Adherence to follow-up care and treatment in HIV patients admitted to a multidisciplinary hospital

Objective. Assessment of the risk structure of non-adherence to follow-up care and treatment for HIV infection in patients admitted to a multidisciplinary hospital.

Materials and methods. The study was conducted using direct written interviews with pre-prepared questionnaires after obtaining informed consent from the respondent. Sixty-eight patients (45 men and 23 women) aged 24 to 73 years were interviewed. Forty-two patients responded to the question about their antiretroviral therapy (ART) status. Twenty-nine patients were receiving treatment continuously, two patients interrupted therapy, and 11 patients were not receiving ART. Undetectable HIV RNA levels were noted in 31 survey reports. Eight patients died. Only one of the eight who died was receiving ART.

Results. The most common signs of cognitive decline were difficulty concentrating, word finding, and memory loss for recent events. Moderate and severe depressive symptoms were detected in 17.6% of respondents, and a positive alcohol abuse screening result was found in 22.5%. High levels of stigma associated with HIV infection were reported by 35.3% of patients. More than a quarter of patients were not receiving ART, and 4.8% of patients interrupted therapy. Statistically significant correlations were found between missed ART doses and forgetfulness (p = 0.000), severity of depressive symptoms (p = 0.002), alcohol abuse (p = 0.004), as well as low self-rated memory (p = 0.001) and health (p = 0.005).

Conclusion. The most significant risks for poor treatment adherence in HIV-infected patients were hostility related to HIV infection, a positive screening result for alcohol abuse, and forgetfulness.