Assessment of Adherence to Antiretroviral Therapy Among Adult People Living with HIV/AIDS in North East, Ethiopia

Mengistie, Almaz; Birhane, Adugnaw; Tesfahun, Esubalew

doi:10.1101/492330

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…This finding is not in line with a study conducted in northeast Ethiopia, in which there was no significant association between WHO clinical staging and adherence status. 36 The study also found that patients with a current CD4 category greater than or equal to 500 cells/mm 3 were five times more adherent than those with CD4 of below 200 cells/mm 3 . This is supported by other studies, which found that strict adherence can bring about immune reconstitution and rebuilding.…”

Section: Discussionmentioning

confidence: 79%

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

Angelo¹,

Alemayehu²

2021

PPA

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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.

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Section: Discussionmentioning

confidence: 79%

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

Angelo¹,

Alemayehu²

2021

PPA

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“…The optimal ART adherence level found from this study result for study participants on a routine schedule (74.3%) is consistent with the results of a study done in Yirgalem hospital in 2009, which was 74.2%, 12 in Cape Coast metropolis, Ghana in 2018 which was 79.5% 20 and in behavioral disease counseling center, Iran in 2019 which was 75.4%. 46 However, it is lower than the study findings in Bale Robe Hospital of 2014, which was 83.1%, 21 DebreBerhan Keble Health Centre and DebreBerhan Referral Hospital of 2018 which was 87.2%, 22 Kathmandu District in Nepal of 2014, which was 86.7%, 23 and University of Gondar Referral Hospital of 2014, which was 88.2% 24 and higher than the study findings in Embu teaching and referral hospital comprehensive care clinic of 2016 which was 48.2% 25 and Embe Hospital of 2016 which was 48.2%. 26…”

Section: Discussionmentioning

confidence: 64%

Antiretroviral Treatment Adherence Level and Associated Factors Among Adult HIV-Positive Patients on Both HIV/AIDS Care Models: Comparative Study in Selected Hospitals of Western Ethiopia, 2019

Dibaba¹,

Kajela²,

Chego³

et al. 2021

HIV

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Background Many studies investigating antiretroviral treatment (ART) adherence found the majority of patients had suboptimal adherence for a variety of different reasons. The study aimed to compare the ART adherence level and associated factors among adult human immune deficiency virus (HIV) positive patients on both care models in selected hospitals. Methods An institution-based comparative cross-sectional study was conducted among 463 HIV positive patients on ART. The study samples were selected using systematic random sampling, and pretested semi-structured interviewer administered questionnaire was used to collect data. Binary and multivariable logistic regression analyses were used to see the association between outcome and predictors using odds ratio with a 95% confidence interval to estimate the strength of the association. Results The study had a response rate of 445 (96.1%). Of the study participants, 325 (73%) and 120 (27%) were from the routine and appointment spacing models, respectively. Patients on the appointment spacing model had higher levels of optimum adherence (87.5% vs 74.27%, respectively; p = 0.006). Patients’ satisfaction with health service delivery (OR = 0.31, 95%: CI 0.11–0.84), antiretroviral drug dosage taken per day (OR = 3, 95%: CI 1.16–8.1), disclosure of HIV status (OR = 0.30, 95%: CI 0.09–0.93), distance from patient residency to health facility (OR = 0.11, 95%: CI 0.03–0.34), the memory aids used (OR = 0.02, 95%: CI 0.01–0.05), and type of HIV/AIDS care model (OR= 0.24, 95%: CI 0.1–0.6) were factors significantly associated with ART adherence level. Conclusion ART patients on the appointment spacing model had higher optimum ART adherence levels than those on the routine schedule due to factors like satisfaction status, disclosure status, type of memory aid used, type of ART care model used, and distance from the care facility. Therefore, promoting adherence enablers and alleviating barriers of ART adherence will improve ART adherence levels.

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“…With regard to the age of the patients, patients in the age groups 30-34, 35-39, 45-49 and 50+ years old, their odds of having good adherence compared with those who had fair and poor adherences combined were 1.54, 1.47, 1.87 and 1.68 times higher keeping all the other variables in the model constant. Studies from Gondar, Northwest Ethiopia, 23 Northeast Ethiopia 25 and Gobba Hospital, Southeast Ethiopia 20 reported that age has no significant associations with adherences. However, a study from Kenya had found that adherence to ART increased with increased age and decreased as the age goes beyond 60 years.…”

Section: Discussionmentioning

confidence: 99%

“…32 However, studies from Gobba Hospital, Southeast Ethiopia and Northeast Ethiopia have shown that gender was not significantly associated with ART adherence. 20,25 The reason why males were prone to viral non-suppression might be due to low health-seeking behavior. [32][33][34] Compared to females, males were more likely to forgo ART because of side effects.…”

Section: Discussionmentioning

confidence: 99%

“…However, a study from Northeast Ethiopia indicated that WHO clinical staging was not associated with medication adherence. 25 This difference might be in study method difference, in which the later one was with a small sample size that cannot ensure external validity. On the other hand, for patients with viral non-suppression taking viral suppression as reference, the odds of good adherence versus the combined poor and fair adherence was 46% lower, given that all of the other variables in the model held constant.…”

Section: Discussionmentioning

confidence: 99%

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<p>Level of Adherence and Associated Factors Among HIV-Infected Patients on Antiretroviral Therapy in Northern Ethiopia: Retrospective Analysis</p>

Desta

Kidane

Woldegebriel

et al. 2020

PPA

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Background: Poor adherence to ART increases viremia, which leads to disease progression and transmission of drug-resistant HIV strains. This study aimed to assess the level of ART adherence and associated factors among adolescents and adult patients enrolled in ART care in Northern Ethiopia. Methods: A retrospective analysis was conducted among 19,525 patients from April 2015 to March 2019. Data verification and filtration were done in Excel 2013 before exporting to STATA 14.0. Ordinal logistic regression was used to analyze the data. Results: About 94.84%, 95% CI (94.52%, 95.14%) of the study subjects were in good adherence. However, about 1.46%, 95% CI (1.30%, 1.64%) and 3.70%, 95% CI (3.44%, 3.97%) of them had poor and fair adherence respectively. In the adjusted analysis, being male (AOR = 0.75; 95% CI: 0.0.65, 0.87), patients from general hospitals (AOR = 0.52; 95% CI: 0.39, 0.69), WHO staging IV (AOR = 0.57; 95% CI: 0.41, 0.81) and non-suppressed viral load (VL) status (AOR = 0.54; 95% CI: 0.47, 0.63) were negatively associated with good adherence. Whereas, age of 50+ years old (AOR = 1.68; 95% CI: 1.13, 2.50), recent CD4 count of 200-499 (AOR = 1.45; 95% CI: 1.21, 1.74) and recent CD4 count of 500 and above (AOR = 1.84; 95% CI: 1.47, 2.32) were positively associated with good ART drug adherence. Conclusion: There was a higher level of adherence compared to the previous studies conducted in Ethiopia. Being male, patients from general hospitals, WHO staging II, II and IV and non-suppressed VL status were negatively associated with good adherence. Whereas, older ages, recent CD4 count of 200-499 and ≥500 CD4 count were positively associated with good ART drug adherence. The health system should recognize a higher need of younger age groups and males to design targeted counseling and support to encourage consistently high levels of adherence for a better ART treatment outcome.

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Assessment of Adherence to Antiretroviral Therapy Among Adult People Living with HIV/AIDS in North East, Ethiopia

Cited by 5 publications

References 15 publications

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

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

Antiretroviral Treatment Adherence Level and Associated Factors Among Adult HIV-Positive Patients on Both HIV/AIDS Care Models: Comparative Study in Selected Hospitals of Western Ethiopia, 2019

<p>Level of Adherence and Associated Factors Among HIV-Infected Patients on Antiretroviral Therapy in Northern Ethiopia: Retrospective Analysis</p>

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