title: Adherence to antiretroviral therapy and clinical outcomes among young adults reporting high-risk sexual behavior, including men who have sex with men, in coastal Kenya.
abstract: African men who have sex with men (MSM) face significant stigma and barriers to care. We investigated antiretroviral therapy (ART) adherence among high-risk adults, including MSM, participating in a clinic-based cohort. Survival analysis was used to compare attrition across patient groups. Differences in adherence, weight gain, and CD4 counts after ART initiation were assessed. Among 250 HIV-1-seropositive adults, including 108 MSM, 15 heterosexual men, and 127 women, patient group was not associated with attrition. Among 58 participants who were followed on ART, 40 % of MSM had less than 95 % adherence, versus 28.6 % of heterosexual men and 11.5 % of women. Although MSM gained less weight after ART initiation than women (adjusted difference -3.5 kg/year), CD4 counts did not differ. More data are needed on barriers to adherence and clinical outcomes among African MSM, to ensure that MSM can access care and derive treatment and prevention benefits from ART.
authors.affiliation: Departments of Medicine and Global Health, University of Washington, Box 359909, 325 Ninth Avenue, Seattle, WA 98104-2499, USA. grahamsm@uw.edu
authors.forename: Susan M
authors.initials: SM
authors.lastname: Graham
authors.forename: Peter
authors.initials: P
authors.lastname: Mugo
authors.forename: Evanson
authors.initials: E
authors.lastname: Gichuru
authors.forename: Alexander
authors.initials: A
authors.lastname: Thiong'o
authors.forename: Michael
authors.initials: M
authors.lastname: Macharia
authors.forename: Haile S
authors.initials: HS
authors.lastname: Okuku
authors.forename: Elise
authors.initials: E
authors.lastname: van der Elst
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Price
authors.forename: Nicholas
authors.initials: N
authors.lastname: Muraguri
authors.forename: Eduard J
authors.initials: EJ
authors.lastname: Sanders
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D015497:HIV-1; D020010:Heterosexuality / Q000208:ethnology / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007630:Kenya; D059012:Lost to Follow-Up; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers / Q000523:psychology / Q000706:statistics & numerical data; D057545:Social Stigma; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents