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Factors Associated with the Acceptance of Immediate Antiretroviral Therapy after HIV Diagnosis in Thai Cohort



Author(s)

Waraporn Kingkaew, Buranee Kanchanatawan, Nipat Teeratakulpisarn, Deondara Trachunthong, Prapaipan Plodgratoke, Chanjiraporn Pondet, Chanin Suksom, Siriporn Noennoy, Somsong Teeratakulpisarn, Nittaya Phanuphak and Praphan Phanuphak

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DOI:10.17265/1548-6648/2017.05.004

 

BACKGROUND: Since 2014, Thailand has recommend initiation of antiretroviral therapy (ART) immediately after HIV diagnosis, regardless of CD4 count. HIV treatment can prevent illnesses and deaths, avert new infections, and save costs. Achieving UNAIDS 90-90-90 targets by 2020 will enable Thailand to end the AIDS epidemic by 2030. Therefore, patients immediate consent to treatment to immediate ART treatment in people recently diagnosed with HIV are key to successful ART initiation and long-term adherence. We studied factors associated with acceptance of ART initiation among Thai people promptly after their HIV diagnoses. OBJECTIVES: To examine the prevalence and associated factors of consent to immediate initiation of antiretroviral therapy after HIV diagnosis among HIV-positive Thai patients. DESIGN: A cross-sectional descriptive study. SETTING: Anonymous Clinic, Thai Red Cross AIDS Research Centre. MATERIAL AND METHODS: This research is combination of quantitative and qualitative cross-sectional data collected for the purpose of identifying acceptance levels and associated factors with the initiation of ART treatment among people infected. A total of 216 participants were included in the study. Self-administered questionnaire and in-depth interviews were used to collect data from clients  18 years. Binary logistic regression was performed to assess factors related to immediate ART acceptance. RESULTS: Enrollment of participants was 216 and 95.40% indicating they were prepared to start ART immediately and had demonstrated acceptance of their condition and 4.60% chose to defer. 61% were men who have sex with men,  31% were heterosexual, 2% were transgender women and 6% were bisexual men. Median (IQR) age was 29 (24-36) years; median (IQR) CD4 count was 274 (168-396) cells per cubic millimeter. 72% had unprotected sex over the past 6 months, and 9% had HIV-associated symptoms/AIDS-defining illness. Median (IQR) HIV knowledge score was 12 out of 15 (11-13.5), 74% were aware of possible adverse health outcomes and 85% knew about resistance development as a result of poor ART adherence. Multivariable analysis showed that education equal or higher than bachelor’s degree increased acceptance of immediate ART initiation (aOR 0.71, 95%CI 0.008-0.645, P = 0.01). Having STI (aOR 7.822, 95%CI 1.374-44.534, P = 0.02) and obligation (aOR 0.157, 95%CI 0.032-0.770, P = 0.02) were significantly associated with ART acceptance. CONCLUSION: Acceptance of immediate ART after HIV diagnosis was very high among newly diagnosed HIV-positive clients at the Thai Red Cross Anonymous Clinic. Education, experience of STI and obligation consequences influenced ART acceptance.

Acceptance of ART, HIV-positive.