ObjectiveDrug adherence is crucial to the success of highly active antiretroviral therapy (HAART) in the treatment of HIV disease. Adherence to HAART and its determinants may, however, differ across HIV/AIDS populations. MethodsWe retrospectively studied drug adherence by self-report in HIV-1 infected Chinese patients who have been on HAART for at least 1 year as at the end of year 2000. HAART is de®ned as three or more antiretrovirals with at least one protease inhibitor or non-nucleoside analogue reverse transcriptase inhibitor. ResultsThe last drug adherence level assessed by self-report in 161 Chinese patients were: grade A (100%) ± 130, 80.7%; grade B (95±99%) ± 25, 15.5%; grade C (90±94%) ± three, 1.9% and grade D (< 90%) ± three, 1.9%. Patients with full adherence were more likely to have undetectable (< 500 copies/mL) plasma virus level (adjusted OR, 4.22; 95% CI, 1.75±12.33). Patients' demographics, HIV disease status and antiretroviral regimen did not affect adherence. Partial drug adherence was, however, independently associated with the psychosocial factors of missing clinic appointments (adjusted OR, 3.13; 95% CI, 1.23±8.33), forgetfulness (adjusted OR, 4.55; 95% CI, 1.64±12.5) and a busy work life (adjusted OR, 6.67; 95% CI, 1.75±25). ConclusionThere were similarities and differences in determinants affecting HAART adherence in Chinese compared with other patients. Psychosocial factors rather than HIV disease or treatment were more important factors in our Chinese patients. The relevance of patient populations and care setting for adherence to HAART shall be further studied. IntroductionMorbidity and mortality among patients with HIV infection has declined with the advent of highly active antiretroviral therapy (HAART) [1,2]. To have maximal suppression of plasma virus load beyond detection limit is the laboratory target for gauging success of HAART. However, factors such as prior exposure to antiretrovirals [3], advanced HIV disease [4] and suboptimal drug adherence [5] were shown to affect the likelihood of prolonged virus suppression. Furthermore, since antiretroviral therapy is a long-term treatment, and not without side effects, maintaining a high level of drug adherence often represents a big challenge for both the patient and healthcare provider [6]. To maximally substantiate the bene®ts of HAART, measures to continually monitor and enhance patients' drug adherence has become indispensable for effective HIV management nowadays [7].Unfortunately, availability of HAART for treating HIV/AIDS patients has so far been largely limited to the developed Western countries. Hence, most studies on drug adherence to HAART had originated from these countries. A variety of factors has been found to predict antiretroviral MethodsThis was a retrospective study conducted at one of the largest HIV clinical services in Hong Kong ± the Integrated Treatment Centre of the Department of Health. In early 1997, shortly after the availability of HAART in our clinic, we commenced a drug adherence counselling program...