Factors associated with adherence to Antiretroviral Therapy (ART) among adult people living with HIV and attending their clinical care, Eastern Ethiopia

Shiferaw Letta,Lemessa Oljira,Asrat Demissie,Yadeta Dessie

doi:10.1186/s12914-015-0071-x

Abstract

BackgroundTo attain a successful treatment outcome, Antiretroviral Therapy (ART) treatment for people living with HIV requires more than 95 % adherence level. The adherence level varies depending on different population contexts. Thus, the objective of this study was to investigate ART adherence level among HIV positive patients attending their clinical care in public health facilities in Harar and Dire Dawa, Eastern Ethiopia.MethodsWe conducted a cross-sectional study among 626 ART attendees. Data were collected using a structured questionnaire with a face-to-face interview. ART adherence was considered when taking all antiretroviral treatment in a correctly prescribed doses at a right time (no dose missed or delayed for greater than or equal to 90 min) in the week prior to the study. Multivariable logistic analysis was applied to examine the association between the dependent and independent variables. Statistical significance was set at p-value <0.05.ResultsThe level of ART adherence was 85 %. Adherence was more likely among patients of 35–44 years (AOR = 2.39; 95 % CI = 1.15–5.01), had monthly income of 501.00–999.00 Ethiopian Birr (ETB) (AOR = 6.73; 95 % CI = 2.71–16.75), no history of opportunistic infection (AOR = 2.81; 95 % CI = 1.47–5.36), and had good family support (AOR = 2.61; 95 % CI = 1.45–4.72). However, those who did not disclose their sero-status (AOR = 0.45; 95 % CI = 0.21–0.97) and did experience depression (AOR = 0.36; 95 % CI = 0.21–0.61) were less likely adherent than their counter parts.ConclusionsThe level of ART adherence was sub-optimal. Concerted and collaborative efforts through effective and efficient interventions are needed in view of the identified factors in order to improve the adherence level.

Highlights

To attain a successful treatment outcome, Antiretroviral Therapy (ART) treatment for people living with Human immune deficiency virus (HIV) requires more than 95 % adherence level
People living with HIV/Acquired immune deficiency syndrome (AIDS), who are 18 years old and above, able to hear and communicate well or mentally fit and being on ART at least for 3 months were included in the study
Medication and related characteristics The majority of the respondents, 420 (67.7 %), were tested for HIV before 24 weeks (2-years) and among those patients who were on ART, 369 (59.5 %) had started ART before 24 weeks (2 years)

Summary

Introduction

To attain a successful treatment outcome, Antiretroviral Therapy (ART) treatment for people living with HIV requires more than 95 % adherence level. Improving adherence requires collaboration with the patient in an effort to understand and improve individual impediments to adherence This can generally be done by establishing dedicated time to educate every patient, plan for adherence, and maintain support and collaboration throughout the course of treatments. There are many alterable factors known to affect the treatment adherence These are depression, regimen complexity, Letta et al BMC International Health and Human Rights (2015) 15:33 medication side effects, and relationship between patients and care providers which should be addressed prior to starting their treatments and throughout the ongoing treatments [7,8,9]

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