DOI: http://dx.doi.org/10.18203/2349-3933.ijam20163735

Factors associated with anti-retroviral therapy adherence among people living with HIV visiting IRT Perundurai medical college hospital link ART centre, Perundurai, Tamilnadu, India

Mohankumar Vedhanayagam, Rajesh Rajagopalan, Balamurgan Bhavani Rajendran, Sendhil Sengodan, Senthilkumar Sengodan

Abstract


Background: National AIDS control organisation aims to provide wholesome management to PLHIV. This is ensured by universal access to free and comprehensive care, support and treatment in health delivery facilities across the country by dynamic linkages and referral mechanism for monitoring, mentoring, decentralization and specialized care and treatment. Objective of the study was to analyse factors associated with ART adherence among PLHIV visiting IRT Perundurai Medical College Hospital link ART centre, Tamilnadu, India.

Methods: A prospective observational study was conducted during June 2015 to May 2016. All PLHIV receiving ART drugs as per protocol from LAC were included.

Results: 139 clients were registered for treatment and follow up till May 2016 in our centre. 31 were transferred to nearby ART, link ART centres. Currently 98 (38 male; 60 female) were utilizing our services. Majority of the patients were on ZLN followed by TLE and ZLE. Most of clients were from rural areas belonging to low or low middle income group.  Common occupation was found to be farming and cattle rearing. Most women were housewives. The average age in present study was 38.3 years. Oldest was 73 years old male and youngest 10 years old female. Family support and benefits of ART drugs tops the list of facilitators; supply chain, alcohol issues, family issues were commonly observed barriers.

Conclusions: Our results supported the measurement of multiple dimensions of medication-taking behaviours in order to avoid overestimating adherence to ART. Investigation of factors associated with long term adherence would require elaborate and constant follow-ups than in this study period.


Keywords


Adherence, Barriers, Facilitators, Link ART centre, PLHIV

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References


Annual Report 2014-15, NACO. Available at http://naco.gov.in/NACO/Divisions/CST/; Ministry of Health and Family Welfare, Government of India. Accessed on 12 June 2016.

Annual report 2014. Available at http://www.naco.gov.in/upload/2015%20MSLNS/Annual%20report%20_NACO_2014-15.pdf. Accessed on 12 June 2016.

Antiretroviral therapy guidelines for hiv-infected adults and adolescents including post-exposure prophylaxis, May 2007, NACO, Ministry of Health and Family Welfare, Government of India.

ART guidelines for HIV-Infected adults and adolescents: May 2013, NACO, Ministry of Health and Family Welfare, Government of India. 2013.

Adherence to long-term therapies-Evidence for action; World Health Organization. 2003.

Orrell C. Adherence is not a barrier to successful antiretroviral therapy in South Africa. AIDS. 2003;17:1369-75.

Kim MH. Why did I stop? barriers and facilitators to uptake and adherence to ART in option B+ HIV care in lilongwe, Malawi. PLoS ONE. 2016;1(2):0149527.

Patel S. Perceptions regarding barriers and facilitators to combination antiretroviral therapy adherence among people living with HIV/AIDS in Gujarat, India: A qualitative study. Indian J Sex Transm Dis. 2012;33:107-11.

Meena LP. Study the drug adherence and possible factor influencing drug adherence in HIV/AIDS patients in north eastern part of India. J Educ Health Promot. 2014; 3: 31.

Shukla M. Non-adherence to antiretroviral therapy among people living with HIV/AIDS attending two tertiary care hospitals in district of northern India. Indian J Community Med. 2016;41(1):55-61.

Hansana. Adherence to antiretroviral therapy (ART) among people living with HIV (PLHIV): a cross-sectional survey to measure in Lao PDR. BMC Public Health. 2013;13:617.

Letta. Factors associated with adherence to antiretroviral therapy (ART) among adult people living with HIV and attending their clinical care, Eastern Ethiopia. BMC International Health and Human Rights. 2015;15:33.

Langebeek. Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis; BMC Medicine. 2014;12:142.

Beer L. Use of and adherence to antiretroviral therapy in a large U.S. Sample of HIV-infected Adults in Care, 2007-2008. Open AIDS Journal. 2012;6(1):213-23.

What time is it? Adherence to antiretroviral therapy in Ethiopia. Available at http:/ /www. ncbi.nlm.nih.gov /pubmed /26873491 AIDS Behav. Accessed on 12 February 2016.

Wouters E, Masquillier C, Booysen RF. The importance of the family: a longitudinal study of the predictors of depression in HIV patients in South Africa. AIDS Behav. 2016 Aug;20(8):1591-602.

Daniel NA, Ankrah. Facilitators and barriers to antiretroviral therapy adherence among adolescents in Ghana; Patient Preference and Adherence. 2016;10:329-37.

Amico KR. Provider guidance for linking patients to antiretroviral therapy adherence interventions: recommendations from an IAPAC advisory committee on adherence monitoring and support. J Int Assoc Provid AIDS Care. 2013;12(2):7983.

Kuchinad. A qualitative study of barriers to and facilitators of optimal engagement in care among PLWH and substance use/misuse. BMC Res Notes. 2016;9:229.

Bhatti. Current scenario of HIV/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy. Cureus. 2016;8(3):515.

Vedhanayagam M, Rajagopalan R. Prevalence of mucocutaneous manifestations in human immunodeficiency infection - learning from a rural centre in Tamilnadu, India. Int J Res Med Sci. 2016;4(6):1959-1965.

Vedhanayagam M, Sengodan S, Rajagopalan R. Occupational exposure, drug toxicities and adherence to HIV post exposure prophylaxis: a cohort study at the teaching hospital in Erode district, Tamilnadu, India. Int J Adv Med. 2016;3:625-31.

Jan D, Hirsch. Evaluation of the first year of a pilot program in community pharmacy: HIV/AIDS medication therapy management for medi-cal beneficiaries. J Manag Care Pharm. 2009;15(1):32-41.

Ware NC, Pisarski EE, Tam M, Wyatt MA, Atukunda E, Musiimenta A. The meanings in the messages: How SMS reminders and realtime adherence monitoring improve ART adherence in rural Uganda. AIDS. 2016 May 15;30(8):1287-94.

Mccoy K. Correlates of antiretroviral therapy adherence among HIV infected older adults. J Int Assoc Provid AIDS Care. 2016;15(3):248-55.

Rai S, Mahapatra B, Sircar S, Raj PY, Venkatesh S. Adherence to antiretroviral therapy and its effect on survival of HIV-infected individuals in Jharkhand, India. PLoS ONE. 2013 Jun 18;8(6):e66860.

Zhonghua. Factors associated with adherence of highly active antiretroviral therapy among 386 HIV/AIDS patients in 3 provinces of China. 2016;50(4):3348.

Meg C, Kong. Association between race, depression, and antiretroviral therapy adherence in a low-income population with HIV infection. J Gen Intern Med. 2012;27(9):1159-64.

Grierson J. Adherence to antiretroviral therapy: factors independently associated with reported difficulty taking antiretroviral therapy in a national sample of HIV-positive Australians; HIV medicine. 2011;12:562-9.

Christopher J, Johnsona. Adherence to antiretroviral medication in older adults living with HIV/AIDS: a comparison of alternative models AIDS Care. 2009;21(5):541-51.

Musumari PM. Food Insecurity Is Associated with increased risk of non-adherence to antiretroviral therapy among HIV-infected adults in the democratic republic of congo: a cross-sectional study. PLoS ONE. 2004;9(1):85327.

Charles H, Hinkina. Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse; AIDS. 2004;18(1):19-25.

Koole O. Reasons for missing antiretroviral therapy: results from a multi-country study in Tanzania, Uganda, and Zambia. PLoS ONE. 2016;11(1):0147309.

Zhang L. Side effects, adherence self efficacy, and adherence to antiretroviral treatment: a mediation analysis in a Chinese sample. AIDS Care. 2016;24:18.

Ghidei L. Aging, antiretroviral, and adherence- a meta-analysis of adherence among older hiv-infected individuals. Drugs Aging. 2013;30(10):7.

Saha S. Trust in physicians and racial disparities in HIV Care; AIDS patient care and STDs. 2009;24(7):415-20.

Bernaysa S. When information does not suffice: young people living with HIV and communication about ART adherence in the clinic; Vulnerable children and youth studies. 2016;11(1):60-8.

Christine T. Female gender predicts lower access and adherence to antiretroviral therapy in a setting of free healthcare; BMC Infect Dis. 2011;11:86.

Subramanian T, Gupte MD, Ezhil R. AIDS: An understanding in rural women of South-India. Indian J Sex Transm Dis. 2007;28:10-4.

Nyamathi A. Correlates of adherence among rural Indian women living with HIV/AIDS . J HIV AIDS Soc Serv. 2012;1(4):5164.