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Resistance to Anti-HIV Drugs in Uganda Developed Due to Drug Supply Problems

an self-pay therapy because free treatment may be less susceptible to interruptions that lead to resistance" said study senior author David R. Bangsberg, MD, MPH, director of the UCSF Epidemiology and Prevention Interventions Center at San Francisco General Hospital.

The climate in Uganda has changed since the study took place between September 2002 and April 2004. At that time, most patients paid for antiretroviral therapy. Today, most HIV patients are receiving drugs supplied for free by either PEPFAR—the U.S. President’s Emergency Plan for AIDS Relief, a five-year, $15-billion, multifaceted approach to combating HIV/AIDS around the world—or The Global Fund to Fight AIDS, Tuberculosis and Malaria, which was created to dramatically increase resources to fight three of the world's most devastating diseases, and to direct those resources to areas of greatest need.

"Notwithstanding the current programs providing free antiretrovirals, these findings do highlight the need for strong logistics and drug supply management in any antiretroviral therapy program as well as continued monitoring of adherence. While our patients did a great job of taking their medications as directed when they were affordable and available, their overall adherence did wane a bit over the study period," said Oyugi.

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