Background: The human immune system can be impaired due to lack of adherence
to treatment among HIV positive patients. This is reflected in lower levels of
CD4 count and incomplete viral suppression leading to the disease's progression and increased
risks of opportunistic infections. Little is known about adherence to antiretroviral
therapy (ART) and Tuberculosis (TB) treatment and barriers to ART adherence faced by
prisoners. Therefore, we conducted a study to evaluate adherence to ART, treatment of
latent TB infection (LTBI), and TB treatment and barriers of ART adherence in the Great
Tehran Prison in 2014.
Materials and Methods: We conducted a study to evaluate adherence to ART, latent TB
infection treatment, and TB treatment via Directly Observed Therapy (DOT) among HIV
positive patients in the Great Tehran Prison in 2014. Furthermore, we examined the barriers
of adherence to ART through focus group discussions (FGDs) with 22 people living
with HIV in the prison.
Results: The mean of adherence to ART, latent TB infection treatment, and TB treatment
were 93.3%, 92.7% and 93.3%, respectively. Addiction, negative drug reactions, bad experiences
with staffs, and psychosocial and nutritional problems were cited as the most
common barriers to adherence.
Conclusion: It is recommended to implement DOT for ART in Iranian prisons. In addition,
through removing the barriers and implementation of DOT for ART, HIV positive
prisoners can achieve a complete adherence.