Adherence to Highly Active Antiretroviral Therapy (HAART): A Meta-Analysis

Abstract

This meta-analysis synthesizes eighty-four observational studies, conducted across twenty countries, to determine the mean proportion of people who reported ≥90% adherence to prescribed highly active antiretroviral therapy (HAART) and to identify the factors associated with high levels of adherence. Eight electronic databases were searched to locate all relevant studies available by January 2010, which were then coded for sample characteristics and adherence levels. The average rate of reporting ≥90% adherent HAART adherence is 62%. However, this proportion varies greatly across studies. In particular, a greater proportion of individuals maintaining ≥90% adherence to HAART is more likely in studies with higher proportions of men who have sex with men (MSM) and lower proportions of injection drug users (IDU), with participants in an earlier stage of infection, and in studies conducted in countries characterized by lower Human Development Index (HDI) scores.

Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis

“…The added challenge of more frequent daily dosing could therefore more easily result in lower levels of adherence in these countries. However, this explanation is in contrast to results from previous studies showing higher levels of adherence in low income countries than in high income countries [3],[228]. …”

“…Sufficiently high levels of adherence to ART are necessary to achieve and sustain viral suppression and to prevent disease progression and death [2], yet, many patients infected with human immunodeficiency virus (HIV)do not succeed in achieving or maintaining adequate levels of adherence to ART [3]. …”

“…One systematic review provided a comprehensive assessment of predictors/correlates of adherence to ART, but did not aggregate findings into quantitative estimates of their effect on adherence [5]. A number of other reviews did aggregate findings into quantitative estimates, but focused only on patient-reported barriers and facilitators [1], sociodemographic factors [3], clinical, comorbid, and treatment-related factors [6] and depression [7], or investigated a particular patient population, such as drug users [8]. …”

The City of Johannesburg can end AIDS by 2030: modelling the impact of achieving the Fast‐Track targets and what it will take to get there

“…Despite the recognition of the importance of cities in achieving the Fast‐Track targets, most studies tend to focus on analysing the care and treatment cascade within countries 7, 9, 11, 12, 13 or within clinics14, 15. Aside from the strategic importance of cities, an analysis of a city's cascade can shed light on how well the network of clinics is working together as a whole.…”

La mala calidad de sueño se asocia a una menor adherencia al tratamiento antirretroviral de gran actividad en pacientes peruanos con infección por VIH/SIDA

“…En este contexto, la adherencia a la indicación terapéutica por parte de los pacientes constituye un factor fundamental para el éxito o fracaso del TARGA 16,17,18 . Sin embargo, la adherencia se ve afectada por múltiples factores, en particular por los efectos secundarios del tratamiento 17,18,19,20 . Problemas de salud mental como la depresión 21 , así como el consumo de alcohol 22,23 y el abuso de sustancias, se asocian también a una baja adherencia al tratamiento 20,24,25,26,27,28,29 .…”