Adherence to Anti-Retroviral Therapy among People Living with HIV and AIDS in Far West, Nepal

Bam, Kiran; Karki, Deepak Kumar; Lohani, Sadichhya; Thapa, Rajshree; Aryal, Umesh Raj; Pathak, Laxmi

doi:10.3126/ajms.v2i1.4290

Cited by 9 publications

(23 citation statements)

References 13 publications

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“…ART adherence in this study is consistent with previous, similar studies in Nepal, and is comparable to self-reported ART adherence in several other low- and middle-income countries 3,17,19,20. The slightly higher ART adherence in this study might be due the assessment of 7-day adherence.…”

Section: Discussionsupporting

confidence: 91%

“…However, the 13% non-adherence observed in the present study constitutes a serious problem in a resource-limited country like Nepal, as the development of treatment resistance will lead to increased hospitalization rates, increased health care costs, reduced productivity, disruption of families and communities, and increased morbidity and mortality. The main reasons participants gave for non-adherence were simply forgetting to take ART and having a busy schedule, which is in accordance with previous findings 12,19,23,24…”

Section: Discussionsupporting

confidence: 91%

“…This study shows that health complaints due to HIV infection, or as an adverse effect of ART, are associated with non-adherence. This is consistent with findings of several other studies 17,19,24. In addition, one meta-analysis showed that varying from mild to severe and from acute to chronic, adverse effects and toxicity of the complex ART drugs was an important reason for non-adherence 28.…”

Section: Discussionsupporting

confidence: 90%

“…Generally, zidovudine (ZDV)/lamivudine (3TC)/neverapine (NVP), ZDV/3TC/efavirenz (EFV), tenofovir disoproxil fumarate (TDF)/3TC/NVP, TDF/3TC/EFV, stavudine (d4T)/3TC/EFV, and d4T/3TC/NVP are used as first-line regimens, while TDF/3TC/lopinavir boosted with ritonavir and didanosine/abacavir/lopinavir boosted with ritonavir are commonly used as the second-line regimens 15. Previous studies in Nepal reported 85.5% ART adherence among attendees of 10 ART centers located in different districts,17 79% ART adherence at the Tribhuvan University Teaching Hospital in Kathmandu,18 and 84% ART adherence in the far west of Nepal 19…”

Section: Introductionmentioning

confidence: 92%

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Factors associated with adherence to antiretroviral therapy in HIV-infected patients in Kathmandu District, Nepal

Shigdel¹,

Klouman²,

Bhandari³

et al. 2014

HIV

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PurposeThere are a high number of HIV-infected patients receiving antiretroviral therapy (ART) in the Kathmandu District of Nepal, but information on adherence and factors influencing it are scarce in this population. The present study aimed to estimate ART adherence among HIV-infected patients in the Kathmandu District of Nepal, and to determine the factors associated with ART adherence.Patients and methodsThis study included 316 HIV-infected patients attending three ART centers in the Kathmandu District. Information on sociodemographic characteristics, socioeconomic status, and ART use for the previous 7 days was collected via interview. Participants were considered adherent if they reported taking ≥95% of their ART as prescribed. The association between explanatory variables and ART adherence was measured using logistic regression and reported as odds ratios (OR) with 95% confidence intervals (CI).ResultsMale participants accounted for 64.6% (n=204). Overall ART adherence was 86.7%. ART adherence in men and women were 84.3% and 91.1%, respectively. Age (OR 1.04; 95% CI 1.00–1.09), travel time to ART centers (OR 1.38; 95% CI 1.12–1.71), history of illegal drug use (OR 3.98; 95% CI 1.71–9.24), and adverse effects (OR 4.88; 95% CI 1.09–21.8), were all independently and negatively associated with ART adherence. Use of reminder tools (OR 3.45; 95% CI 1.33–8.91) was independently and positively associated with ART adherence.ConclusionThe observed ART adherence in this study is encouraging. Travel time to ART centers, self-reported adverse effects, illegal drug use, and not using reminder tools were the major determinants of ART adherence. Interventions that take these factors into account could further improve ART adherence.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 92%

See 2 more Smart Citations

Factors associated with adherence to antiretroviral therapy in HIV-infected patients in Kathmandu District, Nepal

Shigdel¹,

Klouman²,

Bhandari³

et al. 2014

HIV

View full text Add to dashboard Cite

show abstract

“…7 Similar to other studies sex, educational status, occupation were not affecting adherence to ART. 5,7 Age and ethnicity are significantly associated with drug adherence. Family history of HIV and Family History of ART are not associated to drug adherence as contrast to study conducted by Saha.…”

mentioning

confidence: 99%

Treatment adherence of antiretroviral therapy among people living with HIV/AIDS

Sharma

Joshi

2017

J Chitwan Med Coll

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Adherence to Antiretroviral therapy (ART)is a principle predictor for the success of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome treatment. Highly Active Antiretroviral Therapy (HAART) has led to the reduction of mortality and the improvement of the quality of people living with HIV/AIDS. It has been estimated that at least 95% adherence with therapy is required to reduce HIV viral load. Non-adherence to treatment can lead to inadequate suppression of viral replication, continued destruction of CD4 cells, progressive decline in immune function and disease progression. The aim of the study is to assess treatment adherence of antiretroviral therapy among people living with HIV/AIDS at Seti Zonal Hospital, Kailali. A descriptive cross-sectional study was conducted among 160 people living with HIV/AIDS in ART Clinic, Seti Zonal Hospital, Kailali. Non-probability purposive sampling technique was used for data collection between 22/03/2071 to 02/04/2071. Informed consent was obtained prior collecting data from self-structured questionnaire using interview technique. Collected data were entered and analyzed by SPSS 17.0 and represented by using percentage, frequency, mean, standard deviation and chi-square test. Results: Among the respondents majority of them were "female" 85(53.1%) sex, from age group "31-45 years" 85 (53.1%), ethnicity "minority group/ Dalit" 76 (47.5%) and education "illiterate" 79 (50.3%). The mean adherence rate for one month was found to be 89.92%. Majority of the respondents were adherent to ART 96 (60%). Regarding non-adherence the major barrier was "forgetting" 52 (45.6%). There is statistically significant association between age of the respondents (p=0.04), ethnicity (p=0.03) and prescribed ARV regimen (p=0.02) with drug adherence. More than half of the respondents were adherent to ART. Among non-adherent, the most of them reported "forgetting to take drug". Non adherence patient and family members can be addressed with proper counseling and motivation for their drug compliance.

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Confined vulnerability of HIV infection among pregnant women attending antenatal care clinics in Karnataka, India: Analysis of data from the HIV sentinel surveillance 2017

Aridoss

Ganesh

Jaganathasamy

et al. 2020

Clinical Epidemiology and Global Health

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Background: HIV Sentinel Surveillance among pregnant women attending antenatal care clinics, ANC-HSS, is used to estimate HIV prevalence among the general population. Despite the declining trend, HIV prevalence among the general population in Karnataka is still higher than the national average (0.22%), with a recent, noticeable stabilization. Demographic analysis on concentrated HIV infection among pregnant women could be potential indicators for targeted HIV interventions among general population as well as and prevention of parent to child transmission (PPTCT). Objectives: To analyse the demographics of HIV-positive pregnant mothers in Karnataka, thereby identifying the most-at-risk populations (MARP) within the general population. Methods: In total, 24800 eligible pregnant women aged 15-49 attending the ANC clinic for the first time during the surveillance period (Jan-Mar, 2017) were enrolled. Demographic data and blood samples were collected, recorded and tested for HIV. Age-specific factors associated with HIV prevalence, besides the demographics of the HIV positive pregnant women, were analysed to identify the MARP for targeted HIV interventions. Results: Comprehensively, none of the demographic factors was significantly associated with HIV prevalence. Nevertheless, analysis of demographics, HIV test history and ART status of HIV-positive pregnant women reveals prominent prevalence patterns. The epidemic was majorly confined within young, less educated, primigravida and rural mothers of low economic status. Conclusion: ANC-HSS is designed to estimate the HIV prevalence among general population at national, state and district levels and is not reflective of the concentrated epidemic confined to MARP. Identifying the disease pattern specific to MARP is essential for effective targeted interventions and disease management.

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Adherence to Anti-Retroviral Therapy among People Living with HIV and AIDS in Far West, Nepal

Cited by 9 publications

References 13 publications

Factors associated with adherence to antiretroviral therapy in HIV-infected patients in Kathmandu District, Nepal

Factors associated with adherence to antiretroviral therapy in HIV-infected patients in Kathmandu District, Nepal

Treatment adherence of antiretroviral therapy among people living with HIV/AIDS

Confined vulnerability of HIV infection among pregnant women attending antenatal care clinics in Karnataka, India: Analysis of data from the HIV sentinel surveillance 2017

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