Equity of antiretroviral treatment use in high HIV burden countries: Analyses of data from nationally-representative surveys in Kenya and South Africa.
PLoS One
; 13(8): e0201899, 2018.
Article
en En
| MEDLINE
| ID: mdl-30096199
ABSTRACT
OBJECTIVE:
To assess changes and equity in antiretroviral therapy (ART) use in Kenya and South Africa.METHODS:
We analysed national population-based household surveys conducted in Kenya and South Africa between 2007 and 2012 for factors associated with lack of ART use among people living with HIV (PLHIV) aged 15-64 years. We considered ART use to be inequitable if significant differences in use were found between groups of PLHIV (e.g. by sex).FINDINGS:
ART use among PLHIV increased from 29.3% (95% confidence interval [CI] 22.8-35.8) to 42.5% (95%CI 37.4-47.7) from 2007 to 2012 in Kenya and 17.4% (95%CI 14.2-20.9) to 30.3% (95%CI 27.2-33.6) from 2008 to 2012 in South Africa. In 2012, factors independently associated with lack of ART use among adult Kenyan PLHIV were rural residency (adjusted odds ratio [aOR] 1.98, 95%CI 1.23-3.18), younger age (15-24 years aOR 4.25, 95%CI 1.7-10.63, and 25-34 years aOR 5.16, 95%CI 2.73-9.74 versus 50-64 years), nondisclosure of HIV status to most recent sex partner (aOR 2.41, 95%CI 1.27-4.57) and recent recreational drug use (aOR 2.50, 95%CI 1.09-5.77). Among South African PLHIV in 2012, lack of ART use was significantly associated with younger age (15-24 years aOR 4.23, 95%CI 2.56-6.70, and 25-34 years aOR 2.84, 95%CI 1.73-4.67, versus 50-64 years), employment status (aOR 1.61, 95%CI 1.16-2.23 in students versus unemployed), and recent recreational drug use (aOR 4.56, 95%CI 1.79-11.57).CONCLUSION:
Although we found substantial increases in ART use in both countries over time, we identified areas needing improvement including among rural Kenyans, students in South Africa, and among young people and drug users in both countries.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
/
Fármacos Anti-VIH
/
Disparidades en Atención de Salud
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Africa
Idioma:
En
Revista:
PLoS One
Asunto de la revista:
CIENCIA
/
MEDICINA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Sudáfrica