High levels of medication adherence are central to HIV treatment success. Barriers to medication adherence may differ by cultural setting. We aimed to determine risk factors for medication non-adherence in HIV infected individuals in the Dominican Republic. Adherence was measured in 300 individuals using a visual analog scale assessing the prior month and dichotomized at 95%. High levels of adherence were reported by 228 (76%). Risk factors for non-adherence included heavy alcohol use: 2.5 times odds (95% CI: 1.4-4.5), having children: 2.2 times higher odds (95% CI: 1.1-4.9) and perceptions of less social support related to adherence: 2 times higher odds (95% CI: 1.1-3.6). Culturally appropriate interventions are needed to address alcohol use, which is common in this setting. Parenting may represent a competing demand on time and resources and be an adherence barrier. Self-reported perceived lack of adherence support may be a useful marker for need for adherence interventions.

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