Adherence to Antiretroviral Therapy and Its Determinants in HIV Patients in Mashhad, IRAN, 2018: a Prospective Study

Proper adherence to antiretroviral therapy (ART) provides good viral load suppression, while poor adherence can give rise to resistant strains and failure of the treatment.

We performed a prospective cohort study from December 2017 to March 2018. Of 245 patients, 103 of them were compliant with ART. Patient adherence is determined through the self-report method and pill-count method. Pill-count failed, and only self-reports of adherence were used for analysis. In each visit, we gave each patient medication needed for one month’s treatment and asked them to bring back drug-pockets in the next visit. We also ask the number of tablets they did consume in this period. Mean adherence in three months is considered final adherence. Pearson chi-square model was used for analysis.

Mean age ± SD was 40 ± 1.36 years. 44.7% were female. 84.5% of patients are considered adherent (≥ 95% of doses were consumed). Married patients had better adherence (p = 0.04). Age, sex, addiction, imprisonment history, intravenous drug usage were not associated with adherence (p > 0.05). We also extracted previews history of treatment cessation and regimen changes. Efavirenz containing regimens had a higher rate of failure (p = 0.001).

Although the adherence level was acceptable, the lack of a self-report control method might overestimate adherence.