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Longitudinal Analysis of Interruptio...

Nawar, Eric .

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Longitudinal Analysis of Interruptions in HIV Care and Treatment among HIV-Positive Pregnant Women Engaged in Clinical Care in Kigali, Rwanda.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Longitudinal Analysis of Interruptions in HIV Care and Treatment among HIV-Positive Pregnant Women Engaged in Clinical Care in Kigali, Rwanda./
Author:	Nawar, Eric .
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
Description:	92 p.
Notes:	Source: Dissertations Abstracts International, Volume: 81-07, Section: A.
Contained By:	Dissertations Abstracts International81-07A.
Subject:	Public health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27548128
ISBN:	9781392416082

Longitudinal Analysis of Interruptions in HIV Care and Treatment among HIV-Positive Pregnant Women Engaged in Clinical Care in Kigali, Rwanda.
Nawar, Eric .

Longitudinal Analysis of Interruptions in HIV Care and Treatment among HIV-Positive Pregnant Women Engaged in Clinical Care in Kigali, Rwanda. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 92 p.

Source: Dissertations Abstracts International, Volume: 81-07, Section: A.

Thesis (Sc.D.)--Tulane University, School of Public Health and Tropical Medicine, 2019.

This item must not be sold to any third party vendors.

The World Health Organization (WHO) currently recommends the provision of lifelong antiretroviral therapy (ART) to all pregnant HIV-positive women regardless of their clinical stage of infection-an approach referred to as "Option B+." There is still no cure for HIV/AIDS, and therefore treatment is needed for life. Stopping treatment can cause the HIV virus to rebound to unhealthy levels resulting in poor outcomes, including death. Yet retention in HIV care programs and treatment adherence remain challenging. While many studies have explored risk factors and outcomes associated with non-retention or poor adherence, a standard measurement approach is lacking, making comparison and generalization of findings difficult. In addition, retention and adherence are mostly described as an overall value at one point in time or at the end of the study period. Few studies explore actual patterns of adherence over time, which may better capture longitudinal health-seeking behavior. With regular monthly visits to HIV clinics and daily doses of ART recommended for life, patterns of interruptions in care and treatment are likely to vary and may differ in both their determinants and impact on HIV viral load.As part of a national strategy to end mother-to-child- transmission of HIV, the Government of Rwanda adopted Option B+ in 2012. In 2013, the Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) study was established to evaluate the effectiveness of the program. The purpose of this dissertation is to describe patterns of interruptions in clinical visits for women on ART enrolled in the Kabeho Study, and to explore both determinants of the interruption patterns as well as associations with detectable HIV viral load and treatment failure.

ISBN: 9781392416082Subjects--Topical Terms:

534748
Public health.
Subjects--Index Terms:

ART

Longitudinal Analysis of Interruptions in HIV Care and Treatment among HIV-Positive Pregnant Women Engaged in Clinical Care in Kigali, Rwanda.
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520 $a The World Health Organization (WHO) currently recommends the provision of lifelong antiretroviral therapy (ART) to all pregnant HIV-positive women regardless of their clinical stage of infection-an approach referred to as "Option B+." There is still no cure for HIV/AIDS, and therefore treatment is needed for life. Stopping treatment can cause the HIV virus to rebound to unhealthy levels resulting in poor outcomes, including death. Yet retention in HIV care programs and treatment adherence remain challenging. While many studies have explored risk factors and outcomes associated with non-retention or poor adherence, a standard measurement approach is lacking, making comparison and generalization of findings difficult. In addition, retention and adherence are mostly described as an overall value at one point in time or at the end of the study period. Few studies explore actual patterns of adherence over time, which may better capture longitudinal health-seeking behavior. With regular monthly visits to HIV clinics and daily doses of ART recommended for life, patterns of interruptions in care and treatment are likely to vary and may differ in both their determinants and impact on HIV viral load.As part of a national strategy to end mother-to-child- transmission of HIV, the Government of Rwanda adopted Option B+ in 2012. In 2013, the Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) study was established to evaluate the effectiveness of the program. The purpose of this dissertation is to describe patterns of interruptions in clinical visits for women on ART enrolled in the Kabeho Study, and to explore both determinants of the interruption patterns as well as associations with detectable HIV viral load and treatment failure.
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