title: Factors associated with self-reported adherence to antiretroviral therapy in a Tanzanian setting.
abstract: This study aimed to determine the level of antiretroviral adherence and factors associated with adherence among patients receiving free antiretroviral therapy (ART) at one clinic in Tanzania. Adult patients were recruited into the cross-sectional study and completed a survey that included self-reported adherence over four days and over one month. Less than 95% adherence on either measure was considered "poor." Factors associated with adherence in unadjusted analyses (alpha = 0.10) were included in a logistic regression model. A total of 340 patients participated in the study, and 5.9% (20/340) reported poor adherence. The final model found poor adherence associated with: being young (odds ratio (OR) = 4.03) or old (OR = 6.68); having lower perceived quality of patient-provider interaction (OR = 2.75); and ever missing a clinic appointment (OR = 3.13). Results highlight good adherence, but suggest the importance of addressing: (1) age-specific challenges of adherence through counseling and support; (2) client-focused care and quality of patient-provider interaction; and (3) clinic appointment reminder systems.
authors.affiliation: Duke Global Health Institute, Duke University, Durham, NC, USA. melissa.watt@duke.edu
authors.forename: Melissa H
authors.initials: MH
authors.lastname: Watt
authors.forename: Suzanne
authors.initials: S
authors.lastname: Maman
authors.forename: Carol E
authors.initials: CE
authors.lastname: Golin
authors.forename: Jo Anne
authors.initials: JA
authors.lastname: Earp
authors.forename: Eugenia
authors.initials: E
authors.lastname: Eng
authors.forename: Shrikant I
authors.initials: SI
authors.lastname: Bangdiwala
authors.forename: Mark
authors.initials: M
authors.lastname: Jacobson
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D011369:Professional-Patient Relations; D012944:Social Support; D013240:Stereotyping; D013636:Tanzania; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents
references.citation: Clin Infect Dis. 2006 Oct 1;43(7):939-41
references.pmid: 16941380
references.citation: AIDS. 2007 Jul;21 Suppl 4:S81-7
references.pmid: 17620757
references.citation: J Acquir Immune Defic Syndr. 2007 Jul 1;45(3):355-8
references.pmid: 17438479
references.citation: PLoS Med. 2007 Oct 16;4(10):e298
references.pmid: 17941716
references.citation: AIDS Patient Care STDS. 2000 Jan;14(1):47-58
references.pmid: 12240882
references.citation: J Acquir Immune Defic Syndr. 2002 Dec 15;31 Suppl 3:S123-7
references.pmid: 12562034
references.citation: AIDS Behav. 2006 May;10(3):227-45
references.pmid: 16783535
references.citation: J Gen Intern Med. 2004 Nov;19(11):1096-103
references.pmid: 15566438
references.citation: S Afr Med J. 2007 Jul;97(7):524-9
references.pmid: 17805455
references.citation: J Acquir Immune Defic Syndr. 2003 Nov 1;34(3):281-8
references.pmid: 14600572
references.citation: AIDS Care. 2003 Apr;15(2):251-61
references.pmid: 12856346
references.citation: Health Psychol. 2007 Jan;26(1):40-9
references.pmid: 17209696
references.citation: PLoS One. 2007 Jun 20;2(6):e552
references.pmid: 17579723
references.citation: J Am Board Fam Med. 2006 Sep-Oct;19(5):478-86
references.pmid: 16951297
references.citation: N Engl J Med. 2007 Jun 21;356(25):2564-7
references.pmid: 17582065
references.citation: J Assoc Nurses AIDS Care. 2003 Jul-Aug;14(4):61-9
references.pmid: 12953613
references.citation: Int J STD AIDS. 2005 Jan;16(1):38-41
references.pmid: 15705271
references.citation: Clin Infect Dis. 2007 Dec 1;45(11):1492-8
references.pmid: 17990233
references.citation: Soc Sci Med. 1995 Mar;40(6):743-53
references.pmid: 7747209
references.citation: J Acquir Immune Defic Syndr. 2008 Aug 1;48(4):468-75
references.pmid: 18614918
references.citation: AIDS Care. 2003 Apr;15(2):217-30
references.pmid: 12856343
references.citation: AIDS Res Hum Retroviruses. 2004 Oct;20(10):1053-6
references.pmid: 15585095
references.citation: AIDS Care. 2000 Jun;12(3):255-66
references.pmid: 10928201
references.citation: J Acquir Immune Defic Syndr. 2003 Jun 1;33 Suppl 2:S153-65
references.pmid: 12853864
references.citation: Soc Sci Med. 1990;30(3):325-39
references.pmid: 2408150
references.citation: Ann Intern Med. 2001 May 15;134(10):968-77
references.pmid: 11352698
references.citation: AIDS Educ Prev. 2002 Aug;14(4):318-29
references.pmid: 12212718
references.citation: AIDS Behav. 2010 Aug;14(4):778-84
references.pmid: 19283464
references.citation: Acta Psychiatr Scand. 2002 Jul;106(1):9-19
references.pmid: 12100343
references.citation: AIDS Care. 2004 Feb;16(2):219-30
references.pmid: 14676027
references.citation: AIDS. 2007 Aug 20;21(13):1799-803
references.pmid: 17690579
references.citation: Soc Sci Med. 1998 Aug;47(3):381-94
references.pmid: 9681908
references.citation: AIDS Care. 2004 May;16(4):471-84
references.pmid: 15203415
references.citation: AIDS. 2007 Oct;21 Suppl 5:S55-63
references.pmid: 18090270
references.citation: AIDS Care. 2009 Mar;21(3):271-9
references.pmid: 19280404
references.citation: AIDS Care. 2007 May;19(5):658-65
references.pmid: 17505927
references.citation: Clin Infect Dis. 2001 Oct 15;33(8):1417-23
references.pmid: 11550118
references.citation: AIDS Patient Care STDS. 2003 Apr;17(4):169-77
references.pmid: 12737640
references.citation: AIDS Patient Care STDS. 2007 Nov;21(11):799-812
references.pmid: 17944556
references.citation: Curr HIV Res. 2004 Jul;2(3):207-14
references.pmid: 15279584
references.citation: Soc Sci Med. 1991;32(6):705-14
references.pmid: 2035047
references.citation: AIDS. 2003 Jul;17 Suppl 3:S103-8
references.pmid: 14565616
references.citation: AIDS Behav. 2003 Mar;7(1):61-72
references.pmid: 14534391
references.citation: AIDS Care. 2000 Aug;12(4):405-8
references.pmid: 11091773
references.citation: Int J Health Serv. 2002;32(4):799-815
references.pmid: 12456126
references.citation: Am J Public Health. 2006 Jun;96(6):1044-51
references.pmid: 16670232
references.citation: AIDS Care. 2002 Apr;14(2):203-18
references.pmid: 11940279
references.citation: AIDS Patient Care STDS. 2002 Jan;16(1):43-50
references.pmid: 11839218
references.citation: Ann Intern Med. 2000 Jul 4;133(1):21-30
references.pmid: 10877736
references.citation: Soc Sci Med. 2009 May;68(10):1793-800
references.pmid: 19328609
references.citation: AIDS. 2000 Mar 10;14(4):357-66
references.pmid: 10770537
references.citation: AIDS. 2003 Jun 13;17(9):1369-75
references.pmid: 12799558
references.citation: Braz J Med Biol Res. 2002 Oct;35(10):1173-81
references.pmid: 12424490
references.citation: Health Policy Plan. 2009 May;24(3):189-96
references.pmid: 19276155
references.citation: J Acquir Immune Defic Syndr. 2004 Feb 1;35(2):203-4
references.pmid: 14722455
references.citation: JAMA. 2006 Aug 9;296(6):679-90
references.pmid: 16896111