International Journal of STD & AIDS · 2005 · 199 citations · 0 references
Public HealthCommunity HealthHealth SciencesHealth Services ResearchHiv ControlHiv PreventionAntiretroviral TherapyHiv EpidemiologyMedication AdherencePatient AdherenceTreatment AdherenceAdherence In Hiv TreatmentCurrent Marital StatusHiv Antiretroviral TherapyLogistic RegressionLow IncomeMarital Status ClassificationSemi-structured InterviewsUnstructured Clinical Interviews
The study aimed to assess adherence levels and identify reasons for non‑adherence to antiretroviral therapy among HIV‑positive patients in a resource‑limited setting. A cross‑sectional survey of 304 patients from three Kampala treatment centers measured missed doses over the previous three days via structured interviews, classified adherence at 95%, and evaluated barriers through qualitative interviews and logistic regression. Non‑adherence was linked to being married (OR 2.93) and having a monthly income below US $50 (OR 2.77), yet overall self‑reported adherence matched that of resource‑rich settings, with supply instability being the main barrier.
Our objective was to determine the level of adherence and reasons for non-adherence to antiretroviral therapy (ART) among HIV-positive (HIV+) people on ART in a resource-limited setting. Patients receiving ART were recruited into the cross-sectional study from three treatment centres in Kampala, Uganda. The number of missed doses over the last three days was assessed by structured patient interviews and dichotomized at ±95% adherence. Reasons for non-adherence were assessed with both structured patient interviews and unstructured qualitative interviews. Independent predictors of non-adherence were assessed with multivariate logistic regression. In all, 304 HIV-infected persons on ART were enrolled into the study. Factors associated with non-adherence were marital status (odds ratio (OR) = 2.93, 95% confidence interval (CI) 1.32–6.50) and low monthly income <50 US&dollar; [OR = 2.77, 95% CI 1.64–4.67]. We concluded that levels of self-reported adherence in patients receiving ART in Kampala are comparable to levels in resource-rich settings with inability to purchase and secure a stable supply as a major barrier to adherence.