Browsing by Author "Ragland, Kathleen"
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Item Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time(AIDS and Behavior, 2009) Tusiime, Jayne Byakika; Crane, Johanna; Oyugi, Jessica H.; Ragland, Kathleen; Kawuma, Annet; Musoke, Philippa; Bangsberg, David R.We conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.Item Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uganda(AIDS (London, England), 2014) Weiser, Sheri D.; Palar, Kartika; Frongillo, Edward A.; Tsai, Alexander C.; Kumbakumba, Elias; dePee, Saskia; Hunta, Peter W.; Ragland, Kathleen; Martin, Jeffrey; Bangsber, David R.Food insecurity is a potentially important barrier to the success of antiretroviral therapy (ART) programs in resource-limited settings. We undertook a longitudinal study in rural Uganda to estimate the associations between food insecurity and HIV treatment outcomes. Longitudinal cohort study. Participants were from the Uganda AIDS Rural Treatment Outcomes study and were followed quarterly for blood draws and structured interviews. We measured food insecurity with the validated Household Food Insecurity Access Scale. Our primary outcomes were: ART nonadherence (adherence <90%) measured by visual analog scale; incomplete viral load suppression (>400 copies/ml); and low CD4รพ T-cell count (<350 cells/ml). We used generalized estimating equations to estimate the associations, adjusting for socio-demographic and clinical variables.