Determinants of non-compliance with antiretroviral therapy in adult patients in Kinshasa

Introduction: the purpose of this study was to identify the determinants of non-compliance of persons living with HIV with antiretroviral treatment in Kinshasa. Methods: we conducted a cross-sectional study in Kinshasa from 1st May to 31st August 2015. The study population was composed of patients aged at least 18 years living with HIV who had been treated with antiretroviral drugs for at least 3 months. Adherence Index (subjective method) and prescription refills (objective method) were used to assess compliance. Determinants of non-compliance were identified by logistic regression model. Results: the 400 patients living with HIV had a median age of 43 years (18-75). Global non-compliance rate was 25.5%. Objective non-compliance rate was higher than that of subjective non-compliance (29% vs 21%, p = 0.01). Payment for consultation [adjusted odds ratio (AOR): 1.70; 95% confidence interval (95% CI): 1.02-2.81; p = 0.042), adverse reactions (AOR: 2.23; 95% CI: 1.33-3.75; p = 0.002) and the lack of awareness that missing a dose may worsen disease (AOR: 4.16; 95% CI: 1.04-16.68; p = 0.045) were determinants of non-compliance. Having trusted person was a protective factor versus non-compliance (AOR: 0.54; 95% CI: 0.39-0.93; p = 0.004). Conclusion: the rate of non-compliance with antiretroviral treatment is high in Kinshasa. The evaluation of determinants is necessary to establish strategies for improving compliance.