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Impact of COVID-19 on Adherence to Treatment in Patients with HIV
Pablo Carbonero-Lechuga1, Javier Castrodeza-Sanz1,2,3, Iván Sanz-Muñoz3
1Department of Preventive Medicine and Public Health, University of Valladolid, 47005 Valladolid, Spain.
Insights
The COVID-19 pandemic did not significantly impact human immunodeficiency virus (HIV) treatment adherence. Patient age and adverse drug reactions were key factors influencing adherence, highlighting the need for targeted interventions.
Area of Science:
- Infectious Diseases
- Public Health
- Pharmacology
Background:
- Treatment adherence is crucial for managing human immunodeficiency virus (HIV).
- Factors influencing adherence include adverse effects, comorbidities, and social support.
- The COVID-19 pandemic presented a novel challenge to healthcare access and patient routines.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on antiretroviral treatment adherence in HIV patients.
- To identify sociodemographic, clinical, and pharmacological factors associated with adherence before and after the pandemic.
Main Methods:
- An observational retrospective study analyzed adherence using the simplified medication adherence questionnaire (SMAQ) and medication possession rate.
- Statistical analyses included chi-squared and Student's t-tests to compare adherence before and after the pandemic.
- Variables examined included age, sex, occupation, treatment regimen, viral load, COVID-19 status, and adverse drug reactions (ADRs).
Main Results:
- No statistically significant difference in adherence was observed before and 22 months after the pandemic's onset.
- Patient age (under 45 years) was associated with lower adherence in both periods.
- Adverse drug reactions impacted adherence before the pandemic but not significantly afterwards.
Conclusions:
- The COVID-19 pandemic did not alter adherence levels to antiretroviral therapy in the studied HIV patient cohort.
- Patient age and the occurrence of adverse drug reactions remain significant determinants of treatment adherence.
- The simplified medication adherence questionnaire (SMAQ) proved effective in assessing adherence.
Abstract:
In patients with human immunodeficiency virus (HIV), adherence to treatment is affected by the adverse effects of treatment, the presence of additional comorbidities, the complexity of dosage, and family and community support. However, one recent circumstance that was likely to have influenced therapeutic adherence was the COVID-19 pandemic and the applied containment measures. An observational retrospective study of a sample of patients with HIV was conducted to establish the relationship between sociodemographic, clinical, and pharmacological variables and therapeutic adherence before and after the pandemic. Adherence was measured using the validated simplified medication adherence questionnaire (SMAQ) and medication possession rate. A statistical analysis was performed to determine the mean, standard deviation, and median of the quantitative variables and the frequencies of the qualitative variables, and the relationship between the dependent and independent variables was analysed using the chi-squared test and Student's t-test. No statistically significant differences were found between treatment adherence measured before and 22 months after the start of the pandemic. Sex, occupation, treatment regimen, viral load levels, and COVID-19 disease status did not influence adherence during either period. However, the age of patients with HIV had an impact on adherence during both periods (p = 0.008 and p = 0.002, respectively), with the age group under 45 years being less adherent. In addition, experiencing adverse drug reactions (ADRs) was shown to have an impact on adherence before the pandemic (p = 0.006) but not afterwards. The COVID-19 pandemic was not shown to have an impact on the degree of adherence to antiretroviral treatment in patients with HIV. Instead, adherence was influenced by patient age and ADR occurrence; therefore, measures must be taken in this regard. The SMAQ demonstrated sensitivity in assessing adherence.
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