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Coverage and adherence of antiretroviral therapy among Chinese HIV‐positive men who have sex with men with high CD4 counts in the era of ‘Treat all’
Author(s) -
Yang Xueying,
Wang Zixin,
Harrison Sayward,
Lau Joseph T. F.
Publication year - 2020
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13353
Subject(s) - antiretroviral therapy , medicine , human immunodeficiency virus (hiv) , men who have sex with men , antiretroviral treatment , demography , gynecology , family medicine , viral load , syphilis , sociology
Objectives HIV‐positive men who have sex with men (MSM) with CD4 cell counts> 350 cells/mm 3 in China recently became eligible for free antiretroviral therapy (ART) due to updated national guidelines. This study aimed to investigate ART coverage and adherence among a large sample of HIV‐positive MSM in China. Methods A cross‐sectional survey was conducted in Chengdu and Hangzhou, China, from February to November 2016. Participants were 277 MSM who had received a confirmatory HIV diagnosis and had CD4 levels of> 350 cells/mm 3 . Trained staff of collaborating non‐governmental organizations contacted all HIV‐positive MSM listed in their service records and invited them to join the study. The ART initiation, ART adherence and interactions between healthcare professionals and the patients were assessed. Results ART coverage was 60.3%. Among those who were on ART ( n = 167), no participants reported missing any doses in the last four days, but 25.7% reported non‐compliance to either ART dosing schedule or dosage instructions. After adjusting for background variables and perceived eligibility for ART, two variables were significant factors of higher ART coverage: (i) receiving a recommendation from healthcare professionals for immediate ART initiation and (ii) perceiving having received an adequate explanation of potential harms of ART. Being prescribed> 3 pills per dose and not having a temporary resident permit were associated with non‐compliance. Conclusions Significant efforts are needed to increase ART coverage among HIV‐positive MSM with high CD4 counts in China. Although prevalence of missing doses was low, non‐compliance to dosing schedule/instructions should not be neglected. Interactions between healthcare professionals and MSMs play an important role in facilitating ART initiation.