Assessment of Factors Associated with Suboptimal Adherence of HIV Antiretroviral Therapy in Asia: A Systematic Review

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Jessica Audrey
Ayers Gilberth Ivano Kalaij


Introduction Despite efforts done to battle human immunodeficiency virus (HIV) infection, it still remains as one of the leading cause of deaths worldwide. Asia sits as the second region with most HIV prevalence worldwide. Non-adherence to antiretroviral therapy (ART) is one of the factors which contribute to treatment ineffectiveness. Plenty of studies have tried to research on this problem, yet reviews regarding non-adherence factors in Asia are still lacking.

Objective To analyze factors associated with ART suboptimal adherence in Asia

Methods A systematic review was conducted through PubMed, Scopus, and CENTRAL, searching for observational studies which analyze factors contributing to ART non-adherence in Asia. Studies selected were then assessed for bias risk with STROBE’s criteria.

Results The search yielded twenty observational studies with a total of 18,546 subjects, consisting of 16 cross-sectional studies and 4 cohort studies. Non-adherence to ART was associated with a number of factors. Personal factors, such as gender, age, and personal backgrounds, as well as socioeconomic factors, such as one’s education level and monthly income were significantly associated with adherence. Psychological health of HIV patients also affected their adherence to treatment. Furthermore, distance to health care facilities and patients’ relationship with health care providers were also important.

Conclusions To conclude, addressing factors related to treatment non-adherence is important to enhance treatment effectiveness. Knowledge of these factors is hoped to help improve strategies and guidelines for ART adherence, especially in Asia, therefore helping to increase treatment effectiveness and reducing HIV mortality worldwide.


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Audrey, J., Kalaij, A. G. I. and Michelle, F. (2020) “Assessment of Factors Associated with Suboptimal Adherence of HIV Antiretroviral Therapy in Asia: A Systematic Review”, Journal of Asian Medical Students’ Association. Kuala Lumpur, Malaysia, 8(4), pp. 11-23. Available at: (Accessed: 12July2020).
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