Research Article
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Published Online: 18 October 2004

Adherence to Antiretroviral Therapy in HIV-Infected Adults in Soweto, South Africa

Publication: AIDS Research & Human Retroviruses
Volume 20, Issue Number 10

Abstract

Little is known about achievable levels of antiretroviral treatment (ART) adherence in resource-limited settings. We conducted a cross-sectional study of adherence among patients at Chris Hani Baragwanath Hospital's Adult HIV Clinic in Soweto, South Africa. Adherence was assessed using a 1-month, self-report questionnaire and was calculated as a ratio of doses taken to doses prescribed. The 66 patients studied had a mean age of 36.1 years, a median duration of ART use of 18 months, and an overall baseline median CD4+ cell count of 200/mm3 (IQR: 114–364). The adherence reported by these patients for the previous month was >95% for 58 patients (88%), 90–95% for 6 (9%) and, <90% for 2 (3%). The main reasons given for missing doses were being away from home (30%), difficulty with the dosing schedules (23%), and running out of pills (12%). Adherence decreased considerably with fear of being stigmatized by the sexual partner (OR = 0.13 95%, CI 0.02–0.70). Plasma HIV RNA levels were <400 copies/ml in the majority of patients (73% of those with adherence >95% and 88% of patients with ≤95% adherence) and the overall median CD4+ cell count rose to 324/mm3 (IQR: 193–510). High adherence and viral suppression are achievable for a significant proportion of HIV-infected patients taking ART in a resource-limited area such as Soweto, South Africa. Strategies to maximize adherence in this setting should emphasize ready access to affordable and simple ART regimens, as well as HIV education programs to help increase awareness and decrease disease stigmatization.

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cover image AIDS Research and Human Retroviruses
AIDS Research & Human Retroviruses
Volume 20Issue Number 10October 2004
Pages: 1053 - 1056
PubMed: 15585095

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Published online: 18 October 2004
Published in print: October 2004

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J. B. Nachega
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205.
D. M. Stein
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205.
D. A. Lehman
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205.
D. Hlatshwayo
Adult HIV Outpatient Clinic, Chris Hani Baragwanath Hospital, Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
R. Mothopeng
Adult HIV Outpatient Clinic, Chris Hani Baragwanath Hospital, Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
R.E. Chaisson
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205.
Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland 21205.
A.S. Karstaedt
Adult HIV Outpatient Clinic, Chris Hani Baragwanath Hospital, Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.

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