Page 292 - HIVMED_v21_i1.indb

Page 2 of 10 Original Research

Materials and methods by running data quality checks in REDCap and STATA

Study design and setting (quantitative data). For the closed-ended questions, we assessed
the association between outcome variables and selected socio-
This was a cross-sectional study conducted between July and demographic and health-related characteristics. Pearson’s chi-
August 2018 in a sub-population of patients receiving second- squared test was used to assess trend associations between
line ART at the end of June 2018. Five public health facilities in categorical variables. Continuous data were summarised and
inner-city Johannesburg (two hospitals, one community health analysed using the median and interquartile ranges (IQRs).
centre and two primary healthcare clinics) were included in the Logistic and multiple logistic regression models (bivariate and
study. multivariate logistic regression) were built for key outcome
variables, such as viral load, difficulties in taking second-line
Study population regimen and side effects, to identify independent predictors.
We reported unadjusted and adjusted odds ratios (ORs), 95%
The study population comprised patients aged 18 years and confidence interval (CI) and p-values – p-values that were less
older who were on second-line ART for at least 1 month or than 0.05 were considered significant. Open-ended questions
longer. were analysed using qualitative data analysis methods. Data
were coded and thematic analysis was performed. Where
Data collection appropriate, quotations have been included to support the
reported results.
Sample selection and recruitment
We randomly sampled 10% of the population of 1500 eligible Ethical consideration
patients. The total number of active patients on second-line
treatment per facility was divided by the total sample size Ethical approval to conduct the study was obtained from the
(n = 150) to determine the interval that needed to be used to University of the Witwatersrand Human Research Ethics
select the eligible patients. Using this formula, every nth Committee (ethical clearance number: M170691). Approval
(different for each facility) record from the register or list of was also granted by the Johannesburg Health District (DRC
active patients on second-line treatment in each facility was Ref No. 2017-08-003 and NHRD Ref No. GP_201708_030).
selected and recruited to the study until the facility sample Participants were informed that participation in the study was
size was reached. Once the eligible patients were identified, voluntary and that refusal would not affect their relationship
they were invited to participate in the study in one of the two with their healthcare provider or facility. All patients who
ways: telephonically or in facility recruitment where agreed to participate in the study signed an informed consent
researchers met them at the facility during their scheduled form. To ensure confidentiality, there were no linkages between
clinic visit. For the patients who refused to participate in the the data collected in the questionnaire and the patients’ clinic
study, the next nth patient was recruited. information. Participants were reimbursed for their travel.

Data collection, tool and variables Results
A pretested semi-structured questionnaire was used, which Sample characteristics
consisted of five sections: (1) demographic data, (2)
comorbidity information, (3) human immunodeficiency A total of 150 out of 1500 active patients on second-line ART
virus (HIV) diagnosis and care information, (4) experiences across the five public health facilities were interviewed
on the first-line regimen and adherence and (5) experiences (69.1%, n = 103 women). During the quality checking
on second-line regimen and adherence. Information collected processes, we found that one of the participants was younger
included demographic information (facility name, sex, age, than 18 years and was subsequently omitted from the analysis.
relationship status, employment status and education level), The median age of the participants was 42 years (IQR 36–47
comorbidity information, experiences on both first- and years). Most of the participants were single (38.1%, n = 57);
second-line treatment, disclosure information, duration on 30.2% (n = 45) participants were married. Nearly two-thirds of
ART, reasons for starting ART, side effects, self-reported the participants were born in South Africa (61.1%, n = 91),
treatment interruptions, challenges with taking second-line whilst almost one-third of the participants were born in
treatment, treatment supporter information and insights Zimbabwe (32.9%, n = 49). The majority (87.2%, n = 130) of
into how adherence could be improved. participants had completed at least their secondary or high
school-level education. A minority (8.1%, n = 12) of participants
had completed tertiary qualifications; 4.7% (n = 7) participants
Questionnaire administration
had never attended a school. Of the total participants, 45.6%
Data were collected by the principal investigator and a (n = 68) were unemployed. The majority of participants were
trained research assistant. The interviews were conducted in identified as Christian (87.9%, n = 131). Hypertension (65.1%,
English as it was the most commonly spoken language in the n = 28/43), diabetes (9.3%, n = 4/43) and hypercholesterolaemia
study setting and all participants could speak it. (9.3%, n = 4/43) were the most common concomitant
conditions reported by the participants. The average distance
Data entry, cleaning and analysis travelled to reach a health facility was 5 km (IQR: 2 km – 15
Data were captured into REDCap immediately after interviews km), with 57.7% (n = 86) participants travelling 5 km or less to
were conducted. The research team conducted data clean-up reach the health facility.

http://www.sajhivmed.org.za 284 Open Access