Determinants contributing for poor adherence to antiretroviral therapy: A hospital record-based study in Balasore, Odisha

CONTEXT: Over the years, because of the increase in the awareness among the population and strong political will, people have better access to services for diagnosis and treatment of the HIV and it is ensured that their confidentiality is maintained. To attain good results from Antiretoviral therapy (ART), high level of sustained adherence to ART is essential. High level of adherence to ART (at least 95%) is needed to ensure optimal benefits. OBJECTIVE: The objective of the study is to find out the proportion of patients who did not adhere to ART and its associated factors among people living with HIV/AIDS attending ART center of a tertiary care government hospital in Balasore, Odisha. SETTINGS AND DESIGN: This was a hospital record-based study. SUBJECTS AND METHODS: Overall, 131 HIV-positive individuals were selected from hospital records using simple random sampling technique. STATISTICAL ANALYSIS USED: Data analysis used SPSS version 20.0. Chi-square test and logistic regression were used to identify determinants affecting nonadherence to ART. RESULTS: The mean age of the study participants was 33 years ± 7 SD. The study data revealed that 47.3% of the study subjects were on ART for less than 24 months. There was a statistically significant association between duration of ART and adherence rate (P = 0.036), and using logistic regression, we found that patients who were on ART for less than 24 months are 2.1 times more at risk of becoming nonadherent. Of the total, 48% of patients are suffering from the concurrent infection. There was also a statistically significant association found between opportunistic infection and nonadherence to ART. CONCLUSION: This study has shown that the duration of treatment and opportunistic infections were factors associated with nonadherence to medication.