Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic

Detalhes bibliográficos
Autor(a) principal: Costa, J. M.
Data de Publicação: 2018
Outros Autores: Torres, T. S., Coelho, L. E., Luz, P. M.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/33631
Resumo: Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
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spelling Costa, J. M.Torres, T. S.Coelho, L. E.Luz, P. M.2019-06-24T13:46:39Z2019-06-24T13:46:39Z2018COSTA, Jessica de Mattos et al. Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis. Journal of the International AIDS Society, v. 21, n. 1, p. 1-20, 2018.1758-2652https://www.arca.fiocruz.br/handle/icict/3363110.1002/jia2.250661758-2652engWiley Open AccessAdherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematicinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Introduction: Optimal adherence to antiretroviral therapy is closely related with suppression of the HIV viral load in plasma, slowing disease progression and decreasing HIV transmission rates. Despite its importance, the estimated proportion of people living with HIV in Latin America and the Caribbean with optimal adherence has not yet been reported in a meta-analysis. Moreover, little is known of the factors leading to poor adherence which may be setting-specific. We present a pooled estimate of adherence to antiretroviral therapy (ART) of people living with HIV in Latin America and Caribbean, report the methods used to measure adherence and describe the factors associated with poor adherence among the selected studies. Methods: We electronically searched published studies up to July 2016 on the PubMed, Web of Science and Virtual Health Library (Latin America and the Caribbean Regional Portal); considering the following databases: MEDLINE, LILACS, PAHO and IBECS. Two independent reviewers selected and extracted data on ART adherence and study characteristics. Pooled estimate of adherence was derived using a random-effects model. Risk of bias in individual studies was assessed independently by two investigators using the Risk of Bias Assessment tool for Non-randomized Studies (RoBANS). Results and discussion: The meta-analysis included 53 studies published between 2005 and 2016, which analysed 22,603 people living with HIV in 25 Latin America and Caribbean countries. Overall adherence in Latin America and Caribbean was 70% (95% CI: 63–76; I2 = 98%), similar to levels identified by studies conducted in high-income regions. Self-report was the most frequently used method to measure adherence. Subgroup analysis showed that adherence was higher for the shortest recall time frame used, as well as in countries with lower income level, Gross National Income (GNI) per capita and Human Development Index (HDI). Studies reported diverse adherence barriers, such as alcohol and substance misuse, depression, unemployment and pill burden. Conclusions: Our study suggests that adherence to ART in Latin America and Caribbean may be below the sufficient levels required for a successful long-term viral load suppression.most frequently used method to measure adherence. Subgroup analysis showed that adherence was higher for the shortest recall time frame used, as well as in countries with lower income level, Gross National Income (GNI) per capita and Human Development Index (HDI). Studies reported diverse adherence barriers, such as alcohol and substance misuse, depression, unemployment and pill burden. Conclusions: Our study suggests that adherence to ART in Latin America and Caribbean may be below the sufficient levels required for a successful long-term viral load suppression.Anti-HIV agentsAntiretroviral therapyCaribbean regionDeveloping countriesHighly activeLatin Americainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/33631/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51ORIGINALve_Costa_Jessica_etal_INI_2018.pdfve_Costa_Jessica_etal_INI_2018.pdfapplication/pdf513536https://www.arca.fiocruz.br/bitstream/icict/33631/2/ve_Costa_Jessica_etal_INI_2018.pdf6230ae6ba0aa1e1008dd3c79bef2ee7dMD52TEXTve_Costa_Jessica_etal_INI_2018.pdf.txtve_Costa_Jessica_etal_INI_2018.pdf.txtExtracted texttext/plain101029https://www.arca.fiocruz.br/bitstream/icict/33631/3/ve_Costa_Jessica_etal_INI_2018.pdf.txt64f947dfb131927bd1e64aced4401f6eMD53icict/336312019-06-25 02:03:04.187oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352019-06-25T05:03:04Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic
title Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic
spellingShingle Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic
Costa, J. M.
Anti-HIV agents
Antiretroviral therapy
Caribbean region
Developing countries
Highly active
Latin America
title_short Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic
title_full Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic
title_fullStr Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic
title_full_unstemmed Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic
title_sort Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis: Systematic
author Costa, J. M.
author_facet Costa, J. M.
Torres, T. S.
Coelho, L. E.
Luz, P. M.
author_role author
author2 Torres, T. S.
Coelho, L. E.
Luz, P. M.
author2_role author
author
author
dc.contributor.author.fl_str_mv Costa, J. M.
Torres, T. S.
Coelho, L. E.
Luz, P. M.
dc.subject.en.pt_BR.fl_str_mv Anti-HIV agents
Antiretroviral therapy
Caribbean region
Developing countries
Highly active
Latin America
topic Anti-HIV agents
Antiretroviral therapy
Caribbean region
Developing countries
Highly active
Latin America
description Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
publishDate 2018
dc.date.issued.fl_str_mv 2018
dc.date.accessioned.fl_str_mv 2019-06-24T13:46:39Z
dc.date.available.fl_str_mv 2019-06-24T13:46:39Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv COSTA, Jessica de Mattos et al. Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis. Journal of the International AIDS Society, v. 21, n. 1, p. 1-20, 2018.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/33631
dc.identifier.issn.pt_BR.fl_str_mv 1758-2652
dc.identifier.doi.none.fl_str_mv 10.1002/jia2.25066
dc.identifier.eissn.none.fl_str_mv 1758-2652
identifier_str_mv COSTA, Jessica de Mattos et al. Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: systematic review and meta-analysis. Journal of the International AIDS Society, v. 21, n. 1, p. 1-20, 2018.
1758-2652
10.1002/jia2.25066
url https://www.arca.fiocruz.br/handle/icict/33631
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Wiley Open Access
publisher.none.fl_str_mv Wiley Open Access
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
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reponame_str Repositório Institucional da FIOCRUZ (ARCA)
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