Adherence to highly active antiretroviral treatment in HIV-infected Rwandan women

Stephenson Musiime, Fred Muhairwe, Alfred Rutagengwa, Eugene Mutimura, Kathryn Anastos, Donald R. Hoover, Shi Qiuhu, Elizaphane Munyazesa, Ivan Emile, Annette Uwineza, Ethan Cowan

Research output: Contribution to journalArticle

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Abstract

Background: Scale-up of highly active antiretroviral treatment therapy (HAART) programs in Rwanda has been highly successful but data on adherence is limited. We examined HAART adherence in a large cohort of HIV+ Rwandan women. Methods: The Rwanda Women's Interassociation Study Assessment (RWISA) was a prospective cohort study that assessed effectiveness and toxicity of ART. We analyzed patient data 12±3 months after HAART initiation to determine adherence rates in HIV+ women who had initiated HAART. Results: Of the 710 HIV+ women at baseline, 490 (87.2%) initiated HAART. Of these, 6 (1.2%) died within 12 months, 15 others (3.0%) discontinued the study and 80 others (19.0%) remained in RWISA but did not have a post-HAART initiation visit that fell within the 12±3 month time points leaving 389 subjects for analysis. Of these 389, 15 women stopped their medications without being advised to do so by their doctors. Of the remaining 374 persons who reported current HAART use 354 completed the adherence assessment. All women, 354/354, reported 100% adherence to HAART at the post-HAART visit. The high self-reported level of adherence is supported by changes in laboratory measures that are influenced by HAART. The median (interquartile range) CD4 cell count measured within 6 months prior to HAART initiation was 185 (128, 253) compared to 264 (182, 380) cells/mm 3 at the post-HAART visit. Similarly, the median (interquartile range) MCV within 6 months prior to HAART initiation was 88 (83, 93) fL compared to 104 (98, 110) fL at the 12±3 month visit. Conclusion: Self-reported adherence to antiretroviral treatment 12±3 months after initiating therapy was 100% in this cohort of HIV-infected Rwandan women. Future studies should explore country-specific factors that may be contributing to high levels of adherence to HAART in this population.

Original languageEnglish (US)
Article numbere27832
JournalPLoS One
Volume6
Issue number11
DOIs
StatePublished - Nov 17 2011

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Highly Active Antiretroviral Therapy
Toxicity
HIV
therapeutics
Rwanda
Therapeutics
cohort studies
physicians
CD4 Lymphocyte Count
drug therapy
Cohort Studies

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Musiime, S., Muhairwe, F., Rutagengwa, A., Mutimura, E., Anastos, K., Hoover, D. R., ... Cowan, E. (2011). Adherence to highly active antiretroviral treatment in HIV-infected Rwandan women. PLoS One, 6(11), [e27832]. https://doi.org/10.1371/journal.pone.0027832

Adherence to highly active antiretroviral treatment in HIV-infected Rwandan women. / Musiime, Stephenson; Muhairwe, Fred; Rutagengwa, Alfred; Mutimura, Eugene; Anastos, Kathryn; Hoover, Donald R.; Qiuhu, Shi; Munyazesa, Elizaphane; Emile, Ivan; Uwineza, Annette; Cowan, Ethan.

In: PLoS One, Vol. 6, No. 11, e27832, 17.11.2011.

Research output: Contribution to journalArticle

Musiime, S, Muhairwe, F, Rutagengwa, A, Mutimura, E, Anastos, K, Hoover, DR, Qiuhu, S, Munyazesa, E, Emile, I, Uwineza, A & Cowan, E 2011, 'Adherence to highly active antiretroviral treatment in HIV-infected Rwandan women', PLoS One, vol. 6, no. 11, e27832. https://doi.org/10.1371/journal.pone.0027832
Musiime S, Muhairwe F, Rutagengwa A, Mutimura E, Anastos K, Hoover DR et al. Adherence to highly active antiretroviral treatment in HIV-infected Rwandan women. PLoS One. 2011 Nov 17;6(11). e27832. https://doi.org/10.1371/journal.pone.0027832
Musiime, Stephenson ; Muhairwe, Fred ; Rutagengwa, Alfred ; Mutimura, Eugene ; Anastos, Kathryn ; Hoover, Donald R. ; Qiuhu, Shi ; Munyazesa, Elizaphane ; Emile, Ivan ; Uwineza, Annette ; Cowan, Ethan. / Adherence to highly active antiretroviral treatment in HIV-infected Rwandan women. In: PLoS One. 2011 ; Vol. 6, No. 11.
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abstract = "Background: Scale-up of highly active antiretroviral treatment therapy (HAART) programs in Rwanda has been highly successful but data on adherence is limited. We examined HAART adherence in a large cohort of HIV+ Rwandan women. Methods: The Rwanda Women's Interassociation Study Assessment (RWISA) was a prospective cohort study that assessed effectiveness and toxicity of ART. We analyzed patient data 12±3 months after HAART initiation to determine adherence rates in HIV+ women who had initiated HAART. Results: Of the 710 HIV+ women at baseline, 490 (87.2{\%}) initiated HAART. Of these, 6 (1.2{\%}) died within 12 months, 15 others (3.0{\%}) discontinued the study and 80 others (19.0{\%}) remained in RWISA but did not have a post-HAART initiation visit that fell within the 12±3 month time points leaving 389 subjects for analysis. Of these 389, 15 women stopped their medications without being advised to do so by their doctors. Of the remaining 374 persons who reported current HAART use 354 completed the adherence assessment. All women, 354/354, reported 100{\%} adherence to HAART at the post-HAART visit. The high self-reported level of adherence is supported by changes in laboratory measures that are influenced by HAART. The median (interquartile range) CD4 cell count measured within 6 months prior to HAART initiation was 185 (128, 253) compared to 264 (182, 380) cells/mm 3 at the post-HAART visit. Similarly, the median (interquartile range) MCV within 6 months prior to HAART initiation was 88 (83, 93) fL compared to 104 (98, 110) fL at the 12±3 month visit. Conclusion: Self-reported adherence to antiretroviral treatment 12±3 months after initiating therapy was 100{\%} in this cohort of HIV-infected Rwandan women. Future studies should explore country-specific factors that may be contributing to high levels of adherence to HAART in this population.",
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AU - Hoover, Donald R.

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