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Epidemiology and Population Health

Association between obesity and combination antiretroviral therapy (cART) adherence among persons with early-stage HIV infection initiating cART

International Journal of Obesity volume 45, pages 1855–1859 (2021)Cite this article

Subjects

Abstract

Background

Obesity is common among people living with HIV (PLWH) and early-stage infection, yet associations with combination antiretroviral (cART) adherence are unclear.

Methods

Among PLWH initiating cART in Uganda and South Africa, body mass index (BMI) was assessed at cART initiation, and cART adherence was monitored in real-time over 12 months. The association of obesity (BMI ≥ 30 kg/m2) with adherence was assessed among nonpregnant participants with CD4 > 350 cells/mm3 using fractional regression modeling.

Results

Among 322 participants, median age was 32 years, 70% were female, and 54% were from Uganda. Prevalence of obesity was 12% in Uganda and 28% in South Africa. Mean overall cART adherence was 83% in Uganda and 66% in South Africa. Participants with obesity had higher adherence than those without obesity: +3.6% (p = 0.44) in Uganda and +11.4% (p = 0.02) in South Africa.

Conclusion

Obesity at cART initiation was common and associated with higher adherence, although only significantly in South Africa.

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Funding

This study was supported by the Bill and Melinda Gates Foundation (OPP1056051). Authors report the following additional support: P30DK040561 (FCS), L30DK118710 (FCS), K23HD097300 (AAB), and the Massachusetts General Hospital Executive Committee on Research through the Center for Diversity and Inclusion (AAB).

META team

Bosco M. Bwana1,9, Gideon Amanyire1,10, Lynn T. Matthews11,12, Alexander C. Tsai11,12, Ingrid T. Katz12,13, Kathleen Bell11, Annet Kembabazi1, Stephen Mugisha1, Victoria Kibirige1, Anna Cross14, Nicola Kelly14, Bethany Hedt-Gauthier11,12, David R. Bangsberg15

Author information

Authors and Affiliations

  1. Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda

    Nicholas Musinguzi, Stephen Asiimwe, Bosco M. Bwana, Gideon Amanyire, Annet Kembabazi, Stephen Mugisha & Victoria Kibirige

  2. Department of Medicine- Neuroendocrine Unit, Department of Pediatrics- Endocrine, Nutrition Obesity Research Center at Harvard (NORCH) Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Fatima Cody Stanford

  3. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Adeline A. Boatin

  4. Desmond Tutu HIV Centre, Department of Medicine & Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa

    Catherine Orrell

  5. Kabwohe Clinical Research Centre, Kabwohe, Uganda

    Stephen Asiimwe

  6. Center for Global Health, Massachusetts General Hospital, Boston, MA, USA

    Mark Siedner & Jessica E. Haberer

  7. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Mark Siedner & Jessica E. Haberer

  8. Africa Health Research Institute, KwaZulu-Natal, South Africa

    Mark Siedner

  9. Mbarara University of Science and Technology, Mbarara, Uganda

    Bosco M. Bwana

  10. Makerere University Joint AIDS Program, Kampala, Uganda

    Gideon Amanyire

  11. Massachusetts General Hospital Center for Global Health, Boston, MA, USA

    Lynn T. Matthews, Alexander C. Tsai, Kathleen Bell & Bethany Hedt-Gauthier

  12. Harvard Medical School, Boston, MA, USA

    Lynn T. Matthews, Alexander C. Tsai, Ingrid T. Katz & Bethany Hedt-Gauthier

  13. Brigham and Women’s Hospital, Boston, MA, USA

    Ingrid T. Katz

  14. Desmond Tutu HIV Foundation, Cape Town, South Africa

    Anna Cross & Nicola Kelly

  15. Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA

    David R. Bangsberg

Authors
  1. Nicholas Musinguzi
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  2. Fatima Cody Stanford
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  3. Adeline A. Boatin
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  4. Catherine Orrell
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  5. Stephen Asiimwe
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  6. Mark Siedner
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  7. Jessica E. Haberer
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Consortia

on behalf of the META team

  • Bosco M. Bwana
  • , Gideon Amanyire
  • , Lynn T. Matthews
  • , Alexander C. Tsai
  • , Ingrid T. Katz
  • , Kathleen Bell
  • , Annet Kembabazi
  • , Stephen Mugisha
  • , Victoria Kibirige
  • , Anna Cross
  • , Nicola Kelly
  • , Bethany Hedt-Gauthier
  •  & David R. Bangsberg

Corresponding author

Correspondence to Nicholas Musinguzi.

Ethics declarations

Conflict of interest

JEH reports consulting fees from Merck. The other authors declare no competing financial interests

Ethics statement

Ethical review boards at Mbarara University of Science and Technology, Uganda National Council Science and Technology, the University of Cape Town and Partners Healthcare approved the META study. All participants provided written informed consent.

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Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Members of the META team are listed below Funding.

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Cite this article

Musinguzi, N., Stanford, F.C., Boatin, A.A. et al. Association between obesity and combination antiretroviral therapy (cART) adherence among persons with early-stage HIV infection initiating cART. Int J Obes 45, 1855–1859 (2021). https://doi.org/10.1038/s41366-021-00837-y

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  • DOI: https://doi.org/10.1038/s41366-021-00837-y

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