Abstract
This cross-sectional analysis describes HIV-related risk behaviours and adherence to antiretroviral therapy (ART) in a population of HIV-positive patients at a clinic in Metro Manila, Philippines participating in the Philippines Connect for LifeTM cohort study. Among 426 HIV-positive adults taking ART, 79% reported ≥95% adherence over the prior 30 days. Longer time on treatment was associated with reduced adherence to ART (adjusted odds ratio (AOR) = 0.87 per year, P = 0.027). Being in a serodiscordant relationship, in which the subject's primary partner was HIV negative, increased adherence (AOR = 3.19, P = 0.006). Inconsistent condom use (AOR = 0.50, P = 0.103) and injection drug use (AOR = 0.54, P = 0.090) are potentially associated with reduced adherence to ART. Patients used drugs and alcohol at significantly higher rates than the general population.? The study found that patients in this setting require intervention to address treatment fatigue. Interventions to improve social support of PLHIV, as well as harm-reduction approaches for drug and alcohol use, could improve adherence in this population, strengthening the test-and-treat strategy to control the epidemic.
Highlights
All patients starting or continuing on antiretroviral therapy (ART) at the Sustained Health Initiatives of the Philippines (SHIP) clinic who had a mobile phone and who spoke English were eligible to participate in the study
The study coordinator screened 485 patients as they presented during routine clinic visits, of whom 483 were eligible to participate in the study, and 462 patients provided consent and were enrolled
Of 462 people enrolled in the Connect for Life intervention study, 31 were either ineligible to fill out the adherence questionnaire or had missing questionnaires; as a result 426 individuals reported ART adherence, and are included in this analysis
Summary
The Philippines has the fastest growing HIV/AIDS epidemic in the Asia–Pacific region. National surveillance data show that the number of new HIV cases in the Philippines has risen at an alarming rate during the past decade, with an increase from 311 cases identified in 2007 to 11 427 cases identified in 2018 – a 36-fold increase in new HIV diagnoses. According to the Joint United Nations Programme on HIV/AIDSJournal compilation Ó CSIRO 2021 Open Access CC BY (UNAIDS)’s surveillance reports, the Philippines’ progress towards reaching HIV/AIDS 90–90–90 goals is slow, with 67% of people living with HIV (PLHIV) aware of their status, 48% of those who know their status on treatment, and low coverage of viral load testing (
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