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Multivariate analysis of covariates of adherence among HIV-positive mothers with low viral suppression

Overview of attention for article published in AIDS Research and Therapy, March 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (79th percentile)
  • Good Attention Score compared to outputs of the same age and source (66th percentile)

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1 blog
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3 X users
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1 Google+ user

Citations

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184 Mendeley
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Title
Multivariate analysis of covariates of adherence among HIV-positive mothers with low viral suppression
Published in
AIDS Research and Therapy, March 2018
DOI 10.1186/s12981-018-0197-8
Pubmed ID
Authors

Tamara Nsubuga-Nyombi, Simon Sensalire, Esther Karamagi, Judith Aloyo, John Byabagambi, Mirwais Rahimzai, Linda Kisaakye Nabitaka, Jacqueline Calnan

Abstract

As part of efforts to improve the prevention of mother-to-child transmission in Northern Uganda, we explored reasons for poor viral suppression among 122 pregnant and lactating women who were in care, received viral load tests, but had not achieved viral suppression and had more than 1000 copies/mL. Understanding the patient factors associated with low viral suppression was of interest to the Ministry of Health to guide the development of tools and interventions to achieve viral suppression for pregnant and lactating women newly initiating on ART as well as those on ART with unsuppressed viral load. A facility-based cross-sectional and mixed methods study design was used, with retrospective medical record review. We assessed 122 HIV-positive mothers with known low viral suppression across 31 health facilities in Northern Uganda. Adjusted odds ratios were used to determine the covariates of adherence among HIV positive mothers using logistic regression. A study among health care providers shed further light on predictors of low viral suppression and a history of low early retention. This study was part of a larger national evaluation of the performance of integrated care services for mothers. Adherence defined as taking antiretroviral medications correctly everyday was low at 67.2%. The covariates of low adherence are: taking other medications in addition to ART, missed appointments in the past 6 months, experienced violence in the past 6 months, and faces obstacles to treatment. Mothers who were experiencing each of these covariates were less likely to adhere to treatment. These covariates were triangulated with perspectives of health providers as covariates of low adherence and included: long distances to health facility, missed appointments, running out of pills, sharing antiretroviral drugs, violence, and social lifestyles such as multiple sexual partners coupled with non-disclosure to partners. Inadequate counseling, stigma, and lack of client identity are the frontline factors accounting for the early loss of mothers from care. Adherence of 67% was low for reliable viral suppression and accounts for the low viral suppression among HIV-positive mothers studied, in absence of any other factors. This study provided insights into the covariates for low adherence to ART and low viral load suppression; these covariates included taking other medications in addition to ART, missed appointments in the past 6 months, feels like giving up, doesn't have someone with whom to share private concerns, experienced violence in the past 6 months, and faces obstacles to treatment and confirmed by health providers. To improve adherence, we recommend use of a screening tool to identify mothers with any of these covariates so that more intensive adherence support can be provided to these mothers.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 184 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 184 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 35 19%
Researcher 26 14%
Student > Ph. D. Student 21 11%
Student > Bachelor 10 5%
Student > Doctoral Student 9 5%
Other 29 16%
Unknown 54 29%
Readers by discipline Count As %
Nursing and Health Professions 33 18%
Medicine and Dentistry 29 16%
Psychology 14 8%
Social Sciences 12 7%
Agricultural and Biological Sciences 4 2%
Other 30 16%
Unknown 62 34%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 October 2020.
All research outputs
#3,281,163
of 23,344,526 outputs
Outputs from AIDS Research and Therapy
#74
of 576 outputs
Outputs of similar age
#68,786
of 330,813 outputs
Outputs of similar age from AIDS Research and Therapy
#2
of 6 outputs
Altmetric has tracked 23,344,526 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 576 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.6. This one has done well, scoring higher than 86% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 330,813 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 79% of its contemporaries.
We're also able to compare this research output to 6 others from the same source and published within six weeks on either side of this one. This one has scored higher than 4 of them.