The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis
Abstract Background Several 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 a...
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doaj-304095bc824b4fe8bf00062f6cb0827e2020-11-25T02:47:52ZengBMCBMC Infectious Diseases1471-23342019-06-011911810.1186/s12879-019-4148-3The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysisGetenet Dessie0Fasil Wagnew1Henok Mulugeta2Dessalegn Amare3Dube Jara4Cheru Tesema Leshargie5Ayenew Negesse6Swati Rayasam7Sahai Burrowes8Department of Nursing, school of health science, College of medicine and Health Science Bahr Dar UniversityDepartment of Nursing, College of Health Science Debre Markos UniversityDepartment of Nursing, College of Health Science Debre Markos UniversityDepartment of Nursing, school of health science, College of medicine and Health Science Bahr Dar UniversityDepartment of Public Health, College of Health Science Debre Markos UniversityDepartment of Environmental Health, College of Health Science Debre Markos UniversityDepartment of Human Nutrition and Food Sciences, College of Health Science Debre Markos UniversityIndependent ResearcherPublic Health Program, College of Education and Health Sciences, Touro University CaliforniaAbstract Background Several 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. Methods We 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. Results Our 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. Conclusion This 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.http://link.springer.com/article/10.1186/s12879-019-4148-3AdherenceAntiretroviral therapyHIV/AIDSDisclosureEthiopia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Getenet Dessie Fasil Wagnew Henok Mulugeta Dessalegn Amare Dube Jara Cheru Tesema Leshargie Ayenew Negesse Swati Rayasam Sahai Burrowes |
spellingShingle |
Getenet Dessie Fasil Wagnew Henok Mulugeta Dessalegn Amare Dube Jara Cheru Tesema Leshargie Ayenew Negesse Swati Rayasam Sahai Burrowes The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis BMC Infectious Diseases Adherence Antiretroviral therapy HIV/AIDS Disclosure Ethiopia |
author_facet |
Getenet Dessie Fasil Wagnew Henok Mulugeta Dessalegn Amare Dube Jara Cheru Tesema Leshargie Ayenew Negesse Swati Rayasam Sahai Burrowes |
author_sort |
Getenet Dessie |
title |
The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis |
title_short |
The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis |
title_full |
The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis |
title_fullStr |
The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis |
title_full_unstemmed |
The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis |
title_sort |
effect of disclosure on adherence to antiretroviral therapy among adults living with hiv in ethiopia: a systematic review and meta-analysis |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2019-06-01 |
description |
Abstract Background Several 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. Methods We 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. Results Our 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. Conclusion This 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. |
topic |
Adherence Antiretroviral therapy HIV/AIDS Disclosure Ethiopia |
url |
http://link.springer.com/article/10.1186/s12879-019-4148-3 |
work_keys_str_mv |
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