Nonadherence to Antiretroviral Therapy in HIV-Positive Patients in Costa Rica

Abstract

A cross-sectional study was performed among seropositive individuals who sought HIV treatment at an outpatient clinic in San Jose, Costa Rica, to determine the prevalence, predictors, and reasons for nonadherence to antiretroviral. A structured, face-to-face interview was administered to 88 patients. The primary outcome of adherence was measured as taking 100% of medications within 3 days prior to interview. A number of risk factors, including demographic information, HIV knowledge, logistics of the regimen, and management skills were assessed. Statistical analyses included logistic regression. Eighty-five percent of patients took 100% of their medications in the last 3 days. Factors that were correlated with nonadherence included difficulty in finding transportation to the clinic (odds ratio [OR] = 6.3, p = 0.01), not laying pills out as a management skill (OR = 9.9, p = 0.01), and prescription instructions to take medication on an empty stomach (OR = 6.7, p = 0.03). HIV-positive patients in this Costa Rican sample were fairly adherent to their drug regimens. To increase adherence among non-adherent individuals, interventions that increase access in remote areas and help people manage their regimens may be beneficial.

Barriers and Facilitators for Adherence to Antiretroviral Therapy in Papua New Guinea

“…While adherence to ART has been widely studied in resource-rich settings [7][8][9][10][11][12], fewer studies have been conducted on adherence in the developing world -in Africa [13], Latin and Central America [14,15] and more recently China [16]. A systematic literature search for adherence studies in the Pacific revealed none.…”

Expansion of antiretroviral treatment to rural health centre level by a mobile service in Mumbwa district, Zambia

“…1 Several studies reported that long travel distances are a potential barrier to accessing services and, after starting ART, they are a barrier to optimal adherence. [4][5][6] To improve accessibility, ART services need to be located as close to the community as possible. Thus, Mumbwa district health management team introduced a mobile ART service at rural health centres as a pilot programme of the Ministry of Health.…”

Implementation and Operational Research

“…18, 27 In addition, we did not have the necessary data to weight distance measures by costs associated with travel (e.g., car, bus, bicycle, foot). This analysis thus assumes that potential modes of transportation have no influence on PMTCT uptake, which may not be realistic, 28 since cost would likely increase with distance.…”