title: Antiretroviral therapy adherence and predictors to adherence in Albania: a cross-sectional study.
abstract: BACKGROUND
  The possibility of an HIV/AIDS epidemic in southeastern Europe (SEE) is not improbable. Thus, an understanding of the current issues surrounding HIV/AIDS care, specifically antiretroviral therapy (ART) adherence, in countries within SEE is critical. This study was conducted to determine the ART adherence characteristics of Albania's HIV-positive population.
  
  
  METHODS
  This cross-sectional study reports initial demographic and adherence characteristics of patients receiving HIV/AIDS treatment in Albania. Retrospective review of pharmacy medications dispensed supplemented reported adherence behavior. Further, an adherence index was utilized to explore adherence more thoroughly.
  
  
  RESULTS
  Patient-reported adherence and pharmacy review showed adherence levels of 98.9±4.4% and 97.7±4.7%, respectively. Assessment by adherence index revealed an index level of 91.7±6.7. Factors associated with a score of < 95 on the adherence index were: being partnered (OR = 0.29, 95% CI = 0.09 - 0.98), history of depression (OR = 0.24, 95% CI = 0.08 - 0.76), increased number of barriers to care (OR = 0.80, 95% CI = 0.66 - 0.97), and increased number of current social and medical needs (OR = 0.72, 95% CI = 0.58 - 0.91).
  
  
  CONCLUSIONS
  Interventions aimed at reducing barriers to care, addressing current medical and social needs, and treating mental health issues may help improve adherence to ART in patients with HIV/AIDS in Albania. With little known about HIV/AIDS in SEE, this study provides guidance on how SEE countries can help prevent a possible rise in the prevalence of HIV given the close link of ART adherence and spread of HIV.
authors.affiliation: Stanford University School of Medicine, Stanford, CA, United States. shanem@stanford.edu.
authors.forename: Shane D
authors.initials: SD
authors.lastname: Morrison
authors.forename: Vania
authors.initials: V
authors.lastname: Rashidi
authors.forename: Clea
authors.initials: C
authors.lastname: Sarnquist
authors.forename: Vilson H
authors.initials: VH
authors.lastname: Banushi
authors.forename: Michael K
authors.initials: MK
authors.lastname: Hole
authors.forename: Namrata J
authors.initials: NJ
authors.lastname: Barbhaiya
authors.forename: Valbona H
authors.initials: VH
authors.lastname: Gashi
authors.forename: Lars
authors.initials: L
authors.lastname: Osterberg
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Maldonado
authors.forename: Arjan
authors.initials: A
authors.lastname: Harxhi
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000415:Albania; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006306:Health Surveys; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D010594:Pharmacies; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents