Barriers to Starting Antiretrovirals during Tuberculosis Therapy in Africa
Author Information
Author(s): Pepper Dominique J., Marais Suzaan, WIlkinson Robert J., Bhaijee Feriyl, De Azevedo Virginia, Meintjes Graeme
Primary Institution: Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
Hypothesis
What barriers prevent eligible TB patients from initiating life-saving ART during TB therapy?
Conclusion
One-third of eligible TB patients, especially young men, did not initiate ART during TB therapy.
Supporting Evidence
- 34% of eligible TB patients did not initiate ART.
- Male gender and younger age were associated with failure to initiate ART.
- CD4+ count <100 cells/µL was linked to death during TB therapy.
Takeaway
Many people with TB and HIV in Africa don't start their life-saving medicine because of various barriers, especially young men.
Methodology
Logistic regression analyses of a prospective cohort of HIV-1 infected adults who commenced TB therapy and were eligible for ART.
Potential Biases
Potential bias due to loss to follow-up and inability to determine if early or late ART is more beneficial.
Limitations
The study could not ascertain the proportion of eligible patients referred to ART clinics and did not address other socio-demographic barriers.
Participant Demographics
100 HIV-1 infected adults, mean age 36 years, 54% male.
Statistical Information
P-Value
0.003
Confidence Interval
95% CI: 25–43%
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website