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

• Published in: BMC infectious diseases Vol. 13; no. 1; p. 154
• Main Authors: Do, Hoa M, Dunne, Michael P, Kato, Masaya, Pham, Cuong V, Nguyen, Kinh V
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 27.03.2013; BioMed Central
• Subjects: Acasis; Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Analysis; Anti-HIV Agents - therapeutic use; Audiovisual Aids; Clinics; Cross-Sectional Studies; Depression - complications; Depression - drug therapy; Depression, Mental; Developing countries; Drug Administration Schedule; Female; Health Knowledge, Attitudes, Practice; Highly active antiretroviral therapy; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV patients; Human immunodeficiency virus; Humans; Male; Medical records; Medication Adherence - statistics & numerical data; Middle Aged; Patient compliance; Public health; Self Report; Studies; Substance abuse; Substance-Related Disorders - complications; Substance-Related Disorders - drug therapy; Tropical diseases; Vietnam; Vietnam; Asia; United States > US; Europe; Africa
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-13-154

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. 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). 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). 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.