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Year : 2020  |  Volume : 9  |  Issue : 12  |  Page : 6217-6223

What influences adherence among HIV patients presenting with first-line antiretroviral therapy failure (ART failure)? A retrospective, cross-sectional study from a private clinic in Nagpur, India

1 Visiting Research Scholar, AFPI National Center for Primary Care Research and Policy, Bangalore, Karnataka, India
2 Laboratory Technician, Molecular Solutions Care Health, Bangalore, Karnataka, India
3 Chief of Genotyping Services, Molecular Solutions Care Health, Bangalore, Karnataka, India
4 Clinical Director, PCMH Restore Health Center, Bangalore, Karnataka, India
5 Executive Director, PCMH Restore Health Center, Bangalore, Karnataka, India
6 Director and Co-founder, Molecular Solutions Care Health, Bangalore, Karnataka, India
7 Central Indian Institute of Infectious Diseases and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India

Correspondence Address:
Dr. Sanjana Chetana Shanmukhappa
#101, 1st Main, SBM Colony, Anandanagar, Bengaluru, Karnataka - 560024
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jfmpc.jfmpc_1155_20

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Background: Multiple reports show increasing occurrences of ART failure in India. Despite the fact that a significant volume of outpatient and on-going healthcare occurs in private clinics, there are very few studies on adherence from private clinics in India. Objective: To evaluate the factors influencing adherence to ART in patients with first-line ART failure. Materials and Methods: Data were collected from a convenience sample of 139 individuals diagnosed with clinical, immunological or virologic failure from a private HIV clinic in Nagpur, India. A retrospective cross-sectional study was undertaken and data were statistically analysed. Results: Of the 139 patients, 118 (84.9%) were male and 21 (15.1%) were female. 64 (46%) had received pre-treatment and adherence counselling. 81 (58.3%) were not told about the side effects of ART medications and 65 (46.8%) avoided friends and family. Most common reasons for suboptimal adherence by stopping treatment were high cost, alcoholism, choosing non-allopathic medications and depression. Reasons cited for suboptimal adherence due to missed doses included feeling healthy, depression, forgetfulness and busy schedule. A significant association was found between pre-treatment counselling, adherence counselling and being told the importance of lifelong treatment and decreased occurrence of complete stoppage of treatment. Conclusion: This study brings to light some of the predictors of ART failure. Counselling, having a strong support system as well as early identification and tackling of reasons for suboptimal adherence plays an important role in preventing ART failure.

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