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首页> 外文期刊>AIDS care. >The heterogeneous effect of short-term transfers for improving ART adherence among HIV-infected Tanzanian adults
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The heterogeneous effect of short-term transfers for improving ART adherence among HIV-infected Tanzanian adults

机译：短期转移改善艾滋病毒感染坦桑尼亚成年人艺术粘附的异质效应

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A recently concluded randomized study in Tanzania found that short-term conditional cash and food transfers significantly improved HIV-infected patients' possession of antiretroviral therapy (ART) and reduced patient loss to follow-up (LTFU) (McCoy, S.I., Njau, P.F., Fahey, C., Kapologwe, N., Kadiyala, S., Jewell, N.P., & Padian, N.S.(2017). Cash vs. food assistance to improve adherence to antiretroviral therapy among HIV-infected adults in Tanzania. AIDS, 31(6), 815-825. doi:10.1097/QAD.0000000000001406 ). We examined whether these transfers had differential effects within population subgroups. In the parent study, 805 individuals were randomized to one of three study arms: standard-of-care (SOC) HIV services, food assistance, or cash transfer. We compared achievement of the medication possession ratio (MPR) 95% at 6 and 12 months and patient LTFU at 12 months between those receiving the SOC and those receiving food or cash (combined). Using a threshold value of p0.20 to signal potential effect measure modifiers (EMM), we compared intervention effects, expressed as risk differences (RD), within subgroups characterized by: sex, age, wealth, and time elapsed between HIV diagnosis and ART initiation. Short-term transfers improved 6 and 12-month MPR 95% and reduced 12-month LTFU in most subgroups. Study results revealed wealth and time elapsed between HIV diagnosis and ART initiation as potential EMMs, with greater effects for 6-month MPR 95% in the poorest patients (RD: 32, 95% CI: (9, 55)) compared to those wealthier (RD: 16, 95% CI: (5, 27); p=0.18) and in newly diagnosed individuals (90 days elapsed since diagnosis) (RD: 25, 95% CI: (13, 36)) compared to those with 90 days (RD: 0.3, 95% CI (-17, 18); p=0.02), patterns which were sustained at 12 months. Results suggest that food and cash transfers may have stronger beneficial effects on ART adherence in the poorest patients. We also provide preliminary data suggesting that targeting interventions at patients more recently diagnosed with HIV may be worthwhile. Larger and longer-term assessments of transfer programs for the improvement of ART adherence and their potential heterogeneity by sub-population are warranted.
机译：坦桑尼亚最近的随机研究发现，短期有条件现金和食物转移显着改善了艾滋病毒感染患者的抗逆转录病毒治疗（艺术品），并降低了患者丧失后续患者（LTFU）（McCoy，Si，Njau，PF ，Fahey，C.，Kapologwe，N。，Kadiyala，S.，Jewell，NP，＆Padian，NS（2017）。现金与粮食援助，以改善坦桑尼亚艾滋病毒感染成年人的抗逆转录病毒治疗。艾滋病，31 （6），815-825。DOI：10.1097 / QAD.0000000000001406）。我们检查了这些转移是否在人口亚组内具有差异影响。在母体研究中，805人随机分为三个研究武器之一：护理标准（SoC）艾滋病毒服务，粮食援助或现金转移。我们将在6至12个月的6和12个月和患者LTFU之间进行患者在接受SOC和接收食品或现金（合并）之间的12个月内实现药物占有率（MPR）95％的成就。使用P <0.20的阈值;信号电位效果测量修饰剂（EMM），我们比较了介入效应，表达为风险差异（RD），其特征在于：性别，年龄，财富和时间在艾滋病毒诊断和艺术之间经过的时间引发。短期转移改善了6和12个月的MPR 95％，并在大多数子组中减少了12个月的LTFU。研究结果揭示了艾滋病毒诊断和艺术发起的财富和时间作为潜在的EMM，在最贫穷的患者中对6个月MPR 95％的效果更大（RD：32,95％CI：（9,55））与那些富裕人士相比（RD：16,95％CI：（5,27）; p = 0.18）和在新诊断的个体（自诊断以来经过）（RD：25，95％CI：（13,36））相比那些90天（RD：0.3,95％CI（-17,18）; p = 0.02），在12个月内持续的模式。结果表明，食品和现金转移可能对最贫困患者的艺术遵守效果更强。我们还提供初步数据，表明最近患有艾滋病毒的患者的靶向疗效可能是值得的。有必要提供对改善艺术遵守的转让方案的较大和长期评估及亚群体的潜在异质性。

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