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There are limited published investigations about
adherence to antiretroviral and its determinants. Many determinants influence on
adherence to therapy. The effects of some determinants on adherence are
controversial. More studies are needed to be fulfilled about adherence and its
determinants to compile strategies. Key to the success of antiretroviral
therapies is the ability and willingness of HIV-positive individuals to adhere to antiretroviral
regimens. There are
different definitions for full adherence. In the most studies, adherence is defined as taking ≥95% of prescribed medication.
Adherence rate needs to be >95% to prevent virologic failure and for complete supper-ssion.
The consequences of poor adherence include not only diminished benefits for the
patient, but also the public health threat of the emergence of
multidrug-resistant viruses, as these resistant strains can then be transmitted
from a patient to their contacts. Evaluating adherence has proven to be
difficult and
there is no gold standard for evaluating adherence to medication. Adherence is assessed
in various ways. The most studies evaluate adherence to treatment by
using patient's self report and the pill count
method but these are methods known to overestimate adherence. Some determinants
are associated with adherence include: age, gender, addiction specially
injection drug users, alcohol consumption, depression, social support, level of
education, work situation, adverse antiretroviral effects, pregnancy, type of
antiretroviral drug regimen, number of pills and daily doses received, severe traumas, social and psychological factors,
and relationship between clinician and patient.0
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