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

Abstract

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.

Evaluating drug interactions, adverse drug reactions, and level of adherence to highly active antiretroviral therapy regimen amongst HIV-positive patients who referred to an AIDS healthcare center in Fars, southern Iran: the first multifaceted study from Iran

“…As mentioned earlier, forgetfulness and incomplete understanding of the medication benefits was one of the main issues for non-adherence to treatment [35], which is consistent with previous findings [36]. Also, in the study of Hosseini et al, some mentioned psychological reactions such as forgetfulness, hesitation, and exhaustion due to taking HAART create a great challenge for the participants' adherence to treatment [37].…”

“…There is an acceptable correlation between self-reported drug adherence and HIV-1 plasma viral load, which validates self-reported drug intake in HIV-infected individuals taking HAART [36]. Developing treatment resistance can lead to increased hospitalisation rates, increased health care costs, reduced productivity, families and communities disorder, and increased morbidity and mortality.…”

Factors Influencing Adherence to Antiretroviral Therapy among People Living with HIV in Coastal South India

“…10,12,[21][22][23][24][25][26][27] Better adherence in our settings could be due to the fact that all PLHIV receive free ART, regular adherence monitoring, and better literacy rate and awareness about HIV disease in coastal South India. Our facility is one of the earliest center in coastal south India, taking care of health care needs of PLHIV.…”

Effect of Adherence to Anti-Retroviral Therapy on Cd4 T Cells and Hiv Viral Load in Nepalese Tertiary Care Hospital

“…Adherence to antiretroviral therapy (ART) has been strongly correlated with HIV durable viral suppression, reduced destruction of CD4 cells. [5] Incomplete adherence is <95%.…”

“…Virological failure is >400 copies/ml HIV virus [9] and is currently associated with suboptimal adherence(<95%) [5,10] and/or suboptimal ART regimen. [11] Hence, the strict adherence to HAART and proper dosing of the ART is believed to maintenance of virological suppression.…”