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Table 2 Overview of reported findings per study on association between equity criteria and ART initiation or adherence

From: Equity in utilization of antiretroviral therapy for HIV-infected people in South Africa: a systematic review

Reference

Equity criteria

Name, year

Quality score

Sex

Age

Severity of disease

Area of living

Socio-economic status (including education and employment)

Marital status

Ethnicity

ART initiation (lower < higher likelihood to initiate)

Cleary 2011[25]

***

Not associated, men = women

   

SES: not associated, SES distribution HIV + in need = ART clinic patients

 

Inconclusive results population size too small to draw conclusions

Cooke 2010[32]

***

Not associated

      
  

men = women

Associated, younger (15–19 yrs), < older (>19 yrs)

 

Not associated, peri-urban = urban = rural

SES: not associated, index profile 1 = 2 = 3 = 4 = 5 (SES), education: not associated, years of education as continuous variable

  

Govindasamy 2011[26]

***

Not associated, men = women

Not associated, ≤ 30 yrs = ≥ 30 yrs

Contradicting results, CD4 cell count: associated, CD4 > 350 < ≤350, WHO stages: not associated

 

Education: not associated, primary school completed = not completed, employment: not associated, employed < unemployed

  

Tsai 2009[33]

**

Not associated, men = women

Associated, younger (18–30 yrs) < older (30–35 yrs)

  

Education: associated, lower education (secondary) < higher education (matric/ tertiary), employment: associated, non salaried employment < salaried employment, unemployed < employed

Associated never married < married or cohabiting

 

Adam 2009[34]

**

   

Associated4, unequal ART coverage between 9 provinces

   

Muula 2007[24]

*

Associated4, male < female

      

Nattrass 2006[23]

    

Associated4, unequal ART coverage between 9 provinces

   

ART adherence (poorer < better adherence)

Boyles 2011[30]

***

Not associated, men = women

Associated, younger (<25 yrs) < older, (25–50 yrs)

Associated, CD4 ≥ 200 < <200

    

Orrell 2003[31]

***

Not associated, men = women

Associated, younger < older, adherence group is older (34 yrs) than non-adhererce group (31 yrs)

Contradicting results, CD4 cell count: associated, patients that not adhere had lower CD4 level, Viral load: associated, patients that not adhere had higher VL, WHO stage: not associated

 

SES: not associated, % low SES in patient group that continued, ART = that not continued

  

Kranzer 2010[27]

***

Associated, men < women

Not associated, ≤ 30 yrs = > 30 yrs

Contradicting results, CD4 cell count: associated, > 200 < ≤100, WHO stage: not associated

    

Fatti 2010[29]

***

Not associated, men = women

Not associated, younger children (≤2 yrs) = older children (>2 yrs)

Contradicting results, CD4 cell count (severe immunodeficiency1): associated, patients with severe immunodeficiency were less adherent, WHO stage (severe clinical status2): not associated

Associated, rural/urban < urban/urban < rural/ rural3

   

Cornell 2009[28]

**

Not associated, men = women

Not associated, age as continuous variable

Contradicting results, CD4 cell count: associated, CD4 < 50 < 50–150, but CD4 < 50 = >150, WHO stage: not associated, Viral load: not associated

 

Employment: associated, no income < income

  
  1. ART = antiretroviral therapy, LTFU = lost to follow up, SES = socio-economic status, VL = viral load, WHO = world health organization.
  2. 1defined according to WHO criteria, i.e. < 12 months old: CD4 percentage <25% or CD4 count <1500 cells/mm3; 12–35 months: <20% or CD4 count <750; 36–59 months: CD4 percentage <15% or CD4 count <350; 5 years and older: CD4 count <200.
  3. 2defined as a WAZ score of < −3 (severe underweight) or a WHO stage ≥3.
  4. 3rural/urban, urban/urban, rural/rural = first term indicates place of residence and second the area of accessing ART clinic.
  5. 4no significance was reported and authors concluded that ART utilization was different among groups that were compared.
  6. * = low quality, ** = medium quality, *** = high quality.