Determinants of Adherence to Anti-Retroviral Therapy (ART) medication among HIV infected patients: A snapshot study at ART Centre, Odisha

Abstract

Highly active anti-retroviral therapy (HAART) has now transformed HIV pandemic from “virtual death sentence” to a “chronic manageable disease”. An adherence rate of 95% to ART decreases viral suppression to nearly 78% and is thus ear marked as an optimum therapy for viral suppression. The objectives are to estimate the level and associated factors of adherence (with respect to the five WHO dimensions) to ART among HIV positive patients. It was a cross-sectional study carried out at the ART center of a tertiary care teaching hospital. Simple random sampling was done from the new enrollment list of the previous 6 months. A total of 120 respondents were interviewed by a pre-designed semi structured questionnaire and analyzed using SPSS. Majority of the participants (55.1%) aged 26 to 40 years and 57% of them were found to be adherent. Patients aged more than 40 years (OR 11.55), distance < 100 kms from the ART Centre (OR 2.75), dissatisfied with family support (OR 3.42), and those with decreased CD4 count from the previous count (OR 6.56) were found to be highly significantly associated with the probability of being adherent to ART. Adherence to ART was found among 57% among the study subjects. Elderly patients residing nearer to service delivery centre and those at higher risk of morbidity due to lower CD4 count were found to be some of the major determinants of adherence to ART. Link ART centres and LAC Plus Centres with community level awareness programs are recommended.