HIV drug compliance related to social support & age

Younger age, lack of social support and complex regimens contribute to poor adherence to antiretroviral therapy among HIV patients. Researchers from the University of Basel, Switzerland found that adherence to antiretroviral drug regimens is important and the treatment needs to be closely monitored for indications of disease progression, such as an increase in viral load and a decrease in CD4 cell levels. The researching team used data from the Swiss HIV Cohort Study to determine the prevalence of self-reported adherence to antiretroviral therapy and to explore relationships among socioeconomic, patient, and systematic factors related to adherence. Nearly one third of patients admitted missing at least one dose of medication in the four weeks preceding their questionnaire. About 15 percent reported missing at least two doses, and 7 percent said they took less than 95 percent of prescribed antiretroviral therapy doses. Increases in missed doses correlated with increases in viral load and decreases in CD4 cell count. Regardless of the definition of adherence used, patients who were younger, lived alone, had been on more previous antiretroviral therapy regimens and received a boosted protease inhibitor regimen, were significantly more likely not to adhere to therapy. Patients with optimal viral suppression in the previous six months and those with increases in CD4 cell counts were more likely to have adhered to treatment. Adherence ranged among centres between 26 percent and nearly 42 percent (average 31 percent). This observed effect suggests that system factors related to how care is organised and provided are also associated with non-adherence.