Predictors of Nonadherence to Highly Active Antiretroviral Therapy Among HIV-Infected South Indians in Clinical Care: Implications for Developing Adherence Interventions in Resource-Limited Settings

Abstract

In light of the increasing availability of generic highly active antiretroviral therapy (HAART) in India, further data are needed to examine variables associated with HAART nonadherence among HIV-infected Indians in clinical care. We conducted a cross-sectional analysis of 198 HIV-infected South Indian men and women between January and April 2008 receiving first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based HAART. Nonadherence was defined as taking less than 95% of HAART doses in the last 1 month, and was examined using multivariable logistic regression models. Half of the participants reported less than 95% adherence to HAART, and 50% had been on HAART for more than 24 months. The median CD4 cell count was 435 cells per microliter. An increased odds of nonadherence was found for participants with current CD4 cell counts greater than 500 cells per microliter (adjusted odds ratio [AOR]

Adherence to antiretroviral therapy and factors affecting adherence among paediatric HIV patients

“…This was consistent with the study by Venkatesh et al who showed that demographic characteristics, such as age, gender, occupation, and residential status, did not predict treatment adherence. 17 In this study, education of caretaker (p=0.005) and employment (p=0.016) was positively associated with adherence. Higher education level was associated with better understanding regarding ART regimens and effective counselling was possible in them.…”

Factors Associated with Non-Adherence to Antiretroviral Therapy among Adults living with HIV/AIDS in Arsi Zone, Oromia

“…However, study done in Cameroon found that drinking alcohol was associated with non-adherence [9]. A study done in South India also indicated the association of alcohol use with non-adherence [47]. A study done in London showed that alcohol use were associated with an increased risk of non-adherence [41].…”

“…Likewise, study done in South Africa showed that alcohol use is independently associated with antiretroviral adherence [46]. Study done in South India also indicated the association of alcohol use with non-adherence [47]. Similarly, alcohol dependence was a significant predictor of non-adherence only in women [42].…”

Is expanded HIV treatment preventing new infections? Impact of antiretroviral therapy on sexual risk behaviors in the developing world

“…Some of these early studies were later summarized in a systematic review on the impact of ART on sexual risk behavior [59]. A study conducted among HIV-infected Indians in care documented an association between ART and sexual abstinence, as well as an association between desire for having children and unprotected sex [46,60]. A national survey in the Cameroon found that not being on ARTwas associated with an over two-fold higher rate of inconsistent condom use [47], which also held for those who reported a partner who was HIV-uninfected or of unknown status [48].…”