The Impact of Place of Residence on Antiretroviral Therapy Adherence: A Systematic Review and Meta‐Analysis
Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies o...
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| Published in: | AIDS research and treatment Vol. 2025; no. 1; p. 5757907 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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John Wiley & Sons, Inc
01.01.2025
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| ISSN: | 2090-1240, 2090-1259 |
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| Abstract | Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies on the influence of place of residence on ART adherence among PLWH in Nigeria have been reported in the literature. However, no review has synthesized these findings. Against this backdrop, this review seeks to determine whether adherence to ART differs by place of residence in Nigeria.
Methods: In May 2024, we searched four databases (CINAHL Plus, PubMed, Scopus, and Web of Science). Only empirical studies with a test of association between place of residence (i.e., urban and rural) and adherence to ART were included. We performed a fixed‐effect meta‐analysis with the meta package on R Studio Version 4.2.0.
Results: We included six of the 91 articles across the four databases. Most studies ( n = 5) were conducted in the Southern region. The assessment of place of residence and adherence varies across the studies. We found that PLWH who reside in urban areas were 20% more likely to adhere to ART compared to those who live in rural areas (odds ratio: 1.20; 95% confidence interval: 1.01–1.43). Similarly, PLWH in the South‐South region of Nigeria and reside in the urban areas were 1.27 (95% CI: 1.01–1.58) more likely to adhere to ART than those living in the rural areas. This observation was insignificantly true for the South‐East region.
Conclusion: PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non‐governmental organizations and government agencies working with PLWH should prioritize those living in rural areas because they are more likely to face greater barriers to adherence. |
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| AbstractList | Conclusion: PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non-governmental organizations and government agencies working with PLWH should prioritize those living in rural areas because they are more likely to face greater barriers to adherence. Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies on the influence of place of residence on ART adherence among PLWH in Nigeria have been reported in the literature. However, no review has synthesized these findings. Against this backdrop, this review seeks to determine whether adherence to ART differs by place of residence in Nigeria. Methods: In May 2024, we searched four databases (CINAHL Plus, PubMed, Scopus, and Web of Science). Only empirical studies with a test of association between place of residence (i.e., urban and rural) and adherence to ART were included. We performed a fixed-effect meta-analysis with the meta package on R Studio Version 4.2.0. Results: We included six of the 91 articles across the four databases. Most studies (n=5) were conducted in the Southern region. The assessment of place of residence and adherence varies across the studies. We found that PLWH who reside in urban areas were 20% more likely to adhere to ART compared to those who live in rural areas (odds ratio: 1.20; 95% confidence interval: 1.01-1.43). Similarly, PLWH in the South-South region of Nigeria and reside in the urban areas were 1.27 (95% CI: 1.01-1.58) more likely to adhere to ART than those living in the rural areas. This observation was insignificantly true for the South-East region. Conclusion: PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non-governmental organizations and government agencies working with PLWH should prioritize those living in rural areas because they are more likely to face greater barriers to adherence. Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies on the influence of place of residence on ART adherence among PLWH in Nigeria have been reported in the literature. However, no review has synthesized these findings. Against this backdrop, this review seeks to determine whether adherence to ART differs by place of residence in Nigeria. Methods: In May 2024, we searched four databases (CINAHL Plus, PubMed, Scopus, and Web of Science). Only empirical studies with a test of association between place of residence (i.e., urban and rural) and adherence to ART were included. We performed a fixed-effect meta-analysis with the meta package on R Studio Version 4.2.0. Results: We included six of the 91 articles across the four databases. Most studies (n = 5) were conducted in the Southern region. The assessment of place of residence and adherence varies across the studies. We found that PLWH who reside in urban areas were 20% more likely to adhere to ART compared to those who live in rural areas (odds ratio: 1.20; 95% confidence interval: 1.01–1.43). Similarly, PLWH in the South-South region of Nigeria and reside in the urban areas were 1.27 (95% CI: 1.01–1.58) more likely to adhere to ART than those living in the rural areas. This observation was insignificantly true for the South-East region. Conclusion: PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non-governmental organizations and government agencies working with PLWH should prioritize those living in rural areas because they are more likely to face greater barriers to adherence. Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies on the influence of place of residence on ART adherence among PLWH in Nigeria have been reported in the literature. However, no review has synthesized these findings. Against this backdrop, this review seeks to determine whether adherence to ART differs by place of residence in Nigeria. Methods: In May 2024, we searched four databases (CINAHL Plus, PubMed, Scopus, and Web of Science). Only empirical studies with a test of association between place of residence (i.e., urban and rural) and adherence to ART were included. We performed a fixed-effect meta-analysis with the meta package on R Studio Version 4.2.0. Results: We included six of the 91 articles across the four databases. Most studies (n = 5) were conducted in the Southern region. The assessment of place of residence and adherence varies across the studies. We found that PLWH who reside in urban areas were 20% more likely to adhere to ART compared to those who live in rural areas (odds ratio: 1.20; 95% confidence interval: 1.01-1.43). Similarly, PLWH in the South-South region of Nigeria and reside in the urban areas were 1.27 (95% CI: 1.01-1.58) more likely to adhere to ART than those living in the rural areas. This observation was insignificantly true for the South-East region. Conclusion: PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non-governmental organizations and government agencies working with PLWH should prioritize those living in rural areas because they are more likely to face greater barriers to adherence.Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies on the influence of place of residence on ART adherence among PLWH in Nigeria have been reported in the literature. However, no review has synthesized these findings. Against this backdrop, this review seeks to determine whether adherence to ART differs by place of residence in Nigeria. Methods: In May 2024, we searched four databases (CINAHL Plus, PubMed, Scopus, and Web of Science). Only empirical studies with a test of association between place of residence (i.e., urban and rural) and adherence to ART were included. We performed a fixed-effect meta-analysis with the meta package on R Studio Version 4.2.0. Results: We included six of the 91 articles across the four databases. Most studies (n = 5) were conducted in the Southern region. The assessment of place of residence and adherence varies across the studies. We found that PLWH who reside in urban areas were 20% more likely to adhere to ART compared to those who live in rural areas (odds ratio: 1.20; 95% confidence interval: 1.01-1.43). Similarly, PLWH in the South-South region of Nigeria and reside in the urban areas were 1.27 (95% CI: 1.01-1.58) more likely to adhere to ART than those living in the rural areas. This observation was insignificantly true for the South-East region. Conclusion: PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non-governmental organizations and government agencies working with PLWH should prioritize those living in rural areas because they are more likely to face greater barriers to adherence. There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies on the influence of place of residence on ART adherence among PLWH in Nigeria have been reported in the literature. However, no review has synthesized these findings. Against this backdrop, this review seeks to determine whether adherence to ART differs by place of residence in Nigeria. In May 2024, we searched four databases (CINAHL Plus, PubMed, Scopus, and Web of Science). Only empirical studies with a test of association between place of residence (i.e., urban and rural) and adherence to ART were included. We performed a fixed-effect meta-analysis with the meta package on R Studio Version 4.2.0. We included six of the 91 articles across the four databases. Most studies ( = 5) were conducted in the Southern region. The assessment of place of residence and adherence varies across the studies. We found that PLWH who reside in urban areas were 20% more likely to adhere to ART compared to those who live in rural areas (odds ratio: 1.20; 95% confidence interval: 1.01-1.43). Similarly, PLWH in the South-South region of Nigeria and reside in the urban areas were 1.27 (95% CI: 1.01-1.58) more likely to adhere to ART than those living in the rural areas. This observation was insignificantly true for the South-East region. PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non-governmental organizations and government agencies working with PLWH should prioritize those living in rural areas because they are more likely to face greater barriers to adherence. |
| Audience | Academic |
| Author | Okonkwo, Rita Ifeyinwa Badru, Oluwaseun Abdulganiyu Bain, Luchuo Engelbert Adeagbo, Oluwafemi Atanda Edeh, Joy Chioma |
| AuthorAffiliation | 4 Department of Psychology, Faculty of Humanities, University of Johannesburg, Auckland Park, Johannesburg, South Africa 1 Department of Community and Behavioral Health, The University of Iowa, Iowa City, Iowa, USA 2 International Research Centre of Excellence, Institute of Human Virology, Abuja, Nigeria 6 Department of Sociology, University of Johannesburg, Johannesburg, South Africa 5 International Programs Unit, APHRC, African Population Health Research Center, Nairobi, Kenya 3 Department of Epidemiology, The University of Iowa, Iowa City, Iowa, USA |
| AuthorAffiliation_xml | – name: 1 Department of Community and Behavioral Health, The University of Iowa, Iowa City, Iowa, USA – name: 2 International Research Centre of Excellence, Institute of Human Virology, Abuja, Nigeria – name: 3 Department of Epidemiology, The University of Iowa, Iowa City, Iowa, USA – name: 6 Department of Sociology, University of Johannesburg, Johannesburg, South Africa – name: 5 International Programs Unit, APHRC, African Population Health Research Center, Nairobi, Kenya – name: 4 Department of Psychology, Faculty of Humanities, University of Johannesburg, Auckland Park, Johannesburg, South Africa |
| Author_xml | – sequence: 1 givenname: Oluwaseun Abdulganiyu orcidid: 0000-0003-0076-2745 surname: Badru fullname: Badru, Oluwaseun Abdulganiyu – sequence: 2 givenname: Joy Chioma orcidid: 0009-0001-0485-464X surname: Edeh fullname: Edeh, Joy Chioma – sequence: 3 givenname: Rita Ifeyinwa orcidid: 0009-0007-4697-5320 surname: Okonkwo fullname: Okonkwo, Rita Ifeyinwa – sequence: 4 givenname: Luchuo Engelbert orcidid: 0000-0002-6006-2698 surname: Bain fullname: Bain, Luchuo Engelbert – sequence: 5 givenname: Oluwafemi Atanda orcidid: 0000-0003-1462-9275 surname: Adeagbo fullname: Adeagbo, Oluwafemi Atanda |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40028421$$D View this record in MEDLINE/PubMed |
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| Copyright | Copyright © 2025 Oluwaseun Abdulganiyu Badru et al. AIDS Research and Treatment published by John Wiley & Sons Ltd. COPYRIGHT 2025 John Wiley & Sons, Inc. Copyright © 2025 Oluwaseun Abdulganiyu Badru et al. AIDS Research and Treatment published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (the “License”), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0 Copyright © 2025 Oluwaseun Abdulganiyu Badru et al. AIDS Research and Treatment published by John Wiley & Sons Ltd. 2025 |
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| Keywords | meta-analysis HIV Nigeria place of residence antiretroviral therapy ART adherence |
| Language | English |
| License | Copyright © 2025 Oluwaseun Abdulganiyu Badru et al. AIDS Research and Treatment published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
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| Snippet | Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place... There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of... Conclusion: PLWH who reside in urban areas may better adhere to ART than their counterparts living in rural areas. Non-governmental organizations and... |
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| SubjectTerms | Antiretroviral drugs Data analysis Drug therapy Females Gender Geopolitics Health facilities Highly active antiretroviral therapy HIV HIV patients Human immunodeficiency virus Influence Meta-analysis Patient compliance Review Rural areas Sampling techniques Systematic review |
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| Title | The Impact of Place of Residence on Antiretroviral Therapy Adherence: A Systematic Review and Meta‐Analysis |
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