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Adherence to antiretroviral therapy for HIV in sub-Saharan Africa and Asia: a comparative analysis of two regional cohorts

Bijker R 1 , Jiamsakul A 2 , Kityo C 3 , Kiertiburanakul S 4 , Siwale M 5 , Phanuphak P 6 Show all authors , Akanmu S 7 , Chaiwarith R 8 , Wit FW 1 , Sim BL 9 , Boender TS 1 , Ditangco R 10 , Rinke De Wit TF 1 , Sohn AH 11 , Hamers RL 1

Affiliations 

  • 1 Amsterdam Institute for Global Health and Development and Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
  • 2 The Kirby Institute, Biostatistics and Databases Program, UNSW Australia, Sydney, NSW, Australia
  • 3 Joint Clinical Research Centre, Kampala, Uganda
  • 4 Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 5 Lusaka Trust Hospital, Lusaka, Zambia
  • 6 HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand
  • 7 College of Medicine, University of Lagos, Lagos, Nigeria
  • 8 Division of Infectious Diseases, Department of Medicine, Research Institute for Health Sciences, Chiang Mai, Thailand
  • 9 Infectious Disease Unit, Department of Medicine, Hospital Sungai Buloh, Sungai Buloh, Malaysia
  • 10 Research Institute for Tropical Medicine, Manila, Philippines
  • 11 TREAT Asia/amfAR, The Foundation for AIDS Research, Bangkok, Thailand
J Int AIDS Soc, 2017 03 03;20(1):21218.
PMID: 28362063 DOI: 10.7448/IAS.20.1.21218

Abstract

INTRODUCTION: Our understanding of how to achieve optimal long-term adherence to antiretroviral therapy (ART) in settings where the burden of HIV disease is highest remains limited. We compared levels and determinants of adherence over time between HIV-positive persons receiving ART who were enrolled in a bi-regional cohort in sub-Saharan Africa and Asia.
METHODS: This multicentre prospective study of adults starting first-line ART assessed patient-reported adherence at follow-up clinic visits using a 30-day visual analogue scale. Determinants of suboptimal adherence (<95%) were assessed for six-month intervals, using generalized estimating equations multivariable logistic regression with multiple imputations. Region of residence (Africa vs. Asia) was assessed as a potential effect modifier.
RESULTS: Of 13,001 adherence assessments in 3934 participants during the first 24 months of ART, 6.4% (837) were suboptimal, with 7.3% (619/8484) in the African cohort versus 4.8% (218/4517) in the Asian cohort (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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