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IntroductionDramatically, Anti-Retroviral drug Therapy (ART) has reduced morbidity andmortality of People Living with HIV/AIDS (PLWHA). However, adherence toantiretroviral therapy has become a challenge because this therapy must beendured for a lifetime. Adherence to antiretroviral therapy is one of the factorsthat determine the success of treatment. Poor adherence to ARV therapy inIndonesia is arround 23-55%. The objective of this study was to determine theinfluence of medication non-adherence to the 3-years survival of patients withHIV/AIDS.MethodsThis study used a retrospective cohort design at RSPI Prof. Dr. Sulianti Saroso in2010-2012.ResultsThe cumulative survival probability of patients with HIV/AIDS at RSPI Prof. dr.Sulianti Saroso in the second year (24th month) was 95.6% and the third year (inthe 36th) was 91%. Multivariate analysis with Cox regression showed the factorsthat affected the 3-years survival of patients with HIV/AIDS are non-adherence toART, after controlled by initial CD4 count (aHR = 7.608; 95% CI: 1.664 to34.790), and non-compliance appointments, after controlled by opportunisticinfection, age and initial CD4 count (aHR = 2.456; 95% CI: 0.802 to 7.518).Among patient non-adherence to ART, non-compliance appointments affected the3-years survival of patients with HIV/AIDS, after controlled by initial CD4 count,sex, CPT, modes of HIV transmission, WHO clinical stage, opportunisticinfection, and age (aHR = 4.517 ; 95%CI : 0.729-27.987).DiscussionsNonadherence to ART may caused a failure of the suppression on HIV viral, thusincrease the possibility of HIV virus mutations that can lead to drug-resistant andultimately increase the risk of death. Poor adherence to appointments of takingdrugs in the first year also assumed the poor adherence of the next assignment totake drugs in the further, and show disobedience to ART, so it will increase therisk of death.RecomendationMonitoring coverage of medication adherence of patients with HIV/AIDS in aregular basis as the early warning on the risk of death among patients withHIV/AIDS.Keyword : non-adherence to ART, appointment keeping, retrospective cohort
Background: Hypertension is one of the largest public health burdens in Indonesia and a major trigger for cardiovascular disease. The success of controlling hypertension is highly dependent on patient compliance. Based on SKI 2023 data, non-compliance with taking antihypertensive drugs is still a significant problem in Indonesia. Methods: Using secondary data from SKI 2023 with a cross-sectional study design. The sample was respondents aged ≥18 years with a diagnosis of hypertension. Respondents with incomplete data and pregnant women were excluded, resulting in a final sample of 49,026 respondents. Data analysis used multinomial logistic regression. Results: All independent variables tested (education, occupation, economic status, geographic region, comorbidities, time since diagnosis, age, gender, place of residence, traditional medicine use behavior, alcohol consumption, access to health facilities, insurance ownership, and information support) were significantly associated with non-compliance. The percentage of non-compliance was 53.5%, specifically 36.7% (95% CI: 35.9-37.4) of respondents did not follow the routine, and 16.8% (95% CI: 16.2-17.4) did not take their medication. The highest AOR was found in respondents who did not receive information support, both in the non-routine category (AOR 3.76; 95% CI 3.59-3.95; p<0.001) and in the category of not taking medication (AOR 8.63; 95% CI: 8.12-9.19; p<0.001). Conclusion: Non-compliance with taking antihypertensive medication is still a major challenge in Indonesia. Community-based interventions, increased education, and improved access to health are needed to improve treatment adherence.
Background: Hypertension is the leading cause of premature death worldwide and is a major risk factor for cardiovascular diseases, including in Indonesia. West Java is the province with the highest prevalence of hypertension in Indonesia, with a rate of 34.4% based on blood pressure measurements and 10.7% based on doctor diagnoses. This makes West Java the third largest province in terms of hypertension prevalence among individuals aged ≥ 18 years. In managing hypertension, indicators related to hypertension therapy or medication are crucial factors that need attention. Recent data from the Indonesia Health Survey (SKI) shows that non-adherence to antihypertensive medication in West Java reaches 53.8%, with 35.5% of patients taking medication irregularly and 18.3% not taking medication at all. The low level of adherence among hypertensive patients to taking antihypertensive medication remains a significant issue in hypertension management in Indonesia, particularly in West Java. Objective: This study aims to identify the factors associated with non-adherence to antihypertensive medication among hypertensive patients aged ≥ 18 years in West Java. Methods: This research used a cross-sectional study design with univariate and bivariate analyses. Results: The prevalence of non-adherence to antihypertensive medication among hypertensive patients aged ≥ 18 years in West Java is 53.1%, with “feeling healthy” being the most common reason for non-adherence. Significant factors associated with non-adherence to antihypertensive medication include: being aged 18–59 years (PR = 1.23; 95% CI = 1.06–1.47), having a low education level (PR = 1.17; 95% CI = 1.09–1.27), lacking health insurance (PR = 1.26; 95% CI = 1.18–1.36), smoking (PR = 1.12; 95% CI = 1.04–1.21), and lacking knowledge related to antihypertensive medication (PR = 1.88; 95% CI = 1.72–1.97). Conclusion: The government needs to enhance health education and emphasize the importance of regularly taking antihypertensive medication, even when no symptoms are present. Additionally, cross-sector collaboration is necessary to support the prevention of non-adherence to antihypertensive medication.
HIV tetap menjadi tantangan besar bagi kesehatan global. Meskipun telah terjadi penurunan infeksi baru dan peningkatan akses ke pengobatan antiretroviral (ARV), tantangan signifikan masih ada. Keberhasilan terapi ARV sangat ditentukan oleh kepatuhan minum obat ARV. Klinik PDP RSUD Brebes merupakan salah satu rumah sakit umum daerah yang menjalankan pengobatan HIV/AIDS yang ada di Kabupaten Brebes, Jawa Tengah. Penelitian ini bertujuan untuk melihat Gambaran Ketidakpatuhan Minum Obat ARV Pada Pasien HIV/AIDS Lelaki Seks Lelaki (LSL) Di Klinik PDP (Perawatan Dukungan & Pengobatan) RSUD Brebes. Untuk melihat gambaran ketidak patuhan minum obat ARV berdasarkan 6 komponen Health Belief Model yaitu Modifying Factors (Faktor Modifikasi), Perceived Susceptibility (Persepsi Kerentanan), Perceived Severity (Persepsi Keseriusan), Perceived Benefits (Persepsi Manfaat), Perceived Barriers (Persepsi Hambatan), Cues to Action (Isyarat untuk Bertindak) dan Self-Efficacy (Efikasi Diri). Penelitian ini merupakan penelitian kualitatif dengan menggunakan wawancara mendalam. Penelitian ini menunjukkan bahwa masih ditemukan ketidakpatuhan ODHIV LSL dalam pengambil obat di RSUD dan tidak rutin dalam minum obat ARV. Faktor Modifikasi yang mendukung pasien tidak patuh dalam pengobatan diantaranya pengetahuan dan sosial ekonomi. Persepsi Kerentanan terhadap tidak rutin minum obat ARV pasien akan merasakan badan tidak bersemangat dan mudah rentan dengan muncul penyakit-penyakit lain. Persepsi keseriusan akibat tidak rutin minum obat ARV, CD4 menurun, Viral Load meningkat, terjadi resisten obat ARV dan bisa mengakibatkan kematian. Persepsi manfaat yang dirasakan dari rutin minum obat ARV tubuh tetap sehat dan produktif. Hambatan yang dialami oleh pasien diantaranya efek samping obat, biaya pengobatan, jarak, pekerjaan, konsumsi alkohol/penggunaan popers, merasa diri sudah sehat dan belum buka status HIV dengan keluarga, menggunakan alaram, pengingat dari whatssap grup, sering berdiskusi dengan sesama sebaya dan konseling rutin dari petugas kesehatan merupakan isyarat untuk bertindak demikian juga dengan keyakinan diri untuk bisa minum obat ARV secara teratur.
HIV remains a major challenge for global health. Despite a decrease in new infections and increased access to antiretroviral (ARV) treatment, significant challenges persist. The success of ARV therapy is highly dependent on adherence to ARV medication. The PDP Clinic at RSUD Brebes is one of the regional public hospitals providing HIV/AIDS treatment in Brebes Regency, Central Java. This study aims to examine the Non-Adherence to ARV Medication among HIV/AIDS Patients who are Men who have Sex with Men (MSM) at the PDP (Care, Support & Treatment) Clinic of RSUD Brebes. It aims to explore non-adherence to ARV medication based on the six components of the Health Belief Model: Modifying Factors, Perceived Susceptibility, Perceived Severity, Perceived Benefits, Perceived Barriers, Cues to Action, and Self-Efficacy. This research is a qualitative study using in-depth interviews. The study shows that non-adherence among MSM HIV patients in taking medication at RSUD is still found, and they are not consistent in taking ARV medication. Modifying factors that contribute to non-adherence include knowledge and socioeconomic status. Perceived susceptibility to not regularly taking ARV medication includes feeling unenergetic and being more susceptible to other diseases. The perceived severity of not regularly taking ARV medication includes decreased CD4 count, increased viral load, ARV drug resistance, and potential death. The perceived benefits of regularly taking ARV medication include maintaining health and productivity. Barriers experienced by patients include medication side effects, treatment costs, distance, work, alcohol consumption/poppers use, feeling healthy, and not disclosing HIV status to family. Using alarms, reminders from WhatsApp groups, frequent discussions with peers, and regular counseling from healthcare workers are cues to action, along with self-confidence to regularly take ARV medication. Key words: HIV/AIDS, ARV Therapy, Non-compliance, MSM
