title: Adherence to highly active antiretroviral therapy in Hyderabad, India: barriers, facilitators and identification of target groups.
abstract: We assessed the barriers and facilitators to highly active antiretroviral therapy adherence and determined their prevalence among HIV/AIDS patients in Hyderabad, India. We conducted a cross-sectional study among HIV-infected adults prescribed highly active antiretroviral therapy and receiving care from nine clinics. Depression was screened using Patient Health Questionnaire 9 and facilitators of HIV medication adherence were assessed using an 11-item scale which yielded a total positive attitude to disease score. Prevalence ratios of non-adherence between different categories of potential risk factors were calculated. We compared mean 'facilitators to adherence' scores between the adherent and non-adherent population. Multivariable Poisson regression with robust variance was used to identify independent risk factors. Among the 211 respondents, nearly 20% were non-adherent, approximately 8% had either moderately severe or severe depression and mean score for combined facilitators to medication adherence was 33.35 (±7.88) out of a possible 44 points. Factors significantly associated with non-adherence included older age, female sex worker, moderate-to-severe depression and the combined facilitators to medication adherence score. These data from a broad range of clinical settings in Hyderabad reveal that key groups to focus on for adherence intervention are female sex workers, older persons and those with depression.
authors: School of Public Health, University of Illinois at Chicago, Chicago, IL, USA mdworkin@uic.edu.
authors: Mark S
authors: MS
authors: Dworkin
authors: School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
authors: G W
authors: GW
authors: Douglas
authors: SHARE INDIA, Secunderabad, Andhra Pradesh, India.
authors: G P
authors: GP
authors: Sabitha Rani
authors: School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
authors: Apurba
authors: A
authors: Chakraborty
mesh_terms: D000328:Adult; D017677:Age Distribution; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; HIV; Hyderabad; India; adherence; barriers; facilitators; female sex workers; highly active antiretroviral therapy; medication; non-adherence; treatment