Overall, the distress levels associated with a few side effects were similar in both the UK and Uganda; for example, lipodystrophy (very distressing) and weight gain (least distressing). Poor access to healthcare resources may explain why side effects such as diarrhea and vomiting were ranked so highly in Uganda and cultural differences may also contribute to differences in the acceptability of side effects.
The relationship between a patient and their physician is important in determining acceptance and adherence to cART [8–10]. Antiretroviral prescribers in established market economies should be mindful of these differences when prescribing and discussing treatment plans with patients from different cultural backgrounds.
We are grateful to the patients who completed the questionnaire.
1. Hammer SM. Clinical practice. Management of newly diagnosed HIV infection. N Engl J Med 2005; 353:1702–1710.
2. Thompson MA, Aberg JA, Cahn P, Montaner JS, Rizzardini G, Telenti A, et al
. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel
3. Miller LG, Huffman HB, Weidmer BA, Hays RD. Patient preferences regarding antiretroviral therapy. Int J STD AIDS 2002; 13:593–601.
4. Ammassari A, Murri R, Pezzotti P, Trotta MP, Ravasio L, De Longis P, et al
. Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection. J Acquir Immune Defic Syndr 2001; 28:445–449.
5. Stone VE, Hogan JW, Schuman P, Rompalo AM, Howard AA, Korkontzelou C, Smith DK. Antiretroviral regimen complexity, self-reported adherence, and HIV patients' understanding of their regimens: survey of women in the her study. J Acquir Immune Defic Syndr 2001; 28:124–131.
6. Nieuwkerk P, Gisolf E, Sprangers M, Danner S. Adherence over 48 weeks in an antiretroviral clinical trial: variable within patients, affected by toxicities and independently predictive of virological response. Antivir Ther 2001; 6:97–103.
7. Cramer JA, Mattson RH, Prevey ML, Scheyer RD, Ouellette VL. How often is medication taken as prescribed? A novel assessment technique. JAMA 1989; 261:3273–3277.
8. Altice FL, Mostashari F, Friedland GH. Trust and the acceptance of and adherence to antiretroviral therapy. J Acquir Immune Defic Syndr 2001; 28:47–58.
9. Davidson I, Beardsell H, Smith B, Mandalia S, Bower M, Gazzard B, et al
. The frequency and reasons for antiretroviral switching with specific antiretroviral associations: the SWITCH study
. Antiviral Res
10. Beach MC, Duggan PS, Moore RD. Is patients' preferred involvement in health decisions related to outcomes for patients with HIV? J Gen Intern Med 2007; 22:1119–1124.