ABSTRACT
Background: Adherence to antiretroviral therapy (ART) is a strong predictor of progression to AIDS and death. It remainsthe most important potentially alterable factor that determines treatment outcomes.Methods: The study is a cross-sectional survey of self-reported adherence to ART and associated factors. It included arandomly selected sample of 100 adult patients who began ART between June 2006 and December 2007. A modified Adult AIDS Clinical Trials Group questionnaire was used. The analysis compared self-reported adherence levels by factor and viral load test results. Results: Only 71of patients had an adherence 95. Poor adherence was related to changes in daily routines (being away from home [21] and busy with other things [17]). All patients with symptoms suggestive of clinical depression had virologic failure. More unemployed patients (50.7) had virologic failure than did employed patients (40) (p = 0.05). The clinic had a tenfold increase in patient enrolment and a ninefold decline in staff-to-patient ratio; and the proportion of patients lost to follow-up doubled in the preceding four years. Conclusion: Adherence to ART was poor. The capacity of the clinic to manage patients adequately has declined significantly. Decentralisation of ART services to primary health care facilities should be considered
Subject(s)
HIV Infections , Patient ComplianceABSTRACT
Background: Adherence to antiretroviral therapy (ART) is a strong predictor of progression to AIDS and death. It remains the most important potentially alterable factor that determines treatment outcomes. Methods: The study is a cross-sectional survey of self-reported adherence to ART and associated factors. It included a randomly selected sample of 100 adult patients who began ART between June 2006 and December 2007. A modified Adult AIDS Clinical Trials Group questionnaire was used. The analysis compared self-reported adherence levels by factor and viral load test results. Results: Only 71of patients had an adherence 95. Poor adherence was related to changes in daily routines (being away from home [21] and busy with other things [17]). All patients with symptoms suggestive of clinical depression had virologic failure. More unemployed patients (50.7) had virologic failure than did employed patients (40) (p = 0.05). The clinic had a tenfold increase in patient enrolment and a ninefold decline in staff-to-patient ratio; and the proportion of patients lost to follow-up doubled in the preceding four years. Conclusion: Adherence to ART was poor. The capacity of the clinic to manage patients adequately has declined significantly. Decentralisation of ART services to primary health care facilities should be considered