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Adherence to Antiretroviral Therapy Among HIV Patients in India: A Systematic Review and Meta-analysis

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Abstract

We conducted a systematic review and meta-analysis to estimate the prevalence of adherence to antiretroviral therapy (ART) in India, the third largest HIV epidemic in the world. We identified peer reviewed literature published between 2007 and 2017 to extract data on ART adherence. We estimated pooled prevalence of adherence to ART using a random-effects model. Thirty-two eligible studies (n = 11,543) were included in the meta-analysis. Studies were mostly clustered in the southern and western Indian states. Overall, 77% (95% Confidence Interval 73–82; I2 = 96.80%) of patients had optimum adherence to ART. Women had higher prevalence of optimum adherence compared to men. Depression or anxiety were significant risk factors in seven of the fifteen studies reporting determinants of nonadherence. Studies should be performed to explore the reasons for gender gap in ART adherence and HIV program in India should prioritize mental health issues among HIV patients to improve ART adherence.

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Acknowledgements

We would like to thank Ms. Rosie Hanneke in developing the literature search strategy and Dr. Shimu Paul for her contribution in identifying eligible studies and in data abstraction.

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Authors and Affiliations

  1. Division of Epidemiology and Biostatistics, University of Illinois At Chicago School of Public Health, 1603 W. Taylor Street, MC 923, Chicago, IL, 60612, USA

    Apurba Chakraborty, Ronald C. Hershow, Leslie Stayner & Mark S. Dworkin

  2. University of Illinois At Chicago College of Pharmacy, 833 S. Wood St, Chicago, IL, 60612, USA

    Dima M. Qato

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  1. Apurba Chakraborty
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Correspondence to Apurba Chakraborty.

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Appendices

Appendix 1

See Fig. 3.

Fig. 3
figure 3

Geographic distribution of studies reporting ART adherence in India, by state, 2007–2017

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Appendix 2

See Fig. 4.

Fig. 4
figure 4

Forest plot presenting pooled prevalence of ART adherence by categories of percent female participants in the study in India 2007–2017

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Appendix 3

See Fig. 5.

Fig. 5
figure 5

Funnel plot for publication bias

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Chakraborty, A., Hershow, R.C., Qato, D.M. et al. Adherence to Antiretroviral Therapy Among HIV Patients in India: A Systematic Review and Meta-analysis. AIDS Behav 24, 2130–2148 (2020). https://doi.org/10.1007/s10461-020-02779-4

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