|Title||Effect of antiretroviral therapy on patients’ economic well-being: five-year follow up in South Africa|
|Authors||Sydney Rosen; Bruce Larson; Julia Rohr; Ian Sanne; Constance Mongwenyana; Alana T. Brennan; Omar Galárraga|
|Publication||AIDS. 2013 Sep;.|
Objective:Evaluate the effect of antiretroviral therapy (ART) on South African HIV patients' economic well being, as indicated by symptoms, normal activities, employment, and external support, during the first 5 years on treatment.
Methods:Prospective cohort study of 879 adult patients at public or nongovernmental clinics enrolled before ART initiation or on ART less than 6 months and followed for 5.5 years or less. Patients were interviewed during routine clinic visits. Outcomes were estimated using population-averaged logistic regression and reported as proportions of the cohort experiencing outcomes by duration on ART.
Results:For patients remaining in care, outcomes improved continuously and substantially, with all differences between baseline and 5 years statistically significant (P < 0.05) and continued significant improvement between year 3 and year 5. The probability of reporting pain last week fell from 69% during the three months before starting ART to 17% after 5 years on ART and fatigue from 62 to 7%. The probability of not being able to perform normal activities in the previous week fell from 47 to 5% and of being employed increased from 32 to 44%; difficulty with job performance among those employed fell from 56 to 6%. As health improved, the probability of relying on a caretaker declined from 81 to less than 1%, and receipt of a disability grant, which initially increased, fell slightly over time on ART.
Conclusion:Results from one of the longest prospective cohorts tracking economic outcomes of HIV treatment in Africa suggest continuous improvement during the first 5 years on treatment, confirming the sustained economic benefits of providing large-scale treatment.
|Related Projects||Economic Outcomes of HIV/AIDS Treatment in South Africa|
Economics and Epidemiology of HIV/AIDS, Tuberculosis, and Non-Communicable Diseases in Africa and Asia