1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP
October 25 - 29, 2003 Warsaw, Poland
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9TH EUROPEAN AIDS CONFERENCE (EACS) 1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP October 25 - 29, 2003 Warsaw, Poland |
| 10.1 Adherence F5/4 - STUDY OF DETERMINANTS OF NON-ADHERENCE TO ANTIRETROVIRAL DRUG THERAPY IN A RESOURCE-LIMITED SETTING |
| (1) 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria,2 Military Hospital, Awolowo Road, Ikoyi, Lagos, Nigeria,3 Central Public Health Laboratory, Yaba, Lagos, Nigeria,4 Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria |
Background: The Nigerian government recently offered a nationwide accelerated antiretroviral (ARV) drug initiative for 10,000 adults and 5,000 children using generic forms of NVP, 3TC, and d4T at $350.00/patient/year in 25 centres with patients paying only $120/year. Non-adherence and non-compliance are present, posing great challenges to clinical management of the patients.
Objectives: To evaluate reasons of self-reported non-adherence to ARV use, and the predictive value of physicians' estimate of non-adherence.
Methods: Prospective study of HIV/AIDS patients on ARVs in four centers in Nigeria, using self-administered questionnaires and physicians' assessment. Data included sex, age, ARV therapy history, education, socioeconomic status, frequency and reasons of non-adherence, opportunistic infections, CD4 count and weight. Study period was March 2002 to April 2003.
Results: Total 232 patients in four centers, 78% males, 15% CDC stage C. Mean baseline CD4 240±110 cells/ml. Five percent skipped therapy in the 'last one day', 11% in the last one week, 11% ran out of drugs for to 4-7days between visits, and 6% forgot correct regimen. Reasons for non-adherence were: sharing drugs with other patients (12%), peripheral neuropathy (7%), stigmatization (7%), adverse effects (7%), reducing dosage when they felt very well (5%), pill load (4%), fatigue (4%), weight loss (2%), jaundice and diarrhoea. Physician's assessment corresponded to 22% of patients who self-reported, while predictive value of physician's assessment was 35%. Non-adherence was more in males, low-educated, and the low income.
Conclusion: Non-adherence varied with sex, socioeconomic status and others. There is need for regular counseling and monitoring of patients.
Presenting Author: Research Clinician Ernest Ekong, Nigeria HIV/AIDS Research Network, 14 Reeve Road, Flat E 17, Ikoyi,, LG1234, Lagos,, Nigeria, Phone: 23412672374
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