Adherence to generic reverse transcriptase inhibitor-based antiretroviral medication at a Tertiary Center in North India

At least 95% adherence to medications is required for sustained response to antiretroviral therapy (ART). In resource constraint restrained settings it is not possible to use electronic methods to determine adherence. We determined adherence during the previous 4 weeks by the recall method in 200 patients (138 males) receiving generic triple drug reverse transcriptase inhibitor-based antiretroviral medications. They were administered a uniform questionnaire to determine the number of time they forgot or were unable to take their medications and the reasons thereof. One hundred and fifty received two and 50 took three pills daily. One hundred and forty-seven did not miss any dose. Fifty-three (26.5%) missed at least one dose during the preceding 4 weeks. Thirty-one took treatment on and off. Seven missed a dose in the preceding 3 days, nine more between the last 3 and 7 days, and six from 1 to 4 weeks. The major reasons for non-adherence were financial constraints, forgetting to take the medication, drug toxicity, lack of access to the drug, fear of getting immune to the benefit of the drug, and to avoid adverse effects. Non-adherence in 26.5% individuals could be an additional factor that can increase the risk of drug resistance.