Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.

<h4>Background</h4>The prevalence of HIV in Panama is estimated to be 1.0%; only 71% of individuals on antiretroviral treatment (ART) were virally suppressed in 2022. This study aimed to describe the prevalence of suboptimal adherence (≥1 missed doses in previous four weeks) and limited...

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Main Authors: Amanda Gabster, Félix Díaz Fernández, Juan Miguel Pascale, Angelique Orillac, Samuel Moreno-Wynter, Casey D Xavier Hall, Eugenia Flores Millender, Frank Frankie Wong, Mónica Jhangimal, Anyi Yu-Pon, Cristel Rodríguez-Vargas, Diógenes Arjona-Miranda, Bárbara Fuentes, Germán Henostroza, Ana Belén Araúz
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0311048
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author Amanda Gabster
Félix Díaz Fernández
Juan Miguel Pascale
Angelique Orillac
Samuel Moreno-Wynter
Casey D Xavier Hall
Eugenia Flores Millender
Frank Frankie Wong
Mónica Jhangimal
Anyi Yu-Pon
Cristel Rodríguez-Vargas
Diógenes Arjona-Miranda
Bárbara Fuentes
Germán Henostroza
Ana Belén Araúz
author_facet Amanda Gabster
Félix Díaz Fernández
Juan Miguel Pascale
Angelique Orillac
Samuel Moreno-Wynter
Casey D Xavier Hall
Eugenia Flores Millender
Frank Frankie Wong
Mónica Jhangimal
Anyi Yu-Pon
Cristel Rodríguez-Vargas
Diógenes Arjona-Miranda
Bárbara Fuentes
Germán Henostroza
Ana Belén Araúz
author_sort Amanda Gabster
collection DOAJ
description <h4>Background</h4>The prevalence of HIV in Panama is estimated to be 1.0%; only 71% of individuals on antiretroviral treatment (ART) were virally suppressed in 2022. This study aimed to describe the prevalence of suboptimal adherence (≥1 missed doses in previous four weeks) and limited retention in HIV care (≥1 missed HIV care appointments in previous 12 months) among adults (aged ≥18 years) who attended the most populous urban ART Clinic in Panama City.<h4>Methods</h4>In this cross-sectional study, participants completed a self-administered questionnaire. Univariable and bivariable analyses were used to describe the prevalence of suboptimal adherence and limited retention in HIV care. Multivariable logistic regression identified factors associated with suboptimal adherence at p<0.05.<h4>Results</h4>We included 375 participants (209 identified as men, 158 as women, 8 another gender). Of those who responded, 37.3% (n = 125/335) reported suboptimal adherence: 28.6% (n = 53/185) of men, 49.0% (n = 71/145) women, 20.0% (n = 1/5) another gender; p<0.01; 18.6% (n = 69/371) reported limited retention in care:13.6% (n = 28/206) men, 24.2% (n = 38/157) women, 37.5% (n = 3/8) another gender, p = 0.01. In multivariable analyses, suboptimal adherence was associated with gender (49.0%women vs. 28.6% men, AOR = 1.86, 95%CI:0.97-3.57), depressive symptoms:46.2% severe symptoms vs. 28.1% minimal-mild, AOR = 2.19,95%CI:0.96-5.04), and lifetime intimate partner emotional violence (IPV) 48.2% vs.no emotional IPV 32.2%, OR = 1.96,95%CI:1.15-2.90, and lifetime physical IPV 46.9% vs.no physical IPV 32.6%, OR = 1.82, 95%CI:1.15-2.90. In unadjusted analyses, limited retention in care was associated with gender (24.2%women vs.13.6% men OR = 2.03, 95%CI:1.18-3.49), difficulty paying rent/mortgage/utilities (22.6% vs.14.9% no difficulty paying, OR = 1.67,95%CI = 0.98-2.83); no variables were associated in the multivariable model.<h4>Conclusions</h4>This study found high prevalence of suboptimal ART adherence and limited retention in care, especially among women; these factors were associated with severe depressive symptoms, as well as lifetime emotional and physical IPV. These results show the need for integrated mental health and IPV intervention for all individuals, including focused support for women.
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spelling doaj-art-3c4c19a41b7649008d2f0b29add553c22025-08-20T02:38:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011911e031104810.1371/journal.pone.0311048Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.Amanda GabsterFélix Díaz FernándezJuan Miguel PascaleAngelique OrillacSamuel Moreno-WynterCasey D Xavier HallEugenia Flores MillenderFrank Frankie WongMónica JhangimalAnyi Yu-PonCristel Rodríguez-VargasDiógenes Arjona-MirandaBárbara FuentesGermán HenostrozaAna Belén Araúz<h4>Background</h4>The prevalence of HIV in Panama is estimated to be 1.0%; only 71% of individuals on antiretroviral treatment (ART) were virally suppressed in 2022. This study aimed to describe the prevalence of suboptimal adherence (≥1 missed doses in previous four weeks) and limited retention in HIV care (≥1 missed HIV care appointments in previous 12 months) among adults (aged ≥18 years) who attended the most populous urban ART Clinic in Panama City.<h4>Methods</h4>In this cross-sectional study, participants completed a self-administered questionnaire. Univariable and bivariable analyses were used to describe the prevalence of suboptimal adherence and limited retention in HIV care. Multivariable logistic regression identified factors associated with suboptimal adherence at p<0.05.<h4>Results</h4>We included 375 participants (209 identified as men, 158 as women, 8 another gender). Of those who responded, 37.3% (n = 125/335) reported suboptimal adherence: 28.6% (n = 53/185) of men, 49.0% (n = 71/145) women, 20.0% (n = 1/5) another gender; p<0.01; 18.6% (n = 69/371) reported limited retention in care:13.6% (n = 28/206) men, 24.2% (n = 38/157) women, 37.5% (n = 3/8) another gender, p = 0.01. In multivariable analyses, suboptimal adherence was associated with gender (49.0%women vs. 28.6% men, AOR = 1.86, 95%CI:0.97-3.57), depressive symptoms:46.2% severe symptoms vs. 28.1% minimal-mild, AOR = 2.19,95%CI:0.96-5.04), and lifetime intimate partner emotional violence (IPV) 48.2% vs.no emotional IPV 32.2%, OR = 1.96,95%CI:1.15-2.90, and lifetime physical IPV 46.9% vs.no physical IPV 32.6%, OR = 1.82, 95%CI:1.15-2.90. In unadjusted analyses, limited retention in care was associated with gender (24.2%women vs.13.6% men OR = 2.03, 95%CI:1.18-3.49), difficulty paying rent/mortgage/utilities (22.6% vs.14.9% no difficulty paying, OR = 1.67,95%CI = 0.98-2.83); no variables were associated in the multivariable model.<h4>Conclusions</h4>This study found high prevalence of suboptimal ART adherence and limited retention in care, especially among women; these factors were associated with severe depressive symptoms, as well as lifetime emotional and physical IPV. These results show the need for integrated mental health and IPV intervention for all individuals, including focused support for women.https://doi.org/10.1371/journal.pone.0311048
spellingShingle Amanda Gabster
Félix Díaz Fernández
Juan Miguel Pascale
Angelique Orillac
Samuel Moreno-Wynter
Casey D Xavier Hall
Eugenia Flores Millender
Frank Frankie Wong
Mónica Jhangimal
Anyi Yu-Pon
Cristel Rodríguez-Vargas
Diógenes Arjona-Miranda
Bárbara Fuentes
Germán Henostroza
Ana Belén Araúz
Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.
PLoS ONE
title Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.
title_full Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.
title_fullStr Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.
title_full_unstemmed Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.
title_short Factors associated with self-reported suboptimal antiretroviral adherence and limited retention in care among people living with HIV who attend a large ART clinic in Panama City, Panama.
title_sort factors associated with self reported suboptimal antiretroviral adherence and limited retention in care among people living with hiv who attend a large art clinic in panama city panama
url https://doi.org/10.1371/journal.pone.0311048
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