Mapping HIV Progression and Co-Factors Affecting AIDS Survival Time in Women and Men on ART in India

Abstract

HIV is continuum of progressive damage traversed through survival time. Using data from 204 positive women and men, we carried-out survival analysis using Kaplan– Meier curves, Cox proportional hazard regression and Markov-chain model to map CD4 progression and health-condition outcomes. Progression was better among nondefaulters {adjusted hazard ratio [AHR]-0.11, 95% CI 0.03–0.31 (Log rank p<0.001) (chi2=73.62, p<0.001)}, those with higher self-perceived adherence and early initiation of ART. TB-HIV co-infection translated in lower progression and even lower among women [AHR]-0.08, 95% CI 0.02–0.28; Log rank p<0.001) (chi2=71.72, p<0.001). Similar result was observed in women who reported side effects and who defaulted treatment. Immune reconstitution emerged strongly from Markov-chain model, with striking gender gap. Probability of women maintaining working condition was quite low (0.88) as compared to men (0.94). Transition to better health from bed-ridden state was also lower among women. A health-care delivery gender-responsive.