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Title The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis.
Full text https://escholarship.org/uc/item/18g5m8gs
Date 2019
Author(s) Dessie, Getenet; Wagnew, Fasil; Mulugeta, Henok; Amare, Dessalegn; Jara, Dube; Leshargie, Cheru Tesema; Negesse, Ayenew; Rayasam, Swati; Burrowes, Sahai
Abstract BackgroundSeveral factors have been identified as being associated with increased adherence to antiretroviral therapy, including sero-status disclosure; however, studies examining the effect of disclosure on ART adherence in Ethiopia have had inconsistent findings. This systematic review and meta-analysis therefore aims to estimate the pooled effect of disclosure on adherence to ART among adults living with HIV in Ethiopia.MethodsWe performed a systematic search for articles reporting on peer-reviewed, quantitative, English-language observational studies of reporting the association between self sero-status disclosure and good ART adherence in adults living with HIV/AIDS in Ethiopia during published from 2010 to 2015. We searched four electronic databases: PubMed/Medline, the World Health Organization's Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) for studies from December 1, 2017 to January 30, 2018. We also searched university repositories and conference abstracts for unpublished studies. We conducted a meta-analysis for the pooled effect of adherence using a random effects model in Stata version 14 and assessed publication bias using the Egger's test for funnel plot asymmetry.ResultsOur search returned in 179 studies, of which seven (3.9%), were eligible and included in the final meta-analysis. The seven included studies were conducted from 2010 to 2015. Our analysis found that disclosure had a significant effect on the adherence to ART in adult patients living with HIV. Patients who disclosed were 1.64 times more likely to have good adherence to ART compared with those who did not (OR: 1.64, 95% CI: 1.11, 2.42). The small number of studies eligible for review and differences in study definitions of adherence and disclosure were the main limitations of this study.ConclusionThis review found a statistically significant positive effect of disclosure status on the adherence to ART in adult patients living with HIV in Ethiopia. This suggests that Ethiopia's national treatment and prevention programs should redouble efforts to encourage self-disclosure among people living with HIV/AIDS. Encouraging supportive social environments for disclosure, and promoting partner notification and partner disclosure support initiatives might be particularly helpful in this regard.
Subject(s) Humans; HIV Infections; Anti-HIV Agents; Self Disclosure; Social Support; Adult; Sexual Partners; Ethiopia; Medication Adherence; Adherence; Antiretroviral therapy; Disclosure; HIV/AIDS; Mental Health; Infectious Diseases; Behavioral and Social Science; Prevention; 7.1 Individual care needs; Management of diseases and conditions; Infection; Good Health and Well Being; HIV; AIDS; Microbiology; Clinical Sciences; Medical Microbiology
Coverage 528
Publisher eScholarship, University of California
Type of publication article
Format application/pdf
Source BMC infectious diseases, vol 19, iss 1
Rights public
Identifier qt18g5m8gs
Repository Berkeley - University of California
Added to C-A: 2023-09-04;09:07:02