Inadequate adherence to antiretroviral treatment and prevention in hospital and community sites in Burkina Faso and Mali: a study by the ATARAO group

Abstract

Our objective was to determine the prevalence and identify the factors that influence antiretroviral therapy (ART) adherence among patients in Bamako and Ouagadougou. A cross-sectional study was conducted among 94 men and 176 women receiving ART. Data were collected through questionnaires and chart reviews. Logistic regressions were performed to isolate determinants of adherence. Overall, 58% of the patients were adherent, but there were differences in the levels of adherence according to country and treatment site. Sociodemographic factors were not associated with adherence. However, social characteristics such as having children, in Ouagadougou, or being a housewife and not planning to have a child in the next year, in Bamako were associated with adherence. Time on ART was negatively associated with adherence in both countries with decline occurring later in Bamako. Levels of adherence are inadequate particularly among more experienced patients. Further adherence research and monitoring using longitudinal designs are warranted to assess the extent to which adherence is declining with time on treatment.

Contrasting predictors of poor antiretroviral therapy outcomes in two South African HIV programmes: a cohort study

“…Despite these encouraging early results, declining levels of adherence and poorer treatment outcomes have been reported in some lower-income countries as ART programmes have been scaled up [12-16]. Little is known about the reasons for worsening outcomes in these programmes, and since the majority of published literature represents studies that are cross-sectional in design, even less is known about baseline factors predictive of poor treatment outcomes.…”

Livelihood Security and Adherence to Antiretroviral Therapy in Low and Middle Income Settings: A Systematic Review

“…There was near perfect agreement between BR and DCC on choosing the potentially relevant 42 papers and 21 abstracts from this larger set. Of these, 20 papers [26]–[45] and 6 conference abstracts [46]–[51] were judged relevant for our review (See Figure 1). There was perfect agreement on the final papers and abstracts selected (kappa = 1).…”

“…All were published in English. The majority of included papers initially were identified in PubMed via Medline (n = 15, 75%) [26]–[30], [32], [33], [35], [37]–[42], [45]. Of the remaining 5 papers, 4 were from Embase [31], [34], [36], [43] and one was identified from the CAB Abstracts database [44].…”

“…All included papers and abstracts employed a quantitative methodology and used structured questionnaires (n = 8) [26], [35], [37], [42], [45], [48], [50], [51] or structured interviews (n = 18) [27]–[34], [36], [38]–[41], [43], [44], [46], [47]. Seventeen of the papers [26]–[42] and 3 of the conference abstracts [46]–[48] were cross-sectional studies and 3 papers [43]–[45] and 3 abstracts [49]–[51] were longitudinal studies, following up patients over time.…”

“…Seventeen of the papers [26]–[42] and 3 of the conference abstracts [46]–[48] were cross-sectional studies and 3 papers [43]–[45] and 3 abstracts [49]–[51] were longitudinal studies, following up patients over time. Almost all studies (n = 19) used logistic regression analysis to measure the association between livelihoods and adherence.…”