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Bast ES, Stonbraker S, Halpern M, Lowenthal E, Gross R. Barriers to HIV treatment adherence among adults living with HIV in the eastern Dominican Republic. Int J STD AIDS 2021; 32:1014-1019. [PMID: 33990170 DOI: 10.1177/09564624211014102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite access to nationally supplied antiretroviral treatment, viral load suppression rates remain suboptimal in the Dominican Republic. Counseling and support services are available but mainly targeted to those identified as having the most need. At Clínica de Familia La Romana (CFLR) in La Romana, all patients undergo a structured baseline interview including exploration of expected barriers to care. We conducted a retrospective cohort study of a random sample of patients at CFLR with treatment initiation between 1 January 2015 and 1 December 2017 to determine if self-identified barriers to HIV care predict viral load suppression. Viral load suppression occurred in 63% of the 203 patients evaluated. Lack of food (n = 19) was significantly associated with lack of viral suppression (OR 3.0, 95% CI 1.14-7.87). Nondisclosure of HIV status (n = 24) showed evidence for a protective effect (OR 0.33; 95% CI 0.11-1.0). Further steps should be taken to address food insecurity as well as to understand associated barriers to care among individuals with food insecurity.
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Affiliation(s)
- Elizabeth S Bast
- 19994Bruce W Carter Department of Veterans Affairs Medical Center, Miami, FL, USA
| | - Samantha Stonbraker
- Clinica de Familia La Romana, La Romana, Dominican Republic.,University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
| | - Mina Halpern
- Clinica de Familia La Romana, La Romana, Dominican Republic
| | - Elizabeth Lowenthal
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA.,Global Health Center, 547315Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Robert Gross
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA
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