title: Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam.
abstract: BACKGROUND
  Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality.
  
  
  METHODS
  A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART.
  
  
  RESULTS
  Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes.
  
  
  CONCLUSIONS
  The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes.
authors.affiliation: Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.|Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Bach Xuan
authors.initials: BX
authors.lastname: Tran
authors.affiliation: Department of Health Promotion, Daegu University, Gyeongsan, Republic of Korea.
authors.forename: Jongnam
authors.initials: J
authors.lastname: Hwang
authors.affiliation: School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.
authors.forename: Long Hoang
authors.initials: LH
authors.lastname: Nguyen
authors.affiliation: Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
authors.forename: Anh Tuan
authors.initials: AT
authors.lastname: Nguyen
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Noah Reed Knowlton
authors.initials: NR
authors.lastname: Latkin
authors.affiliation: Woolcock Medical Research Institute, Hanoi, Vietnam.
authors.forename: Ngoc Kim
authors.initials: NK
authors.lastname: Tran
authors.affiliation: Department of Immunology and Allergy, National Otolaryngology Hospital, Hanoi, Vietnam.
authors.forename: Vu Thi
authors.initials: VT
authors.lastname: Minh Thuc
authors.affiliation: Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
authors.forename: Huong Lan Thi
authors.initials: HL
authors.lastname: Nguyen
authors.affiliation: Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam.
authors.forename: Huong Thu Thi
authors.initials: HT
authors.lastname: Phan
authors.affiliation: Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
authors.forename: Huong Thi
authors.initials: HT
authors.lastname: Le
authors.affiliation: Department of Hepatobiliary Surgery, Vietnam-Germany Hospital, Hanoi, Vietnam.
authors.forename: Tho Dinh
authors.initials: TD
authors.lastname: Tran
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Carl A
authors.initials: CA
authors.lastname: Latkin
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D015497:HIV-1 / Q000502:physiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D057566:Self Report; D012923:Social Class; D012959:Socioeconomic Factors; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult; D016903:Drug Monitoring