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. 2010 Jun;22(2):49-56.
doi: 10.4314/mmj.v22i2.58794.

Gender differences in retention and survival on antiretroviral therapy of HIV-1 infected adults in Malawi

Katie Taylor-Smith  1 , Hannock Tweya, Anthony Harries, Erik Schoutene, Andreas Jahn
Affiliations

Gender differences in retention and survival on antiretroviral therapy of HIV-1 infected adults in Malawi

Katie Taylor-Smith et al. Malawi Med J. 2010 Jun.

Abstract

BACKGROUND; There is currently a dearth of knowledge on gender differences in mortality among patients on ART in Africa.

Methods: Using data from the national ART monitoring and evaluation system, a survival analysis of all healthcare workers, teachers, and police/army personnel who accessed ART in Malawi by June, September and December 2006 respectively, was undertaken. Gender differences in survival were analysed using Kaplan-Meier estimates and rate ratios were derived from Poisson regression adjusting for confounding.

Results: 4670 ART patients (49.8% female) were followed up for a median of 8.7 months after starting ART. Probability of death was significantly higher for men than women (p < 0.001). Controlling for age, WHO clinical stage and occupation, men experienced nearly 2 times the mortality of women RR 1.90 [95% CI: 1.57-2.29]. A higher proportion of men initiated ART in WHO stage 4 (p < 0.001).

Conclusion: Among healthcare workers, teachers, police/army personnel, men have higher mortality on ART than women. Possible reasons are unclear but could be biological or because men present for ART at a later clinical stage or have poorer adherence to therapy. Improving early access to ART may reduce mortality, especially among men. A gender difference in adherence to therapy needs further investigation.

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Figures

Figure 1
Figure 1
Cumulative survival probabilities by gender
See this image and copyright information in PMC

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