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ORIGINAL ARTICLE
Year : 2010  |  Volume : 54  |  Issue : 4  |  Page : 179-183

A two-site hospital-based study on factors associated with nonadherence to highly active antiretroviral therapy


1 Assistant Professor, Institute of Health Management Research, Jaipur, India
2 Professor, All India Institute of Medical Sciences, New Delhi, India
3 Professor and Head of Medicine, Lok Nayak Jai Prakash Hospital, New Delhi, India
4 Associate Professor, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Vivek Lal
Assistant Professor, Institute of Health Management Research, 1, Prabhu Dayal Marg, Sanganer Airport, Jaipur-302011
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-557X.77256

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Objectives : To describe the pattern of adherence to Highly Active Antiretroviral therapy (HAART) and ascertain the factor(s) associated with nonadherence. Methods: This was a cross-sectional, two-site, hospital-based study. The study was undertaken in 2005; as a result of phased roll out of free HAART as part of National AIDS Control Program, patients at Lok Nayak Jai Prakash (LNJP) hospital were receiving free HAART, while patients at All India Institute of Medical Sciences (AIIMS) had to bear out-of-pocket expenses for HAART. Adherence was defined as not having missed even a single pill over the previous 4-day period on self-reporting. Results: Adherence at AIIMS was 47%, whereas it was 90% at LNJP. The difference was statistically significant. Multivariate analysis showed that nonadherence was associated with not having been told about the importance of HAART, having to pay out-of-pocket for HAART and reported continued risk behavior post HAART. Conclusion: With the provision of free HAART, adherence is likely to be high. Emphasis should be given on simultaneous recruitment of counselors, and physicians should be made aware about the need to inquire and counsel patients against continued risk behavior.


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