As the HIV epidemic threatens the social fabric of countries struggling with HIV prevalence rates as high as 10% to 30%, access to antiretroviral therapy (ART) alone is only the beginning of the clinical challenge. There is a need to identify adherence indicators that will ensure long-term treatment success. A cross-sectional review of 921 adult patients on ART for at least 1 year was conducted. Through an administered adherence survey, key indicators were found to be highly correlated with patient adherence. The adherence rate in this sample was 72% after being on treatment for an average of 15 months. This data suggest that having a high perceived quality of care and owning one’s own home positively affected patients’ adherence. Indicators such as alcohol use in the last month and a high level of depression negatively affected patients’ adherence. Targeting specific indicators for specific interventions will guard against nonadherence, leading to treatment failure.
Celebrating Life: The U.S. President’s Emergency Plan for AIDS Relief. 2009 Annual Report to Congress. Office of the United States Global AIDS Coordinator in collaboration with the United States Departments of State (including the United States Agency for International Development), Defense, Commerce, Labor, Health and Human Services (including the Centers for Disease Control and Prevention, the Food and Drug Administration, the Health Resources and Services Administration, the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, and the Office of Global Health Affairs), and the Peace Corps.
2.
Tsasis P., Tsoukas C., Deutsch G.Evaluation of patient satisfaction in a specialized HIV/AIDS care unit of a major hospital. AIDS Patient Care STDS. 2000;14(7):347-349. doi:10.1089/ 108729100413211.
3.
Beach MC, Keruly, Moore RD.Is the quality of the patient-provider relationship associated with better adherence and health outcomes for patients with HIV?J Gen Intern Med. 2006;21(6): 661-665.
4.
Bakken S., Holzemer WL, Brown MA, et al. Relationships between perception of engagement with health care provider and demographic characteristics, health status, and adherence to therapeutic regimen in persons with HIV/AIDS. AIDS Patient Care STDS. 2000;14(4):189-197.
5.
Wouters M.Outcome-based referral to improve quality of care in upper GI surgery. J Surg Oncol. 2008;98(5):307-308.
6.
Fawole AO, Okunlola MA, Adekunle AOClients’ perceptions of the quality of antenatal care. J Natl Med Assoc. 2008;100(9): 1052-1058.
7.
Mfinanga SG, Kahwa A., Kimaro G., et al. Dissatisfaction with the laboratory services in conducting HIV related testing among public and private medical personnel in Tanzania. BMC Health Serv Res. 2008;8:171.
8.
Sanjobo N., Frich JC, Fretheim A.Barriers and facilitators to patients’ adherence to antiretroviral treatment in Zambia: a qualitative study. Sahara J. 2008;5(3):136-143.
9.
Morineau G., Vun MC, Barennes H., et al. Survival and Quality of Life Among HIV-Positive People on Antiretroviral Therapy in Cambodia. AIDS Patient Care STDS. 2009;23(8):669-677.
10.
Protopopescu C., Raffi F., Roux P., et al., on behalf of the ANRS CO8 (APROCO-COPILOTE) Study Group.Factors associated with nonadherence to long-term highly active antiretroviral therapy: a 10 year follow-up analysis with correction for the biase induced by missing data . J Antimicrob Chemother. 2009;64(3):599-606.
11.
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 . BioMed Central Public Health. 2008;8:265.
12.
Poupard M., Ngom Gueye NF, Thiam D., et al. Quality of life and depression among HIV-infected patients receiving efavirenz- or protease inhibitor-based therapy in Senegal. HIV Med.2007;8(2):92-95.
13.
DiMatteo MR , Lepper HS, Croghan TWDepression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000 ;160(14):2101-2107.
14.
Weiser SD, Leiter K., Heisler M., et al. A population-based study on alcohol and high risk sexual behaviors in Botswana. PLOS Med.2006;3(10):e392. Doi:10.1371/journal.pmed.0030392.
15.
Carrieri MP , Leport C., Protopopescu C., et al. Factors associated with nonadherence to highly active antiretroviral therapy. A 5-year follow up analysis with correction for the bias induced by missing data in the treatment maintenance phase. J Acquir Immune Defic Syndr. 2006;41(4):477-485.
16.
Chipimo JP, Fylkesnes K.Mental distress in the general population in Zambia: impact of HIV and social factors. BMC Public Health. 2009;9:298. doi: 10.1186/1471-2458-9-298.
17.
Byakika-Tusiime J., Crane J., Oyugi JH, et al. Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-Plus family treatment model:role of depression in declining adherence over time . J AIDS Behav.2009;13(suppl 1):82-91.
18.
Boarts JM, Sledjeski EM, Bogart LM, Delahanty DLThe differential impact of PTSD and Depression on HIV disease markers and adherence to HAART in people living with HIV. AIDS Behav. 2006;10(3):253-261.
19.
Vlassova N. , Angelino FA, Treisman GJUpdate on mental health issues in patients with HIV infection. Curr Infect Dis Rep.2009 ; 11(2):163-169.
