Patient-level outcomes and virologic suppression rates in HIV-infected patients receiving antiretroviral therapy in Rwanda

David J. Riedel, Kristen A. Stafford, Peter Memiah, Modupe Coker, Cyprien Baribwira, Jackson Sebeza, Eva Karorero, Sabin Nsanzimana, Fernando Morales, Robert R. Redfield

Research output: Contribution to journalArticle

Abstract

The Rwanda national HIV program has been successful at scaling up antiretroviral therapy (ART) to achieve universal access. The AIDSRelief Model of Care focuses on four key principles: (1) earlier initiation of ART; (2) use of durable, highly-potent, and sequence-friendly first-line ART regimens; (3) early detection of treatment failure; and (4) provision of community-based care and support to ensure optimal adherence and follow up/engagement in care. We conducted a retrospective cohort study of randomly-selected HIV-infected patients at AIDSRelief-supported sites using a stratified, random sample of 583 adults (>15 years) who initiated ART from 30 June 2008 to 1 February 2010. At ART initiation, the median patient age was 38 years, and 67% were female. The baseline median CD4+ cell count was 309 cells/mm3. Overall virologic suppression was 91%. Married/ever married status (adjusted prevalence odds ratio [aPOR] 3.75, 95% confidence interval [CI] 1.30–10.78) and self-reported adherence ≥95% in the past month (aPOR 2.76, 95% CI 1.00–7.62) were significantly associated with viral suppression in the multivariable model. Excellent virologic outcomes were achieved in Rwandan AIDSRelief sites utilizing the AIDSRelief Model of Care during the scale-up of ART in the country.

Original languageEnglish (US)
Pages (from-to)861-872
Number of pages12
JournalInternational Journal of STD and AIDS
Volume29
Issue number9
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)
  • Infectious Diseases
  • Dermatology

Keywords

  • AIDSRelief
  • HIV
  • Rwanda
  • virologic outcomes, antiretroviral therapy

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    Riedel, D. J., Stafford, K. A., Memiah, P., Coker, M., Baribwira, C., Sebeza, J., Karorero, E., Nsanzimana, S., Morales, F., & Redfield, R. R. (2018). Patient-level outcomes and virologic suppression rates in HIV-infected patients receiving antiretroviral therapy in Rwanda. International Journal of STD and AIDS, 29(9), 861-872. https://doi.org/10.1177/0956462418761695