2023-09-28 14:46:10 +00:00
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abstract: 'Operational research to identify factors predicting poor clinical
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outcomes is critical to maximize patient care and prolong first-line
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regimens for those receiving free antiretroviral therapy (ART) in India.
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We sought to identify social or clinical factors amenable to
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intervention that predict virological outcomes after 12 months of ART.
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We examined a retrospective cohort of consecutive adults initiating free
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nonnucleoside reverse transcriptase inhibitor-based regimens.
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Individuals remaining in care 12 months post-ART initiation were tested
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for HIV viral load and surveyed to identify barriers and facilitators to
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adherence, and to determine clinic travel times and associated costs.
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Uni- and multivariate logistic regression identified factors predicting
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HIV viral load >200 copies/mL after 12 months of ART. Of 230 adults
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initiating ART, 10\% of patients died, 8\% transferred out, 5\% were
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lost to follow-up, and 174/230 (76\%) completed 12 months of ART, the
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questionnaire, and viral load testing. HIV viral load was <200 copies/mL
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in 140/174 (80\%) patients. In multivariate models, being busy with work
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or caring for others (OR 2.9, p < 0.01), having clinic transport times 3
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hours (OR 3.0, p = 0.02), and alcohol use (OR 4.8, p = 0.03) predicted
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viral load >200 copies/mL after 12 months of ART. Clinical outcomes
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following ART are related to programmatic factors such as prolonged
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travel time and individual factors such as being busy with family or
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using alcohol. Simple interventions that alter these factors should be
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evaluated to improve clinical outcomes for populations receiving free
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ART in similar settings.'
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affiliation: 'McMahon, JH (Corresponding Author), Alfred Hosp, Infect Dis Unit, Melbourne,
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Vic, Australia.
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McMahon, James H.; Elliott, Julian H.; Lewin, Sharon R., Alfred Hosp, Infect Dis
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Unit, Melbourne, Vic, Australia.
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McMahon, James H.; Wanke, Christine; Jordan, Michael R., Tufts Univ, Sch Med, Dept
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Publ Hlth \& Community Med, Boston, MA 02111 USA.
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Manoharan, Anand; Jose, Hepsibah; Malini, Thabeetha; Kadavanu, Tony; Mathai, Dilip,
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Christian Med Coll \& Hosp, Dept Med, Vellore, Tamil Nadu, India.
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Mammen, Shoba, Christian Med Coll \& Hosp, Dept Clin Virol, Vellore, Tamil Nadu,
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India.
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Elliott, Julian H.; Lewin, Sharon R., Monash Univ, Dept Infect Dis, Melbourne, Vic
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3004, Australia.
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Elliott, Julian H.; Lewin, Sharon R., Burnet Inst, Melbourne, Vic, Australia.'
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author: McMahon, James H. and Manoharan, Anand and Wanke, Christine and Mammen, Shoba
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and Jose, Hepsibah and Malini, Thabeetha and Kadavanu, Tony and Jordan, Michael
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R. and Elliott, Julian H. and Lewin, Sharon R. and Mathai, Dilip
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author-email: ja.mcmahon@alfred.org.au
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author_list:
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- family: McMahon
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given: James H.
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- family: Manoharan
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given: Anand
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- family: Wanke
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given: Christine
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- family: Mammen
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given: Shoba
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- family: Jose
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given: Hepsibah
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- family: Malini
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given: Thabeetha
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- family: Kadavanu
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given: Tony
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- family: Jordan
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given: Michael R.
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- family: Elliott
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given: Julian H.
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- family: Lewin
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given: Sharon R.
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- family: Mathai
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given: Dilip
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da: '2023-09-28'
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doi: 10.1080/09540121.2013.845282
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eissn: 1360-0451
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files: []
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issn: 0954-0121
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journal: AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV
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keywords: 'HIV; intervention targets; antiretroviral therapy; India; virological
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outcomes; adherence'
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keywords-plus: 'DRUG-RESISTANCE; MEDICATION ADHERENCE; INCOME COUNTRIES; HIV; CARE;
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CHENNAI; SUPPRESSION; PREDICTORS; RETENTION; CLINICS'
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language: English
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month: MAY 4
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number: '5'
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number-of-cited-references: '37'
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orcid-numbers: 'McMahon, James/0000-0003-1460-5572
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Lewin, Sharon Ruth/0000-0002-0330-8241'
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pages: 559-566
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papis_id: 56ece1e0bcabaca29a4120ed101cd65c
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ref: Mcmahon2014targetsintervention
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researcherid-numbers: 'Lewin, Sharon/Z-3297-2019
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'
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times-cited: '2'
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title: Targets for intervention to improve virological outcomes for patients receiving
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free antiretroviral therapy in Tamil Nadu, India
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000331337200006
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '26'
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web-of-science-categories: 'Health Policy \& Services; Public, Environmental \& Occupational
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Health;
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Psychology, Multidisciplinary; Respiratory System; Social Sciences,
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Biomedical'
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year: '2014'
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