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1.
Mushy SE et al., 2024. Barriers to viral load suppression among adolescents living with HIV on anti-retroviral therapy: A retrospective study in Tanga, Tanzania. AIDS Res Ther 21: 35.
-
2.
Bonner K, Mezochow A, Roberts T, Ford N, Cohn J, 2013. Viral load monitoring as a tool to reinforce adherence: A systematic review.J Acquir Immune Defic Syndr 64: 74–78.
-
3.
Beja H, Daisy N, Edek MT, Kobusinge V, Akaki O, Owachgiu IO, Udho S, 2022. Barriers and facilitators to successful intensive adherence counseling in rural northern Uganda: An exploratory interview with HIV-positive clients using the COM-B framework. HIV AIDS (Auckl) 14: 553–563.
-
4.
Nasuuna E, Kigozi J, Muwanguzi PA, Babirye J, Kiwala L, Muganzi A, Sewankambo N, Nakanjako D, 2019. Challenges faced by caregivers of virally non-suppressed children on the intensive adherence counselling program in Uganda: A qualitative study. BMC Health Serv Res 19: 150.
-
5.
Birungi J et al., 2020. Lack of effectiveness of adherence counselling in reversing virological failure among patients on long-term antiretroviral therapy in rural Uganda. HIV Med 21: 21–29.
-
6.
Izudi J, Castelnuovo B, King R, Cattamanchi A, 2023. Impact of intensive adherence counseling on viral load suppression and mortality among people living with HIV in Kampala, Uganda: A regression discontinuity design. PLOS Glob Public Health 3: e0002240.
-
7.
Izudi J, Castelnuovo B, King R, Cattamanchi A, 2023. Risk factors for unsuppressed viral load after intensive adherence counseling among HIV infected persons in Kampala, Uganda: A nested case-control study. AIDS Res Ther 20: 90.
-
8.
Frescura L, Godfrey-Faussett P, Feizzadeh AA, El-Sadr W, Syarif O, Ghys PD; 2025 Testing Treatment Target Working Group, 2022. Achieving the 95 95 95 targets for all: A pathway to ending AIDS. PLoS One 17: e0272405.
-
9.
Okot SP, Izudi J, Ssenyonga R, Babirye JN, 2024. Factors associated with completion of intensive adherence counseling among people living with HIV at a large referral hospital in Uganda: A retrospective analysis. BMC Health Serv Res 24: 1093.
-
10.
Izudi J, Tamwesigire IK, Bajunirwe F, 2024. Effect of missed clinic visits on treatment outcomes among people with tuberculosis: A quasi-experimental study utilizing instrumental variable analysis. IJID Reg 13: 100461.
-
11.
Villiera JB, Matanje B, Suffrin D, Munyaneza F, Hosseinipour M, Mwapasa V, Kachimanga C, 2023. How Do I Open Up?: Exploring Factors Associated with Completion of Intensive Adherence Counselling Sessions among HIV Patients with High Viral Load in Neno, Malawi. Available at: https://www.researchgate.net/publication/370990267_How_Do_I_Open_Up_Exploring_Factors_Associated_With_Completion_of_Intensive_Adherence_Counselling_Sessions_Among_Hiv_Patients_With_High_Viral_Load_in_Neno_Malawi/fulltext/646e330d8bf29018ccbce2ac/How-Do-I-Open-Up-Exploring-Factors-Associated-With-Completion-of-Intensive-Adherence-Counselling-Sessions-Among-Hiv-Patients-With-High-Viral-Load-in-Neno-Malawi.pdf?origin=scientificContributions. Accessed September 15, 2024.
-
12.
Mundamshimu JS et al., 2023. Failure to attain HIV viral suppression after intensified adherence counselling-what can we learn about its factors? Infect Drug Resist 16: 1885–1894.
-
13.
Akilimali PZ, Musumari PM, Kashala-Abotnes E, Kayembe PK, Lepira FB, Mutombo PB, Tylleskar T, Ali MM, 2017. Disclosure of HIV status and its impact on the loss in the follow-up of HIV-infected patients on potent anti-retroviral therapy programs in a (post-) conflict setting: A retrospective cohort study from Goma, Democratic Republic of Congo. PloS One 12: e0171407.
-
14.
Ndikabona G, Alege JB, Kirirabwa NS, Kimuli D, 2021. Unsuppressed viral load after intensive adherence counselling in rural eastern Uganda; a case of Kamuli district, Uganda. BMC Public Health 21: 2294.
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15.
Pius A, Josephine NN, Erick S, Winifred A, Rita M, Silverjoseph O, Lucy E, Novatus N, 2021. Influence of intensified adherence counselling on viral load suppression of people receiving antiretroviral therapy at a health centre IV in southwestern Uganda: A qualitative study. AIDS Res Ther 18: 45.
-
16.
Viertiö S, Kiviruusu O, Piirtola M, Kaprio J, Korhonen T, Marttunen M, Suvisaari J, 2021. Factors contributing to psychological distress in the working population, with a special reference to gender difference. BMC Public Health 21: 611.
-
17.
Gordon TP, Talbert M, Mugisha MK, Herbert AE, 2022. Factors associated with HIV viral suppression among adolescents in Kabale district, South Western Uganda. PLoS One 17: e0270855.
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Effect of Active Follow-Up on Viral Load Suppression among People Living with HIV on Intensive Adherence Counseling in Uganda: An Instrumental Variable Analysis
Jonathan Izudi
jonahzd@gmail.com
Jonathan Izudi
Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda;
African Population and Health Research Center, Nairobi, Kenya;
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African Population and Health Research Center, Nairobi, Kenya;
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Solomon Paul Okot
Solomon Paul Okot
Makerere University School of Public Health (MakSPH), Kampala, Uganda;
Baylor College of Medicine Children’s Foundation, Mulago Hospital Complex, Kampala, Uganda;
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Baylor College of Medicine Children’s Foundation, Mulago Hospital Complex, Kampala, Uganda;
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Allan Komakech
Allan Komakech
Africa Centers for Disease Control and Prevention (Africa CDC), Kinshasha, The Democratic Republic of Congo;
Clarke International University, Kampala, Uganda
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Clarke International University, Kampala, Uganda
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Francis Bajunirwe
Francis Bajunirwe
Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda;
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ABSTRACT.
We assessed the effect of active follow-ups on viral load (VL) suppression among people living with HIV (PLWH) who had missed their clinic visit(s) and were receiving intensive adherence counseling (IAC) at a large referral hospital in mid-western Uganda. We designed a quasi-experimental study, using a locator map (a local map showing residence) as an external factor (instrumental variable) that influenced active follow-up. We performed instrumental variable analysis. Of the 165 participants included, 24.8% had a client locator map, and possessing a map was associated with active follow-up (F-statistics 53.1; P <0.0001). Active follow-up did not significantly improve VL suppression at varying cutoffs, namely <1,000 copies/ml (P = 0.607), less than 200 copies/ml (P = 0.684), and less than 50 copies/ml (P = 0.435). Although active follow-up did not significantly improve VL suppression among PLWH on IAC, it showed a modest trend toward improvement. Large, randomized trials are needed.
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Author Notes
Disclosure: The Makerere University School of Public Health Higher Degrees Research and Ethics Committee approved the parent study (reference number: HDREC 2017/HD07/1965U).
Current contact information: Jonathan Izudi, Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda, E-mail: jonahzd@gmail.com. Solomon Paul Okot, Makerere University School of Public Health, Kampala, Uganda, E-mail: paulsolomonokot@gmail.com. Allan Komakech, Africa Centers for Disease Control and Prevention, Kinshasha, The Democratic Republic of Congo, E-mail: komallanokot@gmail.com. Francis Bajunirwe, Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda, E-mail. fbaj@yahoo.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Mushy SE et al., 2024. Barriers to viral load suppression among adolescents living with HIV on anti-retroviral therapy: A retrospective study in Tanga, Tanzania. AIDS Res Ther 21: 35.
-
2.
Bonner K, Mezochow A, Roberts T, Ford N, Cohn J, 2013. Viral load monitoring as a tool to reinforce adherence: A systematic review.J Acquir Immune Defic Syndr 64: 74–78.
-
3.
Beja H, Daisy N, Edek MT, Kobusinge V, Akaki O, Owachgiu IO, Udho S, 2022. Barriers and facilitators to successful intensive adherence counseling in rural northern Uganda: An exploratory interview with HIV-positive clients using the COM-B framework. HIV AIDS (Auckl) 14: 553–563.
-
4.
Nasuuna E, Kigozi J, Muwanguzi PA, Babirye J, Kiwala L, Muganzi A, Sewankambo N, Nakanjako D, 2019. Challenges faced by caregivers of virally non-suppressed children on the intensive adherence counselling program in Uganda: A qualitative study. BMC Health Serv Res 19: 150.
-
5.
Birungi J et al., 2020. Lack of effectiveness of adherence counselling in reversing virological failure among patients on long-term antiretroviral therapy in rural Uganda. HIV Med 21: 21–29.
-
6.
Izudi J, Castelnuovo B, King R, Cattamanchi A, 2023. Impact of intensive adherence counseling on viral load suppression and mortality among people living with HIV in Kampala, Uganda: A regression discontinuity design. PLOS Glob Public Health 3: e0002240.
-
7.
Izudi J, Castelnuovo B, King R, Cattamanchi A, 2023. Risk factors for unsuppressed viral load after intensive adherence counseling among HIV infected persons in Kampala, Uganda: A nested case-control study. AIDS Res Ther 20: 90.
-
8.
Frescura L, Godfrey-Faussett P, Feizzadeh AA, El-Sadr W, Syarif O, Ghys PD; 2025 Testing Treatment Target Working Group, 2022. Achieving the 95 95 95 targets for all: A pathway to ending AIDS. PLoS One 17: e0272405.
-
9.
Okot SP, Izudi J, Ssenyonga R, Babirye JN, 2024. Factors associated with completion of intensive adherence counseling among people living with HIV at a large referral hospital in Uganda: A retrospective analysis. BMC Health Serv Res 24: 1093.
-
10.
Izudi J, Tamwesigire IK, Bajunirwe F, 2024. Effect of missed clinic visits on treatment outcomes among people with tuberculosis: A quasi-experimental study utilizing instrumental variable analysis. IJID Reg 13: 100461.
-
11.
Villiera JB, Matanje B, Suffrin D, Munyaneza F, Hosseinipour M, Mwapasa V, Kachimanga C, 2023. How Do I Open Up?: Exploring Factors Associated with Completion of Intensive Adherence Counselling Sessions among HIV Patients with High Viral Load in Neno, Malawi. Available at: https://www.researchgate.net/publication/370990267_How_Do_I_Open_Up_Exploring_Factors_Associated_With_Completion_of_Intensive_Adherence_Counselling_Sessions_Among_Hiv_Patients_With_High_Viral_Load_in_Neno_Malawi/fulltext/646e330d8bf29018ccbce2ac/How-Do-I-Open-Up-Exploring-Factors-Associated-With-Completion-of-Intensive-Adherence-Counselling-Sessions-Among-Hiv-Patients-With-High-Viral-Load-in-Neno-Malawi.pdf?origin=scientificContributions. Accessed September 15, 2024.
-
12.
Mundamshimu JS et al., 2023. Failure to attain HIV viral suppression after intensified adherence counselling-what can we learn about its factors? Infect Drug Resist 16: 1885–1894.
-
13.
Akilimali PZ, Musumari PM, Kashala-Abotnes E, Kayembe PK, Lepira FB, Mutombo PB, Tylleskar T, Ali MM, 2017. Disclosure of HIV status and its impact on the loss in the follow-up of HIV-infected patients on potent anti-retroviral therapy programs in a (post-) conflict setting: A retrospective cohort study from Goma, Democratic Republic of Congo. PloS One 12: e0171407.
-
14.
Ndikabona G, Alege JB, Kirirabwa NS, Kimuli D, 2021. Unsuppressed viral load after intensive adherence counselling in rural eastern Uganda; a case of Kamuli district, Uganda. BMC Public Health 21: 2294.
-
15.
Pius A, Josephine NN, Erick S, Winifred A, Rita M, Silverjoseph O, Lucy E, Novatus N, 2021. Influence of intensified adherence counselling on viral load suppression of people receiving antiretroviral therapy at a health centre IV in southwestern Uganda: A qualitative study. AIDS Res Ther 18: 45.
-
16.
Viertiö S, Kiviruusu O, Piirtola M, Kaprio J, Korhonen T, Marttunen M, Suvisaari J, 2021. Factors contributing to psychological distress in the working population, with a special reference to gender difference. BMC Public Health 21: 611.
-
17.
Gordon TP, Talbert M, Mugisha MK, Herbert AE, 2022. Factors associated with HIV viral suppression among adolescents in Kabale district, South Western Uganda. PLoS One 17: e0270855.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 21416 | 21416 | 9143 |
| Full Text Views | 58 | 58 | 15 |
| PDF Downloads | 19 | 19 | 11 |