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Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam.

Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam.
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Tran BX, Hwang J, Nguyen LH, Nguyen AT, Latkin NR, Tran NK, Minh Thuc VT, Nguyen HL, Phan HT, Le HT, Tran TD, Latkin CA,


Tran BX, Hwang J, Nguyen LH, Nguyen AT, Latkin NR, Tran NK, Minh Thuc VT, Nguyen HL, Phan HT, Le HT, Tran TD, Latkin CA, (click to view)

Tran BX, Hwang J, Nguyen LH, Nguyen AT, Latkin NR, Tran NK, Minh Thuc VT, Nguyen HL, Phan HT, Le HT, Tran TD, Latkin CA,

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PloS one 2016 12 2211(12) e0168687 doi 10.1371/journal.pone.0168687

Abstract
BACKGROUND
Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality.

METHODS
A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART.

RESULTS
Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes.

CONCLUSION
The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes.

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