Antiretroviral Adherence and Treatment Outcomes Among People Living with HIV Receiving Monthly and Multi-Month Dispensing: A Cross-Sectional Study

Abstract

Background: Human immunodeficiency virus (HIV) requires lifelong antiretroviral therapy (ART), and sustained adherence is essential for achieving viral suppression and preventing disease progression. Multi-month dispensing (MMD) was introduced to reduce clinic visits and improve treatment continuity; however, comparative evidence between MMD and monthly dispensing remains limited in Indonesia. Objective: This study aimed to assess treatment adherence and therapeutic outcomes among people living with HIV who received ART through MMD and monthly dispensing systems. Methods: A cross-sectional study was conducted at the HIV clinic of Universitas Airlangga Hospital, Indonesia, involving 160 people living with HIV, consisting of 80 patients in the MMD group and 80 in the monthly care group. MMD was operationally defined as ART dispensation for two or more months in the study setting. Adherence was assessed using the Self-Reported Adherence (SERAD) questionnaire and pill count method, while therapeutic outcomes were evaluated based on viral load (VL) results. Data were analyzed using appropriate statistical tests to determine the differences between the groups. Results: Significant differences were found in adherence based on the pill count (p = 0.03) and SERAD drug use (p = 0.00). Viral suppression rates were significantly higher in the MMD group (p < 0.001), with all patients achieving undetectable VL levels. Conclusion: MMD was associated with better adherence and improved virological outcomes than monthly dispensing, suggesting an association that warrants further evaluation with a longitudinal design to optimize HIV treatment outcomes.