Factors associated with poor adherence to ant-retroviral therapy among HIV/AIDS patients attending care and treatment clinic at Mnazi Mmoja Hospital, Zanzibar

Abstract

Background: To reach the global goal of reducing new HIV and HIV/AIDS-related deaths, more HIV infected individuals must be reached and enrolled in HIV care. For those already in care, adherence to ART is important as it can prolong the lives of many people infected with HIV, and lower their chance of infecting others. Poor adherence to ART may result in treatment failure and the emergence of drug resistant strains of HIV, leading to an increase in morbidity and mortality of people living with HIV and AIDS. Adherence to ART can be influenced by either socio-demographic, behavioral and/or treatment related factors. The aim of this study was to determine factors associated with poor adherence to ART among HIV/AIDS patients attending care and treatment clinic at Mnazi Mmoja Hospital, Zanzibar. Methods & Materials: Unmatched case control study was conducted at MMH from February to April 2017. A case was defined as any patient on ART attending MMH care and treatment clinic who missed two or more ART doses in the last 30 days followed up visit. Cases and controls were selected using CTC2 database. Data entry and data analysis were performed using Epi Info version 3.5.4. Results: A total of 388 HIV/AIDS patients were recruited in the study, where 25% were cases and 75% were controls. Majority of participants (67.3%) were females, aged between 34 and 44 years (38.7%), self-employed (67.5%), had primary education (49.0%), and married (47.9%). Factors that were independently associated with poor adherence to ART includes; drinking alcohol (AOR = 4.34, 95%CI:1.97,9.59), drug abuses (AOR = 26.2, 95%CI:2.95,232.49), ART interfere with activities (AOR = 5.99,95%CI:2.35,15.27), no treatment supporter (AOR = 2.51, 95%CI:1.41,4.46), not living in the same house with treatment support (AOR = 3.43, 95%CI:1.20,9.82), undisclosed HIV status (AOR = 3.45,95%CI:1.16,10.17), and twice a day doses (AOR = 0.52,95%CI:0.30,0.88). Conclusion: HIV/AIDS patient who has no treatment supporter, who treatment supporter not living in the same house with supporter, who takes twice a day ART doses, who ART interfere with their daily activity, who did not disclose HIV status, who drink alcohol and who abuses drugs were the major significant factors for poor adherence to ART.