Predictors of Adherence to Antiretroviral Therapy in Rural Zambia

Abstract

Patients in rural Zambia can achieve adherence rates compatible with good clinical outcomes despite long travel distances. The MMH was able to provide quality HIV/AIDS care by implementing programmatic features selecting for a highly adherent population in this resource-limited setting.

Neuropsychiatric and Socioeconomic Status Impact Antiretroviral Adherence and Mortality in Rural Zambia

“…In a previous study conducted in rural southern Zambia, travel times were not predictive of adherence, 13 however travel time in this earlier study was estimated using global positioning systems while we ascertained this information directly from patient interviews.…”

“…13,14 In a 2006 meta-analysis, poor adherence was found to be related to the cost of accessing medication, a lack of disclosure to one's spouse, alcohol use/misuse, and the complexity of the treatment regimen. 15 The presence of HIV-associated cognitive impairment might impact a person's capacity for good ART adherence, 16,17 but this has not been studied prospectively.…”

Effect of cotrimoxazole on mortality in HIV-infected adults on antiretroviral therapy: a systematic review and meta-analysis

“…45 Unfortunately, at present over 50% of HIV-infected individuals are lost to care between diagnosis and the start of ART. [46][47][48][49] Giving free cotrimoxazole can help increase the retention rate, 50 provide an opportunity to assess an individual's adherence to treatment before the start of ART 51 and improve survival in those not on ART. 52 Efforts to reduce early mortality in HIV-infected individuals and to increase retention rates in treatment programmes could be assisted by implementing intensified tuberculosis case-finding at every health-care visit and by providing free isoniazid to those with tuberculosis who do not have a cough, night sweats, weight loss or fever.…”

Gender Differences in Adverse Drug Reactions during HAART Therapy in HIV/AIDS Patients at a Tertiary Care Hospital Penang, Malaysia

“…There are few studies from resource-limited settings that have examined sex differences in adherence to ART and its association with treatment outcomes. In Zambia, no association was observed between sex and adherence to medications, defined as the number of antiretroviral doses taken out of the number of doses prescribed using pharmacy pick up records and pill counts [41].…”