Primary Care for HIV-Infected Patients in Resource-Limited Settings

  • Authors: Charles van der Horst, MD; F. Parker Hudson, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 9/4/18 (What's New)

Summary

  • Attaining and sustaining high-level adherence to ART are critical for achieving an optimal clinical response and maximizing the benefits of ART
  • Barriers to adherence to HIV treatment in the developing world include pill burden, adverse events, HIV-related stigma, suspicion of medical authorities, clinic wait times, comorbidities, costs of care, distances to clinic, interruptions in medication supply, and competing work and family responsibilities[Mukherjee 2006; Mills 2006; Chander 2006; WHO ART]
  • Adherence can be improved by minimizing financial costs to patients,[Mukherjee 2006] psychosocial interventions and community-based approaches to healthcare delivery,[Rich 2012; Ware 2009] improving drug supply,[WHO ART] use of simpler, better-tolerated regimens,[Simoni 2006; Amico 2006; Kent 2003] directly observed therapy,[Hart 2010; Pearson 2006; Pearson 2007; Farmer 2001] and reminders[Pop-Eleches 2011]

Action required

Keywords: Adherence, Initial Antiretroviral Therapy, Resource-Limited Settings, Special Populations, Treatment Complications

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