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Factors associated with enrollment into differentiated service delivery model among adults with HIV in Kenya

Lavoie, Marie-Claude C ; Koech, Emily ; Blanco, Natalia ; Wangusi, Rebecca ; Jumbe, Marline ; Kimonye, Francis ; Ndaga, Angela ; Ndichu, Geofrey ; Makokha, Violet ; Awuor, Patrick ; Momanyi, Emmah ; Oyuga, Roseline ; Nzyoka, Sarah ; Mutisya, Immaculate ; Joseph, Rachel ; Miruka, Fredrick ; Musingila, Paul ; Stafford, Kristen A ; Lascko, Taylor ; Ngunu, Carol ; Owino, Elizabeth ; Kiplangat, Anthony ; Kepha, Abuya ; Ng'eno, Caroline

AIDS (London), 2023-12, Vol.37 (15), p.2409-2417 [Periódico revisado por pares]

England

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Título:
Factors associated with enrollment into differentiated service delivery model among adults with HIV in Kenya
Autor: Lavoie, Marie-Claude C ; Koech, Emily ; Blanco, Natalia ; Wangusi, Rebecca ; Jumbe, Marline ; Kimonye, Francis ; Ndaga, Angela ; Ndichu, Geofrey ; Makokha, Violet ; Awuor, Patrick ; Momanyi, Emmah ; Oyuga, Roseline ; Nzyoka, Sarah ; Mutisya, Immaculate ; Joseph, Rachel ; Miruka, Fredrick ; Musingila, Paul ; Stafford, Kristen A ; Lascko, Taylor ; Ngunu, Carol ; Owino, Elizabeth ; Kiplangat, Anthony ; Kepha, Abuya ; Ng'eno, Caroline
Assuntos: Adult ; Anti-HIV Agents - therapeutic use ; Health Facilities ; HIV Infections - drug therapy ; Humans ; Kenya - epidemiology ; Middle Aged ; Research Design ; Retrospective Studies ; Young Adult
É parte de: AIDS (London), 2023-12, Vol.37 (15), p.2409-2417
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Descrição: Differentiated service delivery (DSD) such as multimonth dispensing (MMD) aims to provide client-centered HIV services, while reducing the workload within health facilities. We assessed individual and facility factors associated with receiving more than three MMD and switching from ≥3MMD back to <3MMD in Kenya. We conducted a retrospective cohort study of clients eligible for DSD between July 2017 and December 2019. A random sample of clients eligible for DSD was selected from 32 randomly selected facilities located in Nairobi, Kisii, and Migori counties. We used a multilevel Poisson regression model to assess the factors associated with receiving ≥3MMD, and with switching from ≥3MMD back to <3MMD. A total of 3501 clients eligible for ≥3MMD were included in our analysis: 1808 (51.6%) were receiving care in Nairobi County and the remaining 1693 (48.4%) in Kisii and Migori counties. Overall, 65% of clients were enrolled in ≥3MMD at the time of entry into the cohort. In the multivariable model, younger age (20-24; 25-29; 30-34 vs. 50 or more years) and switching ART regimen was significantly associated with a lower likelihood of ≥3MMD uptake. Factors associated with a higher likelihood of enrollment in ≥3MMD included receiving DTG vs. EFV-based ART regimen (aRR: 1.10; 95% confidence interval: 1.05-1.15). Client-level characteristics are associated with being on ≥3MMD and the likelihood of switching from ≥3MMD to <3MMD. Monitoring DSD enrollment across different populations is critical to successfully implementing these models continually.
Editor: England
Idioma: Inglês

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Factors associated with enrollment into differentiated service delivery model among adults with HIV in Kenya

England

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