title: Adherence to anti-retroviral therapy among HIV patients in Bangalore, India.
abstract: BACKGROUND
  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.
authors.affiliation: The School of Medicine, University of Aberdeen, Aberdeen, Scotland, UK. m.cauldbeck@nhs.net
authors.forename: Mary B
authors.initials: MB
authors.lastname: Cauldbeck
authors.forename: Catherine
authors.initials: C
authors.lastname: O'Connor
authors.forename: Mortimer B
authors.initials: MB
authors.lastname: O'Connor
authors.forename: Jean A
authors.initials: JA
authors.lastname: Saunders
authors.forename: Bhimasena
authors.initials: B
authors.lastname: Rao
authors.forename: V G
authors.initials: VG
authors.lastname: Mallesh
authors.forename: Nagendrappa Kotehalappa
authors.initials: NK
authors.lastname: Praveen Kumar
authors.forename: Gurushanthappa
authors.initials: G
authors.lastname: Mamtha
authors.forename: Claire
authors.initials: C
authors.lastname: McGoldrick
authors.forename: Robert Bs
authors.initials: RB
authors.lastname: Laing
authors.forename: Kadappa Shivappa
authors.initials: KS
authors.lastname: Satish