Factors affecting antiretroviral treatment adherence among people living with human immunodeficiency virus/acquired immunodeficiency syndrome: A prospective study.

CONTEXT

Antiretroviral adherence is the second strongest predictor of progression to acquired immunodeficiency syndrome (AIDS) and death, after CD4 count. Adherence to antiretroviral therapy (ART) has been strongly correlated with human immunodeficiency virus (HIV) viral suppression, reduced rates of resistance, an increase in survival, and improved quality of life.

AIMS

To determine the adherence rates and factors affecting adherence to ART among people living with HIV/AIDS (PLWHA).

SETTINGS AND DESIGN

A Prospective study for 1 year was conducted among PLWHA, aged between 15 and 49 years, visiting ART center.

SUBJECTS AND METHODS

242 PLWHAs were included in the study. Structured questionnaire was used to obtain data on sociodemographic profile, factors affecting adherence. Adherence was assessed through self-reports, routine and random pill counts, and assessment of medical records.

STATISTICAL ANALYSIS USED

Descriptive statistics, logistic regression, and Chi-square tests were computed using Epi Info 7 version CDC (Centers for Disease Control and Prevention) U.S. Department of Health and Human Services.

RESULTS

Adherence to ART was finally assessed on 242 PLWHAs. Mean age of subjects was 35 ± 7.8 years. One hundred percent adherence rate (consistent adherers) for the whole 6 month period was seen only in 31.6% patients. Lower 6 month averages of 95-100%, 80-95%, and <80% were noted in 49.8%, 9.1%, and 9.5% patients, thus resulting in optimal adherence rate of >95% in 81.4%. Earning member (odds ratio [OR] =0.404) and weight difference (OR = 0.818) were most associated with the adherent individuals. Most common psychological reason was forgetfulness in 44.9%.

CONCLUSIONS

Adherence rate was poor among PLWHA and economic factors play an important role in adherence.