Factors associated with suboptimal adherence to antiretroviral therapy in Viet Nam: a cross-sectional study using audio computer-assisted self-interview (ACASI)

BMC Infectious Diseases

Kinh V Nguyen²  Cuong V Pham³  Masaya Kato⁴  Michael P Dunne¹  Hoa M Do³ 

[1] Queensland University of Technology, School of Public Health, Brisbane, Australia;National Hospital for Tropical Diseases, Hanoi, Viet Nam;Hanoi School of Public Health, Hanoi, Viet Nam;World Health Organization Representative Office in Viet Nam, Hanoi, Viet Nam

关键词: Viet Nam;    Substance use;    Depression;    Antiretroviral therapy;    Adherence;    ACASI;   

Others  :  1149101
DOI  :  10.1186/1471-2334-13-154

 received in 2012-07-13, accepted in 2013-03-21,  发布年份 2013

【 摘 要 】

Background

Optimal adherence to antiretroviral therapy (ART) is necessary for people living with HIV/AIDS (PLHIV). There have been relatively few systematic analyses of factors that promote or inhibit adherence to antiretroviral therapy among PLHIV in Asia. This study assessed ART adherence and examined factors associated with suboptimal adherence in northern Viet Nam.

Methods

Data from 615 PLHIV on ART in two urban and three rural outpatient clinics were collected by medical record extraction and from patient interviews using audio computer-assisted self-interview (ACASI).

Results

The prevalence of suboptimal adherence was estimated to be 24.9% via a visual analogue scale (VAS) of past-month dose-missing and 29.1% using a modified Adult AIDS Clinical Trial Group scale for on-time dose-taking in the past 4 days. Factors significantly associated with the more conservative VAS score were: depression (p < 0.001), side-effect experiences (p < 0.001), heavy alcohol use (p = 0.001), chance health locus of control (p = 0.003), low perceived quality of information from care providers (p = 0.04) and low social connectedness (p = 0.03). Illicit drug use alone was not significantly associated with suboptimal adherence, but interacted with heavy alcohol use to reduce adherence (p < 0.001).

Conclusions

This is the largest survey of ART adherence yet reported from Asia and the first in a developing country to use the ACASI method in this context. The evidence strongly indicates that ART services in Viet Nam should include screening and treatment for depression, linkage with alcohol and/or drug dependence treatment, and counselling to address the belief that chance or luck determines health outcomes.

【 授权许可】

   
2013 Do et al.; licensee BioMed Central Ltd.

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