Adherence to anti-retroviral therapy among HIV patients in Bangalore, India

May 1, 2009

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.

Conclusions:

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.

Author: M B Cauldbeck, C O'Connor, M B O'Connor, J A Saunders, B Rao, G V

Mallesh, K N Praveenkumar, D Mamtha, C McGoldrick, Rbs Laing and K S Satish

Credits/Source: AIDS Research and Therapy 2009, 6:7

hiv_patients_in_bangalore_india.htm

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