Proportion and Determinants of Adherence to Antiretroviral Therapy among HIV Positive People Registered Under ART Center in South India

Abstract

Background: Antiretroviral therapy (ART) significantly delays the progression from HIV to AIDS. Adherence to ART is the second strongest predictor of progression to AIDS and death, after CD4
count. A very high level of adherence (≥95%) is required for ART to be effective on a long term and
to prevent the emergence of resistant viral strains and prevent comorbidities.

Methods: A case series
study was undertaken at an ART center for a period of 6 months. Non‑probability purposive sampling
was adapted to select HIV‑positive subjects aged >15 years on ART for more than 6 months.
A predesigned semi‑structured questionnaire was used to obtain the data. Treatment compliance
was assessed by self‑reported 1‑week recall method.

Results: A total of 536 HIV‑positive people
were interviewed, among which 315 (58.8%) of them were males and 214 (39.9%) were females.
Nearly two third of the participants (359, 67.0%) reported ≥95% adherence to treatment. Personal
commitments (51, 28.8%) and working time inconvenience (42, 23.7%) were the common reasons
for less adherence. On bivariate analysis, married people (OR: 1.586, CI: 1.097‑2.292), participants
residing in rural area (OR: 1.628, CI: 1.130‑2.345), participants not having side effects of drugs (OR:
5.324, CI: 3.491‑8.181), participants equipped with better knowledge about ART (OR: 2.019, CI:
1.377‑2.961), and participants having support of friends and family members (OR: 1.612, CI:
1.019‑2.540) showed a higher level of adherence to ART.

Conclusions: Demographic factors such
as marital status, residing in rural area, and other personal factors like having good knowledge about
ART, without side effects to drugs, and having support of friends and family members were found to
show a high level of adherence to ART.

Keywords: Acquired immunodeficiency syndrome, adherence, antiretroviral therapy, human immunodeficiency virus