Factors associated with adherence to therapy among HIV-infected patients in Bangui

Objective: To identify the factors related to good or non-adherence met among patients under highly active antiretroviral therapy (HAART) or cotrimoxazole prophylaxis (CTX) in Bangui. Method: A cross-sectional study was conducted on a sample representative of patients with HIV followed up in two health centres in Bangui. Patients had been under treatment for at least 2 months. Information concerning adherence was collected through a questionnaire and by interview of the patients. The questionnaire was designed to measure if patients with HIV were taking less than the total number of antiretroviral or CTX pills prescribed by their physician. Adherence was measured by the patient self-reported question of taking the drugs during the last 4 days and the remaining pill count (RPC). Results: 141 patients with the criteria of inclusion were questioned; among these, 89 patients under antiretroviral treatment (d4T/3TC/NVP) and 52 patients under cotrimoxazole. In the study, adherence varies from 67.3 to 94.3 %. According to the type of treatment, adherence of the patients under CTX is lower (65.4 %.) than that of the patients under HAART (77.5 %). Adherence was better for the patients who had a personal project and with a need of information on HIV infection. It is worse for the patients with another affection. Conclusion: These results suggest the necessity of assessing and supporting HIV-infected adult's adherence routinely in AIDS care institutions. In addition, the method used to assess adherence must be simple, accessible and low-cost for the countries with limited resources.