Adherence to Antiretroviral Therapy and Tuberculosis Treatment in a Prison of Tehran, Iran.
BACKGROUND
The human immune system can be impaired due to lack of adherence to treatment among HIV positive patients. This is reflected in lower levels of CD4 count and incomplete viral suppression leading to the disease&amp;#039;s progression and increased risks of opportunistic infections. Little is known about adherence to antiretroviral therapy (ART) and Tuberculosis (TB) treatment and barriers to ART adherence faced by prisoners. Therefore, we conducted a study to evaluate adherence to ART, treatment of latent TB infection (LTBI), and TB treatment and barriers of ART adherence in the Great Tehran Prison in 2014.


METHODS
We conducted a study to evaluate adherence to ART, latent TB infection treatment, and TB treatment via Directly Observed Therapy (DOT) among HIV positive patients in the Great Tehran Prison in 2014. Furthermore, we examined the barriers of adherence to ART through focus group discussions (FGDs) with 22 people living with HIV in the prison.


RESULTS
The mean of adherence to ART, latent TB infection treatment, and TB treatment were 93.3%, 92.7% and 93.3%, respectively. Addiction, negative drug reactions, bad experiences with staffs, and psychosocial and nutritional problems were cited as the most common barriers to adherence.


CONCLUSIONS
It is recommended to implement DOT for ART in Iranian prisons. In addition, through removing the barriers and implementation of DOT for ART, HIV positive prisoners can achieve a complete adherence.
Seyed Ahmad
SA
Seyed Alinaghi
Islamic Azad University, Tehran Medical Sciences Branch, Shariati Street, Zargandeh, Tehran, Iran. b_farhoudi@yahoo.com.
Behnam
B
Farhoudi
Minoo
M
Mohraz
Amin
A
Alipour
Raheleh
R
Golrokhy
Mostafa
M
Hosseini
Jamal
J
Miri
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D023801:Directly Observed Therapy; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007492:Iran; D055985:Latent Tuberculosis / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology; D008875:Middle Aged; D011329:Prisoners; D011330:Prisons; D014376:Tuberculosis / Q000188:drug therapy* / Q000382:microbiology
D019380:Anti-HIV Agents; D000995:Antitubercular Agents