Adherence to Anti-Retroviral Therapy among People Living with HIV and AIDS in Far West, Nepal

Authors

  • Kiran Bam District AIDS Coordination Committee(DACC), District Health Office, Silgadhi, Doti
  • Deepak Kumar Karki National Centre for AIDS and STD Control (NCASC), Kathmandu
  • Shyam Prasad Lohani Department of Public Health, Nobel College, Kathmandu Nepal Drug and Poison Information Centre, Kathmandu
  • Rajshree Thapa AMDA Nepal, Jhapa
  • Umesh Raj Aryal Department of Community Medicine, Kathmandu Medical College
  • Laxmi Raj Pathak Ministry of Health & Population, Kathmandu

DOI:

https://doi.org/10.3126/ajms.v2i1.4290

Keywords:

Adherence, ART, PLHA, Far West, Nepal

Abstract

Objective: Adherence to Anti-Retroviral Therapy is a principal predictor for the success of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) treatment. It remains as a challenge to AIDS treatment and care with the wide spread of the associated risks. The study aims to assess adherence level and factors associated with adherence to Anti-Retroviral Therapy (ART) among people living with HIV and AIDS in Far West, Nepal.

Material & Methods: A cross sectional study was carried out in Far West between May 2009 to September 2009. A total of 176 samples allowed with 95% CI and 5% error proportionately from four ART sites were drawn. Random sampling technique was used to recruit patients. Semi-structured questionnaire schedule adapted from the Adult AIDS Clinical Trials Group (AACTG) was used and pre-tested to collect data on drug adherence. We compared non-adherent patients with adherent patients and associations with key risk factors were determined.

Results: An overall self reported adherence for a month was 84%. Those who were more than 95% adherent responded that use of watch, electronic devices such as mobiles, watch and calendar facilitated them to take the drugs regularly. Improved adherence was significantly determined by time to reach the health faility at terai (OR: 2.86, 1.10-7.47), disclosing of the HIV status (OR: 3.25; 1.02-10.19), the perceived positive benefits of ART (OR: 21.07; 6.79-68.04) and excellent satisfaction with the provider (OR: 13.11; 4.75-36.19). Travel cost more than 2$ (OR: 9.84; 3.44-28.73) was significant barrier to adherence.

Conclusion: Timely detection of non-adherence behaviours and understanding of patients' difficulties with ART could potentially help patients for adherence and therefore improve the treatment outcomes in rural hilly Nepal. Government’s initiatives towards moral support for encouraging to join support group including discussions of side-effects, and everyday problems in sticking to a regimen and financial support to PHLA should be promoted to optimize the adherence rate.

Key Words: Adherence; ART; PLHA; Far West Nepal

DOI: 10.3126/ajms.v2i1.4290

Asian Journal of Medical Sciences 2 (2011) 7-13

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Published

2011-05-14

How to Cite

Bam, K., Karki, D. K., Lohani, S. P., Thapa, R., Aryal, U. R., & Pathak, L. R. (2011). Adherence to Anti-Retroviral Therapy among People Living with HIV and AIDS in Far West, Nepal. Asian Journal of Medical Sciences, 2(1), 7–13. https://doi.org/10.3126/ajms.v2i1.4290

Issue

Vol. 2 No. 1 (2011)

Section

Original Articles

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