To be on antiretroviral treatment (ART) or not: What contributes to differences in ART uptake patterns?

Stream: HIV Treatment: Issues in uptake and adherence
Date: Thursday, 31 March 2016
Time: 1.45 pm – 3.00 pm

Abstract

An online survey was conducted from October 2014 to August 2015 among people living with HIV (PLHIV) in Australia to discern personal, clinical and social factors associated with ART use or non-use.

A final 360 responses were retained with the response rate estimated to be 82.4%. The majority (n=347, 96.4%) were men who mostly identify as gay, homosexual or queer (n=325). All 13 females identified as straight. Participants were, on average, 46.7 years old (sd=10.8; median=48) with about three-quarters born in Australia (n=263).

The 358 participants with a known ART status were further divided into three groups: 208 (57.8%) had been on continuous ART; 117 (32.5%) were on intermittent ART with at least one treatment break before; and 33 (9.2%) were not on ART, including 26 being ART naïve.

Multinomial logistic regression results show that, compared to those on continuous ART, people who had intermittent ART were more likely to be diagnosed with HIV earlier (AOR=0.37; 95% CI=0.27-0.51; p<0.001) and less likely to be screened by the PHQ9 protocol in the survey as having major depression in the past two weeks (AOR=0.38; 95% CI=0.15-0.99; p=0.045); whereas people who were NOT on ART at the time of survey tend to perceived more ART-related concerns than necessities (AOR=0.14; 95% CI=0.06-0.32; p<0.001) and had lower HIV self-management score (AOR=0.67; 95% CI=0.49-0.91; p=0.011).

These findings strongly suggest that to improve timely ART initiation, communicating both the personal and population benefits of early ART with PLHIV and building HIV self-management and treating depression are essential steps.

Authors

Limin Mao (Presenter), Centre for Social Research in Health
Dr Limin Mao is a Senior Research Fellow at the Centre for Social Research in Health (CSRH) at UNSW Australia. She is CIB on this NHMRC funded project on ART use or non-use. This is the survey among PLHIV in Australia who were either on or not on ART at the time of survey. This is a collaborative project between CSRH and other partner organisations.

John de Wit, CSRH
Professor John de Wit is CIA on this NHMRC funded project on ART use or non-use.

Philippe Adam, CSRH
Dr Philippe Adam from CSRH is an AI on this NHMRC funded project on ART use or non-use.

Aaron Cogle, National Association of People with HIV Australia (NAPWHA)
Mr Aron Cogle from NAPWHA is a key partner on this NHMRC funded project on ART use or non-use.

Sean Slavin, Australian Federation of AIDS Organisations (AFAO)
Dr Sean Slavin from AFAO is a CI on this NHMRC funded project on ART use or non-use.

Jeffrey Post, The Prince of Wales Hospital, Sydney
Associate Professor Jeffrey Post from POWH is a CI on this NHMRC funded project on ART use or non-use.

Edwina Wright, The Alfred Hospital, Melbourne
Associate Professor Edwina Wright from The Alfred Hospital is a CI on this NHMRC funded project on ART use or non-use.

Michael Kidd, Flinders Univeristy, Adelaide
Professor Michael Kidd from Flinders University is a CI on this NHMRC funded project on ART use or non-use.