ART adherence, demographic variables and CD4 outcome among HIV-positive patients on antiretroviral therapy in Chennai, India

Steven A. Safren, N. Kumarasamy, R. James, S. Raminani, S. Solomon, Kenneth H. Mayer

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

This is an analysis of available chart data recorded by HIV counselors and physicians on patient adherence and CD4 count in 304 patients with HIV who were prescribed antiretroviral therapy (ART) in Chennai, India. HIV counselors had categorized the majority of patients' adherence as 'regular' (74.3%), with a significant minority being categorized as 'irregular' (17.8%), or 'recently missed some doses' (6.9%). Those categorized as 'irregular' had significantly lower CD4 counts than those classified as 'regular'. Adherence was not associated with any demographic variable; however, it was associated with current CD4 and with change in CD4 since initiation of ART. This association was significant over and above the effects of time on ART. The most common reason for non-adherence was cost (32%), followed by the inability to return for a refill (i.e., patients who were unable or refused to obtain medicines elsewhere) (7.5%). These data suggest that although most patients in this Indian cohort reported regular adherence to ART, a subset admitted to less than regular adherence to ART, and those who admitted to less than regular adherence had worse CD4 outcomes. These data do not support concerns about adherence as a reason to withhold ART in developing countries, nor do they support claims that patients in India who struggle with adherence would be unwilling or unable to admit to non-adherence to health care professionals.

Original languageEnglish (US)
Pages (from-to)853-862
Number of pages10
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume17
Issue number7
DOIs
StatePublished - Oct 1 2005
Externally publishedYes

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

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