Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patients.
OBJECTIVE
Drug adherence is crucial to the success of highly active antiretroviral therapy (HAART) in the treatment of HIV disease. Adherence to HAART and its determinants may, however, differ across HIV/AIDS populations.


METHODS
We retrospectively studied drug adherence by self-report in HIV-1 infected Chinese patients who have been on HAART for at least 1 year as at the end of year 2000. HAART is defined as three or more antiretrovirals with at least one protease inhibitor or non-nucleoside analogue reverse transcriptase inhibitor.


RESULTS
The last drug adherence level assessed by self-report in 161 Chinese patients were: grade A (100%) - 130, 80.7%; grade B (95-99%) - 25, 15.5%; grade C (90-94%) - three, 1.9% and grade D (< 90%) - three, 1.9%. Patients with full adherence were more likely to have undetectable (< 500 copies/mL) plasma virus level (adjusted OR, 4.22; 95% CI, 1.75-12.33). Patients' demographics, HIV disease status and antiretroviral regimen did not affect adherence. Partial drug adherence was, however, independently associated with the psychosocial factors of missing clinic appointments (adjusted OR, 3.13; 95% CI, 1.23-8.33), forgetfulness (adjusted OR, 4.55; 95% CI, 1.64-12.5) and a busy work life (adjusted OR, 6.67; 95% CI, 1.75-25).


CONCLUSIONS
There were similarities and differences in determinants affecting HAART adherence in Chinese compared with other patients. Psychosocial factors rather than HIV disease or treatment were more important factors in our Chinese patients. The relevance of patient populations and care setting for adherence to HAART shall be further studied.
Fong
O W
OW
Integrated Treatment Centre, Special Preventive Programme, Department of Health, Hong Kong.
Ho
C F
CF
Fung
L Y
LY
Lee
F K
FK
Tse
W H
WH
Yuen
C Y
CY
Sin
K P
KP
Wong
K H
KH
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D001071:Appointments and Schedules; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1; D006723:Hong Kong; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D019562:Viral Load; D016526:Workload