Brief communication: clinical jaundice is associated with poor adherence to boosted atazanavir among adults in an HIV clinic in Kampala, Uganda.

BACKGROUND: Boosted atazanavir (ATV/r) is associated with clinical jaundice, which may affect ART adherence. However, the prevalence of clinical jaundice among people on ATV/r and its association with ART adherence is unknown in Uganda. METHODS: We conducted a cross-sectional study among 236 adult patients on ATV/r at the Infectious Disease Institute. Clinical jaundice was assessed by self-report and observation; ART adherence was measured using the 8-item Morisky scale. RESULTS: Period prevalence of clinical jaundice was 31.8%, while point prevalence was 21.1%. While 8.5% had poor adherence, clinical jaundice was a significant predictor of poor adherence (adjusted odds ratio = 3.03, 95% CI: 1.18-7.76, p = 0.021). CONCLUSION: Clinical jaundice is common among patients on ATV/r in Uganda and is associated with poor ART adherence. Strengthening pre-ATV/r (pre-switch) counselling and exploring safer regimen alternatives are required to improve outcomes.