Risk Factors for Medication Non-Adherence in an HIV Infected Population in the Dominican Republic
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High levels of medication adherence are central to HIV treatment success. Barriers to medication adherence may differ by cultural setting. We aimed to determine risk factors for medication non-adherence in HIV infected individuals in the Dominican Republic. Adherence was measured in 300 individuals using a visual analog scale assessing the prior month and dichotomized at 95%. High levels of adherence were reported by 228 (76%). Risk factors for non-adherence included heavy alcohol use: 2.5 times odds (95% CI: 1.4–4.5), having children: 2.2 times higher odds (95% CI: 1.1–4.9) and perceptions of less social support related to adherence: 2 times higher odds (95% CI: 1.1–3.6). Culturally appropriate interventions are needed to address alcohol use, which is common in this setting. Parenting may represent a competing demand on time and resources and be an adherence barrier. Self-reported perceived lack of adherence support may be a useful marker for need for adherence interventions.
KeywordsHIV-1 Antiretroviral therapy Adherence Developing world
- 3.Wood E, Hogg RS, Yip B, Harrigan PR, O’Shaughnessy MV, Montaner JS. Effect of medication adherence on survival of HIV-infected adults who start highly active antiretroviral therapy when the CD4 + cell count is 0.200 to 0.350 × 10(9) cells/L. Ann Internal Med. 2003;139:810–6.Google Scholar
- 12.Tuller DM, Bangsberg DR, Senkungu J, Ware NC, Emenyonu N, Weiser SD. Transportation costs impede sustained adherence and access to HAART in a clinic population in Southwestern Uganda: a qualitative study. AIDS Behav 2009.Google Scholar
- 15.Millenium Development Goals. UNICEF. Available at: http://www.unicef.org/republicadominicana/english/overview_12559.htm. Accessed 30 October, 2009.
- 16.Encuesta Demografica y de Salud Republica Dominicana Informe Preliminar. Santo Domingo: Centro de Estudios Sociales y Demograficos; November 2007.Google Scholar
- 19.US Department of Agriculture. Alcoholic Beverages, Chap 9. Dietary Guidelines for Americans. Washington, D.C.: US Government Printing Office; 2005:43-46.Google Scholar
- 25.Carrieri MP, Leport C, Protopopescu C, et al. Factors associated with nonadherence to highly active antiretroviral therapy: a 5-year follow-up analysis with correction for the bias induced by missing data in the treatment maintenance phase. J Acquir Immune Defic Syndr. 2006;41:477–85.PubMedCrossRefGoogle Scholar