Title : Barriers to antiretroviral medication adherence in people living with HIV (PLHIV) at the time of COVID-19 pandemic in the Philippines
Abstract:
Background:
Adherence to antiretroviral therapy (ART) reduces morbidity and mortality among people living with HIV (PLHIV) by suppression of viral replication, restoration and preservation of immune function. However, poor adherence with ART may lead to treatment failure and death. PLHIV have a high probability of experiencing treatment interruptions due to lockdowns related to social distancing COVID-19 protocol. Moreover, mortality rate among the COVID-19 patients with HIV infection is higher than those COVID-19 patients without HIV infection.
Objectives:
To determine the barriers to antiretroviral medication adherence in PLHIV at the time of COVID-19 pandemic in the Philippines and determine any significant association between the identified HIV treatment barriers and socio-demographic characteristics.
Methods:
A cross-sectional study using online survey questionnaire was distributed via social media. Sample size was computed using Open Epi software. Data was analyzed using Stata software. Categorical variables were summarized using frequencies and percentages, quantitative data was summarized using mean and standard deviation. Chi-square test or Fisher’s exact test, whichever is more appropriate, was used to determine association between socio-demographic characteristics and HIV treatment barriers.
Results:
There is a total of 116 respondents, 115 were males, homosexual (59.5%), with mean age of 30.25 years old (SD = 6.22) and majority (53.4%) were from NCR. The most common HIV treatment barriers reported by people living with HIV in accessing treatment and care were unavailability of transportation and cost of courier services for ARV delivery (62.1%), location of treatment hubs (52.6%) and financial assistance (37.9%).
Conclusion:
As the country continues to contain and delay the spread of COVID-19 virus, healthcare systems may miss out on patients with chronic diseases whose management may be worsened by this pandemic. There is significant association between the following treatment barriers and sociodemographic characteristics: location of treatment hubs and respondents who finished college/graduate studies; checkpoints and crossing borders and: 1. respondents from Northern Luzon Region, 2. unemployed respondents; financial assistance and: 1. Respondents 18 to 25 years old, 2. unemployed respondents, 3. respondents who finished elementary/high school; psychosocial support and: 1. Respondents from NCR, 2. Respondents 26 to 30 years old; stocks of ARVs and other medicines and employed respondents.
Audience take away:
1. Medication adherence and medical related problems have arisen due to restrictions put in place to reduce the spread of COVID-19, along with the fear of exposure to COVID-19. Understanding the consequences of the COVID-19 pandemic in people with HIV is crucial to improve health care, provide safer accessibility to outpatient medical services and resources for this population during this and future pandemics.
2. It is important to recognize that all pandemics have biological, psychological, and social implications of which health care professionals play a crucial role. Acknowledging these implications give a deeper understanding and provide better approach to people living with HIV.
3. This research can be used as a guide in conducting investigation involving medication adherence of a different population (eg. Chronic Kidney Disease Patients on Hemodialysis)
