Prevalence of non-adherence to highly active antiretroviral therapy and its related clinical and therapeutic factors in Ouagadougou (Burkina Faso).

Introduction : Non-adherence to highly active antiretroviral therapy is deleterious in HIV/AIDS programs. This study contributes to the identification of its frequency and of the clinical and therapeutic factors that determine it. Material and methods : This cross-sectional study took place from December 15, 2013, to February 18, 2014, at the Saint Camille health care center and the Pietro Annigoni biomolecular research center in Ouagadougou. It includes adults who had been receiving antiretroviral therapy for at least three months and agreed to participate. The Chi-square test or Fisher's test was used to compare proportions in the univariate analysis. A logistic regression model was applied for the multivariate analysis. P values less than 0.05 were considered significant.

RESULTS: The study included 152 patients. Their mean age was 40.7±7.8 years, and the sex-ratio 0.3. The frequency of non-adherence to antiretroviral therapy was 38.2%. In the univariate analysis, laboratory and clinical factors associated with non-adherence were severe immune depression (P=0.03), opportunistic infections (P=0.001), and lack of clinical improvement (P=0.001), while the therapeutic factors associated with it were inadequate knowledge (P=0.001), side effects (P=0.003), and using the treatment secretly (P=0.001). In the multivariate analysis, opportunistic infections (OR=13.51, 95% CI 3.15-58.82, P=0.000), lack of clinical improvement (OR=4.16, 95% CI 1.06-16.32, P=0.04), inadequate knowledge (OR=16.12, 95% CI 1.67-166.66, P=0.01), and secret treatment use (OR=11.36, 95% CI 3.18-40.00, P=0.000) remained associated with non-adherence.

CONCLUSION: The study underlines the need to improve strategies for the prescription of this therapy and for reinforcing patients' education and support.