ABSTRACT
BACKGROUND: Although antiretroviral therapy has limited efficiency, patients should take multiple drugs in combination in prescribed time for lifelong and they should also require specific food and fluid restriction. Due to these and other factors patients may discontinue their medication and therefore face significant challenges in adherence. OBJECTIVES: To assess factors associated with non-adherence among people living with HIV receiving the antiretroviral therapy. METHODS: Between July 2011 to January 2012, a cross sectional survey was conducted among patients visiting HIV/AIDS unit, Tribhuvan University Teaching Hospital for therapy. After taking informed consent, a pre-structured questionnaire was filled up and data were entered into SPSS 11.5 system and analyzed. RESULTS: Of the 100 studied subjects, 61 (61.0%) were male and 39 (39%) were female. Adherence was found to be 79%. The major barrier to adherence was reported to be simply forgetfulness (33.3% of those non adherents). Non adherence was significantly associated with types of family (X² value, 7.11), smoking (X² value, 5.44) and alcoholic habit (X² value, 5.69) but not with gender (X² value, 2.57). Besides this, poor economic status, and attendance to religious ceremony were reported to be major obstacles to adherence. CONCLUSION: Adherence at this center was found to be only satisfactory. Forgetfulness was reported to be the major cause of non adherence. Persons living in joint family and those with alcoholic and /or smoking habit were more likely to miss the pills. It can be recommended that effective counseling, moral/financial support for HIV/AIDS patients may increase their adherence.
Subject(s)
Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , HIV , Hospitals, Teaching/statistics & numerical data , Medication Adherence/statistics & numerical data , Adolescent , Adult , Aged , Child , Child, Preschool , Cross-Sectional Studies , Female , Follow-Up Studies , HIV Infections/epidemiology , Humans , Incidence , Infant , Male , Middle Aged , Nepal/epidemiology , Retrospective Studies , Risk Factors , Socioeconomic Factors , Surveys and Questionnaires , Young AdultABSTRACT
Tuberculosis itself is a major public health problem in Nepal. The emergence of HIV has caused sharp increase in TB incidence in the community. Surveillance of TB/HIV co-infection helps in developing effective TB/HIV control strategies. The objective of this study was to measure prevalence of TB among HIV/AIDS patients in the selected regions. Between December 2006 and May 2008, a cross-sectional study was conducted in three different settings namely Tribhuvan University Teaching hospital, Kathmandu; Regional Tuberculosis Centre, Pokhara and Shree Siddhanath Science Campus, Mahendranagar. After taking informed consent pre-structured questionnaire was administered. Sputum specimen was collected from HIV/AIDS patients to investigate tuberculosis by culture and microscopy. Data analysis was done using SPSS 11.5. Of the 394 HIV infected persons, 225 (57.1%) were male and 169 (42.9%) female. The overall prevalence of TB was found to be 8.1%. Clinical signs and symptoms were significantly lower in those patients undergoing ART (chi2 value ranging from 4.19 to 9.13). However, development of tuberculosis is independent of ART status (chi2 value 1.14) and CD4 level (chi2 value 3.25). TB case detection rate by cultural technique was found to be twice as superior as direct microscopy. It can be concluded that smear negative TB constitute the significant proportion of TB cases in HIV infected persons.
