New study provides data on adherence to antiretroviral therapy among people living with HIV in Latvia

Adherence to antiretroviral therapy (ART) among people living with HIV is one of the most important prerequisites for the successful treatment of HIV infection and for limiting its spread in the society. As part of the National Research Programme (VPP) study conducted by the Rīga Stradiņš University (RSU) Institute of Public Health, the adherence to ART was analysed by compiling the experiences of people living with HIV through surveys and interviews. The study’s results highlight the need to strengthen patient-tailored, accessible, and sustainable HIV care support in Latvia.

The study was conducted within the framework of the VPP project New Knowledge and Approaches to Reduce Antimicrobial Resistance, Limit the Spread of HIV and Expand Community Vaccination Coverage. The aim was to determine the ART adherence among people living with HIV, as well as to identify factors associated with non-adherence. Although previous studies on ART adherence have been already conducted in Latvia using data on the prescription and dispensing of reimbursed medicines, this study makes a significant additional contribution, as it directly involves patients and compiles their experiences about the daily use of therapy.

ART is the cornerstone of HIV treatment. Regular and accurate use of medications makes it possible to achieve an undetectable viral load in the blood, maintain a person’s health, and prevent further transmission of HIV to others. Whereas non-adherence to therapy can contribute to the development of viral resistance, reduce treatment effectiveness, and limit future treatment options. Therefore, research on adherence is significant in the context of both individual healthcare and public health policy.

The study was conducted from November 2024 to June 2025 and involved 372 adults living with HIV and having visited an infectious disease specialist in Riga and other regions of Latvia. Participants completed an anonymous questionnaire that included questions on their HIV diagnosis, ART use, sociodemographic factors, and medication use adherence. Adherence was analysed by classifying participants into two groups: adherent and non-adherent to therapy.

The study results show that 77.4% of participants were classified as non-adherent to ART. Non-adherence was associated with a lower level of education, a longer time since HIV diagnosis, a longer duration of ART use, and a higher number of daily medications. The results suggest that people who take two or more tablets a day are more likely to be non-adherent than those who take one tablet a day.

In addition to the quantitative part of the study, qualitative research was also conducted through interviews with people having HIV, healthcare professionals, policymakers, and support service representatives. This part of the study provided an in-depth understanding of the factors that help or hinder a regular use of therapy on daily basis. Key barriers identified included issues related to the accessibility and organisation of care, limited social support, stigma, financial difficulties, side effects, the complexity of treatment, and insufficient communication with healthcare specialists, while adherence is enhanced by trusting relationships with healthcare providers, clear information about the therapy, flexibly organised care, and individually tailored support.

The study’s contribution at the national level is related to its ability to provide a better understanding of the practical challenges of HIV care from a patient’s perspective. The results demonstrate that state-funded therapy is an essential prerequisite for successful treatment of HIV infection, however, access to medication alone is not sufficient. To improve treatment outcomes and reduce the spread of HIV, a care system that is understandable, accessible, and provides sustainable support to patients is required.

The results of the study can be used to improve HIV care in Latvia and develop targeted measures to enhance adherence. In practical terms, this could involve promoting simpler treatment regimens, with a particular focus on people with a long-standing HIV diagnosis and extensive treatment experience, patient education, strengthening psychological and social support, as well as training healthcare professionals in patient-centered communication and stigma reduction.

A full research report with recommendations for improving HIV care and promoting adherence measures in Latvia will be prepared following the final analysis of the results. The study outcomes will also be presented in a scientific publication, which will provide a detailed description of the methodology and the quantitative and qualitative findings.

Learn more about the project

The study was conducted within the framework of the VPP project “Public Health 2023–2025” programme 'New Knowledge and Approaches to Reduce Antimicrobial Resistance, Limit the Spread of HIV and Expand Community Vaccination Coverage.' Project No. VPP-VM-Sabiedrības_Veselība-2023/5-0001. The programme is implemented under the supervision of the Ministry of Health of the Republic of Latvia. More information about the project is available here.