Antiretroviral adherence in a resource-poor setting
Adherence is key to successful antiretroviral therapy (ART). Many countries with increased HIV prevalence and the greatest need for ART have limited health resources. Recent assumptions that the adherence required for successful ART will not be achieved in resource-poor settings have led to calls for caution in expanded access programs. New studies from Africa refute this, showing excellent adherence and virologic outcomes. Major factors contributing to adherence or nonadherence are whether the drug is accessed for free or is self-funded, patient preparedness for use of ART, stigmatization related to being HIV-positive, and ease of use of regimen.
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 8.Attaran A, Freedburg KA, Hirsch M: Dead wrong on AIDS. Washington Post. June 15, 2001; Op-Ed section:A33.Google Scholar
- 10.PetrellaP, Brenner B, Loemba H, Wainberg MA: HIV drug resistance and implications for the introduction of antiretroviral therapy in resource-poor countries. Drug Resist Updat 2001, 4:339–346. This review paper examines the impact of structured antiretroviral delivery and adherence on viral resistance.PubMedCrossRefGoogle Scholar
- 12.OyugiJH, Byakika-Tusiime J, Charlebois ED, et al.: Multiple validated measures of adherence indicate high levels of adherence to generic HIV antiretroviral therapy in a resource-limited setting. J Acquir Immune Defic Syndr 2004, 36:1100–1102. A short-term study that validates methods of measuring adherence to antiretroviral therapy.PubMedCrossRefGoogle Scholar
- 19.Hacker M, Petersen ML, Enquirez M, Bastos FI: Highly active antiretroviral therapy in Brazil: the challenge of universal access in a context of social inequality. Pan AM J Public Health 2004, 16:78–83.Google Scholar
- 24.Orrell C, Badri M, Wood R: Measuring adherence in a community setting: which measure most valuable? [abstract WePEB5787]. Paper present at the XV International AIDS Conference. Bangkok, Thailand; July 11–16, 2004.Google Scholar
- 25.Michaels D: Adherence data from MSF, Khayelitsha [abstract]. Paper presented at the Second South African AIDS Conference. Durban, Kwazulu-Natal; June 7–10, 2005.Google Scholar
- 32.Laurent C, Ngom Gueye NF, Tidiane Ndour C, et al.: Long-term benefits of highly active antiretroviral therapy in Senegalese HIV-1 infected adults. J Acquir Immune Defic Syndr 2005, 38:14–17. An African government program that shows excellent adherence and virologic outcomes maintained over 3 years.PubMedCrossRefGoogle Scholar