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Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV–cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study
BACKGROUND: Human Immunodeficiency Virus is a major global public health issue affecting millions of people, and sub-Saharan Africa where Uganda lies is disproportionately affected. There has been an increase in cancer among HIV patients which has resulted into use of co-medications that sometimes a...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386774/ https://www.ncbi.nlm.nih.gov/pubmed/37507710 http://dx.doi.org/10.1186/s12889-023-16387-z |
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author | Achieng, Caroline Bunani, Nelson Kagaayi, Joseph Nuwaha, Fred |
author_facet | Achieng, Caroline Bunani, Nelson Kagaayi, Joseph Nuwaha, Fred |
author_sort | Achieng, Caroline |
collection | PubMed |
description | BACKGROUND: Human Immunodeficiency Virus is a major global public health issue affecting millions of people, and sub-Saharan Africa where Uganda lies is disproportionately affected. There has been an increase in cancer among HIV patients which has resulted into use of co-medications that sometimes affect ART and cancer chemotherapy adherence. We aimed to determine adherence to antiretroviral and cancer chemotherapy and the associated factors among patients with HIV-cancer co-morbidity at the Uganda Cancer Institute. METHODS: We conducted a cross-sectional study among 200 randomly selected adult cancer patients infected with HIV and attending the Uganda cancer institute. Antiretroviral and anti-cancer chemotherapy adherence with associated factors were assessed quantitatively. We collected the data using interviewer administered semi-structured questionnaires. Modified Poisson regression with robust standard errors was used to estimate the prevalence ratios (PR) and its 95% confidence intervals (CI) for the factors associated with adherence to Antiretroviral Therapy (ART) and cancer chemotherapy. RESULTS: Overall, 54% of the study participants adhered to both ART and chemotherapy, and 55% adhered to ART while 65% adhered to cancer chemotherapy. The mean age of the respondents was 42 (SD ± 11years), and a majority, 61% were males.More than half, 56.5% were married and at least 45% had attained a primary level of education. Patients with good adherence to antiretroviral therapy and chemotherapy were 54%. No knowledge of cancer stage (PR = 0.4, 95% CI = 0.3–0.6, P < 0.0001), having an AIDS defining cancer (PR = 0.7, 95% CI = 0.5–0.9, P = 0.005), ART clinic in district not near Uganda Cancer Institute (PR = 0.7,95% CI = 0.8-1.0, P = 0.027) and affordability of cancer chemotherapy (PR = 1.4, 95% CI = 1.0-1.9, P = 0.037) were associated with adherence to both ART and cancer chemotherapy. CONCLUSION: Adherence to both ART and cancer chemotherapy was low. Factors significantly associated with adherence were: knowledge of the cancer stage by the patient, the type of cancer diagnosis, source of ART and affordability/ availability of medications. There is a need to provide information on the stage of cancer and adherence counseling to patients. Furthermore, Integration of HIV- cancer care will be necessary for efficient and effective care for the patients. |
format | Online Article Text |
id | pubmed-10386774 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-103867742023-07-30 Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV–cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study Achieng, Caroline Bunani, Nelson Kagaayi, Joseph Nuwaha, Fred BMC Public Health Research BACKGROUND: Human Immunodeficiency Virus is a major global public health issue affecting millions of people, and sub-Saharan Africa where Uganda lies is disproportionately affected. There has been an increase in cancer among HIV patients which has resulted into use of co-medications that sometimes affect ART and cancer chemotherapy adherence. We aimed to determine adherence to antiretroviral and cancer chemotherapy and the associated factors among patients with HIV-cancer co-morbidity at the Uganda Cancer Institute. METHODS: We conducted a cross-sectional study among 200 randomly selected adult cancer patients infected with HIV and attending the Uganda cancer institute. Antiretroviral and anti-cancer chemotherapy adherence with associated factors were assessed quantitatively. We collected the data using interviewer administered semi-structured questionnaires. Modified Poisson regression with robust standard errors was used to estimate the prevalence ratios (PR) and its 95% confidence intervals (CI) for the factors associated with adherence to Antiretroviral Therapy (ART) and cancer chemotherapy. RESULTS: Overall, 54% of the study participants adhered to both ART and chemotherapy, and 55% adhered to ART while 65% adhered to cancer chemotherapy. The mean age of the respondents was 42 (SD ± 11years), and a majority, 61% were males.More than half, 56.5% were married and at least 45% had attained a primary level of education. Patients with good adherence to antiretroviral therapy and chemotherapy were 54%. No knowledge of cancer stage (PR = 0.4, 95% CI = 0.3–0.6, P < 0.0001), having an AIDS defining cancer (PR = 0.7, 95% CI = 0.5–0.9, P = 0.005), ART clinic in district not near Uganda Cancer Institute (PR = 0.7,95% CI = 0.8-1.0, P = 0.027) and affordability of cancer chemotherapy (PR = 1.4, 95% CI = 1.0-1.9, P = 0.037) were associated with adherence to both ART and cancer chemotherapy. CONCLUSION: Adherence to both ART and cancer chemotherapy was low. Factors significantly associated with adherence were: knowledge of the cancer stage by the patient, the type of cancer diagnosis, source of ART and affordability/ availability of medications. There is a need to provide information on the stage of cancer and adherence counseling to patients. Furthermore, Integration of HIV- cancer care will be necessary for efficient and effective care for the patients. BioMed Central 2023-07-28 /pmc/articles/PMC10386774/ /pubmed/37507710 http://dx.doi.org/10.1186/s12889-023-16387-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Achieng, Caroline Bunani, Nelson Kagaayi, Joseph Nuwaha, Fred Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV–cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study |
title | Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV–cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study |
title_full | Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV–cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study |
title_fullStr | Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV–cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study |
title_full_unstemmed | Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV–cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study |
title_short | Adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with HIV–cancer co-morbidity at the Uganda Cancer Institute: a cross sectional study |
title_sort | adherence to antiretroviral and cancer chemotherapy, and associated factors among patients with hiv–cancer co-morbidity at the uganda cancer institute: a cross sectional study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386774/ https://www.ncbi.nlm.nih.gov/pubmed/37507710 http://dx.doi.org/10.1186/s12889-023-16387-z |
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