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

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.