Abstract
BackgroundOptimal adherence to antiretroviral therapy (ART) is necessary for people living with HIV/AIDS (PLHIV). There have been relatively few systematic analyses of factors that promote or inhibit adherence to antiretroviral therapy among PLHIV in Asia. This study assessed ART adherence and examined factors associated with suboptimal adherence in northern Viet Nam.MethodsData from 615 PLHIV on ART in two urban and three rural outpatient clinics were collected by medical record extraction and from patient interviews using audio computer-assisted self-interview (ACASI).ResultsThe prevalence of suboptimal adherence was estimated to be 24.9% via a visual analogue scale (VAS) of past-month dose-missing and 29.1% using a modified Adult AIDS Clinical Trial Group scale for on-time dose-taking in the past 4 days. Factors significantly associated with the more conservative VAS score were: depression (p < 0.001), side-effect experiences (p < 0.001), heavy alcohol use (p = 0.001), chance health locus of control (p = 0.003), low perceived quality of information from care providers (p = 0.04) and low social connectedness (p = 0.03). Illicit drug use alone was not significantly associated with suboptimal adherence, but interacted with heavy alcohol use to reduce adherence (p < 0.001).ConclusionsThis is the largest survey of ART adherence yet reported from Asia and the first in a developing country to use the ACASI method in this context. The evidence strongly indicates that ART services in Viet Nam should include screening and treatment for depression, linkage with alcohol and/or drug dependence treatment, and counselling to address the belief that chance or luck determines health outcomes.
Highlights
Optimal adherence to antiretroviral therapy (ART) is necessary for people living with Human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS) (PLHIV)
The present study found that recent illicit drug use was not itself associated with suboptimal ART adherence, but we identified a significant interaction with recent heavy alcohol use
Consistent with other research of the influence of patient-provider relationships on ART adherence [39,40], this study found that the perceived quality of information from health care providers was positively associated with adherence
Summary
Optimal adherence to antiretroviral therapy (ART) is necessary for people living with HIV/AIDS (PLHIV). There have been relatively few systematic analyses of factors that promote or inhibit adherence to antiretroviral therapy among PLHIV in Asia. This study assessed ART adherence and examined factors associated with suboptimal adherence in northern Viet Nam. Most studies examining the prevalence and determinants of antiretroviral therapy (ART) adherence have been conducted in the United States, Europe and Africa, but relatively few have been performed in Asia [1]. Nam have estimated the prevalence of ART suboptimal adherence. The second study followed a cohort of 248 PLHIV at two out-patient clinics in Ho Chi Minh City and reported an adherence of over 98% [4]. Neither study in Viet Nam quantitatively examined determinants of ART adherence
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