Factors associated with antiretroviral medication adherence among HIV-positive adults accessing highly active antiretroviral therapy (HAART) in British Columbia, Canada

Abstract

Background: Among those accessing treatment, highly active antiretroviral therapy (HAART) has transformed HIV into a chronic and manageable condition. However, high levels of adherence are required to derive a sustained, long-term clinical benefit. The aim of this study was to examine the predictors of adherence based on prescription refill among persons on HAART in British Columbia, Canada. Methods: This study utilizes data collected between July 2007 and January 2010, as part of the Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort, which is a study of HIV-positive persons who have accessed antiretroviral therapy (ART) in British Columbia. Participants were considered optimally adherent if they were dispensed ≥95% of their prescribed antiretrovirals. Results: Of a total of 566 participants, only 316 (55.8%) were optimally adherent to HAART. Independent predictors of optimal adherence were increasing age (adjusted odds ratio [AOR] = 1.84, 95% confidence interval [CI]: 1.44-2.33), male gender (AOR = 1.68, 95% CI: 1.07-2.64), and being enrolled in a comprehensive adherence assistance program (AOR = 4.26, 95% CI: 2.12-8.54). Having an annual income <95%) adherence. Conclusions: We found that women and people who inject drugs are at increased risk of being suboptimally adherent to HAART. Optimal adherence remains a significant public health and clinical goal in the context of rapidly expanding access to HAART. © The Author(s) 2012.