Magnitude of optimal adherence and predictors for a low level of adherence among HIV/AIDS-infected adults in South Gondar zone, Northwest Ethiopia: a multifacility cross-sectional study

Abstract

ObjectivesThis study aims to identify levels of adherence to antiretroviral therapy (ART) drugs and factors associated with them in Northwest Ethiopia. We hypothesise that in the era of COVID-19, there would be suboptimal adherence to ART drugs.DesignAn observational cross-sectional study was conducted. Factors associated with the level of adherence were selected for multiple logistic regressions at a p value of less than 0.2 in the analysis. Statistically significant associated factors were identified at a p value less than 0.05 and adjusted OR with a 95% CI.SettingThe study was conducted in one specialised hospital and three district hospitals found in the South Gondar zone, Northwest Ethiopia.ParticipantsAbout 432 people living with HIV/AIDS receiving highly active ART in South Gondar zone public hospitals and who have been on treatment for more than a 3-month period participated in the study.Primary and secondary outcome measuresLevels of adherence to ART drugs and their associated factors.ResultsAmong 432 study participants, 81.5% (95% CI: 78% to 85.2%) of participants were optimally adherent to ART drugs. Determinants of a low level of adherence: stigma or discrimination (OR=0.4, p=0.016), missed scheduled clinical visit (OR=0.45, p=0.034), being on tuberculosis treatment (OR=0.45, p=0.01), recent CD4 cell count less than 500 cells/mm3 (OR=0.3, p=0.023) and patients who had been on WHO clinical stage III at the time of ART initiation (OR=0.24, p=0.027) were factors significantly associated with adherence to ART drugs.ConclusionsLevel of adherence was relatively low compared with some local studies. The intervention targeted to reduce discrimination, counselling before initiation of treatment and awareness regarding compliance is advised to improve adherence to antiretroviral regimens.

A descriptive comparative study on COVID-19 impact among people living with human immunodeficiency virus at tertiary care hospital: Bengaluru urban

“…12 According to Zewude et al 74.5% of individuals were married, which is different from what the current study found. 11 It was found from our study that opportunistic infections were more during COVID-19 pandemic. This may be due to reduced immune response due to poor adherence during the pandemic, as accessibility was the issue due to strict lock down measures.…”

“…According to a study by Rodriguez et al 50.2% of participants were between the ages of 25 and 34, and the average age was 48.9±12.3 years. 7,11 Compared to a study by Campbell LS, where 68% of participants had either no education, only primary education, or some secondary education, the majority had completed education up to secondary school in the current study. 12 According to Zewude et al 74.5% of individuals were married, which is different from what the current study found.…”

Non-Adherence to Anti-Retroviral Therapy Among Adult People Living with HIV in Ethiopia: Systematic Review and Meta-Analysis

“…The forty-two studies [ 1 – 3 , 5 , 6 , 8 – 10 , 18 , 19 , 27 , 29 , 34 , 43 , 44 , 52 – 78 ], two studies [ 79 , 80 ] and one study [ 35 ] were conducted using cross-sectional, retrospective cohort and case-control studies respectively. Regarding geographical region, fourteen studies were conducted in Oromia [ 2 , 3 , 9 , 18 , 27 , 44 , 52 , 57 , 59 , 64 , 69 , 76 , 77 , 79 ], eleven studies in Amhara [ 1 , 6 , 19 , 56 , 61 , 66 – 68 , 73 , 75 , 78 ], ten studies in Southern nations nationalities [ 5 , 10 , 34 , 35 , 43 , 53 , 55 , 60 , 62 , 72 ], two studies in Addis Ababa [ 8 , 44 ], two studies in Tigray [ 58 , 80 ], one study in Oromia and Southern nations nationalities [ 54 ], one study in Harari and Dire Dawa [ 63 ] and one study was conducted in each Benishangul Gumuz [ 71 ], Somali [ 74 ], Harari [ 29 ], and Sidama region [ 65 ]. The total sample size of ...…”

“…The quality of each study was evaluated using the Joanna Briggs Institute (JBI) quality appraisal criteria [ 81 ]. Forty-two studies [ 1 – 3 , 5 , 6 , 8 – 10 , 18 , 19 , 27 , 29 , 34 , 43 , 44 , 52 – 78 ], two studies [ 79 , 80 ] and one study [ 35 ] were appraised using JBI checklist for cross-sectional, cohort and case-control studies respectively.…”

Risk factors for poor engagement with a smart pillbox adherence intervention among persons on tuberculosis treatment in Ethiopia

“…This finding was consistent with previous studies conducted in Sub Saharan African countries, including Ethiopia. Pill burden, adverse effects of anti-TB medication and fear of stigma among people with TB/HIV co-infection have been documented to be more common compared to people with TB only [6,27,[32][33][34]. Furthermore, less motivation to take medication among people with TB/HIV co-infection has been reported in studies conducted in Sub-Saharan Africa [35,36].…”