Factors Associated with Antiretroviral Medication Adherence among HIV-Positive Adults Accessing Highly Active Antiretroviral Therapy (HAART) in British Columbia, Canada

2012 | Journal of the International Association of Physicians in AIDS Care

Program(s): Epidemiology and Population Health |
Initiative(s): LISA |

Journal of the International Association of Physicians in AIDS Care (JIAPAC-2012-O'Neil-1545109711423976.pdf

Abstract:

Among those accessing treatment, highly active antiretroviral therapy (HAART) has transformed HIV into a chronic and manageable condition. However, high levels of adherence are required to derive a sustained, long-term clinical benefit. The aim of this study was to examine the predictors of adherence based on prescription refill among persons on HAART in British Columbia, Canada. Methods: This study utilizes data collected between July 2007 and January 2010, as part of the Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort, which is a study of HIV-positive persons who have accessed antiretroviral therapy (ART) in British Columbia. Participants were considered optimally adherent if they were dispensed 95% of their prescribed antiretrovirals. Results: Of a total of 566 participants, only 316 (55.8%) were optimally adherent to HAART. Independent predictors of optimal adherence were increasing age (adjusted odds ratio [AOR] ¼ 1.84, 95% confidence interval [CI]: 1.44-2.33), male gender (AOR ¼ 1.68, 95% CI: 1.07-2.64), and being enrolled in a comprehensive adherence assistance program (AOR ¼ 4.26, 95% CI: 2.12-8.54). Having an annual income <$15 000 (AOR ¼ 0.47, 95% CI: 0.31-0.72) and both former and current injection drug use (AOR ¼ 0.46, 95% CI: 0.29-0.73 and AOR ¼ 0.35, 95% CI: 0.20-0.58, respectively) were independently associated with suboptimal (<95%) adherence. Conclusions: We found that women and people who inject drugs are at increased risk of being suboptimally adherent to HAART. Optimal adherence remains a significant public health and clinical goal in the context of rapidly expanding access to HAART.

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O’Neil C

BC Centre for Excellence in HIV/AIDS

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Factors Associated with Antiretroviral Medication Adherence among HIV-Positive Adults Accessing Highly Active Antiretroviral Therapy (HAART) in British Columbia, Canada

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