Research Article: Non-adherence to anti-retroviral medication in Shiraz, 2014: a cross sectional study

Date Published: June , 2018

Publisher: Makerere Medical School

Author(s): Nasrin Motazedian, Mehrab Sayadi, Ali Firoozbakhtian.


Medication adherence is a dynamic and complex behavioral process, which is strongly influenced by personal, social and environmental factors.

To determine the prevalence and factors affecting non-adherence to medication among HIV-infected patients.

A cross-sectional study.

Voluntary Counseling and Testing Center (VCT), Shiraz, Fars province, in the South of Iran.

Among HIV-positive patients who received anti-retroviral therapy, 214 adult patients were selected through convenience sampling. Their medication adherence was checked by interview and counting the pills on visits during two months. Clinical and laboratory data were obtained from the patients’ records.

Non-adherence and adherence groups included 30.4% (65) and 69.6% (149) of the patients, respectively. The mean age of patients was 40.80±7.77 years, and ranged from 20 to 65 years. Majority of cases (65%) were male. A significant relationship was found between non-adherence to medications and the variables of transmission method, marital status, housing status, and CD4, but there was no significant relationship with gender.

The prevalence of medication adherence was similar to other regions with limited financial resources. To increase patient’s medication adherence, they should be exposed to motivational interventions to promote their drug consumption, social and occupational support.

Partial Text

Background: Anti-retroviral medication suppresses viral replication in HIV-infected individuals. Evidence shows that broader and earlier commencement of ART can reduce HIV rate1. High level drug adherence for a long period of time is necessary to suppress viruses2. Medication adherence is a dynamic and complex behavioral process, strongly influenced by the personal, social and environmental circumstances3.

Study design: This was an analytical cross-sectional study.

Participants: This study was designed to investigate factors influencing non-compliance to medication in patients with HIV/AIDS in Shiraz, Iran. A total of 214 patients were divided into two groups according to medication adherence or non-adherence, and were compared.

Key results: In this study, the prevalence of adherence was evaluated and the factors involved in both groups were compared. The rate of non-adherence in the present study was 30.4%.

This is a cross sectional study, which was conducted in one center and might not be applicable for other regions.

The rate of medication adherence in this study was similar to other regions with limited financial resources. Therefore, to increase adherence, patients should be exposed to motivational interventions for drug consumption and social and occupational support. Medication and medical care should be widespread, provide more over the phone and social workers services. Since medication adherence is a dynamic process and changes over time, it is suggested to design a longitudinal study to achieve better results and higher adherence to drug therapy through monitoring medication and understanding the factors involved in non-adherence in bigger sample sizes over time.




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