ABSTRACT
Objective:To investigate the effect and influencing factors of anti-retroviral therapy (ART) in human immunodeficiency virus (HIV)-positive female commercial sex workers (CSW) in Guangxi Zhuang Autonomous Region.Methods:A retrospective cohort study was used in this study. A total of 661 HIV-positive CSW receiving ART from the Guangxi Zhuang Autonomous Region′s municipal and county-level Centers for Disease Control and Prevention (CDC) reported to Guangxi Zhuang Autonomous Region CDC from January 1, 2009 to December 31, 2018 were included.The demographic information of the patients, marital status, past medical history, acquired immunodeficiency syndrome (AIDS)-related diseases after six to 12 months of ART, medications, CD4 + T lymphocytes, virological and immunological effects after receiving ART for six to 12 months were collected. Logistic regression model was used to analyze the influencing factors of virological failure and immunological failure of HIV-positive CSW after six to 12 months of ART. Results:Among 661 HIV-positive CSW, 50(7.6%) cases experienced virological failure, 80(12.1%) cases experienced immunological failure, and 13(2.0%) had both virological failure and immunological failure.There were 85 cases (12.9%) who had a history of sexually transmitted diseases. Multivariate logistic regression analysis showed that unmarried (adjusted odds ratio (a OR)=3.298, 95% confidence interval ( CI) 1.285 to 8.461), AIDS-related diseases after six to 12 months of ART (a OR=4.391, 95% CI 1.555 to 12.402) and missed medications in the last seven days (a OR=3.731, 95% CI 1.942 to 7.166) were risk factors for virological failure. Compared with CD4 + T lymphocytes<200.00/μL at baseline, 350.00≤CD4 + T lymphocytes <500.00/μL (a OR=3.543, 95% CI 1.631 to 7.701) and CD4 + T lymphocytes≥500.00/μL (a OR=2.358, 95% CI 1.002 to 5.547) were risk factors for immunological failure. Conclusions:HIV-positive CSW in Guangxi Zhuang Autonomous Region have a better treatment effect, with low rates of virological failure and immunological failure. Marital status, baseline CD4 + T lymphocyte counts, AIDS-related diseases after six to 12 months of ART, and missed medication in the last seven days are factors influencing the effect of six to 12 months of ART.
ABSTRACT
Objective:To determine socio-cultural, demographic and highly active antiretroviral therapy (HAART) program-related factors associated with immunological failure (IF) among clients on HAART in Dar es Salaam care and treatment clinics. Methods:A 1:2 matched case control study was done from February to April 2012 in HIV/AIDS care and treatment clinics in Dar es Salaam. Data were collected from National AIDS Control Program (NACP) data base and patient’s charts to obtain 60 sets of study participants who were interviewed using the structured questionnaire. Data analysis was done by using EPI Info 3.5.1 version. Results:The mean age of all study participants was (42.00±9.07) years with 35% (63) being males. History of poor antiretroviral therapy (ART) adherence due to exposure to drug holiday with loss to follow up (OR=11.96;95%CI=2.07-69.26), history of changing care and treatment clinics (OR=12.07;95%CI=2.10-69.27) and the lack of treatment supporter (OR=23.26;95%CI=1.85-291.66) were found to be strongly associated with the occurrence of first line HAART-IF. Conclusions:HAART-IF in Dar es Salaam is associated with ART programmatic and patients’ centered challenges. There is a need to review the approaches on ensuring ART adherence, clients follow up and referral system so as to reduce the incidence of IF as we move to a more decentralized peripheral drug picks clinical initiative.