Antiretroviral Therapy Adherence in Persons with HIV/AIDS in Cuba

Abstract

INTRODUCTION Cuba has an HIV prevalence of 0.1% in the population aged 15 to 49 years, very low despite increased incidence in recent years. In 2001, domestically-produced generic antiretroviral therapy was introduced and there has been complete coverage since . In 2006 , 1986 people with HIV/AIDS were receiving ART; by 2009, that fi gure reached 5034. Adherence to antiretroviral therapy is fundamental: nonadherence leads to treatment failure, development of resistance, progression to AIDS, and death. OBJECTIVE Measure levels of treatment adherence and its predictive factors in persons with HIV/AIDS receiving antiretroviral therapy in 2006 in Cuba.METHODS A cross-sectional study was carried out in 2006 of Cuban HIV-positive individuals receiving antiretroviral therapy. A sample size of 876 was calculated using two-stage sampling (fi rst by strata, and then by simple random sampling in each stratum). An anonymous structured questionnaire was administered to participants. Reporting of doses taken on each of the three days and in the week preceding the survey was recoded into fi ve categories. Participants were considered highly adherent if they reported taking ≥95.0% of their medication as prescribed. Reasons for nonadherence were described and logistic regression modeling used to develop hypotheses on associations between high adherence and its predictive factors. RESULTSInterviews were obtained with 847 individuals, 70.6% of whom self reported high adherence. There were no signifi cant differences between highly adherent and less adherent patients with regard to sex, place of residence, treatment setting, time of diagnosis, or length of treatment. Variables associated with high adherence were communication with the specialist physician, change in treatment, memory, self-effi cacy, as well as commitment to and opinions about treatment.CONCLUSIONS In Cuba, where treatment is free of charge to patients, adherence is good. Treatment adherence might be improved by achieving a closer doctor-patient relationship; taking measures to motivate patients and promote self-effi cacy and commitment to treatment; publicizing treatment outcomes; and providing assistance to patients to help them remember their medication schedule. Further studies are required to determine current adherence levels; and longitudinal research to determine adherence over time.

Socioeconomic Factors in Adherence to HIV Therapy in Low- and Middle-income Countries

“…Therefore, many studies lacked data concerning some of the parameters. There were insufficient data regarding income in 26 studies ( 22 , 28 , 29 , 31 , 33 , 37 , 38 , 41 , 47 , 48 , 50 , 51 , 53 , 54 , 56 , 60 , 68 - 70 , 72 , 74 , 75 , 80 - 82 ) and educational level in 14 ( 26 , 28 , 30 , 37 , 39 - 41 , 46 , 59 , 61 , 62 , 65 , 68 ) of the 62 reviewed studies (Some of the studies had data on income but not on education, and others had the reverse). Employment and/or occupational status was assessed in 28 studies ( 22 - 24 , 28 , 29 , 31 , 34 - 37 , 39 - 42 , 44 , 45 , 53 , 54 , 58 , 59 , 61 , 67 - 69 , 70 , 77 , 78 , 81 , 82 ).…”

Factors associated with anti-retroviral therapy adherence among patients living with HIV during the COVID-19 pandemic: A cross-sectional study

“…According to HIV studies, high ART adherence is required for viral suppression, prevention of ART resistance and disease progression, and decreased risk of transmission ( 17 – 20 ). A variety of factors influence ART adherence, such as drug toxicity and regimen complexity ( 21 , 22 ).…”

Barriers for Antiretroviral Therapy Adherence and Viral Suppression in Members of the Key Population in Mumbai, India

“…These statements were under the following themes: 1) perception about ART; 2) stigma related to ART intake; 3) ART knowledge and behaviors; 4) pill-taking practices; 5) access to ART center; 6) stress/mental health related issues; 7) and substance use [ Figure 1 ]. [ 8 10 11 13 23 ] The responses were collected on a three-point scale: Agree/Disagree/Neutral. All information was collected as a part of the adherence program in HIV-infected individuals.…”

“…[ 5 8 9 ] Side effects to medications, inconvenience about taking medications daily, and forget to take medications are additional common barriers commonly reported by PLHAs. [ 10 11 ] Poor mental health and substance use have also been identified as other barriers. [ 12 13 ]…”