Determinants of optimal adherence over time to antiretroviral therapy amongst HIV positive adults in South Africa : a longitudinal study.

Abstract

Highly active antiretroviral therapy (HAART) requires strict adherence to achieve optimal clinical

and survival benefits. A study was done to explore the factors affecting HAART adherence among

HIV positive adults by reviewing routinely collected patient information in the Centre for the

AIDS Programme of Research in South Africa’s (CAPRISA) AIDS Treatment Programme.

Records of 688 patients enrolled between 2004 and 2006 were analysed. Patients were considered

adherent if they had taken at least 95% of their prescribed drugs. Generalized estimating equations

were used to analyse the data. The results showed that HAART adherence increased over time,

however, the rate of increase differed by some of the socio-demographic and behavioural

characteristics of the patients. For instance, HAART adherence increased in both urban and rural

treatment sites over time, but the rate of increase was higher in the rural site. This helped identify

sub-populations, such as the urban population, that required ongoing adherence counseling.