Abstract
BackgroundFree antiretroviral therapy has been implemented in China since 2004, but adherence to antiretroviral therapy among people living with HIV is suboptimal. The effectiveness of antiretroviral therapy is subject to medication adherence, which decreases with prolonged treatment times. The aim of this study was to investigate medication adherence and related factors among people living with HIV with newly initiated antiretroviral therapy.MethodsThis observational study was conducted in consecutive samples of people living with HIV who had newly initiated antiretroviral therapy. Participants were recruited between March 1, 2013, and August 31, 2014, from the local Center for Disease Control and Prevention and Infectious Disease hospital in a capital city in central China. A standard set of questionnaires was adopted, including the Community Programs for Clinical Research on AIDS Antiretroviral Medications and Self-Report Questionnaire (CPCRA), the Patient Health Questionnaire-9 (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). T-test, Chi square test and multivariate logistic regression analysis with backward stepwise were performed to explore factors that might influence medication adherence.ResultsOf the 207 participants, 85.5% of the participants (177/207) were categorized with good adherence, and 14.5% (30/207) with poor adherence. The multivariate logistic regression analyses showed that participants with positive depression (OR = 5.95, 95% CI: 2.34–15.11) and without disclosure of their HIV status to others (OR = 2.62, 95% CI: 1.06–6.50) were more susceptible to poor adherence.ConclusionsOne-sixth of the participants reported suboptimal medication adherence within the first 6 months. Factors associated with poor adherence included non-disclosure of their HIV status, had positive depression. Tailored interventions, such as effective psychological coping strategies, should be implemented for people living with HIV with newly initiated antiretroviral therapy to improve their medication adherence.
Highlights
Free antiretroviral therapy has been implemented in China since 2004, but adherence to antiretroviral therapy among people living with HIV is suboptimal
This study aimed to investigate medication adherence with respect to both quantity and timing and the factors related to adherence among people living with HIV with newly initiated antiretroviral therapy and to provide evidence for formulating individualized interventions to improve treatment outcomes
19 variables potentially associated with adherence were chosen as the independent variables, which included socio-demographic characteristics, HIV-related information, psychosocial factors, antiviral treatment information, knowledge of Antiretroviral therapy (ART) and satisfaction with medical services
Summary
Free antiretroviral therapy has been implemented in China since 2004, but adherence to antiretroviral therapy among people living with HIV is suboptimal. Zhou et al conducted a meta-analysis of medication adherence among patients receiving antiviral therapy in China from 1985 to 2015 [16] and found that the 90% medication adherence rate was 77.61%, which was lower than the rates reported by similar studies conducted in other countries [17,18,19]. This finding suggested a greater need to pay attention to this group of people in China
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