DOES PROVIDING FREE ANTI-RETROVIRAL THERAPY ENSURE OPTIMAL ADHERENCE AMONG PEOPLE LIVING WITH HIV / AIDS?

Sneha Deepak Mallya; Veena Ganesh Kamath; Suma Nair; Asha Kamath

doi:10.22159/ajpcr.2016.v9i6.14019

Authors

Sneha Deepak Mallya KASTURBA MEDICAL COLLEGE, MANIPAL MANIPAL UNIVERSITY
Veena Ganesh Kamath KASTURBA MEDICAL COLLEGE, MANIPAL MANIPAL UNIVERSITY
Suma Nair KASTURBA MEDICAL COLLEGE, MANIPAL MANIPAL UNIVERSITY
Asha Kamath KASTURBA MEDICAL COLLEGE, MANIPAL MANIPAL UNIVERSITY

DOI:

https://doi.org/10.22159/ajpcr.2016.v9i6.14019

Abstract

Abstract

Introduction/Back ground: Availability of Anti-Retroviral Therapy (ART) has revolutionalised the management of Human Immunodeficiency Virus /Acquired Immuno Deficiency Syndrome (HIV/AIDS) and improved the survival of those infected with the virus. However, adherence to therapy is a prerequisite for treatment success and preventing drug resistance. Aim: The present study was carried out with the aim of determining the level of adherence and factors affecting it among patients receiving free ART. Methods: A cross sectional study design was adopted and 320 HIV positive patients receiving free ART from a district hospital in Udupi were interviewed using a semi-structured questionnaire. Adherence to ART >95% of the prescribed medication was used as the cut off for deciding on the treatment adherence. Results: An encouragingly high 96.9% of the individuals were adherent to the medication over the past month. However, 41.8% of the participants reported to have ever missed doses of ART. On univariate analysis, having ever consumed alcohol, absence of side effects such as fatigue and tingling/numbness, having a feeling of sadness and sleep disturbances, being on Efavirenz based regimen, non-disclosure HIV status, being unsure of continuing lifelong treatment were significantly associated with non-adherence (p<0.05).Conclusion: Although non adherence was of concern among a small proportion of participants, a large number of them reported to have ever missed doses of ART. Â This finding suggests that adherence rate may be lower over longer periods of time. Hence, periodic assessments may address patient specific barriers and help to improve the adherence rate among this population.Â

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Author Biographies

Sneha Deepak Mallya, KASTURBA MEDICAL COLLEGE, MANIPAL MANIPAL UNIVERSITY

ASSISTANT PROFESSOR

DEPARTMENT OF COMMUNITY MEDICINE

Veena Ganesh Kamath, KASTURBA MEDICAL COLLEGE, MANIPAL MANIPAL UNIVERSITY

PROFESSORDEPARTMENT OF COMMUNITY MEDICINE

Suma Nair, KASTURBA MEDICAL COLLEGE, MANIPAL MANIPAL UNIVERSITY

ASSOCIATE PROFESSORDEPARTMENT OF COMMUNITY MEDICINE

Asha Kamath, KASTURBA MEDICAL COLLEGE, MANIPAL MANIPAL UNIVERSITY

ASSOCIATE PROFESSORDEPARTMENT OF COMMUNITY MEDICINE

References

Number of new infections in year 2014. Available on URL (http://www.who.int/mediacentre/factsheets/fs360/en/) .Accessed on 3.2.16

Weber R, Christen L, Christen S, Tschopp S, Znoj H, Schneider C et al. Effect of individual cognitive behaviour intervention on adherence to antiretroviral therapy: prospective randomized trial. Antivir Ther 2004; 9(1):85-95.

Simoni JM, Kurth AE, Pearson CR, Pantalone DW, Merrill JO, Frick PA. Self-report measures of antiretroviral therapy adherence: A review with recommendations for HIV research and clinical management. AIDS Behav 2006;10(3):227-45.

Mannheimer SB, Matts J, Telzak E, Chesney M, Child C, Wu AW, et al. Quality of life in HIV-infected individuals receiving antiretroviral therapy is related to adherence. AIDS Care. 2005;17:10-22.

Ruiz- PI, Olry de Labry A, LÃ³pez-Ruz MA, Del Arco-JimÃ©nez A, RodrÃguez-BaÃ±o J, Causse-Prados M et al. Clinical status, adherence to HAART and quality of life in HIV-infected patients receiving antiretroviral treatment. Enferm Infecc Microbiol Clin. 2005;23:581-85.

Cauldbeck MB, O'Connor C, O'Connor MB, Saunders J A, Rao B, Mallesh VG et al. Adherence to anti-retroviral therapy among HIV patients in Bangalore, India. AIDS Res Ther 2009; 6:7.

Questionnaire on adherence and high risk behaviour. Available from URL: http://www.popcouncil.org/Horizons/ORToolkit/AIDSQuest/surveys_2.html#H . (Accessed on 2/7/10)

Gokarn A, Narkhede MG, Pardeshi GS, Doibale MK. Adherence to antiretroviral therapy. J Assoc Physicians India Dec 2012 ;60:16-20.

Bam K, Rajbhandari RM , Karmacharya DB, Dixit SM. BMC Health Serv Res 2015; 15:188 DOI 10.1186/s12913-015-0846-8.

Talam N C, Gatongi P, Rotich J, Kimaiyo S. Factors affecting antiretroviral drug adherence among HIV/AIDS adult patients attending HIV/AIDS clinic at MOI teaching and referral hospital, Eldoret, Kenya. East Afr J of Public Health 2008;5(2):74-78.

Afolabi M O, Ijadunola K T, Fatusi A O, Olasode O A. Determinants of adherence to antiretroviral drugs among people Living with HIV/AIDS in the Ife-Ijesa zone of Osun state, Nigeria. Afr J Prm Health Care Fam Med 2009; 1(1):6-11.

Ajithkumar K, Neera P G, Rajani P P. Relationship between social factors and treatment adherence: a study from south India. Eastern J Med 2011; 16:147-52.

Amberbir A,Woldemichael K, Getachew S, Girma B, Deribe K . Predictors of adherence to antiretroviral therapy among HIV-infected persons: a prospective study in Southwest Ethiopia. BMC Public Health 2008; 8 : 265.

Bell D J, Kapitao Y, Sikwese R, van Oosterhout J J, Lalloo D J. Adherence to Antiretroviral Therapy in Patients Receiving Free Treatment From a Government Hospital in Blantyre, Malawi. J Acquir Immune Defic Syndr 2007;45:560â€“63.

Bachani D, Garg R, Rewari BB, Hegg L, Rajasekaran S, Deshpande A et al. Two-year treatment outcomes of patients enrolled in Indiaâ€˜s national first-line antiretroviral therapy programme. The Natl Med J India 2010;23:7-12.

Joshi B, Chauhan S, Pasi A, Kulkarni R, Sunil N,Bachani D et al. Level of suboptimal adherence to first line antiretroviral treatment & its determinants among HIV positive people in India. Indian J Med Res July 2014;140:84-95.

Wasti SP, Simkhada P, Randall J, Freeman JV, van Teijlingen E. Factors Influencing Adherence to Antiretroviral Treatment in Nepal: A Mixed Methods Study. PLoS ONE 2012; 7(5): e35547.