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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Determinants of adherence to highly active antiretroviral therapy among HIV-1-infected patients in Côte d'Ivoire
AIDS, Volume 21, No. 13, Year 2007
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Description
OBJECTIVE: To assess adherence to HAART and to determine factors associated with poor adherence among HIV-1-infected patients in Abidjan, Côte d'Ivoire. METHODS: A prospective observational study of 614 consecutive patients attending an HIV/AIDS outpatient clinic. Adherence was measured twice at 3-month intervals by self-report of missing doses over 4 days. An adherence level of less than 95% was defined as poor adherence. We used generalized estimating equation models for binomial distribution with repeated measures for data analysis. RESULTS: Of the 591 subjects who completed the study, 74.3% reported adherence levels of 95% or greater. Six factors were independently related to poor adherence: age less than 35 years [relative risk (RR) 1.45; 95% confidence interval (CI) 1.17-1.79], absence of social support (RR 1.66; 95% CI 1.24-2.24), number of daily pills 10 or more (RR 1.47; 95% CI 1.14-1.91), time of adherence assessment (first versus second time assessment RR 1.36; 95% CI 1.12-1.66), CD4 cell count of 250 cells/μl or greater (RR 1.43; 95% CI 1.10-1.88), and not being less worried about HIV infection now that treatments have improved (RR 1.26; 95% CI 1.01-1.58). Drug supply interruptions in the pharmacies were reported by 10.0% of the non-adherent patients as the reason for missing pills. CONCLUSION: Psychosocial factors were found to impact adherence and should be analysed in more detail by further studies. Scaling up antiretroviral therapy in sub-Saharan Africa should be preceded by reliable drug supply and distribution systems. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Diabaté, Souleymane
Cote D'ivoire, Abidjan
Unité de Soins Ambulatoires et de Conseils
Canada, Quebec
Université Laval
Canada, Quebec
Chu de Québec-université Laval
Alary, Michel
Canada, Quebec
Université Laval
Canada, Quebec
Chu de Québec-université Laval
Canada, Quebec
Institut National de Sante Publique du Québec
Canada, Quebec
Le Réseau de L'université du Québec
Koffi, Constance Kanga
Cote D'ivoire, Abidjan
Unité de Soins Ambulatoires et de Conseils
Statistics
Citations: 91
Authors: 3
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0b013e3282a5667b
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
Ivory Coast