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The reality of treatment adherence for NSW’s most marginalized people living with HIV (PLWH): an analysis of factors affecting adherence and the impact of the Bobby Goldsmith Foundation’s (BGF) financial assistance on adherence

The reality of treatment adherence for NSW’s most marginalized people living with HIV (PLWH): an analysis of factors affecting adherence and the impact of the Bobby Goldsmith Foundation’s (BGF) financial assistance on adherence

A number of sociodemographic and psychosocial factors have been associated with non-adherence to Antiretroviral Therapy (ART). This study aimed to assess whether, by paying for medication, Bobby Goldsmith Foundation (BGF) improves the adherence levels of clients at risk of non-adherence due to these factors. Methods: BGF conducted face to face and phone interviews with 300 PLWH in NSW who were current clients assessed as more at risk of non-adherence due to their psychosocial and sociodemographic factors. The survey consisted of two sections. Firstly, participants were asked to provide demographic and lifestyle information. Participants were then asked a number of questions to investigate their adherence to ART over the past month, reasons for non-adherence and whether BGF’s assistance with the copayment of ART improved adherence levels.

Results: 88% of the respondents were male, 11% female and 1% transgender. 30% were born overseas and 4% were indigenous. 5% were homeless and 47% had a diagnosed mental illness. Participant’s self-reporting on adherence varied, with a number of participants reporting 100% adherence when they had ‘only’ missed taking their medication a few times during the month. Age, gender, ethnicity and AOD use were associated with adherence levels and participants ability to follow their doctor’s instructions. The most common reasons participants gave for missing their ARTs were forgetting, being too busy and changing their routine. Participants who were indigenous, were homeless, had frequent AOD use and / or had low literacy rates were most reliant on BGF’s copayment of ARTs to maintain adherence.

Conclusion: Rates of adherence amongst NSW’s most vulnerable PLWH are considerably lower than average adherence rates. BGF’s assistance with the copayment of ARTs is vital for maintaining some level of adherence amongst marginalised PLWH however organisations working with PLWH need to address the other barriers to adherence amongst these populations for treatment as prevention to be fully effective.

Speakers: Emily Ninnes

Australian Society for HIV 2015

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