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J Int Assoc Provid AIDS Care. 2015 Mar-Apr;14(2):163-71. doi: 10.1177/2325957414539193. Epub 2014 Jun 25.

Predictors of Nonadherence to Antiretroviral Therapy among HIV-Infected Adults in Dar es Salaam, Tanzania.

Author information

1
Management and Development for Health, Dar es Salaam, Tanzania amuya@mdh-tz.org.
2
Harvard School of Public Health, Boston, MA, USA.
3
Department of Epidemiology & Biostatistics, The University of Georgia, Athens, GA, USA.
4
Dar es Salaam City Council, Department of Health and Social services, Dar es Salaam, Tanzania.
5
Northwestern University, Evanston, IL, USA.
6
Management and Development for Health, Dar es Salaam, Tanzania.

Abstract

BACKGROUND:

Adherence rates of ≥95% to antiretroviral therapy (ART) are necessary to maintain viral suppression in HIV-infected individuals. We identified predictors of nonadherence to scheduled antiretroviral drug pickup appointments in a large HIV care and treatment program in Tanzania.

METHODS:

We performed a prospective cohort study of 44, 204 HIV-infected adults on ART between November 2004 and September 2012. Multivariate generalized estimating equation for repeated binary data was used to estimate the relative risk and 95% confidence intervals of nonadherence.

RESULTS:

Nonadherence was significantly greater among patients with high CD4 counts, high body mass indices, males, younger patients, patients with longer durations on ART, and those with perceived low social support.

CONCLUSIONS:

Targeted interventions should be developed to improve ART adherence among healthier, younger, and more experienced patients who are on ART for longer durations within HIV care and treatment programs. Social support for patients on ART should be emphasized.

KEYWORDS:

HIV/AIDS; Tanzania; antiretroviral treatment; nonadherence

PMID:
24966305
DOI:
10.1177/2325957414539193
[Indexed for MEDLINE]

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