264869 Adherence to Anti-Retroviral (ARV) Medications among HIV+ Adults in Haiti

Monday, October 29, 2012

Sankalp Das, BDS , AIDS Prevention Program,Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Anshul Saxena, BDS , AIDS Prevention Program,Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Jennifer Attonito, MS , AIDS Prevention Program,Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Michele Jean-Gilles, PhD , AIDS Prevention Program, Florida International University, Miami, FL
Brenda Lerner, RN, PsyD , AIDS Prevention Program, Florida International University, Miami, FL
Rhonda Rosenberg, Ph.D. , Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Jessy G. Dévieux, Ph.D. , Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Robert Malow, PhD , AIDS Prevention Program, Florida International University, Miami, FL
Antiretroviral medications (ARV) have enhanced quality of life among HIV-positive people. Adherence to ARV is of paramount importance in attaining optimal health outcomes, yet achieving absolute adherence to ARV is often challenging. Approximately 120,000 people in Haiti are infected with HIV, and no comprehensive study has been conducted to measure ARV drug adherence in this population. A cross-sectional study was conducted with HIV+ Haitian adults participating in a behavioral intervention study (n=257). We examined relationships between psycho-demographic variables and ARV adherence. The sample was 61% female; mean age 35 years (SD = 8.4). The majority (58%) were married or in common-law relationships. Nineteen percent had an HIV-negative partner, 57% did not know their partner's HIV status. Sixty-one percent had < 8th grade education. Thirty-seven percent had an income of <$50 per year, and 33.5% were unemployed. Only 1% reported no food insecurity; 10% reported they went hungry every day, 49% more than 10 days, and 40% one to 10 days monthly. Eighty-three percent reported 100% adherence to ARVs and 17% were partially adherent. Males (90%) reported greater complete adherence than females (77%) (p=0.02). Of partial adherers, 72% had missed their medication in the morning. Seventy-two percent had problems taking their pills at a specified time. We suspected a relationship between food insecurity and ARV adherence, but this was not statistically significant. There was a high rate of ARV adherence in this sample. Gender and time-of-day for taking medications appeared to be important determinants of adherence.

Learning Areas:
Administer health education strategies, interventions and programs
Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Discuss barriers to ARV adherence unique to HIV+ adults in Haiti—e.g., issues related to taking pills at a specified time. Consider reasons that males reported greater ARV adherence than females.

Keywords: Adherence, Antiretroviral Combination Therapy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a graduate student who has worked on this data with the authorization and direction of the Principal Investigator.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.