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Prevalence, determinants, and impact of suboptimal adherence to HIV medication in 25 countries
- Source :
- Preventive medicine. 139
- Publication Year :
- 2020
-
Abstract
- Modern antiretroviral therapy (ART) has improved the lives of people living with HIV (PLHIV) but currently requires daily adherence. We assessed prevalence and correlates of suboptimal adherence, and measured associations with self-reported health outcomes. Data were from web-based surveys of confirmed HIV+ adults on antiretroviral treatment within 25 countries during 2019 (n = 2389). Suboptimal adherence was a report of ≥1 reason for missing ART ≥5 times within the past month. Multivariable logistic regression examined associations between suboptimal adherence and self-reported overall health and virologic suppression. Overall, 24.1% (575/2389) reported suboptimal adherence, from 10.0% (5/50) in Austria, to 62.0% (31/50) in China. The most common reasons for missing ART ≥5 times in the overall population were feeling depressed/overwhelmed (7.4%, 176/2389), trying to forget about HIV (7.0%, 168/2389), and work (6.1%, 145/2389). Correlates of suboptimal adherence included being heterosexual,50 years old, ≤high school, having gastrointestinal treatment side effects, and privacy concerns. Odds of suboptimal overall health were 1.41 (95%CI, 1.11-1.80), 2.10 (95%CI, 1.65-2.68), and 2.55 (95%CI, 2.00-3.25) among those who reported the maximum number of times missed ART for any reason within the past month as 1, 2-4, or ≥5 times respectively, vs not missing at all. Odds of virologic nonsuppression were 1.80 (95%CI, 1.33-2.45), and 2.24 (95%CI, 1.66-3.02) for 2-4, or ≥5 times of missed ART respectively, vs not missing at all; missing for only 1 time was not significantly associated with virologic nonsuppression. Novel ART strategies designed to improve adherence along with interventions to empower PLHIV and support self-medication may improve health outcomes and quality of life.
- Subjects :
- Adult
China
Epidemiology
Anti-HIV Agents
media_common.quotation_subject
Population
Human immunodeficiency virus (HIV)
HIV Infections
medicine.disease_cause
Health outcomes
Logistic regression
01 natural sciences
Medication Adherence
03 medical and health sciences
0302 clinical medicine
medicine
Antiretroviral treatment
Prevalence
Humans
030212 general & internal medicine
0101 mathematics
education
media_common
education.field_of_study
business.industry
010102 general mathematics
Public Health, Environmental and Occupational Health
Middle Aged
Antiretroviral therapy
VIROLOGIC FAILURE
Feeling
Quality of Life
business
Demography
Subjects
Details
- ISSN :
- 10960260
- Volume :
- 139
- Database :
- OpenAIRE
- Journal :
- Preventive medicine
- Accession number :
- edsair.doi.dedup.....431c31076ee7d33cdb12357ca1551114