[Non-compliance in HIV-infected patients, supported by a community association]. / La non-observance des patients infectés par le VIH, soutenus par une association communautaire.

OBJECTIVE: To identify the factors linked to non-adherence to antiretroviral therapy in HIV-infected patients among the readership of REMAIDES, the AIDES association's medical information journal; AIDES is the principal organisation involved in the fight against AIDS in France. METHOD: A cross-cutting survey by questionnaire targeting the readers of REMAIDES. People who answered at least two independent questions as never forgetting or suspending their treatment were considered as adherents. RESULTS: Among the 1556 patients having responded to the survey, 888 (57%) are classified as adherents. The factors associated with non-adherence are as follows: young age, minimal financial resources, alcohol consumption, a lack of perceiving the treatment's effectiveness, absence of impact on anticipation of the future or emotional life, difficulties as far as in keeping up the medications or the treatment's integration into daily life, the impossibility of stopping the treatment, a duration of treatment > 2 years, hepatitis C co-infection and problematic side effects. Non-adherence is explained by the negative real-life experience of the person throughout the treatment. Interventions which aim to accompany patients under multiple therapies are preferable in order to improve adherence and increase the probability of successful treatment.

The patient's perspective on life with antiretroviral treatment: results of an 887-person survey.

Soon after treatment with protease inhibitors became widespread, health care providers understood that adherence was essential to prevent emergence of drug-resistant viral strains. However, little was known about factors influencing adherence among patients with HIV infection. To help clarify the patient's perspective, AIDES, a French AIDS service consortium, conducted a survey of 887 patients between June 1 and July 15, 1997, in its 110 chapters throughout France and through its quarterly newsletter, Remaides. Fatigue and gastrointestinal side effects were the most frequent complaints, but patients reported that their greatest difficulty was that of confronting lifelong treatment with no possibility of discontinuation.