Dados do Trabalho

Título

“Women's ART Cohort” - Vulnerability of Young Women Living with HIV

Introdução

Young women living with HIV often face challenges in achieving optimal effectiveness of antiretroviral therapy (ART) potentially due to a reduced perception of risk and socioeconomic barriers. Poor adherence to treatment in this population has been associated with substandard clinical outcomes.

Objetivo (s)

To compare the effectiveness of ART in women living with HIV (WLWH) across two age groups: 18-49 and 50+ years.

Material e Métodos

This observational cohort study included 362 WLWH over 18 years old who were on regular ART between January 2020 and July 2022. Participants were divided into two groups: G1 (18-49 years), G2 (>50 years). The effectiveness of ART was measured by the percentage of participants maintaining HIV-1 viral load (VL) below 50 copies/mL. Immunological parameters, duration of ART use, ART regimens, and demographic variables were also evaluated. The study was approved by the local research ethics committee.

Resultados e Conclusão

Out of the total selected participants 334 were included in the analysis. Loss of contact and changes in service providers were the main reasons for exclusion. Significantly more women in the 50 and above cohort (91.52%) had achieved undetectable status, relative to women below 50 years old (78.21%, p=0.001). Some of this effect is due to different treatment strategies in each age cohort, where 88% of women under 50 were using triple treatment whereas only 32% of the women 50 and above were using triple treatment (p < 0.001). To determine if an effect of age remained after accounting for treatment strategy, a multiple logistic regression was performed. This showed that both effects are significant, with both patient age correlating to improved outcomes (p=0.056) and simple treatment correlating with improved outcomes (p=0.011).  This real life cohort shows that younger women are at a higher risk of remaining detectable, regardless of treatment strategy. This lays out a strong case for continuing research in this area; in future work we hope to analize additional effects such as treatment adherence, perception of risk, and socioeconomic barriers.

Palavras Chave

hiv; antiretroviral therapy; women living with HIV; effectiveness; adherence