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People with HIV more likely to adhere to their antiretroviral therapy than treatment for other chronic health problems
Michael Carter, 2017-11-07 07:00:00
people have significantly higher levels of adherence to their antiretroviral
therapy than to medication taken for other chronic health problems, Swiss
investigators report in HIV Medicine.
The research also revealed that people living with HIV rated the necessity of their HIV
treatment more highly than therapy for other illness and also had lower levels
of concern about their antiretroviral treatment compared to therapy for
“This is the first
study on HIV-infected patients’ beliefs about all their co-treatment in
comparison with their cART [combination antiretroviral therapy],” comment the investigators. “It is essential to
explore the different beliefs about medicines of comorbid HIV-infected patients
which may influence their medication management strategies and decisions to
adhere to prescribed regimens.”
The success of
antiretroviral therapy means that most HIV-positive people now have an
excellent life expectancy. People living with HIV can expect to survive well into old age and
therefore require treatment for chronic health problems such as cardiovascular
disease, osteoporosis and depression.
the Swiss HIV Cohort hypothesised that people would have differing attitudes
towards their HIV treatment and therapy taken for other conditions.
They therefore designed
a prospective, observational cross-sectional study involving
antiretroviral-treated people taking long-term therapy for at least one other
chronic health problem. After a routine clinic visit, individuals were asked to
complete two standardised questionnaires assessing beliefs about the necessity
of their treatment and their concerns about such therapy. The first
questionnaire explored beliefs about antiretroviral treatment, the second
beliefs about therapy taken for other chronic conditions.
rated on a scale from 1 (low) to 5 (high).
Adherence to HIV
therapy and treatment was also measured. Adherence was defined as not missing
any doses in the previous four weeks.
The survey took
place between 2015 and 2016.
The final study
sample consisted of 105 people. Three-quarters
were men and the median age was 56 years. Half the participants were employed
and 26% had a bachelor’s degree or higher. Almost all (97%) had an undetectable
viral load and median CD4 cell count was 707 cells/mm3. The major
prescribed co-therapies were for cardiovascular disease (79%) and depression
higher proportion of people reported being adherent to their HIV treatment
compared to therapy for co-morbidities (87 vs 75%, p = 0.0001).
The necessity of antiretroviral
therapy was rated much higher than treatment for other chronic health problems
(mean scores: 4.46 vs 2.86, p < 0.0001). Individuals without a university
degree gave higher scores for co-treatment necessity than those with a
counterintuitive result might be a consequence of patients with more education
possibly being more likely to question their doctors’ decisions regarding
co-treatment choices and believing that they know their disease and treatment
options well, and are capable of making educated decisions about their
therapy,” suggest the authors.
were more likely to be concerned about their co-medications than their HIV
therapy (mean scores: 4.09 vs 2.9, p < 0.001).
Taking two or more
co-medications was associated with higher necessity scores (p = 0.041) and
increased concerns (p = 0.036). A higher CD4 cell count was associated with a
higher co-treatment necessity score (p = 0.016).
is needed to explore the association between adherence and patients’
perceptions,” conclude the authors. “Although our findings need confirmation,
they suggest that it could be important to focus on patient beliefs to improve
adherence to co-treatments.”