Details:

Alternative Title:
PLoS One
Publisher's site:
http://dx.doi.org/10.1371/journal.pone.0147309
Personal Author:
Koole, Olivier ; Denison, Julie A ; Menten, Joris ; Tsui, Sharon ; Wabwire-Mangen, Fred ; ... More +
Koole, Olivier ; Denison, Julie A ; Menten, Joris ; Tsui, Sharon ; Wabwire-Mangen, Fred ; Kwesigabo, Gideon ; Mulenga, Modest ; Auld, Andrew ; Agolory, Simon ; Mukadi, Ya Diul ; van Praag, Eric ; Torpey, Kwasi ; Williams, Seymour ; Kaplan, Jonathan ; Zee, Aaron ; Bangsberg, David R ; Colebunders, Robert Less -
Description:
Objectives

To identify the reasons patients miss taking their antiretroviral therapy (ART) and the proportion who miss their ART because of symptoms; and to explore the association between symptoms and incomplete adherence.

Methods

Secondary analysis of data collected during a cross-sectional study that examined ART adherence among adults from 18 purposefully selected sites in Tanzania, Uganda, and Zambia. We interviewed 250 systematically selected patients per facility (≥18 years) on reasons for missing ART and symptoms they had experienced (using the HIV Symptom Index). We abstracted clinical data from the patients’ medical, pharmacy, and laboratory records. Incomplete adherence was defined as having missed ART for at least 48 consecutive hours during the past 3 months.

Results

Twenty-nine percent of participants reported at least one reason for having ever missed ART (1278/4425). The most frequent reason was simply forgetting (681/1278 or 53%), followed by ART-related hunger or not having enough food (30%), and symptoms (12%). The median number of symptoms reported by participants was 4 (IQR: 2–7). Every additional symptom increased the odds of incomplete adherence by 12% (OR: 1.1, 95% CI: 1.1–1.2). Female participants and participants initiated on a regimen containing stavudine were more likely to report greater numbers of symptoms.

Conclusions

Symptoms were a common reason for missing ART, together with simply forgetting and food insecurity. A combination of ART regimens with fewer side effects, use of mobile phone text message reminders, and integration of food supplementation and livelihood programmes into HIV programmes, have the potential to decrease missed ART and hence to improve adherence and the outcomes of ART programmes.


Subject:
[+]
Adult
Anti-Retroviral Agents
Cross-Sectional Studies
Female
HIV
HIV Infections
Humans
Male
Medication Adherence
Middle Aged
Patient Compliance

Source:
PLoS One. 11(1).
Series:
PEPFAR
Pubmed ID:
26788919
Pubmed Central ID:
PMC4720476
Document Type:
Journal Article
Funding:
PEPFAR/United States
Place as Subject:
Tanzania ; Uganda ; Zambia
Tanzania ; Uganda ; Zambia Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:c3afbfb7cb71fdc70985684d95c63983dfcca851b68b61ef39c293b65b3e7bc9
File Type:

Supporting Files

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