ArticlePloS one2012
Factors influencing adherence to antiretroviral treatment in Nepal: a mixed-methods study.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 5 of them syntheses that pooled it.
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Who cites it
88 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Pooled it
- Adherence to Highly Active Antiretroviral Therapy Among Children in Ethiopia: A Systematic Review and Meta-analysis.AIDS and behavior · 2018Pooled it
- The Role of ARV Associated Adverse Drug Reactions in Influencing Adherence Among HIV-Infected Individuals: A Systematic Review and Qualitative Meta-Synthesis.AIDS and behavior · 2017Pooled it
- Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis.BMC medicine · 2014Pooled it
- Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis.Journal of the International AIDS Society · 2013Pooled it
- Adherence to Early Antiretroviral Therapy: Results From HPTN 052, a Phase III, Multinational Randomized Trial of ART to Prevent HIV-1 Sexual Transmission in Serodiscordant Couples.Journal of acquired immune deficiency syndromes (1999) · 2015Trial
- Trial
- Multi-level experiences of HIV-related stigma among people living with HIV: an institution-based qualitative study.BMC public health · 2026Article
- Article
- Article
- Knowledge and stigma of people living with HIV treated in a medication dispensing unit: a cross-sectional study.BMC public health · 2025Article
- HIV Care Seeking Pathways and Barriers to the Continuum of Care Faced by Persons Living With HIV in Rural Nepal: A Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Incidence of Adverse Drug Reactions Among HIV Patients on Antiretroviral Drugs in Ethiopia: A Systematic Review and Meta-Analysis.AIDS research and treatment · 2025Review
- Lived experiences of adults living With HIV/AIDS receiving antiretroviral therapy at werabe comprehensive specialized hospital in Silte zone, Ethiopia.Frontiers in reproductive health · 2025Article
- 'I take the drugs… to make the sickness to move out of me': key populations' and service provider perspectives about facilitators and barriers to ART adherence and retention in care in Nigeria.Archives of public health = Archives belges de sante publique · 2024Article
- Cross-sectional analysis of factors associated with medication adherence in western Kenya.BMJ open · 2023Article
- Cost-Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan.Healthcare (Basel, Switzerland) · 2023Article
- A qualitative analysis of factors influencing the implementation of antiretroviral treatment adherence policy in Ghana: stakeholders perspective.Health research policy and systems · 2023Article
- Article
- Health and wellbeing of Nepalese migrant workers in Gulf Cooperation Council (GCC) countries: A mixed-methods study.Journal of migration and health · 2023Article
28 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAntiretroviral therapy (ART) is a lifesaver for individual patients treated for Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Maintaining optimal adherence to antiretroviral drugs is essential for HIV infection management. This study aimed to understand the factors influencing adherence amongst ART-prescribed patients and care providers in Nepal.
methodsA cross-sectional mixed-methods study surveying 330 ART-prescribed patients and 34 in-depth interviews with three different types of stakeholders: patients, care providers, and key people at policy level. Adherence was assessed through survey self-reporting and during the interviews. A multivariate logistic regression model was used to identify factors associated with adherence, supplemented with a thematic analysis of the interview transcripts.
resultsA total of 282 (85.5%) respondents reported complete adherence, i.e. no missed doses in the four-weeks prior to interview. Major factors influencing adherence were: non-disclosure of HIV status (OR = 17.99, p = 0.014); alcohol use (OR = 12.89, p = <0.001), being female (OR = 6.91, p = 0.001), being illiterate (OR = 4.58, p = 0.015), side-effects (OR = 6.04, p = 0.025), ART started ≤24 months (OR = 3.18, p = 0.009), travel time to hospital >1 hour (OR = 2.84, p = 0.035). Similarly, lack of knowledge and negative perception towards ART medications also significantly affected non-adherence. Transport costs (for repeat prescription), followed by pills running out, not wanting others to notice, side-effects, and being busy were the most common reasons for non-adherence. The interviews also revealed religious or ritual obstacles, stigma and discrimination, ART-associated costs, transport problems, lack of support, and side-effects as contributing to non-adherence.
conclusionImproving adherence requires a supportive environment; accessible treatment; clear instructions about regimens; and regimens tailored to individual patients' lifestyles. Healthcare workers should address some of the practical and cultural issues around ART medicine whilst policy-makers should develop appropriate social policy to promote adherence among ART-prescribed patients.
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