Adherence and Its Associated Factors Among Adult HIV-Infected Patients on Antiretroviral Therapy in South Western Ethiopia, 2020

Abstract

Background Good adherence to antiretroviral therapy (ART) suppresses the viral load, reconstitutes the immune system, and decreases opportunistic infections among HIV-positive patients. However, adherence to ART is still challenging in developing countries such as Ethiopia. The study, therefore, aimed to assess adherence and its associated factors among HIV-positive patients on ART in southern Ethiopia in 2020. Materials and Methods A cross-sectional study was conducted among 329 randomly selected participants. A structured questionnaire was used to collect the data through a face-to-face interview from January 23 to February 23, 2020. Data were entered into Epidata 3.1 and exported to SPSS version 21 for analysis. Bivariate and multivariate logistic regressions were used for analysis. A p -value of less than 0.05 was considered significant in a multivariate logistic regression analysis. Results In total, 274 patients (83.3%) had good adherence to ART, while 16.7% did not adhere. Age between 39 and 49 years old (AOR=0.068, 95% CI 0.008, 0.578), urban residency (AOR=5.186, 95% CI 1.732, 15.529), an educational status of being unable to read and write (AOR=0.097, 95% CI 0.012, 0.771), an educational status of reading and writing with no formal education (AOR=0.056, 95% CI 0.006, 0.532), comorbidity (AOR=0.042, 95% CI 0.013, 0.139), disclosure (AOR=3.583, 95% CI 1.008, 12.739), WHO clinical stage II (AOR=0.098, 95% CI 0.021, 0.453), and CD4 count ≥500 cells/mm 3 (AOR=5.634, 95% CI 1.203, 26.383) were significantly associated with adherence to ART among patients. Conclusion The adherence of patients to ART is relatively low compared to other studies conducted in different regions. Age 39–49 years, educational status, comorbidity, and WHO clinical staging were negatively associated with ART adherence. Residency, disclosure, and current CD4 category greater than or equal to 500 cells/mm 3 were positively associated with adherence. Good counseling to patients from rural areas, with low educational status, and with low CD4 counts, and on the importance of disclosure, is recommended and should be given by professionals.

Factors associated with anti-retroviral therapy (ART) adherence among adult people living with HIV (PLWH): A 5-year retrospective multi-centre study in Kumasi, Ghana

“…In our study, being diagnosed at WHO stages II and III was independently associated with lower chances of ART adherence. This is consistent with studies by Angelo et al (2021), and Negash et al (2013), who also reported that WHO stages II and III were significantly associated with lower chances of adherence than in those with WHO clinical stage I [ 23 , 24 ]. This may be due to stigma and discrimination at advanced stages of HIV infection associated with overt manifestation of the disease.…”

ART Adherence Among People Living with HIV Seeking Services from Public Health Facilities in Western Ethiopia

“…The level of poor adherence to ART therapy was significantly affected by the age of the patients, where patients in the age group of ≤24 years were more likely to be non-adherent to ART treatment. This is similar to studies conducted in Ethiopia 36 , 37 that had found an increased level of adherence as age goes beyond 25 years. During the time of COVID-19, the young population may not visit health institutions due to fear of discrimination and stigma.…”

Adherence to option B+ PMTCT program and its predictors among HIV‐positive women in Ethiopia. A systematic review and meta‐analysis

“…Besides, poor educational status among rural residents might hinder their adherence to PMTCT. 46 The odds of adherence were 2.24 times higher among women who received partner support as compared to those women who had not. This finding is congruent with findings of previous studies, 47,48 and could be attributed to improved psychological and economic accessibility by accompanying women to PMTCT clinics.…”

“…A likely explanation is that women from rural areas might have limited access to PMTCT services and information. Besides, poor educational status among rural residents might hinder their adherence to PMTCT 46 …”