Socio-Demographic, Economic and Clinical predictors of HAART Adherence Competence for HIV Positive adults at Felege Hiwot Teaching and Specialized Hospital, North West Ethiopia

Abstract

Background : Currently, around 36.7 million people in the world are living with HIV. Among these, 52% are living in sub-Saharan African. Antiretroviral therapy (ART) has played an important role in improving the prognosis and quality of life of HIV/AIDS patients, and in reducing the rate of disease progression and death. Several previous researches on factors affecting HAART adherence competence had controversies. As far as the author’s knowledge concerned, no research had been conducted on longitudinal HAART adherence competence in the study area. The main objective of this study was to identify Socio-demographic and Clinical factors associated with HAART adherence competence in successive visits among adult HIV patients after commencement of HAART. Methods : A retrospective cohort study on 792 HAART attendants was conducted to analyze the current study for HIV positive adults who had a minimum of two clinical visits. Secondary data were employed to examine Socio-demographic, economic, individual and clinical factors affecting the variable of interest overtime among HAART users. The Structural Equation modeling (SEM) was applied to identify predictors of HAART adherence competence over time. Results : In this longitudinal study, factors affecting long-term HAART adherence competence in successive visits had been identified. Socio-demographic factors (like Marital status, level of disclosure of the disease, residence area, education, economic factors (owner ship of cell phone, household income), individual factors (age, sex, weight) and clinical factors (CD4 cell count, WHO stages), directly associated with retention of HAART medication care. On the other hand, HAART medication care was significantly and independently associated with the longitudinal HAART adherence competence. Conclusion : The HAART adherence competence in successive visits increased with the number of follow-up visits, but the rate of increase was different for different groups such as male & female, urban & rural, and disclosing & hiding the disease to family members. An integrated health related education should be given for poor adherent patients like rural residents, males, patients living without partners, patients with no cell phone and aged patients.