https://orcid.org/0000-0002-7985-9701
Abstract
Background
The scaling-up of antiretroviral therapy (ART) is the greatest accomplishment to reduce the burden of acquired immunodeficiency syndromes (AIDS) to date. However, it requires optimal adherence to be effective. Thus, this study was designed to assess the level of adherence of people living with HIV (PLWH) to ART and its determinants in one of the hardest-hit areas with HIV in Ethiopia.
Methods
A health facility-based cross-sectional study design was conducted among adult PLWH, age >18 years, and receiving ART in southwest Ethiopia. Data was collected by face-to-face interviews following the Self-Rating Scale Item for drug adherence and from participants’ medical cards. The effects of variables related to socio-demographic and socio-economic factors, disease and medication, health facilities, and patients’ behavior on ART adherence were analyzed using a binary logistic regression model. The data was analyzed using R software.
Results
Self-reported good adherence to ART recorded in this study was 73.1% (n =301/412). The risk of poor adherence was significantly higher among those who were divorced, merchants, used ART for longer durationsand were found in stage IV WHO pathogenesis. Contrarily, those who had a positive perception of the effectiveness of ART had significantly better adherence to ART. Longer duration on ART and frequency of pills taken, ≥3 pills per day, were significantly associated with a low CD4+ cell count (<500 cells/mm3). For each unit increase in medication frequency per day, the likelihood of having a high viral load of >1000 copies/mL was 5.35 times higher.
Conclusion
The ART adherence documented in this study was graded as moderately low. Some variables, such as clinical, medical, and behavioral, were found to affect the adherence of people living with HIV to ART. Hence, care providers should be aware of such variables in the process of treatment, follow-up, and monitoring of people living with HIV in the study area.
Data Sharing Statement
The authors confirm that data supporting the results of this study are available in the article. Raw data supporting the results of this study are available from the corresponding author upon reasonable request.
Ethical Approval and Consideration
The study was ethically approved by Research and Ethical Review Board members of the College of Natural Sciences, Jimma University, dated 23 Oct 2019, Ref. No. RPG/18/2019. Initially, an official letter was sent to the hospital for the study cooperation. Data was collected after permission was obtained from the officials, and consent was earned from each participant. The participants were informed about the purpose of the study before data collection. Data was collected only from those who were willing to participate and confidentiality was maintained. The study fulfills the Declaration of Helsinki.
Acknowledgments
The authors would like to thank health authorities at all levels for permitting to conduct of the study and the study participants for their willingness to be recruited and their genuine responses. The authors would also like to thank Jimma University for the financial support of this study.
Disclosure
The authors declare that they have no conflicts of interest in this work.