Adherence to Antiviral Therapy in the Elderly with Human Immunodeficiency Virus: a Review Study

Increasing the awareness of physicians and caregivers about human immunodeficiency virus and AIDS, advanced diagnostic methods, comprehensive use of combined antiviral drugs, highly active antiviral therapies and greater tolerance of new drugs compared to older drugs reduce mortality, increase life expectancy, altogether increase the number of elderly people infected with the virus. Improving treatment outcomes is directly dependent on adherence to antiviral therapy. Therefore, recognizing the factors associated with adherence to antiviral therapy is necessary to successfully combat HIV and prevent its spread in society. The aim of this study was to investigate the factors associated with adherence to antiviral therapy in the elderly with HIV.

English language databases including PubMed, Scopus, Google scholar and ISI were reviewed to access related articles. The review was conducted without time limit and on articles published until February 2020. Finally, 15 articles were selected based on the criteria and objectives of the research.

Most studies were conducted in the United States from 2016 onwards. Based on the review of studies, factors related to adherence to antiviral treatment were divided into three categories: structural and social factors, family factors and individual factors.

Recognizing the factors associated with non-adherence to antiviral therapy and performing appropriate interventions is an important step in maintaining and promoting the health of patients and others in the community. Lack of access to health care, economic problems, insufficient awareness and knowledge about HIV and lack of social support are factors influencing adherence to antiviral and modifiable treatment. Therefore, planning and policy-making in relation to increasing care centers, providing material and non-material assistance to patients, providing appropriate training to medical staff, families and patients, empowering patients, screening for mental health problems, including depression for patients can help improve adherence to treatment. In addition, supportive policies should be considered for immutable factors such as elderly women living with HIV, illiterate elderly and the elderly with cognitive impairment and dementia.