Medication adherence remains a critical link between the prescribed ART regimen and treatment outcome. Several factors may influence adherence behavior. This cross-sectional study aimed to highlight socioeconomic predictors of adherence behavior among a cohort of 242 adult Malaysian patients receiving antiretroviral therapy in Hospital Sungai Buloh, Malaysia, where they were enrolled in a parent study (single-blinded randomized controlled trial) between January and December 2014. Statistical analysis of secondary data on adherence behavior and sociodemographic characteristics of the patients revealed mean age of 33.4 years and ranged from 18 to 64 years; 88.8% were males. A total of 224 (93%) patients who completed 6 months’ adherence assessment were included in the model. Of these, 135 (60.3%) achieved optimal adherence. Multivariate binary logistic regression analysis revealed that patient’s income and ethnicity were significant predictors of adherence behavior. This may be valuable for targeted programmatic interventions to further enhance successful treatment outcomes among the target population.
World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, recommendations for a public health approach. 2013. http://www.who.int/hiv/pub/guidelines/arv2013/download/en/. Accessed November 11, 2016.
2.
GiffordALBormannJEShivelyMJWrightBCRichmanDDBozzetteSA.Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. J Acquir Immune Defic Syndr. 2000;23:386-395.
3.
WengerNGiffordALiuH. Patient characteristics and attitudes associated with antiretroviral (AR) adherence. Paper presented at: 6th Conference on Retroviruses and Opportunistic Infections; January 1999.
4.
GordilloVdel AmoJSorianoVGonzález-LahozJ.Sociodemographic and psychological variables influencing adherence to antiretroviral therapy. AIDS. 1999;13:1763-1769.
5.
FogartyLRoterDLarsonSBurkeJGillespieJLevyR.Patient adherence to HIV medication regimens: a review of published and abstract reports. Patient Educ Couns. 2002;46:93-108.
6.
MillsEJNachegaJBBangsbergDR. Adherence to HAART: a systematic review of developed and developing nation patient-reported barriers and facilitators. PLoS Med. 2006;3:e438.
7.
WastiSPvan TeijlingenESimkhadaP. Factors influencing adherence to antiretroviral treatment in Asian developing countries: a systematic review. Trop Med Int Health. 2012;17:71-81.
TalamNCGatongiPRotichJKimaiyoS.Factors affecting antiretroviral drug resistance among HIV/AIDS adult patients attending HIV/AIDS clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya. East Afr J Public Health. 2008;5:74-78.
10.
OstropNJHallettKAGillMJ.Long-term patient adherence to antiretroviral therapy. Ann Pharmacother. 2000;34:703-709.
11.
SethiAKCelentanoDDGangeSJMooreRDGallantJE.Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance. Clin Infect Dis. 2003;37:1112-1118.
12.
BangsbergDRMossARDeeksSG.Paradoxes of adherence and drug resistance to HIV antiretroviral therapy. J Antimicrob Chemother. 2004;53:696-699.
13.
PatersonDLSwindellsSMohrJ. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21-30. doi:10.7326/0003-4819-133-1-200007040-00004.
14.
WoodEHoggRSYipBHarriganPRO’ShaughnessyMVMontanerJS.The impact of adherence on CD4 cell count responses among HIV-infected patients. J Acquir Immune Defic Syndr. 2004;35:261-268.
15.
NachegaJBUthmanOAPeltzerK. Association between antiretroviral therapy adherence and employment status: systematic review and meta-analysis. Bull World Health Organ.2015;93:29-41.
16.
ReynoldsNRSunJNagarajaHNGiffordALWuAWChesneyMA.Optimizing measurement of self-reported adherence with the ACTG Adherence Questionnaire: a cross-protocol analysis. J Acquir Immune Defic Syndr. 2007;46:402-409.
17.
HosmerDWLemeshowS.Applied Logistic Regression. 2nd ed.New York, NY: Wiley; 2000.
18.
BursacZGaussCHWilliamsDKHosmerDW.Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;16:1.
19.
Malaysia 2015: Global AIDS Response Country Progress Report. Ministry of Health Malaysia, Putrajaya, Malaysia. 2015http://www.moh.gov.my/Accessed July 15, 2016.
20.
HasanahCIZalihaARMahiranM.Factors influencing the quality of life in patients with HIV in Malaysia. Qual Life Res. 2011;20:91-100.
21.
YagoubUBulgibaAMDeviPAliMLeeCZamriC.Factors affecting adherence level to HAART (adherence predictors) in Kuala Lumpur, Malaysia. Life Sci J. 2012;9:3600-3603.
FairleyCKPermanaAReadTR.Long-term utility of measuring adherence by self-report compared with pharmacy record in a routine clinic setting. HIV Med. 2005;6:366-369.
24.
World Health Organization. Prioritizing second-line anti-retroviral drugs for adults and adolescents: a public health approach. 2007. Report of a WHO Working Group Meeting, May21-22, 2007.
25.
OhDLSarafianFSilvestreA. Evaluation of adherence and factors affecting adherence to combination antiretroviral therapy among White, Hispanic, and Black men in the MACS Cohort. J Acquir Immune Defic Syndr. 2009;52:290-293.
26.
JiamsakulAKumarasamyNDitangcoR. Factors associated with suboptimal adherence to antiretroviral therapy in Asia. J Int AIDS Soc. 2014;17:18911.
27.
WastiSPSimkhadaPRandallJFreemanJVVan TeijlingenE.Factors influencing adherence to antiretroviral treatment in Nepal: a mixed-methods study. PLoS One. 2012;7:e35547.
28.
PeltzerKFriend-du PreezNRamlaganSAndersonJ.Antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa. BMC Public Health. 2010;10:1.
29.
OdiliVUObiecheAOAmiborKC. Adherence to antiretroviral therapy and its determinants among HIV-infected patients in Nigeria [published online February25, 2016]. J Pharm Pract. doi:10.1177/0897190016633978.
30.
NaikECasanasBPazareAWabaleGSinnottJSalihuH.Cost of treatment: the single biggest obstacle to HIV/AIDS treatment adherence in lower-middle class patients in Mumbai, India. Indian J Sex Transm Dis. 2009;30:23-27. doi:10.4103/0253-7184.55476.
