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Disparities in Dolutegravir Uptake Affecting Females of Reproductive Age With HIV in Low- and Middle-Income Countries After Initial Concerns About Teratogenicity An Observational Study

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dc.contributor.author Romo, M.L.
dc.contributor.author Patel, R.C.
dc.contributor.author Edwards, J.K.
dc.contributor.author Humphrey, J.M.
dc.contributor.author Musick, B.S.
dc.contributor.author Bernard, C.
dc.contributor.author Maina, M.W.
dc.contributor.author Brazier, E.
dc.contributor.author Castelnuovo, B.
dc.contributor.author Penner, J.
dc.contributor.author Wyka, K.
dc.contributor.author Cardoso, S.W.
dc.contributor.author Ly, P.S.
dc.contributor.author Kunzekwenyika, C.
dc.contributor.author Cortés, C.P.
dc.contributor.author Panczak, R.
dc.contributor.author Kelvin, E.A.
dc.contributor.author Wools-Kaloustian, K.K.
dc.contributor.author Nash, D.
dc.contributor.author Khol, V.
dc.contributor.author Zhang, F.J.
dc.contributor.author Zhao, H.X.
dc.contributor.author Han, N.
dc.contributor.author Lee, M.P.
dc.contributor.author Li, P.C.K.
dc.contributor.author Lam, W.
dc.contributor.author Wong, H.Y.
dc.contributor.author Kumarasamy, N.
dc.contributor.author Ezhilarasi, C.
dc.contributor.author Pujari, S.
dc.contributor.author Joshi, K.
dc.contributor.author Gaikwad, S.
dc.contributor.author Chitalikar, A.
dc.contributor.author Merati, T.P.
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dc.contributor.author Yuliana, F.
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dc.contributor.author Imran, D.
dc.contributor.author Widhani, A.
dc.contributor.author Tanuma, J.
dc.contributor.author Oka, S.
dc.contributor.author Nishijima, T.
dc.contributor.author Choi, J.Y.
dc.contributor.author Na, S.
dc.contributor.author Kim, J.M.
dc.contributor.author Gani, Y.M.
dc.contributor.author Rudi, N.B.
dc.contributor.author Azwa, I.
dc.contributor.author Kamarulzaman, A.
dc.contributor.author Syed Omar, S.F.
dc.contributor.author Ponnampalavanar, S.
dc.contributor.author Ditangco, R.
dc.contributor.author Pasayan, M.K.
dc.contributor.author Mationg, M.L.
dc.contributor.author Chan, Y.J.
dc.contributor.author Ku, W.W.
dc.contributor.author Ke, E.
dc.contributor.author Wu, P.C.
dc.contributor.author Ng, O.T.
dc.contributor.author Lim, P.L.
dc.contributor.author Lee, L.S.
dc.contributor.author Yap, J.K.
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dc.contributor.author Gatechompol, S.
dc.contributor.author Phanuphak, P.
dc.contributor.author Phadungphon, C.
dc.contributor.author Kiertiburanakul, S.
dc.contributor.author Phuphuakrat, A.
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dc.contributor.author Praparattanapan, J.
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dc.contributor.author Khuwuwan, S.
dc.contributor.author Kantipong, P.
dc.contributor.author Kambua, P.
dc.contributor.author Nguyen, K.V.
dc.contributor.author Bui, H.V.
dc.contributor.author Nguyen, D.T.H.
dc.contributor.author Nguyen, D.T.
dc.contributor.author Do, C.D.
dc.contributor.author Ngo, A.V.
dc.contributor.author Nguyen, L.T.
dc.contributor.author Sohn, A.H.
dc.contributor.author Ross, J.L.
dc.contributor.author Petersen, B.
dc.contributor.author Law, M.G.
dc.contributor.author Jiamsakul, A.
dc.contributor.author Bijker, R.
dc.contributor.author Rupasinghe, D.
dc.contributor.author Cahn, P.
dc.contributor.author Cesar, C.
dc.contributor.author Fink, V.
dc.contributor.author Sued, O.
dc.contributor.author Dell'Isola, E.
dc.contributor.author Perez, H.
dc.contributor.author Valiente, J.
dc.contributor.author Yamamoto, C.
dc.contributor.author Grinsztejn, B.
dc.contributor.author Veloso, V.
dc.contributor.author Luz, P.
dc.contributor.author de Boni, R.
dc.contributor.author Wagner, S.C.
dc.contributor.author Friedman, R.
dc.contributor.author Moreira, R.
dc.contributor.author Pinto, J.
dc.contributor.author Ferreira, F.
dc.contributor.author Maia, M.
dc.contributor.author de Menezes Succi, R.C.
dc.contributor.author Machado, D.M.
dc.contributor.author de Fátima Barbosa Gouvêa, A.
dc.contributor.author Wolff, M.
dc.contributor.author Rodriguez, M.F.
dc.contributor.author Allendes, G.
dc.contributor.author Pape, J.W.
dc.contributor.author Rouzier, V.
dc.contributor.author Marcelin, A.
dc.contributor.author Perodin, C.
dc.contributor.author Luque, M.T.
dc.contributor.author Padgett, D.
dc.contributor.author Madero, J.S.
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dc.contributor.author Belaunzaran, P.
dc.contributor.author Vega, Y.C.
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.contributor.author Mejía Cordero, Fernando Alonso
dc.contributor.author Carriquiry, G.
dc.contributor.author McGowan, C.C.
dc.contributor.author Shepherd, B.E.
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dc.contributor.author Person, A.K.
dc.contributor.author Rebeiro, P.F.
dc.contributor.author Castilho, J.
dc.contributor.author Duda, S.N.
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dc.contributor.author Vansell, H.
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dc.contributor.author Pélagie, N.
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dc.contributor.author Niyongabo, T.
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dc.contributor.author Bukuru, H.
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dc.contributor.author Baransaka, E.
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dc.contributor.author Manirakiza, M.
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dc.contributor.author Biziragusenyuka, J.
dc.contributor.author Munezero, A.M.M.
dc.contributor.author Nforniwe, D.N.
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dc.contributor.author Dzudie, A.
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dc.contributor.author Amadou, D.
dc.contributor.author Yone, E.W.P.
dc.contributor.author Kendowo, E.
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dc.contributor.author Clever, A.
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dc.contributor.author Lelo, P.
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dc.contributor.author Ekembe, C.
dc.contributor.author Kaba, D.
dc.contributor.author Diafouka, M.
dc.contributor.author Ekat, M.H.
dc.contributor.author Nsonde, D.M.
dc.contributor.author Mafoua, A.
dc.contributor.author Christ, M.N.
dc.contributor.author Igirimbabazi, J.
dc.contributor.author Ayinkamiye, N.
dc.contributor.author Uwineza, P.
dc.contributor.author Ndamijimana, E.
dc.contributor.author Habarurema, E.
dc.contributor.author Nyiraneza, M.L.
dc.contributor.author Nyiransabimana, M.L.
dc.contributor.author Tuyisenge, L.
dc.contributor.author Shyaka, C.
dc.contributor.author Kankindi, C.
dc.contributor.author Uwakijijwe, B.
dc.contributor.author Ingabire, M.G.
dc.contributor.author Ndumuhire, J.
dc.contributor.author Nyirabahutu, M.G.
dc.contributor.author Muyango, F.
dc.contributor.author Bihibindi, J.C.
dc.contributor.author Uwamahoro, O.
dc.contributor.author Ndoli, Y.
dc.contributor.author Nsanzimana, S.
dc.contributor.author Mugwaneza, P.
dc.contributor.author Remera, E.
dc.contributor.author Umumararungu, E.
dc.contributor.author Rwibasira, G.N.
dc.contributor.author Habimana, D.S.
dc.contributor.author Gasana, J.
dc.contributor.author Kanyabwisha, F.
dc.contributor.author Kubwimana, G.
dc.contributor.author Muhoza, B.
dc.contributor.author Munyaneza, A.
dc.contributor.author Murenzi, G.
dc.contributor.author Musabyimana, F.
dc.contributor.author Umwiza, F.
dc.contributor.author Ingabire, C.
dc.contributor.author Tuyisenge, P.
dc.contributor.author Butera, A.M.
dc.contributor.author Kabahizi, J.
dc.contributor.author Rurangwa, E.
dc.contributor.author Feza, R.
dc.contributor.author Mukashyaka, E.
dc.contributor.author Benekigeri, C.
dc.contributor.author Musaninyange, J.
dc.contributor.author Adedimeji, A.
dc.contributor.author Anastos, K.
dc.contributor.author Dilorenzo, M.
dc.contributor.author Murchison, L.
dc.contributor.author Ross, J.
dc.contributor.author Yotebieng, M.
dc.contributor.author Addison, D.
dc.contributor.author Jones, H.
dc.contributor.author Kulkarni, S.
dc.contributor.author Tymejczyk, O.
dc.contributor.author Elul, B.
dc.contributor.author Cai, X.
dc.contributor.author Dong, A.
dc.contributor.author Hoover, D.
dc.contributor.author Kim, H.-Y.
dc.contributor.author Li, C.
dc.contributor.author Shi, Q.
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dc.contributor.author Kuniholm, M.
dc.contributor.author Edmonds, A.
dc.contributor.author Parcesepe, A.
dc.contributor.author Edwards, J.
dc.contributor.author Keiser, O.
dc.contributor.author Kimmel, A.
dc.contributor.author Diero, L.
dc.contributor.author Ayaya, S.
dc.contributor.author Sang, E.
dc.contributor.author Bukusi, E.
dc.contributor.author Mulwa, E.
dc.contributor.author Nyanaro, G.
dc.contributor.author Kasozi, C.
dc.contributor.author Ssemakadde, M.
dc.contributor.author Bwana, M.B.
dc.contributor.author Muyindike, W.
dc.contributor.author Byakwaga, H.
dc.contributor.author Kanyesigye, M.
dc.contributor.author Semeere, A.
dc.contributor.author Matovu, J.M.
dc.contributor.author Nalugoda, F.
dc.contributor.author Wasswa, F.X.
dc.contributor.author Kazyoba, P.
dc.contributor.author Mayige, M.
dc.contributor.author Lyamuya, R.E.
dc.contributor.author Mayanga, F.
dc.contributor.author Ngonyani, K.
dc.contributor.author Lwali, J.
dc.contributor.author Urassa, M.
dc.contributor.author Nyaga, C.
dc.contributor.author Machemba, R.
dc.contributor.author Yiannoutsos, C.
dc.contributor.author Elul, B.
dc.contributor.author Vreeman, R.
dc.contributor.author Syvertsen, J.
dc.contributor.author Kantor, R.
dc.contributor.author Martin, J.
dc.contributor.author Wenger, M.
dc.contributor.author Cohen, C.
dc.contributor.author Kulzer, J.
dc.contributor.author Maartens, G.
dc.contributor.author Bolton, C.
dc.contributor.author Wood, R.
dc.contributor.author Sipambo, N.
dc.contributor.author Tanser, F.
dc.contributor.author Boulle, A.
dc.contributor.author Fatti, G.
dc.contributor.author Mbewe, S.
dc.contributor.author Singh, E.
dc.contributor.author Chimbetete, C.
dc.contributor.author Technau, K.
dc.contributor.author Eley, B.
dc.contributor.author Muhairwe, J.
dc.contributor.author Rafael, I.
dc.contributor.author Fox, M.P.
dc.contributor.author Prozesky, H.
dc.contributor.author Anderegg, N.
dc.contributor.author Ballif, M.
dc.contributor.author Ostinelli, C.H.D.
dc.contributor.author Egger, M.
dc.contributor.author Fenner, L.
dc.contributor.author Haas, A.
dc.contributor.author Hossmann, S.
dc.contributor.author Rohner, E.
dc.contributor.author Riou, J.
dc.contributor.author Skrivankova, V.
dc.contributor.author Smith, L.
dc.contributor.author Taghavi, K.
dc.contributor.author von Groote, P.
dc.contributor.author Wandeler, G.
dc.contributor.author Zaniewski, E.
dc.contributor.author Zürcher, K.
dc.contributor.author Anderson, K.
dc.contributor.author Boulle, A.
dc.contributor.author Cornell, M.
dc.contributor.author Davies, M.-A.
dc.contributor.author Iyun, V.
dc.contributor.author Johnson, L.
dc.contributor.author Kassanjee, R.
dc.contributor.author Kehoe, K.
dc.contributor.author Kubjane, M.
dc.contributor.author Maxwell, N.
dc.contributor.author Nyakato, P.
dc.contributor.author Patten, G.
dc.contributor.author Tlali, M.
dc.contributor.author Tsondai, P.
dc.contributor.author de Waal, R.
dc.contributor.author International epidemiology Databases to Evaluate AIDS (IeDEA)
dc.date.accessioned 2022-06-25T20:36:41Z
dc.date.available 2022-06-25T20:36:41Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/11853
dc.description.abstract Background: The transition to dolutegravir-containing antiretroviral therapy (ART) in low- and middle-income countries (LMICs) was complicated by an initial safety signal in May 2018 suggesting that exposure to dolutegravir at conception was possibly associated with infant neural tube defects. On the basis of additional evidence, in July 2019, the World Health Organization recommended dolutegravir for all adults and adolescents living with HIV. Objective: To describe dolutegravir uptake and disparities by sex and age group in LMICs. Design: Observational cohort study. Setting: 87 sites that began using dolutegravir in 11 LMICs in the Asia-Pacific; Caribbean, Central and South America network for HIV epidemiology (CCASAnet); and sub-Saharan African regions of the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Patients: 134 672 patients aged 16 years or older who received HIV care from January 2017 through March 2020. Measurements: Sex, age group, and dolutegravir uptake (that is, newly initiating ART with dolutegravir or switching to dolutegravir from another regimen). Results: Differences in dolutegravir uptake among females of reproductive age (16 to 49 years) emerged after the safety signal. By the end of follow-up, the cumulative incidence of dolutegravir uptake among females 16 to 49 years old was 29.4% (95% CI, 29.0% to 29.7%) compared with 57.7% (CI, 57.2% to 58.3%) among males 16 to 49 years old. This disparity was greater in countries that began implementing dolutegravir before the safety signal and initially had highly restrictive policies versus countries with a later rollout. Dolutegravir uptake was similar among females and males aged 50 years or older. Limitation: Follow-up was limited to 6 to 8 months after international guidelines recommended expanding access to dolutegravir. Conclusion: Substantial disparities in dolutegravir uptake affecting females of reproductive age through early 2020 are documented. Although this disparity was anticipated because of country-level restrictions on access, the results highlight its extent and initial persistence. en_US
dc.language.iso eng
dc.publisher American College of Physicians
dc.relation.ispartofseries Annals of Internal Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Age groups en_US
dc.subject Antiretroviral therapy en_US
dc.subject Contraceptives en_US
dc.subject HIV en_US
dc.subject Health equity en_US
dc.subject Pregnancy en_US
dc.subject Prevention, policy, and public health en_US
dc.subject Safety en_US
dc.title Disparities in Dolutegravir Uptake Affecting Females of Reproductive Age With HIV in Low- and Middle-Income Countries After Initial Concerns About Teratogenicity An Observational Study en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.7326/M21-3037
dc.relation.issn 1539-3704


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