</citedby><cites>FETCH-LOGICAL-c4433-6b3b365551dfa5bbe1ad7616971a0e116e74f8640e2f680beb0562d3ec3f692f3</cites><orcidid>0000-0002-0134-1929 ; 0000-0003-4743-5987</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhiv.13223$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhiv.13223$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34964236$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ndege, Robert C.</creatorcontrib><creatorcontrib>Okuma, James</creatorcontrib><creatorcontrib>Kalinjuma, Aneth V.</creatorcontrib><creatorcontrib>Mkumbo, Julius</creatorcontrib><creatorcontrib>Senkoro, Elizabeth</creatorcontrib><creatorcontrib>Fue, Gideon</creatorcontrib><creatorcontrib>Samson, Leila</creatorcontrib><creatorcontrib>Mapesi, Herry</creatorcontrib><creatorcontrib>Shabani, Siraji</creatorcontrib><creatorcontrib>Glass, Tracy R.</creatorcontrib><creatorcontrib>Battegay, Manuel</creatorcontrib><creatorcontrib>Paris, Daniel H.</creatorcontrib><creatorcontrib>Vanobberghen, Fiona</creatorcontrib><creatorcontrib>Weisser, Maja</creatorcontrib><creatorcontrib>Asantiel, Aschola</creatorcontrib><creatorcontrib>Bani, Farida</creatorcontrib><creatorcontrib>Battegay, Manuel</creatorcontrib><creatorcontrib>Byakuzana, Theonestina</creatorcontrib><creatorcontrib>Chale, Adolphina</creatorcontrib><creatorcontrib>Chuwa, Francisca</creatorcontrib><creatorcontrib>Eichenberger, Anna</creatorcontrib><creatorcontrib>Francis, Gideon</creatorcontrib><creatorcontrib>Furrer, Hansjakob</creatorcontrib><creatorcontrib>Glass, Tracy R.</creatorcontrib><creatorcontrib>Hwaya, Speciosa</creatorcontrib><creatorcontrib>Kalinjuma, Aneth V.</creatorcontrib><creatorcontrib>Kasuga, Bryson</creatorcontrib><creatorcontrib>Katende, Andrew</creatorcontrib><creatorcontrib>Kimera, Namvua</creatorcontrib><creatorcontrib>Kivuma, Bernard</creatorcontrib><creatorcontrib>Kisunga, Yassin</creatorcontrib><creatorcontrib>Kitau, Olivia</creatorcontrib><creatorcontrib>Klimkait, Thomas</creatorcontrib><creatorcontrib>Luoga, Ezekiel</creatorcontrib><creatorcontrib>Mapesi, Herry</creatorcontrib><creatorcontrib>Mkulila, Mengi</creatorcontrib><creatorcontrib>Mkumbo, Julius</creatorcontrib><creatorcontrib>Mkusa, Margareth</creatorcontrib><creatorcontrib>Mlembe, Slyakus</creatorcontrib><creatorcontrib>Mnzava, Dorcas K.</creatorcontrib><creatorcontrib>Mollel, Gertrud J.</creatorcontrib><creatorcontrib>Moshi, Lilian</creatorcontrib><creatorcontrib>Mossad, Germana</creatorcontrib><creatorcontrib>Mpundunga, Dolores</creatorcontrib><creatorcontrib>Mtandanguo, Athumani</creatorcontrib><creatorcontrib>Myeya, Selerine</creatorcontrib><creatorcontrib>Nahota, Sanula</creatorcontrib><creatorcontrib>Ndaki, Regina</creatorcontrib><creatorcontrib>Ndege, Robert C.</creatorcontrib><creatorcontrib>Ngulukila, Agatha</creatorcontrib><creatorcontrib>Nyuri, Amina</creatorcontrib><creatorcontrib>Okuma, James</creatorcontrib><creatorcontrib>Paris, Daniel H.</creatorcontrib><creatorcontrib>Sambuta, Aloyce</creatorcontrib><creatorcontrib>Samson, Leila</creatorcontrib><creatorcontrib>Senkoro, Elizabeth</creatorcontrib><creatorcontrib>Sikalengo, George</creatorcontrib><creatorcontrib>Tarimo, Jenifa</creatorcontrib><creatorcontrib>Temba, Yvan</creatorcontrib><creatorcontrib>Utzinger, Juerg</creatorcontrib><creatorcontrib>Vanobberghen, Fiona</creatorcontrib><creatorcontrib>Wigay, John</creatorcontrib><creatorcontrib>Wilson, Herieth</creatorcontrib><creatorcontrib>KIULARCO Study Group</creatorcontrib><creatorcontrib>the KIULARCO Study Group</creatorcontrib><title>Failure to return pillbox is a predictor of being lost to follow‐up among people living with HIV on antiretroviral therapy in rural Tanzania</title><title>HIV medicine</title><addtitle>HIV Med</addtitle><description>Objectives
Pill count is used to assess drug adherence in people living with HIV (PLHIV). Carrying a pillbox is associated with fear of concealment and stigma and might indicate poor adherence and predict someone who will be lost to follow‐up (LTFU). We therefore assessed the association between pillbox return and being LTFU in rural Tanzania.
Methods
This is a nested study of the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO). We included PLHIV aged ≥ 18 years enrolled in KIULARCO between January 2013 and March 2019 with follow‐up through January 2020, who were on antiretroviral treatment (ART) for ≥ 6 months. Baseline was defined as the latest ART initiation or KIULARCO enrolment. We determined the association between time‐dependent failed pillbox return updated at every visit and LTFU using Kaplan–Meier estimation and Cox models.
Results
Among 2552 PLHIV included in the study, 1735 (68.0%) were female, 959 (40.3%) had a WHO stage III/IV and 1487 (66.4%) had a CD4 cell count < 350 cells/µL. The median age was 38.4 years [interquartile range (IQR): 31.7–46.2]. During a median follow‐up of 33.1 months (IQR: 17.5–52.4), 909 (35.6%) participants were LTFU, 43 (1.7%) died and 194 (7.6%) had transferred to another clinic. The probability of being LTFU was higher among PLHIV with failed pillbox return than among those who returned their pillbox [30.0%, 95% confidence interval (CI): 26.8–33.2% vs. 19.4%, 95% CI: 17.4–21.6%, respectively, at 24 months (hazard ratio = 1.67, 95% CI: 1.46–1.90; p < 0.001)].
Conclusions
Failed pillbox return was associated with a higher risk of being LTFU and could be used as a simple tool to identify PLHIV for appropriate interventions to reduce their chance of being LTFU.</description><subject>adherence</subject><subject>Adult</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>antiretroviral treatment</subject><subject>CD4 antigen</subject><subject>CD4 Lymphocyte Count</subject><subject>Confidence intervals</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV treatment outcome</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Lost to Follow-Up</subject><subject>Male</subject><subject>Original Research</subject><subject>pillbox</subject><subject>rural</subject><subject>Statistical analysis</subject><subject>stigma</subject><subject>sub‐Saharan Africa</subject><subject>Tanzania - 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Julius</creator><creator>Senkoro, Elizabeth</creator><creator>Fue, Gideon</creator><creator>Samson, Leila</creator><creator>Mapesi, Herry</creator><creator>Shabani, Siraji</creator><creator>Glass, Tracy R.</creator><creator>Battegay, Manuel</creator><creator>Paris, Daniel H.</creator><creator>Vanobberghen, Fiona</creator><creator>Weisser, Maja</creator><creator>Asantiel, Aschola</creator><creator>Bani, Farida</creator><creator>Battegay, Manuel</creator><creator>Byakuzana, Theonestina</creator><creator>Chale, Adolphina</creator><creator>Chuwa, Francisca</creator><creator>Eichenberger, Anna</creator><creator>Francis, Gideon</creator><creator>Furrer, Hansjakob</creator><creator>Glass, Tracy R.</creator><creator>Hwaya, Speciosa</creator><creator>Kalinjuma, Aneth V.</creator><creator>Kasuga, Bryson</creator><creator>Katende, Andrew</creator><creator>Kimera, Namvua</creator><creator>Kivuma, Bernard</creator><creator>Kisunga, Yassin</creator><creator>Kitau, Olivia</creator><creator>Klimkait, 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John</creator><creator>Wilson, Herieth</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0134-1929</orcidid><orcidid>https://orcid.org/0000-0003-4743-5987</orcidid></search><sort><creationdate>202207</creationdate><title>Failure to return pillbox is a predictor of being lost to follow‐up among people living with HIV on antiretroviral therapy in rural Tanzania</title><author>Ndege, Robert C. ; Okuma, James ; Kalinjuma, Aneth V. ; Mkumbo, Julius ; Senkoro, Elizabeth ; Fue, Gideon ; Samson, Leila ; Mapesi, Herry ; Shabani, Siraji ; Glass, Tracy R. ; Battegay, Manuel ; Paris, Daniel H. ; Vanobberghen, Fiona ; Weisser, Maja ; Asantiel, Aschola ; Bani, Farida ; Battegay, Manuel ; Byakuzana, Theonestina ; Chale, Adolphina ; Chuwa, Francisca ; Eichenberger, Anna ; Francis, Gideon ; Furrer, Hansjakob ; Glass, Tracy R. ; Hwaya, Speciosa ; Kalinjuma, Aneth V. ; Kasuga, Bryson ; Katende, Andrew ; Kimera, Namvua ; Kivuma, Bernard ; Kisunga, Yassin ; Kitau, Olivia ; Klimkait, Thomas ; Luoga, Ezekiel ; Mapesi, Herry ; Mkulila, Mengi ; Mkumbo, Julius ; Mkusa, Margareth ; Mlembe, Slyakus ; Mnzava, Dorcas K. ; Mollel, Gertrud J. ; Moshi, Lilian ; Mossad, Germana ; Mpundunga, Dolores ; Mtandanguo, Athumani ; Myeya, Selerine ; Nahota, Sanula ; Ndaki, Regina ; Ndege, Robert C. ; Ngulukila, Agatha ; Nyuri, Amina ; Okuma, James ; Paris, Daniel H. ; Sambuta, Aloyce ; Samson, Leila ; Senkoro, Elizabeth ; Sikalengo, George ; Tarimo, Jenifa ; Temba, Yvan ; Utzinger, Juerg ; Vanobberghen, Fiona ; Wigay, John ; Wilson, Herieth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4433-6b3b365551dfa5bbe1ad7616971a0e116e74f8640e2f680beb0562d3ec3f692f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>adherence</topic><topic>Adult</topic><topic>Anti-Retroviral Agents - therapeutic use</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>antiretroviral treatment</topic><topic>CD4 antigen</topic><topic>CD4 Lymphocyte Count</topic><topic>Confidence intervals</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV treatment outcome</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Lost to Follow-Up</topic><topic>Male</topic><topic>Original Research</topic><topic>pillbox</topic><topic>rural</topic><topic>Statistical analysis</topic><topic>stigma</topic><topic>sub‐Saharan Africa</topic><topic>Tanzania - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ndege, Robert C.</creatorcontrib><creatorcontrib>Okuma, James</creatorcontrib><creatorcontrib>Kalinjuma, Aneth V.</creatorcontrib><creatorcontrib>Mkumbo, Julius</creatorcontrib><creatorcontrib>Senkoro, Elizabeth</creatorcontrib><creatorcontrib>Fue, Gideon</creatorcontrib><creatorcontrib>Samson, Leila</creatorcontrib><creatorcontrib>Mapesi, Herry</creatorcontrib><creatorcontrib>Shabani, Siraji</creatorcontrib><creatorcontrib>Glass, Tracy R.</creatorcontrib><creatorcontrib>Battegay, Manuel</creatorcontrib><creatorcontrib>Paris, Daniel H.</creatorcontrib><creatorcontrib>Vanobberghen, Fiona</creatorcontrib><creatorcontrib>Weisser, Maja</creatorcontrib><creatorcontrib>Asantiel, Aschola</creatorcontrib><creatorcontrib>Bani, Farida</creatorcontrib><creatorcontrib>Battegay, Manuel</creatorcontrib><creatorcontrib>Byakuzana, Theonestina</creatorcontrib><creatorcontrib>Chale, Adolphina</creatorcontrib><creatorcontrib>Chuwa, Francisca</creatorcontrib><creatorcontrib>Eichenberger, Anna</creatorcontrib><creatorcontrib>Francis, Gideon</creatorcontrib><creatorcontrib>Furrer, Hansjakob</creatorcontrib><creatorcontrib>Glass, Tracy R.</creatorcontrib><creatorcontrib>Hwaya, Speciosa</creatorcontrib><creatorcontrib>Kalinjuma, Aneth V.</creatorcontrib><creatorcontrib>Kasuga, Bryson</creatorcontrib><creatorcontrib>Katende, Andrew</creatorcontrib><creatorcontrib>Kimera, Namvua</creatorcontrib><creatorcontrib>Kivuma, Bernard</creatorcontrib><creatorcontrib>Kisunga, Yassin</creatorcontrib><creatorcontrib>Kitau, Olivia</creatorcontrib><creatorcontrib>Klimkait, Thomas</creatorcontrib><creatorcontrib>Luoga, Ezekiel</creatorcontrib><creatorcontrib>Mapesi, Herry</creatorcontrib><creatorcontrib>Mkulila, Mengi</creatorcontrib><creatorcontrib>Mkumbo, Julius</creatorcontrib><creatorcontrib>Mkusa, Margareth</creatorcontrib><creatorcontrib>Mlembe, Slyakus</creatorcontrib><creatorcontrib>Mnzava, Dorcas K.</creatorcontrib><creatorcontrib>Mollel, Gertrud J.</creatorcontrib><creatorcontrib>Moshi, Lilian</creatorcontrib><creatorcontrib>Mossad, Germana</creatorcontrib><creatorcontrib>Mpundunga, Dolores</creatorcontrib><creatorcontrib>Mtandanguo, Athumani</creatorcontrib><creatorcontrib>Myeya, Selerine</creatorcontrib><creatorcontrib>Nahota, Sanula</creatorcontrib><creatorcontrib>Ndaki, Regina</creatorcontrib><creatorcontrib>Ndege, Robert C.</creatorcontrib><creatorcontrib>Ngulukila, Agatha</creatorcontrib><creatorcontrib>Nyuri, Amina</creatorcontrib><creatorcontrib>Okuma, James</creatorcontrib><creatorcontrib>Paris, Daniel H.</creatorcontrib><creatorcontrib>Sambuta, Aloyce</creatorcontrib><creatorcontrib>Samson, Leila</creatorcontrib><creatorcontrib>Senkoro, Elizabeth</creatorcontrib><creatorcontrib>Sikalengo, George</creatorcontrib><creatorcontrib>Tarimo, Jenifa</creatorcontrib><creatorcontrib>Temba, Yvan</creatorcontrib><creatorcontrib>Utzinger, Juerg</creatorcontrib><creatorcontrib>Vanobberghen, Fiona</creatorcontrib><creatorcontrib>Wigay, John</creatorcontrib><creatorcontrib>Wilson, Herieth</creatorcontrib><creatorcontrib>KIULARCO Study Group</creatorcontrib><creatorcontrib>the KIULARCO Study Group</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>HIV medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ndege, Robert C.</au><au>Okuma, James</au><au>Kalinjuma, Aneth V.</au><au>Mkumbo, Julius</au><au>Senkoro, Elizabeth</au><au>Fue, Gideon</au><au>Samson, Leila</au><au>Mapesi, Herry</au><au>Shabani, Siraji</au><au>Glass, Tracy R.</au><au>Battegay, Manuel</au><au>Paris, Daniel H.</au><au>Vanobberghen, Fiona</au><au>Weisser, Maja</au><au>Asantiel, Aschola</au><au>Bani, Farida</au><au>Battegay, Manuel</au><au>Byakuzana, Theonestina</au><au>Chale, Adolphina</au><au>Chuwa, Francisca</au><au>Eichenberger, Anna</au><au>Francis, Gideon</au><au>Furrer, Hansjakob</au><au>Glass, Tracy R.</au><au>Hwaya, Speciosa</au><au>Kalinjuma, Aneth V.</au><au>Kasuga, Bryson</au><au>Katende, Andrew</au><au>Kimera, Namvua</au><au>Kivuma, Bernard</au><au>Kisunga, Yassin</au><au>Kitau, Olivia</au><au>Klimkait, Thomas</au><au>Luoga, Ezekiel</au><au>Mapesi, Herry</au><au>Mkulila, Mengi</au><au>Mkumbo, Julius</au><au>Mkusa, Margareth</au><au>Mlembe, Slyakus</au><au>Mnzava, Dorcas K.</au><au>Mollel, Gertrud J.</au><au>Moshi, Lilian</au><au>Mossad, Germana</au><au>Mpundunga, Dolores</au><au>Mtandanguo, Athumani</au><au>Myeya, Selerine</au><au>Nahota, Sanula</au><au>Ndaki, Regina</au><au>Ndege, Robert C.</au><au>Ngulukila, Agatha</au><au>Nyuri, Amina</au><au>Okuma, James</au><au>Paris, Daniel H.</au><au>Sambuta, Aloyce</au><au>Samson, Leila</au><au>Senkoro, Elizabeth</au><au>Sikalengo, George</au><au>Tarimo, Jenifa</au><au>Temba, Yvan</au><au>Utzinger, Juerg</au><au>Vanobberghen, Fiona</au><au>Wigay, John</au><au>Wilson, Herieth</au><aucorp>KIULARCO Study Group</aucorp><aucorp>the KIULARCO Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Failure to return pillbox is a predictor of being lost to follow‐up among people living with HIV on antiretroviral therapy in rural Tanzania</atitle><jtitle>HIV medicine</jtitle><addtitle>HIV Med</addtitle><date>2022-07</date><risdate>2022</risdate><volume>23</volume><issue>6</issue><spage>661</spage><epage>672</epage><pages>661-672</pages><issn>1464-2662</issn><eissn>1468-1293</eissn><abstract>Objectives
Pill count is used to assess drug adherence in people living with HIV (PLHIV). Carrying a pillbox is associated with fear of concealment and stigma and might indicate poor adherence and predict someone who will be lost to follow‐up (LTFU). We therefore assessed the association between pillbox return and being LTFU in rural Tanzania.
Methods
This is a nested study of the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO). We included PLHIV aged ≥ 18 years enrolled in KIULARCO between January 2013 and March 2019 with follow‐up through January 2020, who were on antiretroviral treatment (ART) for ≥ 6 months. Baseline was defined as the latest ART initiation or KIULARCO enrolment. We determined the association between time‐dependent failed pillbox return updated at every visit and LTFU using Kaplan–Meier estimation and Cox models.
Results
Among 2552 PLHIV included in the study, 1735 (68.0%) were female, 959 (40.3%) had a WHO stage III/IV and 1487 (66.4%) had a CD4 cell count < 350 cells/µL. The median age was 38.4 years [interquartile range (IQR): 31.7–46.2]. During a median follow‐up of 33.1 months (IQR: 17.5–52.4), 909 (35.6%) participants were LTFU, 43 (1.7%) died and 194 (7.6%) had transferred to another clinic. The probability of being LTFU was higher among PLHIV with failed pillbox return than among those who returned their pillbox [30.0%, 95% confidence interval (CI): 26.8–33.2% vs. 19.4%, 95% CI: 17.4–21.6%, respectively, at 24 months (hazard ratio = 1.67, 95% CI: 1.46–1.90; p < 0.001)].
Conclusions
Failed pillbox return was associated with a higher risk of being LTFU and could be used as a simple tool to identify PLHIV for appropriate interventions to reduce their chance of being LTFU.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34964236</pmid><doi>10.1111/hiv.13223</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-0134-1929</orcidid><orcidid>https://orcid.org/0000-0003-4743-5987</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1464-2662 |
| ispartof | HIV medicine, 2022-07, Vol.23 (6), p.661-672 |
| issn | 1464-2662 1468-1293 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9306592 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | adherence Adult Anti-Retroviral Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy antiretroviral treatment CD4 antigen CD4 Lymphocyte Count Confidence intervals Female HIV HIV Infections - complications HIV Infections - drug therapy HIV treatment outcome Human immunodeficiency virus Humans Lost to Follow-Up Male Original Research pillbox rural Statistical analysis stigma sub‐Saharan Africa Tanzania - epidemiology |
| title | Failure to return pillbox is a predictor of being lost to follow‐up among people living with HIV on antiretroviral therapy in rural Tanzania |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T11%3A46%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Failure%20to%20return%20pillbox%20is%20a%20predictor%20of%20being%20lost%20to%20follow%E2%80%90up%20among%20people%20living%20with%20HIV%20on%20antiretroviral%20therapy%20in%20rural%20Tanzania&rft.jtitle=HIV%20medicine&rft.au=Ndege,%20Robert%20C.&rft.aucorp=KIULARCO%20Study%20Group&rft.date=2022-07&rft.volume=23&rft.issue=6&rft.spage=661&rft.epage=672&rft.pages=661-672&rft.issn=1464-2662&rft.eissn=1468-1293&rft_id=info:doi/10.1111/hiv.13223&rft_dat=%3Cproquest_pubme%3E2615302540%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2673874639&rft_id=info:pmid/34964236&rfr_iscdi=true |