Table 3.
Adjusted odds ratios for factors associated with unmet desire to be involved in care as well as perception of unmet personal needs among people living with HIV in 25 countries (N = 2389)
| Characteristic | Categories | N | Unmet desire to be involved in HIV carea | Unmet personal needs in relation to treatmentb | ||
|---|---|---|---|---|---|---|
| AOR (95% CI) | P-value | AOR (95% CI) | P-value | |||
| Age, years | < 50 (referent) | 1690 | ||||
| 50 + | 699 | 0.67 (0.52–0.88) | 0.003 | 0.87 (0.68–1.11) | 0.253 | |
| Gender/sexual orientation | Men who have sex with men (referent) | 1018 | ||||
| Men who have sex with women | 479 | 0.59 (0.43–0.80) | 0.001 | 1.01 (0.76–1.33) | 0.967 | |
| Women who have sex with men | 481 | 0.91 (0.69–1.20) | 0.511 | 1.16 (0.89–1.52) | 0.268 | |
| Women who have sex with women | 62 | 0.59 (0.28–1.22) | 0.153 | 0.60 (0.31–1.16) | 0.131 | |
| Other/Unknown/Missing | 349 | 0.69 (0.50–0.96) | 0.027 | 1.05 (0.78–1.41) | 0.761 | |
| Education | ≤ High school (referent) | 532 | ||||
| > High school | 1756 | 0.90 (0.70–1.15) | 0.393 | 0.84 (0.66–1.06) | 0.132 | |
| Prefer not to answer | 101 | 0.68 (0.38–1.19) | 0.175 | 2.31 (1.37–3.92) | 0.002 | |
| Geographic regionc | Northern America (referent) | 520 | ||||
| Europe | 1119 | 1.50 (1.12–2.03) | 0.007 | 1.67 (1.28–2.19) | < 0.001 | |
| Latin America | 221 | 2.36 (1.60–3.49) | < 0.001 | 0.97 (0.65–1.43) | 0.868 | |
| Asia | 230 | 0.96 (0.63–1.46) | 0.859 | 1.79 (1.26–2.54) | 0.001 | |
| Australia | 120 | 0.91 (0.49–1.70) | 0.772 | 0.77 (0.41–1.46) | 0.427 | |
| South Africa | 179 | 3.91 (2.50–6.11) | < 0.001 | 1.74 (1.12–2.70) | 0.014 | |
| Year of HIV diagnosis | 2017 to 2019 (referent) | 548 | ||||
| 2010 to 2016 | 913 | 1.03 (0.78–1.36) | 0.823 | 0.94 (0.73–1.20) | 0.610 | |
| Pre-2010 | 928 | 1.59 (1.16–2.17) | 0.004 | 1.08 (0.81–1.44) | 0.619 | |
| Employment status | Employed (referent) | 1653 | ||||
| Nonemployed | 736 | 1.37 (1.09–1.74) | 0.008 | 1.44 (1.15–1.80) | 0.001 | |
| Domicile | Metropolitan (referent) | 1335 | ||||
| Non-metropolitan | 1054 | 0.83 (0.67–1.03) | 0.099 | 1.22 (1.00–1.49) | 0.049 | |
| Commute time to HCP | < 30 min (referent) | 869 | ||||
| 30–59 min | 1027 | 1.10 (0.87–1.40) | 0.411 | 1.06 (0.85–1.32) | 0.627 | |
| 60 + minutes/unspecified | 493 | 1.50 (1.13–1.98) | 0.005 | 1.07 (0.82–1.40) | 0.619 | |
| Experience of ART side effects | Not reported (referent) | 1348 | ||||
| Reported | 1041 | 1.14 (0.93–1.40) | 0.214 | 1.15 (0.95–1.39) | 0.161 | |
| Hiding/disguising HIV pills in past 6 months | Not reported (referent) | 1006 | ||||
| Reported | 1383 | 1.60 (1.28–2.01) | < 0.001 | 1.50 (1.21–1.85) | < 0.001 | |
| Difficulty swallowing pills | Not reported (referent) | 1599 | ||||
| Reported | 790 | 1.29 (1.03–1.63) | 0.026 | 1.70 (1.38–2.09) | < 0.001 | |
| Perceived barriers to discussing salient concerns with HCP | Not reported (referent) | 717 | ||||
| Reported | 1672 | 2.16 (1.66–2.81) | < 0.001 | 3.90 (3.00–5.08) | < 0.001 | |
| Number of times changed ART | Never (referent) | 699 | ||||
| 1 time only | 626 | 1.17 (0.88–1.56) | 0.281 | 0.87 (0.67–1.14) | 0.307 | |
| ≥ 2 times | 1064 | 1.07 (0.81–1.43) | 0.616 | 0.90 (0.70–1.17) | 0.434 | |
| Ever wanted an HIV treatment different from what they were taking | No (referent) | 1119 | ||||
| Yes, but never discussed with HCP | 304 | 1.89 (1.40–2.56) | < 0.001 | 1.48 (1.10–1.98) | 0.009 | |
| Yes, but was not prescribed after discussing with HCP | 348 | 1.86 (1.39–2.48) | < 0.001 | 1.56 (1.18–2.07) | 0.002 | |
| Yes, and was prescribed after discussing with HCP | 618 | 0.91 (0.68–1.23) | 0.553 | 0.75 (0.58–0.99) | 0.041 | |
Logistic regression analyses controlled for all factors listed in table
ART antiretroviral therapy; CI Confidence Interval; HCP Healthcare professional
aPersons who agreed or strongly agreed that they “would like to be more involved when it comes to decisions about [their] HIV treatment”, yet did not agree/strongly agree with the statement “My provider seeks my views about treatment before prescribing an HIV medication”
bA perception of unmet personal needs was defined as failure to provide a strong affirmative response to the following question: “When it comes to the management of your HIV treatment, do you feel your main HIV care provider meets your personal needs and takes into account the things that are most important to you?” Those with scores of 1–3 on a scale from 1 (Does NOT meet my personal needs at all) to 5 (FULLY meets my personal needs) to the question above were classified as having an unmet personal need
cCountries by region were: Northern America (U.S. and Canada); Europe (Austria, Belgium, France, Germany, Italy, the Netherlands, Poland, Portugal, Ireland, Russia, Spain, Switzerland, and the UK); Latin America (Argentina, Brazil, Chile, and Mexico), Asia (China, Japan, South Korea, and Taiwan)