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Association between patient engagement in HIV care and antiretroviral therapy medication adherence: cross-sectional evidence from a regional HIV care center in Kenya

Munene, Edwin and Ekman, Björn LU (2015) In AIDS Care 27(3). p.378-386
Abstract
Consistent individual effort in engagement in HIV medical services has been associated with positive health outcomes in people living with HIV (PLHIV). However, whether these benefits are facilitated by improved medication adherence has not been widely studied. This study aimed to investigate the marginal effect of engagement in HIV care on medication adherence at a public health facility in Kenya. Between February and April 2013, 392 patients on HIV care at Nyeri Provincial General Hospital participated in this study. Data were collected using a self-administered health survey questionnaire assessing health and sociodemographic statuses. A manual stepwise general linear model was specified to measure the effect of engagement in HIV and... (More)
Consistent individual effort in engagement in HIV medical services has been associated with positive health outcomes in people living with HIV (PLHIV). However, whether these benefits are facilitated by improved medication adherence has not been widely studied. This study aimed to investigate the marginal effect of engagement in HIV care on medication adherence at a public health facility in Kenya. Between February and April 2013, 392 patients on HIV care at Nyeri Provincial General Hospital participated in this study. Data were collected using a self-administered health survey questionnaire assessing health and sociodemographic statuses. A manual stepwise general linear model was specified to measure the effect of engagement in HIV and other associated predictors on medication adherence. Engagement in HIV care was significantly associated with log-transformed medication adherence in the sample (100 center dot beta = 9.2%, 95% CI 3.2-15.1) irrespective of gender and other selected predictors. Longer duration on antiretroviral therapy was also a significant predictor of better medication adherence (100 center dot beta = 3.2%, 95% CI 2.3-4.1). Despite inter-gender differences in adherence and engagement determinants, gender's independent effect on medication adherence and engagement in care were not statistically significant. Poor medication adherence was associated with lower patient engagement in HIV care services, suggesting that interventions which remove obstacles to regular observance of scheduled clinic appointments and eventual retention may have a beneficial impact on medication adherence and, accordingly, health outcomes in PLHIV. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
HIV, medication adherence, visit constancy, Kenya, HIV care engagement
in
AIDS Care
volume
27
issue
3
pages
378 - 386
publisher
Taylor & Francis
external identifiers
  • wos:000348663000017
  • scopus:84922530770
ISSN
0954-0121
DOI
10.1080/09540121.2014.963020
language
English
LU publication?
yes
id
9ab7069c-a0c8-4f3c-b01f-65cf4d9fa6a7 (old id 5201125)
date added to LUP
2015-04-01 07:36:40
date last changed
2017-09-03 03:32:59
@article{9ab7069c-a0c8-4f3c-b01f-65cf4d9fa6a7,
  abstract     = {Consistent individual effort in engagement in HIV medical services has been associated with positive health outcomes in people living with HIV (PLHIV). However, whether these benefits are facilitated by improved medication adherence has not been widely studied. This study aimed to investigate the marginal effect of engagement in HIV care on medication adherence at a public health facility in Kenya. Between February and April 2013, 392 patients on HIV care at Nyeri Provincial General Hospital participated in this study. Data were collected using a self-administered health survey questionnaire assessing health and sociodemographic statuses. A manual stepwise general linear model was specified to measure the effect of engagement in HIV and other associated predictors on medication adherence. Engagement in HIV care was significantly associated with log-transformed medication adherence in the sample (100 center dot beta = 9.2%, 95% CI 3.2-15.1) irrespective of gender and other selected predictors. Longer duration on antiretroviral therapy was also a significant predictor of better medication adherence (100 center dot beta = 3.2%, 95% CI 2.3-4.1). Despite inter-gender differences in adherence and engagement determinants, gender's independent effect on medication adherence and engagement in care were not statistically significant. Poor medication adherence was associated with lower patient engagement in HIV care services, suggesting that interventions which remove obstacles to regular observance of scheduled clinic appointments and eventual retention may have a beneficial impact on medication adherence and, accordingly, health outcomes in PLHIV.},
  author       = {Munene, Edwin and Ekman, Björn},
  issn         = {0954-0121},
  keyword      = {HIV,medication adherence,visit constancy,Kenya,HIV care engagement},
  language     = {eng},
  number       = {3},
  pages        = {378--386},
  publisher    = {Taylor & Francis},
  series       = {AIDS Care},
  title        = {Association between patient engagement in HIV care and antiretroviral therapy medication adherence: cross-sectional evidence from a regional HIV care center in Kenya},
  url          = {http://dx.doi.org/10.1080/09540121.2014.963020},
  volume       = {27},
  year         = {2015},
}