Determinants of adherence in a cohort of Belgian HIV patients: a pilot study

Abstract

Since the era of highly active antiretroviral therapy (HAART), HIV is considered a chronic disease. Adherence to HAART is crucial for effectiveness. Non-adherence negatively impacts patient outcome and the larger economy. However, data on adherence among the Belgian HIV cohort are scarce. Therefore, the purpose of this pilot study was to identify determinants of adherence among HIV patients treated in Belgium. The study was conducted at the Aids Reference Centre of Ghent University Hospital between 1 January and 31 December 2012. Sociodemographic data were collected, along with the Simplified Medication Adherence Questionnaire (SMAQ), the Center for Adherence Support Evaluation (CASE) Adherence Index, the EuroQol-6D, the Medical Outcomes Study-HIV (MOS-HIV), the Beck Depression Inventory-II, and three neurocognitive complaints screening questions. To date, 218 patients participated in the study, among whom 173 (79·4%) were male. Mean age was 46·0±10·6 years and 133 patients (63·9%) were homosexual. According to the SMAQ and the CASE, 78·5% and 93·5% of the patients were adherent to antiretroviral therapy. Logistic regression analysis revealed that smoking, neurocognitive complaints, and female sex were independent determinants of non-adherence. In conclusion, there is an elevated risk for non-adherence in smokers, people experiencing neurocognitive problems, and women in our sample. The latter could reflect differences between male and female HIV patients in Belgium. Adherence improving initiatives should be tailored to these three risk groups.

People living with AIDS: Association between nursing diagnoses and sociodemographic/clinical characteristics

“…Fisher's Exact Test and Pearson's Chi-Square were then used to verify the association of NDs, which had a frequency of over 50% in people living with AIDS, with the following sociodemographic and clinical characteristics: age, gender, marital status, family income, modes of transmission of HIV, existence of other diseases, current opportunistic infection, abandonment of treatment, difficulty in accessing to service, being smoker, alcohol consumer and drug user. The characteristics frequently studied in research involving people living with AIDS (9)(10)(11)(12)(13)(14)(15) were used. There was a significance level of 5%.…”

“…The use of alcohol and other drugs are among the main factors leading to abandonment of treatment. However, researchers in Belgium identified that 78.55 to 93.5% of the survey participants were smokers, who reported that alcohol and tobacco were not grounds for dropping out of treatment, but were interpersonal conflicts, and the stigma of the disease (13) .…”

“…Finally, ND, sexual dysfunction, conceptualized as the limitations imposed by the disease and therapy and the inability to achieve the desired satisfaction (8) , showed a significant association with marital status, income and opportunistic infections. The research pointed out that of people living with AIDS, most had several partners, had a minimum wage income and had opportunistic infections, such as streptococcal gonorrhea (13) .…”

Adherence to Antiretroviral Therapy in HIV-Positive Patients in Ethiopia: Review

“…This can be avoided by providing necessary knowledge of how to live with HIV/AIDS. Encouragement and providing social support through community worker can alleviate the depression problem and finally improve adherence [36]. Antidepressants medications are also used in most studies to alleviate the depression and this treatment has increased the adherence to HAART [37][38][39].…”

Adherencia a TARGA: enfoque multi-dimensional

“…En la descripción de las características demográficas de los participantes, se observa una mayor proporción de hombres. Considerando que hay más depresión en mujeres que en hombres 8 , podríamos inferir que hay una subestimación de la medida de asociación. Asimismo, los modelos de regresión no consideran todos los confusores que se leen en la literatura especializada, lo cual hace difícil al lector saber si el efecto realmente es el mostrado.…”