Adherence to Antiretroviral Therapy Among HIV Patients in India: A Systematic Review and Meta-analysis

  • Apurba ChakrabortyEmail author
  • Ronald C. Hershow
  • Dima M. Qato
  • Leslie Stayner
  • Mark S. Dworkin
Original Paper


We conducted a systematic review and meta-analysis to estimate the prevalence of adherence to antiretroviral therapy (ART) in India, the third largest HIV epidemic in the world. We identified peer reviewed literature published between 2007 and 2017 to extract data on ART adherence. We estimated pooled prevalence of adherence to ART using a random-effects model. Thirty-two eligible studies (n = 11,543) were included in the meta-analysis. Studies were mostly clustered in the southern and western Indian states. Overall, 77% (95% Confidence Interval 73–82; I2 = 96.80%) of patients had optimum adherence to ART. Women had higher prevalence of optimum adherence compared to men. Depression or anxiety were significant risk factors in seven of the fifteen studies reporting determinants of nonadherence. Studies should be performed to explore the reasons for gender gap in ART adherence and HIV program in India should prioritize mental health issues among HIV patients to improve ART adherence.


HAART Antiretroviral therapy Adherence Compliance India 



We would like to thank Ms. Rosie Hanneke in developing the literature search strategy and Dr. Shimu Paul for her contribution in identifying eligible studies and in data abstraction.


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Authors and Affiliations

  1. 1.Division of Epidemiology and BiostatisticsUniversity of Illinois At Chicago School of Public HealthChicagoUSA
  2. 2.University of Illinois At Chicago College of PharmacyChicagoUSA

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