Adherence to Antiretroviral Treatment in Prisons

Abstract

The effectiveness of antiretroviral drugs is closely linked to the degree of adherence. The prison environment has specific characteristics that may affect adherence in HIV-positive patients, so that it may not be possible to extrapolate factors associated with nonadherence in HIV+ patients outside prison. The objective was to analyze the prevalence of nonadherence to antiretroviral treatment in three Spanish prisons, and to examine the relation between a large group of factors and nonadherence to the medication. A cross-sectional study of all patients receiving antiretroviral treatment was done. Adherence was evaluated using a validated questionnaire (SMAQ). The prevalence of nonadherence was 54.8%, and the factors independently associated with nonadherence were having difficulties in taking the medication, feeling completely or largely unable to follow the medication, classifying the food as "bad", mentioning not having anyone concerned for them outside prison, suffering anxiety or depression in the last week, and having the flexibility of the prison staff opening their cell in the event of them forgetting their medication.

Anxiety and Depression Symptoms as Risk Factors for Non-adherence to Antiretroviral Therapy in Brazil

“…Two-thirds of the patients with severe anxiety were non-adherent within the follow-up study period. Similar results have been observed in other studies in other settings although anxiety was assessed using diagnostic procedures different from HADS (Blanco et al 2005; Molassiotis et al 2004; Tucker et al, 2003). One recently published study of 198 patients initiating ART linked higher predicted probability of psychiatric morbidity, including any mood, anxiety or substance abuse disorder, and delayed achievement of virologic suppression and overall virologic failure (Pence et al 2007).…”

“…Although we did not find a statistical association between severe depression and non-adherence in either univariate or multivariate analyses, clinicians should pay attention to depression symptoms among patients initiating ART since other studies have shown there to be an association (Ammassari et al 2004; Baford et al 2005; Blanco et al 2005). Our results could be partially explained by a lack of statistical power, because of the low number of participants with severe depression (n=17) in our study.…”

Adherence to antiretroviral therapy among HIV-infected prisoners: a systematic review and meta-analysis

“…Eleven studies yielding a total of 13 adherence estimates met the inclusion criteria and were included (kappa=1.00; 100% agreement) in the meta-analysis (Catz, Sosman, Scheuerell, & Crumble, 2002;N. E. Chen et al, 2013;Chitsaz et al, 2013;Ines et al, 2008;Mostashari, Riley, Selwyn, & Altice, 1998;Palepu et al, 2004;Paparizos et al, 2013;Perez et al, 2006;Soto Blanco, Perez, De Labry Lima, et al, 2005;Soto Blanco, Perez, & March, 2005;Wakoli, Baliddawa, Kimaiyo, & Braitstein, 2010). The sample was composed of 2895 HIV-infected prisoners on ART.…”

Incidence and predictive factors of depression among patients with HIV infection in Guadeloupe: 1988–2009

“…18 Several studies [19][20][21] assessed the relationship between depression and non-adherence or poor adherence to ART. Spire et al 22 between baseline depression among patients initiating ART and non-adherence to ART (n ¼ 445).…”