Factors Affecting Adherence to Antiretroviral Treatment among HIV/AIDS Patients in Turkey

Introduction: Adherence to antiretroviral treatment (ART) is critical for the success of Human Immunodeficiency Virus (HIV) infection treatment. There is no approved consensus that defines adherence. In this study, it was aimed to examine the adherence rate of our patients with high-efficacy ART and to determine the factors affecting treatment adherence. Materials and Methods: Seventy-two patients admitted to the study between January 1, 2018 and July 31, 2018 with the diagnosis of HIV/AIDS who received ART for at least three months and agreed to participate in the study were included in the study. The effect of treatment adherence was investigated by examining the sociodemographic and clinic characteristics and laboratory findings, and moods of the patients. Treatment adherence of the patients was evaluated with the Center for Adherence Support Evaluation (CASE) adherence questionnaire and pill counting method. The Hamilton Depression Rating Scale questionnaire was used to investigate the effect of depression severity on treatment adherence in patients. Results: Of the patients, 72.2% were males and 27.8% were females. Mean age of the patients was 44.9 ± 14.8 years. Of the patients, 59.7% were defined as treatment compatible. Sixty (83.3%) patients used a single tablet regimen. The most commonly used combination was tenofovir alafenamide-emtricitabine-elvitegravir-cobicistate. Patients’ age, disease duration, frequency of follow-up clinic, depressive mood, substance use, and HIV positivity in their partners were found effective on treatment adherence. However, sex, marital and educational status, occupation, residential area, transmission route, duration on ART, ART regimen, ART treatment revision, recent CD4+ T lymphocyte count, recent viral load, side effect, additional treatments, antibiotic prophylaxis, smoking habit, alcohol use, comorbidity, co-infection were not statistically associated with treatment adherence. Conclusion: Sufficient awareness should be created by allocating enough time to patients, and patients should be followed up more frequently. Since alcohol and substance use affects treatment adherence, support should be sought from relevant institutions to limit alcohol and substance use in patients. Depressive mood is more common in HIV/AIDS patients compared to the normal population and negatively affects treatment adherence.