Adherence to antiretroviral therapy in HIV-positive, male intravenous drug users in Pakistan

Background: Human immunodeficiency virus (HIV) is fifth leading cause of mortality and disability among infectious diseases worldwide. HIV burden is increasing annually and compliance with antiretroviral therapy (ART) is low among intravenous drug users, especially in developing countries. Aim: To determine the adherence level to ART among HIV-positive intravenous drug users in Karachi Pakistan. Methods: A cross-sectional study was conducted in 2015. A pretested questionnaire was administered to 375 of 3000 people who inject drugs, registered at the Civil Hospital in Karachi, Pakistan. Results: The mean age was 30 years, 181 were married, 179 were illiterate and 287 had income < 5000 rupees per month. Only 63 patients were adherent to ART and 343 were alcoholics. Nonadherence was greater in patients who were single and did not have children. The most common reason for missing ART was that they simply forgot to take the tablets. Conclusion: We conclude that adherence to ART among intravenous drug users was low. Family cohesion and support were essential to maintain adherence to ART.