Backgrounds:Currently in Kyrgyzstan,ART(antiretroviral therapy)is freely provided to HIV-infected individuals on clinical grounds.Strict adherence to ART is required,it improves HIV-infected individuals’survival and ...Backgrounds:Currently in Kyrgyzstan,ART(antiretroviral therapy)is freely provided to HIV-infected individuals on clinical grounds.Strict adherence to ART is required,it improves HIV-infected individuals’survival and quality of life,prevents HIV transmission and drug resistance.Our study aims to identify the prevalence of non-adherence to ART therapy and factors associated with it so that strategies can be designed to help maintain adherence.Methods:In a retrospective cohort study,we enrolled randomly selected 432 individuals,≥18 years of age,from among all HIV-infected individuals in Kyrgyzstan(n=950)who started ART during Jan.2014-Sep.2016.All were followed up until Dec.2016.Non-adherents were:(1)individuals lost to follow-up;(2)individuals who missed≥4.5 days of treatment per 30 days during the study period-this was established by comparing the total tablets prescribed,dates of visits for treatment,and number of tablets consumed.We reviewed the country’s HIV surveillance data and medical facilities records.We collected information on the known non-adherent risk factors,HIV clinical presentation,and details of treatment-regimens.We used logistic regression to assess the risk factors and non-adherent associations.Results:The overall non-adherence rate was 50%(214/432).In sub-group analysis,the highest rate was:61%(50/82)among alcohol abusers,60%(65/109)in those who received≥2 tablets/dose,59%(44/75)in those receiving≥2 doses/day,57%(89/155)in drug users,and 53%(144/271)in individuals aged<40 years.In multivariate analysis,≥2 tablets/dose(OR=2.1,95%CI 1.0-4.1),age<40 years(OR=1.7,95%CI 1.1-2.6),and alcohol abuse(OR=1.6,95%CI 1-2.8)were associated with non-adherence.Conclusion:The observed non-adherence rate is unacceptably high.Adherence can be improved by introducing the one tablet/day treatment regimen,establishing regular contact with those under ART,and providing them with appropriate counseling,especially those<40 years of age or with substance abuse.展开更多
文摘Backgrounds:Currently in Kyrgyzstan,ART(antiretroviral therapy)is freely provided to HIV-infected individuals on clinical grounds.Strict adherence to ART is required,it improves HIV-infected individuals’survival and quality of life,prevents HIV transmission and drug resistance.Our study aims to identify the prevalence of non-adherence to ART therapy and factors associated with it so that strategies can be designed to help maintain adherence.Methods:In a retrospective cohort study,we enrolled randomly selected 432 individuals,≥18 years of age,from among all HIV-infected individuals in Kyrgyzstan(n=950)who started ART during Jan.2014-Sep.2016.All were followed up until Dec.2016.Non-adherents were:(1)individuals lost to follow-up;(2)individuals who missed≥4.5 days of treatment per 30 days during the study period-this was established by comparing the total tablets prescribed,dates of visits for treatment,and number of tablets consumed.We reviewed the country’s HIV surveillance data and medical facilities records.We collected information on the known non-adherent risk factors,HIV clinical presentation,and details of treatment-regimens.We used logistic regression to assess the risk factors and non-adherent associations.Results:The overall non-adherence rate was 50%(214/432).In sub-group analysis,the highest rate was:61%(50/82)among alcohol abusers,60%(65/109)in those who received≥2 tablets/dose,59%(44/75)in those receiving≥2 doses/day,57%(89/155)in drug users,and 53%(144/271)in individuals aged<40 years.In multivariate analysis,≥2 tablets/dose(OR=2.1,95%CI 1.0-4.1),age<40 years(OR=1.7,95%CI 1.1-2.6),and alcohol abuse(OR=1.6,95%CI 1-2.8)were associated with non-adherence.Conclusion:The observed non-adherence rate is unacceptably high.Adherence can be improved by introducing the one tablet/day treatment regimen,establishing regular contact with those under ART,and providing them with appropriate counseling,especially those<40 years of age or with substance abuse.
