title: Adherence to highly active antiretroviral therapy in a tertiary care hospital in West Bengal, India.
abstract: BACKGROUND
  The introduction of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) has led to the reduction of mortality and the improvement of the quality of life of people living with HIV/AIDS (PLWHA). The present study was conducted to determine the pattern of adherence to HAART among PLWHA, and to assess the factor(s) affecting nonadherence, if any.
  
  
  METHODS
  This study was a hospital-based analytical, cross-sectional epidemiological study conducted between July and October 2011. A total of 370 adult HIV-positive patients registered in the Antiretroviral Therapy Centre of Burdwan Medical College and Hospital, West Bengal, India, were included. Nonadherence was defined as missing at least a single dose of medicine within the last four days. Data was analysed using the Statistical Package for the Social Sciences version 19.0 (IBM Corp, Armonk, NY, USA).
  
  
  RESULTS
  A total of 87.6% of patients were found to be adherent to HAART. Principal causes of nonadherence were forgetting to take medicine (70.2%), being away from home (65.2%), and busyness with other things (64.7%). Multivariate logistic regression analysis revealed that nonadherence was significantly associated with a positive family history of HIV/AIDS (odds ratio [OR] 16; 95% confidence interval [CI] 2.2-114.3; p = 0.01), occurrence of side effects with HAART (OR 9.81; 95% CI 1.9-51.7; p = 0.01) and employment (OR 5.93; 95% CI 1.5-23.2; p = 0.01).
  
  
  CONCLUSIONS
  Although overall adherence was high, the factors that affect nonadherence can be addressed with proper counselling and motivation of patients and their family members. Adherence to HAART could delay the progression of this lethal disease and minimise the risk of developing drug resistance.
authors.affiliation: Department of Pre-Clinical Sciences, Faculty of Medicine and Medical Sciences, Universiti Tunku Abdul Rahman, Sungai Long Campus, Lot PT 21144, Jalan Sungai Long, Bandar Sungai Long, Cheras, 43000 Kajang, Selangor, Malaysia. waifong.chew@gmail.com.
authors.forename: Rajib
authors.initials: R
authors.lastname: Saha
authors.forename: Indranil
authors.initials: I
authors.lastname: Saha
authors.forename: Aditya Prasad
authors.initials: AP
authors.lastname: Sarkar
authors.forename: Dilip Kumar
authors.initials: DK
authors.lastname: Das
authors.forename: Raghunath
authors.initials: R
authors.lastname: Misra
authors.forename: Krishnadas
authors.initials: K
authors.lastname: Bhattacharya
authors.forename: Rabindra Nath
authors.initials: RN
authors.lastname: Roy
authors.forename: Abantika
authors.initials: A
authors.lastname: Bhattacharya
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D003430:Cross-Sectional Studies; D004351:Drug Resistance; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007194:India; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D055815:Young Adult