Risk factors affecting adherence to antiretroviral therapy among HIV patients in Manila, Philippines: a baseline cross-sectional analysis of the Philippines Connect for Life Study
Cara O’Connor
A B C H , Katerina Leyritana A , Kris Calica A , Randeep Gill D , Aoife M. Doyle B , James J. Lewis E and Edsel Maurice Salvaña F G
A Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines.
B London School of Hygiene and Tropical Medicine, London, UK.
C Wits Reproductive Health and HIV Research Institute, Johannesburg, South Africa.
D Johnson & Johnson Global Public Health, London, UK.
E Y Lab, The Public Services Innovation Lab for Wales, School of Social Sciences, Cardiff University, UK.
F Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila, Ermita, Philippines.
G Section of Infectious Disease, Department of Medicine, University of the Philippines College of Medicine, University of the Philippines Manila, Ermita, Philippines.
H Corresponding author. Email: coconnor@ship.ph
Sexual Health 18(1) 95-103 https://doi.org/10.1071/SH20028
Submitted: 6 May 2020 Accepted: 26 October 2020 Published: 2 March 2021
Journal Compilation © CSIRO 2021 Open Access CC BY
Abstract
Background: The Philippines HIV epidemic is one of the fastest growing, globally. Infections among men who have sex with men (MSM) are rising at an alarming rate, necessitating targeted evidence-based interventions to reach epidemic control. Treatment as prevention is a key strategy to end AIDS, making it a priority to explore novel approaches to retain people living with HIV (PLHIV) in care, support adherence, and reach viral suppression. Methods: This cross-sectional analysis describes HIV-related risk behaviours and adherence to antiretroviral therapy (ART) in a population of HIV-positive patients at a clinic in Metro Manila, Philippines participating in the Philippines Connect for LifeTM cohort study. Results: Among 426 HIV-positive adults taking ART, 79% reported ≥95% adherence over the prior 30 days. Longer time on treatment was associated with reduced adherence to ART (adjusted odds ratio (AOR) = 0.87 per year, P = 0.027). Being in a serodiscordant relationship, in which the subject’s primary partner was HIV negative, increased adherence (AOR = 3.19, P = 0.006). Inconsistent condom use (AOR = 0.50, P = 0.103) and injection drug use (AOR = 0.54, P = 0.090) are potentially associated with reduced adherence to ART. Patients used drugs and alcohol at significantly higher rates than the general population.? Conclusions: The study found that patients in this setting require intervention to address treatment fatigue. Interventions to improve social support of PLHIV, as well as harm-reduction approaches for drug and alcohol use, could improve adherence in this population, strengthening the test-and-treat strategy to control the epidemic.
Keywords: adherence, antiretroviral therapy, Asia, evidence-based policy, harm reduction, HIV/AIDS, men who have sex with men, people living with HIV, Philippines.
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