Impact of COVID-19 on Adherence to Treatment in Patients with HIV
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Scope
2.2. Inclusion and Exclusion Criteria
- Living patients who were over the age of majority at the time of the interview;
- Patients diagnosed with HIV before February 2019;
- Patients who had attended at least one telephone or face-to-face consultation between May 2020 and November 2021;
- Patients with at least two viral load determinations: one before February 2020 and one after June 2021.
- Patients who did not meet the inclusion criteria;
- Patients who had missing data for any of the variables analysed in the study;
- Patients who had less than two viral load determinations during the study period.
2.3. Variables
2.4. Data Collection
2.5. Ethical Aspects
2.6. Statistical Analysis
3. Results
3.1. Sample Description
3.2. Adherence Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Schaecher, K.L. The Importance of Treatment Adherence in HIV. Am. J. Manag. Care 2013, 19, s231–s237. [Google Scholar]
- Shubber, Z.; Mills, E.J.; Nachega, J.B.; Vreeman, R.; Freitas, M.; Bock, P.; Nsanzimana, S.; Penazzato, M.; Appolo, T.; Doherty, M.; et al. Patient-Reported Barriers to Adherence to Antiretroviral Therapy: A Systematic Review and Meta-Analysis. PLoS Med. 2016, 13, e1002183. [Google Scholar] [CrossRef]
- Montessori, V.; Press, N.; Harris, M.; Akagi, L.; Montaner, J.S.G. Adverse Effects of Antiretroviral Therapy for HIV Infection. Can. Med. Assoc. J. 2004, 170, 229–238. [Google Scholar]
- Stone, V.E.; Hogan, J.W.; Schuman, P.; Rompalo, A.M.; Howard, A.A.; Korkontzelou, C.; Smith, D.K. Antiretroviral Regimen Complexity, Self-Reported Adherence, and HIV Patients’ Understanding of Their Regimens: Survey of Women in the HER Study. JAIDS J. Acquir. Immune Defic. Syndr. 2001, 28, 124–131. [Google Scholar] [CrossRef] [PubMed]
- Katz, I.T.; Ryu, A.E.; Onuegbu, A.G.; Psaros, C.; Weiser, S.D.; Bangsberg, D.R.; Tsai, A.C. Impact of HIV-Related Stigma on Treatment Adherence: Systematic Review and Meta-Synthesis. J. Int. AIDS Soc. 2013, 16, 18640. [Google Scholar] [CrossRef] [PubMed]
- Singh, N.; Berman, S.M.; Swindells, S.; Justis, J.C.; Mohr, J.A.; Squier, C.; Wagener, M.M. Adherence of Human Immunodeficiency Virus–Infected Patients to Antiretroviral Therapy. Clin. Infect. Dis. 1999, 29, 824–830. [Google Scholar] [CrossRef]
- Detsis, M.; Tsioutis, C.; Karageorgos, S.A.; Sideroglou, T.; Hatzakis, A.; Mylonakis, E. Factors Associated with HIV Testing and HIV Treatment Adherence: A Systematic Review. Curr. Pharm. Des. 2017, 23, 2568–2578. [Google Scholar] [CrossRef]
- Chan, A.S.W.; Leung, L.M.; Li, J.S.F.; Ho, J.M.C.; Tam, H.L.; Hsu, W.L.; Iu, A.N.O.S.; Tang, P.M.K.; Yan, E. Impacts of Psychological Wellbeing with HIV/AIDS and Cancer among Sexual and Gender Minorities: A Systematic Review and Meta-Analysis. Front. Public Health 2022, 10, 912980. [Google Scholar] [CrossRef]
- Morillo Verdugo, R.; Jiménez Galán, R.; Almeida González, C. Perspectiva multidisplicinaria del apoyo a la adherencia antirretroviral en Andalucía. Estudio Andhalusida. Farm. Hosp. 2012, 36, 410–423. [Google Scholar] [CrossRef] [PubMed]
- Kardas, P.; Lewek, P.; Matyjaszczyk, M. Determinants of Patient Adherence: A Review of Systematic Reviews. Front. Pharmacol. 2013, 4, 91. [Google Scholar] [CrossRef] [PubMed]
- Murphy, D.A.; Marelich, W.D.; Hoffman, D.; Steers, W.N. Predictors of Antiretroviral Adherence. AIDS Care 2004, 16, 471–484. [Google Scholar] [CrossRef] [PubMed]
- Chenneville, T.; Gabbidon, K.; Hanson, P.; Holyfield, C. The Impact of COVID-19 on HIV Treatment and Research: A Call to Action. Int. J. Environ. Res. Public Health 2020, 17, 4548. [Google Scholar] [CrossRef] [PubMed]
- Barbera, L.K.; Kamis, K.F.; Rowan, S.E.; Davis, A.J.; Shehata, S.; Carlson, J.J.; Johnson, S.C.; Erlandson, K.M. HIV and COVID-19: Review of Clinical Course and Outcomes. HIV Res. Clin. Pract. 2021, 22, 102–118. [Google Scholar] [PubMed]
- Levy, I.; Wieder-Finesod, A.; Litchevsky, V.; Biber, A.; Indenbaum, V.; Olmer, L.; Huppert, A.; Mor, O.; Goldstein, M.; Levin, E.G.; et al. Immunogenicity and Safety of the BNT162b2 MRNA COVID-19 Vaccine in People Living with HIV-1. Clin. Microbiol. Infect. 2021, 27, 1851–1855. [Google Scholar] [CrossRef] [PubMed]
- Spinelli, M.A.; Jones, B.L.H.; Gandhi, M. COVID-19 Outcomes and Risk Factors Among People Living with HIV. Curr. HIV/AIDS Rep. 2022, 19, 425–432. [Google Scholar] [CrossRef]
- Lee, A.R.Y.B.; Wong, S.Y.; Chai, L.Y.A.; Lee, S.C.; Lee, M.X.; Muthiah, M.D.; Tay, S.H.; Teo, C.B.; Tan, B.K.J.; Chan, Y.H.; et al. Efficacy of Covid-19 Vaccines in Immunocompromised Patients: Systematic Review and Meta-Analysis. BMJ 2022, 376, e068632. [Google Scholar] [CrossRef]
- Hippisley-Cox, J.; Coupland, C.A.; Mehta, N.; Keogh, R.H.; Diaz-Ordaz, K.; Khunti, K.; Lyons, R.A.; Kee, F.; Sheikh, A.; Rahman, S.; et al. Risk Prediction of COVID-19 Related Death and Hospital Admission in Adults after COVID-19 Vaccination: National Prospective Cohort Study. BMJ 2021, 374, n2244. [Google Scholar] [CrossRef]
- Knobel, H.; Alonso, J.; Casado, J.L.; Collazos, J.; González, J.; Ruiz, I.; Kindelan, J.M.; Carmona, A.; Juega, J.; Ocampo, A.; et al. Validation of a Simplified Medication Adherence Questionnaire in a Large Cohort of HIV-Infected Patients: The GEEMA Study. AIDS 2002, 16, 605–613. [Google Scholar] [CrossRef]
- Grupo de expertos de la secretaría del plan nacional sobre el sida (spns), grupo de estudio de sida (gesida) y sociedad española de farmacia hospitalaria (sefh). Available online: https://gesida-seimc.org/wp-content/uploads/2022/05/GuiaGeSIDAPlanNacionalSobreElSidaRespectoAlTratamientoAntirretroviralEnAdultosInfectadosPorElVirusDeLaInmunodeficienciaHumanaActualizacionEnero2022.pdf (accessed on 15 April 2023).
- Miller, L.G.; Liu, H.; Hays, R.D.; Golin, C.E.; Beck, C.K.; Asch, S.M.; Ma, Y.; Kaplan, A.H.; Wenger, N.S. How Well Do Clinicians Estimate Patients’ Adherence to Combination Antiretroviral Therapy? J. Gen. Intern. Med. 2002, 17, 1–11. [Google Scholar] [CrossRef]
- Lam, W.Y.; Fresco, P. Medication Adherence Measures: An Overview. BioMed Res. Int. 2015, 2015, 217047. [Google Scholar] [CrossRef]
- Abdulrahman, S.A.; Ganasegeran, K.; Rampal, L.; Martins, O.F. HIV Treatment Adherence—A Shared Burden for Patients, Health-Care Providers, and Other Stakeholders. AIDS Rev. 2019, 21, 1909. [Google Scholar] [CrossRef]
- Bofill, L.; Waldrop-Valverde, D.; Metsch, L.; Pereyra, M.; Kolber, M.A. Demographic and Psychosocial Factors Associated with Appointment Attendance among HIV-Positive Outpatients. AIDS Care 2011, 23, 1219–1225. [Google Scholar] [CrossRef]
- Zhang, Y.; Dou, Z.; Sun, K.; Ma, Y.; Chen, R.Y.; Bulterys, M.; Zhao, Y.; Zhu, H.; Liu, Z.; Zhang, F. Association Between Missed Early Visits and Mortality Among Patients of China National Free Antiretroviral Treatment Cohort. JAIDS J. Acquir. Immune Defic. Syndr. 2012, 60, 59–67. [Google Scholar] [CrossRef] [PubMed]
- Al-Dakkak, I.; Patel, S.; McCann, E.; Gadkari, A.; Prajapati, G.; Maiese, E.M. The Impact of Specific HIV Treatment-Related Adverse Events on Adherence to Antiretroviral Therapy: A Systematic Review and Meta-Analysis. AIDS Care 2013, 25, 400–414. [Google Scholar] [CrossRef] [PubMed]
- Ridgway, J.P.; Schmitt, J.; Friedman, E.; Taylor, M.; Devlin, S.; McNulty, M.; Pitrak, D. HIV Care Continuum and COVID-19 Outcomes among People Living with HIV during the COVID-19 Pandemic, Chicago, IL. AIDS Behav. 2020, 24, 2770–2772. [Google Scholar] [CrossRef] [PubMed]
- Remor, E. Systematic Review of the Psychometric Properties of the Questionnaire to Evaluate the Adherence to HIV Therapy (CEAT-VIH). Patient 2013, 6, 61–73. [Google Scholar] [CrossRef]
- Nachega, J.B.; Uthman, O.A.; Peltzer, K.; Richardson, L.A.; Mills, E.J.; Amekudzi, K.; Ouédraogo, A. Association between Antiretroviral Therapy Adherence and Employment Status: Systematic Review and Meta-Analysis. Bull. World Health Organ. 2015, 93, 29–41. [Google Scholar] [CrossRef]
- Hacihasanoglu Asilar, R.; Yildirim, A.; Saglam, R.; Demirturk Selcuk, E.; Erduran, Y.; Sarihan, O. The Effect of Loneliness and Perceived Social Support on Medication Adherence Self-Efficacy in Hypertensive Patients: An Example of Turkey. J. Vasc. Nurs. 2020, 38, 183–190. [Google Scholar] [CrossRef]
- Lu, J.; Zhang, N.; Mao, D.; Wang, Y.; Wang, X. How Social Isolation and Loneliness Effect Medication Adherence among Elderly with Chronic Diseases: An Integrated Theory and Validated Cross-Sectional Study. Arch. Gerontol. Geriatr. 2020, 90, 104154. [Google Scholar] [CrossRef]
- Enriquez, M.; Mercier, D.A.; Cheng, A.-L.; Banderas, J.W. Perceived Social Support among Adults Struggling with Adherence to HIV Care and Treatment. J. Assoc. Nurses AIDS Care 2019, 30, 362–371. [Google Scholar] [CrossRef]
- Castillo-Mancilla, J.R.; Haberer, J.E. Adherence Measurements in HIV: New Advancements in Pharmacologic Methods and Real-Time Monitoring. Curr. HIV/AIDS Rep. 2018, 15, 49–59. [Google Scholar] [CrossRef]
- Trotta, M.P.; Ammassari, A.; Melzi, S.; Zaccarelli, M.; Ladisa, N.; Sighinolfi, L.; Mura, M.S.; Monforte, A.D.; Antinori, A. Treatment-Related Factors and Highly Active Antiretroviral Therapy Adherence. JAIDS J. Acquir. Immune Defic. Syndr. 2002, 31, S128–S131. [Google Scholar] [CrossRef]
- Wagner, G.J.; Wagner, Z.; Gizaw, M.; Saya, U.; MacCarthy, S.; Mukasa, B.; Wabukala, P.; Linnemayr, S. Increased Depression during COVID-19 Lockdown Associated with Food Insecurity and Antiretroviral Non-Adherence among People Living with HIV in Uganda. AIDS Behav. 2021, 26, 2182–2190. [Google Scholar] [CrossRef]
- Bogart, L.M.; Ojikutu, B.O.; Tyagi, K.; Klein, D.J.; Mutchler, M.G.; Dong, L.; Lawrence, S.J.; Thomas, D.R.; Kellman, S. COVID-19 Related Medical Mistrust, Health Impacts, and Potential Vaccine Hesitancy among Black Americans Living with HIV. JAIDS J. Acquir. Immune Defic. Syndr. 2021, 86, 200–207. [Google Scholar] [CrossRef] [PubMed]
- Simoni, J.M.; Huh, D.; Frick, P.A.; Pearson, C.R.; Andrasik, M.P.; Dunbar, P.J.; Hooton, T.M. Peer Support and Pager Messaging to Promote Antiretroviral Modifying Therapy in Seattle: A Randomized Controlled Trial. JAIDS J. Acquir. Immune Defic. Syndr. 2009, 52, 465–473. [Google Scholar] [CrossRef] [PubMed]
- Kanters, S.; Park, J.J.H.; Chan, K.; Socias, M.E.; Ford, N.; Forrest, J.I.; Thorlund, K.; Nachega, J.B.; Mills, E.J. Interventions to Improve Adherence to Antiretroviral Therapy: A Systematic Review and Network Meta-Analysis. Lancet HIV 2017, 4, e31–e40. [Google Scholar] [CrossRef] [PubMed]
- Brown, D.C.; BeLue, R.; Airhihenbuwa, C.O. HIV and AIDS-Related Stigma in the Context of Family Support and Race in South Africa. Ethn. Health 2010, 15, 441–458. [Google Scholar] [CrossRef] [PubMed]
N (%) | |
---|---|
Average age (SD) Median | 51.7 (10.7) 52 |
Age range <45 45–60 >60 | 6 (24.0) 13 (52.0) 6 (24.0) |
Sex Male Female | 19 (76.0) 6 (24.0) |
Professional status Active worker Unemployed Retired | 10 (40.0) 4 (16.0) 11 (44.0) |
Family status Live alone Live with someone else | 8 (32.0) 17 (68.0) |
Pre-COVID-19 viral load Detectable Not detectable | 9 (36.0) 16 (64.0) |
Post-COVID-19 viral load Detectable Not detectable | 6 (24.0) 19 (76.0) |
AIDS stage Yes No | 20 (80.0) 5 (20.0) |
Adverse reactions to treatment Yes No Don’t know | 6 (24.0) 17 (68.0) 2 (8.0) |
SARS-CoV-2 infection Yes No | 3 (12.0) 22 (88.0) |
N (SD) | |
Average number of tablets per day | 1.5 (0.7) |
Average number of intakes per day | 1.0 (0.2) |
SMAQ (Pre) | |||
---|---|---|---|
Adherent N (%) | Non-Adherent N (%) | ||
Rate of Medical Possession (Pre) | Adherent | 17 (100%) | 7 (87.5%) |
Non-adherent | - | 1 (12.5%) |
SMAQ (Post) | |||
---|---|---|---|
Adherent N (%) | Non-Adherent N (%) | ||
Rate of Medical Possession (Post) | Adherent | 18 (100.0%) | 7 (100.0%) |
Non-adherent | - | - |
Pre-COVID-19 Adherence | |||
---|---|---|---|
Yes N (%) | No N (%) | p-Value | |
Age range <45 45–60 >60 | 1 (16.7) 11 (84.6) 5 (83.3) | 5 (83.3) 2 (15.4) 1 (16.7) | 0.008 |
Sex Male Female | 13 (68.4) 4 (66.7) | 6 (31.6) 2 (33.3) | 0.936 |
Professional status Active worker Unemployed Retired | 7 (70.0) 2 (50.0) 8 (72.7) | 3 (30.0) 2 (50.0) 3 (27.3) | 0.695 |
Family status Live alone Live with someone else | 6 (75.0) 11 (64.7) | 2 (25.0) 6 (35.3) | 0.607 |
AIDS stage Yes No | 14 (70.0) 3 (60.0) | 6 (30.0) 2 (40.0) | 0.669 |
Adverse reactions to treatment Yes No Don’t know | 2 (33.3) 14 (82.4) 1 (50.0) | 4 (66.7) 3 (17.6) 1 (50.0) | 0.043 |
N (SD) | N (SD) | p-Value | |
Average number of tablets per day | 1.53 (0.80) | 1.50 (0.75) | 0.931 |
Average number of intakes per day | 1.06 (0.24) | 1.00 (0.00) | 0.504 |
Post-COVID-19 Adherence | |||
---|---|---|---|
Yes N (%) | No N (%) | p-Value | |
Age range <45 45–60 >60 | 1 (16.7) 12 (92.3) 5 (83.3) | 5 (83.3) 1 (7.7) 1 (16.7) | 0.002 |
Sex Male Female | 14 (73.7) 4 (66.7) | 5 (26.3) 2 (33.3) | 0.739 |
Professional status Active worker Unemployed Retired | 8 (80.0) 2 (50.0) 8 (72.7) | 2 (20.0) 2 (50.0) 3 (27.3) | 0.527 |
Family status Live alone Live with someone else | 6 (75.0) 12 (70.6) | 2 (25.0) 5 (29.4) | 0.819 |
AIDS stage Yes No | 15 (75.0) 3 (60.0) | 5 (25.0) 2 (40.0) | 0.504 |
Adverse reactions to treatment Yes No Don’t know | 3 (50.0) 14 (82.4) 1 (50.0) | 3 (50.0) 3 (17.6) 1 (50.0) | 0.244 |
N (SD) | N (SD) | p-value | |
Average number of tablets per day | 1.50 (0.78) | 1.57 (0.78) | 0.840 |
Average number of intakes per day | 1.06 (0.24) | 1.00 (0.00) | 0.544 |
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Carbonero-Lechuga, P.; Castrodeza-Sanz, J.; Sanz-Muñoz, I.; Marqués-Sánchez, P.; Eiros, J.M.; Dueñas-Gutiérrez, C.; Prada-García, C. Impact of COVID-19 on Adherence to Treatment in Patients with HIV. Healthcare 2023, 11, 1299. https://doi.org/10.3390/healthcare11091299
Carbonero-Lechuga P, Castrodeza-Sanz J, Sanz-Muñoz I, Marqués-Sánchez P, Eiros JM, Dueñas-Gutiérrez C, Prada-García C. Impact of COVID-19 on Adherence to Treatment in Patients with HIV. Healthcare. 2023; 11(9):1299. https://doi.org/10.3390/healthcare11091299
Chicago/Turabian StyleCarbonero-Lechuga, Pablo, Javier Castrodeza-Sanz, Iván Sanz-Muñoz, Pilar Marqués-Sánchez, Jose M. Eiros, Carlos Dueñas-Gutiérrez, and Camino Prada-García. 2023. "Impact of COVID-19 on Adherence to Treatment in Patients with HIV" Healthcare 11, no. 9: 1299. https://doi.org/10.3390/healthcare11091299