Access to antiretroviral therapy during excess black-water flooding in central Thailand
Khawcharoenporn, T.; Apisarnthanarak, A.; Chunloy, K.; Mundy, L.M.
Aids Care 25(11): 1446-1451
2013
ISSN/ISBN: 0954-0121 PMID: 23428255 DOI: 10.1080/09540121.2013.772284Document Number: 626431
Excess black-water flooding in central Thailand resulted in closure of several healthcare facilities in the Fall of 2011. Persons living with human immunodeficiency virus (HIV) infection were presumably at risk for interruption of antiretroviral therapy (ART), with consequent treatment failure. We conducted a retrospective cohort study of ART use among patients in care at a Thai HIV clinic that closed due to excess flood water. Among 217 patients on ART who had clinic appointments within the one-month interval before the floods through the one-month interval after the clinic re-opened, seven (3%) reported non-sustained ART access. Non-sustained ART access was independently associated with prior low self-reported ART adherence (P<0.001) and less than six-months duration on the ART regimen (P=0.03). Advanced ART receipt or procurement at other flood-free healthcare facilities were strategies associated with ART access. During a flood disaster, identification and close monitoring of at-risk patients, patient-staff communication, flood preparedness plans, "HIV care access for all" policies, and collaboration among patients, healthcare providers and the government are relevant issues within preparedness plans to optimize ART access.