Adherence to highly active antiretroviral therapy in Hyderabad, India: barriers, facilitators and identification of target groups

Int J STD AIDS. 2016 Mar;27(3):186-95. doi: 10.1177/0956462415578545. Epub 2015 Mar 22.

Abstract

We assessed the barriers and facilitators to highly active antiretroviral therapy adherence and determined their prevalence among HIV/AIDS patients in Hyderabad, India. We conducted a cross-sectional study among HIV-infected adults prescribed highly active antiretroviral therapy and receiving care from nine clinics. Depression was screened using Patient Health Questionnaire 9 and facilitators of HIV medication adherence were assessed using an 11-item scale which yielded a total positive attitude to disease score. Prevalence ratios of non-adherence between different categories of potential risk factors were calculated. We compared mean 'facilitators to adherence' scores between the adherent and non-adherent population. Multivariable Poisson regression with robust variance was used to identify independent risk factors. Among the 211 respondents, nearly 20% were non-adherent, approximately 8% had either moderately severe or severe depression and mean score for combined facilitators to medication adherence was 33.35 (±7.88) out of a possible 44 points. Factors significantly associated with non-adherence included older age, female sex worker, moderate-to-severe depression and the combined facilitators to medication adherence score. These data from a broad range of clinical settings in Hyderabad reveal that key groups to focus on for adherence intervention are female sex workers, older persons and those with depression.

Keywords: AIDS; HIV; Hyderabad; India; adherence; barriers; facilitators; female sex workers; highly active antiretroviral therapy; medication; non-adherence; treatment.

MeSH terms

  • Adult
  • Age Distribution
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / methods*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Humans
  • India / epidemiology
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Prevalence
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Socioeconomic Factors

Substances

  • Anti-HIV Agents