Prevalence of unsuppressed viraemia in HIV positive female sex workers on the daily single dose TDF/3TC/EFV tablet for 6 months : PSI-Zimbabwe sex worker cohort
Date
2016-03
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: Background: Data on viral suppression and adherence patterns of anti-retroviral
therapy (ART) naïve HIV positive female sex workers (FSWs) initiated on the
Tenofovir/lamivudine/Efavirenz (TDF/3TC/EFV) fixed dose combination are scarce in
Zimbabwe. The objectives of this study were to describe the prevalence of and
factors associated with unsuppressed viraemia as well as the mean adherence of
FSWs on the Efavirenz based fixed dose tablet after 6 months of treatment.
Methods: A retrospective record review was done on 77 FSWs who had been
initiated on TDF/3TC/EFV and had a 6 months post initiation viral load test result at 2
FSW clinics in Gwanda and Bulawayo, Zimbabwe. Recruitment into the clinics was
done between July 2013 and September 2015. Data on monthly adherence per pill
count, 6 months viral load test result and possible predictors of unsuppressed
viraemia were collected.
Results: Prevalence of unsuppressed viraemia after 6 months on TDF/3TC/EFV
FDC tablet was 7.78% (95%CI, 1.67-13.92 %) while viral suppression occurred in
92.22% (95%CI 83.8-97.1%). Based on the 35 patients with complete adherence
data, the mean adherence was 99.69% (95%CI, 99.48%-99.91%). All 35 had
adherence >95% classified as good. Only comorbidity (Adjusted OR 23.31, 95%CI
1.74-310.65, p = 0.017) and baseline CD4 count (Adjusted OR 0.9886; 95%CI
0.9774-0.9998, p= 0.047) showed independent associations with unsuppressed
viraemia.
Conclusion: In the first 6 months on TDF/3TC/EFV, ART there is a low prevalence
of unsuppressed viraemia, high viral suppression rates and high adherence rates in
naïve HIV positive FSWs in our setting.
Description
Keywords
UCTD, Prostitutes -- Diseases -- Zimbabwe, HIV positive persons -- Zimbabwe, HIV infections -- Chemotherapy -- Zimbabwe, Antiretroviral agents -- Zimbabwe, Patient compliance -- Zimbabwe,