Factors Influencing Adherence to Antiretroviral Treatment in Nepal: A Mixed-Methods Study

Wasti, Sharada Prasad; Simkhada, Padam; Randall, Julian; Freeman, Jennifer; Teijlingen, Edwin van

doi:10.1371/journal.pone.0035547

Cited by 143 publications

(183 citation statements)

References 58 publications

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“…This shows that getting much support and advice from the families or friends might favor good adherence. This is consistent with the study done in Jimma university specialized hospital, where patients who get family support were 2 times more likely adherent than those who did not get family support as an independents predictors of overall adherence (24).…”

Section: Discussionsupporting

confidence: 91%

“…The figure is greater than the study done in Jimma University specialized hospital 72.4% (24); where the rate of self-reported adherence was based on the combined indicator of the dose time and food adherence measurement and study done at Yirgalem Hospital 74.2% (25). The probable reason for this difference may be the adherence in this study was only regarding adherence to dose taken.…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

Untitled

2017

Eur J Ther

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Highly active antiretroviral therapy has reduced the number of deaths and increased survival time among HIV/AIDS patients. A major concern with scaling up of antiretroviral therapy in resource-limited settings is the emergence of drug resistant viral strains due to suboptimal adherence and the transmission of these resistant viral strains in the population. The objective of this study was to assess medication adherence and its determinants among HIV/AIDS patients on highly active antiretroviral therapy in Nekemte hospital, Western Ethiopia. A hospital based cross sectional study was conducted among HIV/AIDS patients on highly active antiretroviral therapy. Data was collected by using exit interview and also CD4 count, ARV regimen medication, WHO clinical stage, Existing opportunistic infection, length of treatment with ARV was obtained from the patient follow up record. Data was analyzed using SPSS 16.0. Patients' informed consent was obtained before data collection. Majority of the patients 211 (77.9%) had adherence rate of greater than or equal to ninety five (>95%) in the last one month period. About one third of the patients had missed one of the prescribed pills for HIV/AIDS in the last one month. The main reasons reported by the patients for missing the dose were side effects of the medication 32 (27.1%), forgetting 19 (16.1) and being busy 14 (11.9%) Educational status of the participants (P=0.02); concomitantly used medications (P=0.002); family and social support (P<0.001); belief in efficacy of HAART (P=0.026); following clinical appointment regularly (P=0.001); using reminding aid (P<0.001); having access to medical care regardless of place and time (P<0.001); improvement upon taking HAART (P<0.001); relationship with health professionals (P=0.007); history of substance use (P=0.009) and continuing to take the medication if the disease condition is worsened were associated with medication adherence rate of the patient which is explained by P<0.05. Majority of the study participants were adherent to their medication. According to the current study educational status of the participants; concomitantly used medication, family and social support, belief in efficacy of HAART, following clinical appointment regularly, using reminding aid, having access to medical care regardless of place and time, improvement upon taking HAART, relationship with health professionals, history of substance use and continuing to take the medication if the disease condition is worsened were associated with medication adherence of the patients which is explained by P<0.05. Keywords: Highly active antiretroviral therapy; medication adherence; Nekemte Hospital Özet Yüksek oranda aktif antiretroviral tedavi HIV/AIDS hastalarının ölüm sayılarını azaltmış ve sağkalım süresini artırmıştır. Kısıtlı kaynakların olduğu durumlarda antiretroviral tedavinin artırılmasındaki temel kaygı ilaç tedavisine tam uyulmaması nedeni ile ilaca dirençli viral suşların ortaya çıkması ve bu dirençli suşların toplumda yayılmasıdır. Bu çalışmanın a...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 78%

Untitled

2017

Eur J Ther

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“…The contribution factors include fear, alcohol and substance abuse which makes the patient forget to take medication as scheduled [6,[9][10][11]. Also missing scheduled clinic visit and age of the patients, health care and system related changes [8,9,11] Stigma [12] distance from clinic as well as drugs side effects [9,12,13]. In Tanzania, the main barrier to adherence and retention reported was poverty [14] while in other settings intimate partner violence is also found to affect ART adherence though reported to have more impact on women than in men [15].…”

Section: Check For Updatesmentioning

confidence: 99%

Factors Influencing Adherence to Antiretroviral Therapy among HIV Infected Patients in Nyamagana-Mwanza, Northern Tanzania: A Cross Sectional Study

Edward¹,

Richard²,

Emidi³

et al. 2018

Int Arch Med Microbiol

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Background: High level of Antiretroviral Therapy adherence among HIV infected patients contributes to better treatments outcome and has additional importance in preventing the development of drug resistance. It also improves the quality of life and makes the patient live longer and healthier. The objective of the study was to determine level of adherence as well as factors influencing adherence to antiretroviral therapy among HIV infected patients in Nyamagana district, Mwanza, Tanzania.

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“…HIV-positive people had non-adherence to ART when they consumed alcohol in Nepal [22,23]. Alcohol consumption, however, was measured using a single-item scale in Nepal to examine the association of alcohol use and non-adherence using AIDS Clinical Trial Group (ACTG) questionnaires.…”

Section: Introductionmentioning

confidence: 99%

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

Pokhrel

Pokhrel²,

Neupane³

et al. 2018

Global Health Action

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Background: People living with Human Immunodeficiency Virus (HIV) often suffer from alcohol-use disorders resulting in their poor health and treatment outcomes. Little is known about the association of harmful alcohol drinking with their adherence to anti-retroviral therapy (ART) and health-related quality of life (QOL) in low-resource settings. Objective: This study aimed to investigate associations between harmful alcohol drinking, adherence to ART and health-related QOL in HIV-positive people, stratified by gender, in Nepal. Methods: We conducted a cross-sectional study of 682 HIV-positive people on ART to measure their self-reported harmful alcohol drinking and non-adherence to ART in the previous month of data collection. We also measured health-related QOL using a WHOQOL-HIV BREF scale. The association between harmful alcohol drinking and non-adherence to ART was examined using multiple logistic regressions. Additionally, multiple linear regressions examined association between harmful alcohol drinking and QOL. Results: Harmful alcohol drinking was associated with non-adherence to ART among men (AOR: 2.48, 95% CI: 1.50, 4.11, p < 0.001) and women (AOR: 2.52, 95% CI: 1.32, 4.80, p = 0.005). Men were more likely to have lower score for the psychological (β = −0.55, p = 0.021) and level of independence (β = −0.68, p = 0.018) domains when they had harmful alcohol drinking. Moreover, women were more likely to have lower scores for the physical (β = −1.01, p = 0.015), social relations (β = −0.82, p = 0.033), environmental (β = −0.88, p = 0.011), and spiritual (β = −1.30, p = 0.005) domains of QOL when they had harmful alcohol drinking. Conclusions: Harmful alcohol drinking had a negative association with ART adherence and QOL in both HIV-positive men and women in Nepal. Screening for alcohol-use disorders and community-based counseling services should be provided while delivering ART services to improve treatment adherence and QOL.

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Factors Influencing Adherence to Antiretroviral Treatment in Nepal: A Mixed-Methods Study

Cited by 143 publications

References 58 publications

Untitled

Untitled

Factors Influencing Adherence to Antiretroviral Therapy among HIV Infected Patients in Nyamagana-Mwanza, Northern Tanzania: A Cross Sectional Study

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

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