Study protocol: Strengthening understanding of effective adherence strategies for first-line and second-line antiretroviral therapy (ART) in selected rural and urban communities in South Africa.
Study protocol: Strengthening understanding of effective adherence strategies for first-line and second-line antiretroviral therapy (ART) in selected rural and urban communities in South Africa.
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DOI：
10.1371/journal.pone.0261107
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Lalla-Edward ST
中科院分区：
文献类型：
--
作者：
Gumede SB;de Wit JBF;Venter WDF;Lalla-Edward ST
多种因素使坚持抗逆转录病毒治疗（ART）成为一个复杂的过程。本研究旨在描述接受一线和二线抗逆转录病毒治疗的患者依从性的障碍和促进因素，确定使用的不同依从性策略，并提出改进依从性策略的建议。将在南非豪登的7个高容量公共卫生机构和林波波省的1个公共卫生机构进行这项混合方法平行融合研究。该研究包括四个阶段：对接受ART的大型患者队列进行回顾性次要数据分析（使用TIER.Net，一个用于记录和监测接受抗逆转录病毒治疗和结核病患者的抗逆转录病毒治疗患者和数据管理系统），（豪登省）;强化治疗监测累积（ITREMA）试验的次要数据分析（2015年6月至2019年1月进行的随机对照试验）在Ndlovu医疗中心进行（林波波省）;对正在接受抗逆转录病毒疗法的艾滋病毒感染者进行深入访谈（城市和农村）;以及对撒哈拉以南非洲慢性病坚持治疗干预措施的影响进行系统审查。将收集有关人口统计学、社会经济状况、治疗支持、保持护理状态、披露、耻辱、临床标志物（CD 4计数和病毒载量（VL））、自我报告的依从性信息、自我和人际因素、社区网络和政策水平因素的数据。系统性综述将遵循系统性综述和荟萃分析（PRISMA）报告的首选报告项目以及人群、干预、比较和结局（皮科）标准。分析将涉及关联测试（卡方和t检验），主题分析（演绎和归纳方法）和网络元分析。使用一个综合的多层次的社会生态框架，本研究将描述与PLHIV谁是一线或二线ART坚持相关的因素。实施循证依从性的方法，当采取，将改善患者的整体健康结果。我们的研究结果将提供有关特定背景的干预策略，以提高ART依从性的指导。
Multiple factors make adherence to antiretroviral therapy (ART) a complex process. This study aims to describe the barriers and facilitators to adherence for patients receiving first-line and second-line ART, identify different adherence strategies utilized and make recommendations for an improved adherence strategy. This mixed method parallel convergent study will be conducted in seven high volume public health facilities in Gauteng and one in Limpopo province in South Africa. The study consists of four phases; a retrospective secondary data analysis of a large cohort of patients on ART (using TIER.Net, an ART patient and data management system for recording and monitoring patients on ART and tuberculosis (TB)) from seven Johannesburg inner-city public health facilities (Gauteng province); a secondary data analysis of the Intensified Treatment Monitoring Accumulation (ITREMA) trial (a randomized control trial which ran from June 2015 to January 2019) conducted at the Ndlovu Medical Center (Limpopo province); in-depth interviews with people living with Human Immunodeficiency Virus (PLHIV) who are taking ART (in both urban and rural settings); and a systematic review of the impact of treatment adherence interventions for chronic conditions in sub-Saharan Africa. Data will be collected on demographics, socio-economic status, treatment support, retention in care status, disclosure, stigma, clinical markers (CD4 count and viral load (VL)), self-reported adherence information, intrapersonal, and interpersonal factors, community networks, and policy level factors. The systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting and Population, Interventions, Comparisons and Outcomes (PICO) criteria. Analyses will involve tests of association (Chi-square and t-test), thematic analysis (deductive and inductive approaches) and network meta-analysis. Using an integrated multilevel socio-ecological framework this study will describe the factors associated with adherence for PLHIV who are taking first-line or second-line ART. Implementing evidence-based adherence approaches, when taken up, will improve patient’s overall health outcomes. Our study results will provide guidance regarding context-specific intervention strategies to improve ART adherence.
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DOI：
10.1016/s2352-3018(14)00007-1
发表时间：
2015-01
期刊：
The lancet. HIV
影响因子：
--
作者：
Gross R;Zheng L;La Rosa A;Sun X;Rosenkranz SL;Cardoso SW;Ssali F;Camp R;Godfrey C;Cohn SE;Robbins GK;Chisada A;Wallis CL;Reynolds NR;Lu D;Safren SA;Hosey L;Severe P;Collier AC;ACTG 5234 team
通讯作者：
ACTG 5234 team
影响因子：
3.7
作者：
Adeloye D;Basquill C
通讯作者：
Basquill C
影响因子：
3.9
作者：
Hirasen, Kamban;Evans, Denise;Fox, Matthew P.
通讯作者：
Fox, Matthew P.
影响因子：
1.8
作者：
Berben, Lut;Dobbels, Fabienne;De Geest, Sabina
通讯作者：
De Geest, Sabina
影响因子：
3.7
作者：
Court, Richard;Leisegang, Rory;Maartens, Gary
通讯作者：
Maartens, Gary