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Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patients
Author(s) -
Fong OW,
Ho CF,
Fung LY,
Lee FK,
Tse WH,
Yuen CY,
Sin KP,
Wong KH
Publication year - 2003
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1046/j.1468-1293.2003.00147.x
Subject(s) - medicine , psychosocial , regimen , reverse transcriptase inhibitor , viral load , antiretroviral therapy , disease , human immunodeficiency virus (hiv) , immunology , psychiatry
Objective Drug adherence is crucial to the success of highly active antiretroviral therapy (HAART) in the treatment of HIV disease. Adherence to HAART and its determinants may, however, differ across HIV/AIDS populations. Methods We retrospectively studied drug adherence by self‐report in HIV‐1 infected Chinese patients who have been on HAART for at least 1 year as at the end of year 2000. HAART is defined as three or more antiretrovirals with at least one protease inhibitor or non‐nucleoside analogue reverse transcriptase inhibitor. Results The last drug adherence level assessed by self‐report in 161 Chinese patients were: grade A (100%) – 130, 80.7%; grade B (95–99%) – 25, 15.5%; grade C (90–94%) – three, 1.9% and grade D (< 90%) – three, 1.9%. Patients with full adherence were more likely to have undetectable (< 500 copies/mL) plasma virus level (adjusted OR, 4.22; 95% CI, 1.75–12.33). Patients' demographics, HIV disease status and antiretroviral regimen did not affect adherence. Partial drug adherence was, however, independently associated with the psychosocial factors of missing clinic appointments (adjusted OR, 3.13; 95% CI, 1.23–8.33), forgetfulness (adjusted OR, 4.55; 95% CI, 1.64–12.5) and a busy work life (adjusted OR, 6.67; 95% CI, 1.75–25). Conclusion There were similarities and differences in determinants affecting HAART adherence in Chinese compared with other patients. Psychosocial factors rather than HIV disease or treatment were more important factors in our Chinese patients. The relevance of patient populations and care setting for adherence to HAART shall be further studied.