Factors associated with adherence to antiretroviral therapy in HIV-infected patients. A cross-sectional study in Kathmandu District, Nepal

Abstract

Objective: To determine the prevalence and predictors of antiretroviral therapy adherence among HIV/ AIDS patients in Kathmandu district. Methods: A cross-sectional study of 316 HIV-positive individuals receiving antiretroviral therapy from three ART sites in Kathmandu districts was done from January 2012 to February 2012. The participants were interviewed and answered questions about socio-demographic status and antiretroviral therapy during the past week. Participants were considered adherent if they reported taking ≥95% of their medication as prescribed. The association between explanatory variables and adherence was measured using logistic regression and was reported as odds ratio (OR) with 95% confidence interval. Results: Out of the 316 participants, 64.6% (n=201) were men and 35.4% (n=112) were women. The adherence prevalence of the study participants was 86.7% (n=274). The adherence prevalence in men and women were 84.3 % and 91%, respectively. Age (OR 1.04; 95% CI 1.00-1.09), time taken to reach ART center (OR 1.38; 95% CI 1.12-1.71), past illegal drugs use (OR 3.98; 95% CI 1.71-9.24), side effects (OR 4.88; 95% CI 1.09-21.8), were all independently and negatively associated with adherence. Whereas, use of reminder tools (OR 3.45; 95% CI 1.33-8.91) was independently and positively associated with adherence. Conclusion: The prevalence of adherence found in this study is encouraging. Age, time taken to reach ART center, side effects, illegal drugs use and not using reminder tools present barriers for adherence to ART. Improving adherence requires interventions which recognize these barriers. Key Words: Antiretroviral Therapy (ART), Adherence, Kathmandu, AIDS patients