Research
Adherence to anti-retroviral therapy among HIV patients in Bangalore, India
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* Corresponding authors: Mary B Cauldbeck m.cauldbeck@nhs.net - Mortimer B O'Connor mortimeroconnor@gmail.com
1 The School of Medicine, University of Aberdeen, Aberdeen, Scotland, UK
2 GU/STD Clinics, Department of GU/STD Medicine, Mid-Western Regional Hospital, Limerick, Ireland
3 Department of Medicine, South Infirmary – Victoria University Hospital, Cork, Ireland
4 The School of Medicine, University College Cork, Cork, Ireland
5 Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
6 Department of Respiratory and HIV Medicine, Rajajinagar and Wockhardt Hospital and Heart Institute, Bangalore, India
7 Infection Unit, Department of Infectious Diseases, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK
AIDS Research and Therapy 2009, 6:7 doi:10.1186/1742-6405-6-7
Published: 28 April 2009Abstract
Introduction
Human Immunodeficiency Virus (HIV) has an estimated prevalence of 0.9% in India (5.2 million). Anti-retroviral drugs (ARV) are the treatments of choice and non-adherence is an important factor in treatment failure and development of resistance, as well as being a powerful predictor of survival. This study assesses adherence to ARV in HIV positive patients in Bangalore, India, a country where only 10% of those who need therapy are receiving it.
Methods
A cross-sectional anonymous questionnaire survey of 60 HIV antibody positive patients was carried out with patients attending HIV outpatient services at two centres: The Chest and Maternity Centre, Rajajinagar, and Wockhardt Hospital and Heart Institute, Bangalore. Consent was obtained. Translation was done by a translator and doctors where required. Data was analysed using SPSS statistical analysis.
Results
A response rate of 88% (53/60) was achieved. The mean patient age was 39.98 years, with 50% aged 30–40, and 73.6% of participants being male. Mean family size was 4.8 (1–13). 21% lived less than 50 kms and 21% greater than 400 kms from clinic.
60% reported they were fully adherent. Adherence was statistically significantly linked to regular follow-up attendance (70.5%, p = 0.002). No other results were statistically significant but trends were found. "100% adherence" trends were seen in older patients, male gender, those from larger families, those who had a previous AIDS defining illness, those taking fewer tablets, and without food restrictions. Commonest side-effects causing non-adherence were metabolic reasons (66%) and GI symptoms (50%). No trends were seen for education level, family income, distance travelled to clinic, time since diagnosis, or time on ART.
Conclusion
Regular attendance for follow up was statistically significant for 100% lifetime adherence. Positive trends were seen in those in larger families, older, those who had AIDS defining illness, simple regimes, and without side-effects. Education, income, distance travelled and length of time diagnosed or treated had no effect on adherence.