Assessment of Determinants of Adherence to Antiretroviral Therapy Among People Living With HIV/AIDS at Debre Markos Referral Hospital
No Thumbnail Available
Date
2012-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: At the end of 2009, there were about 33.3 million [31.4 million –35.3
million] people living with HIV globally. About one million people live with HIV in Ethiopia.
More than five million people are now receiving HIV treatment. In Ethiopia 1.1million
people live with HIV at end of 2009. Total number of PLWHA on treatment as of March
2010 was 186,607 with a coverage of 64% of those in need. The advent of highly
active antiretroviral treatment (HAART) has dramatically improved the prognosis for HIVpositive
patients.
The
efficiency
of
antiretroviral
therapy
depends
on
a
near
perfect
level
of
patients’ adherence. Antiretroviral treatment adherence levels of > 95% optimize
patients` outcomes and minimize antiretroviral drug resistance.
Objectives : The objective of this study was to assess the level of adherence and its
determinants for antiretroviral treatment among people living with HIV/AIDS on highly active
antiretroviral therapy(HAART) at Debre Markos Referral Hospital in East Gojjam Zone.
Methods: A cross sectional survey design using both quantitative and qualitative methods
was used to conduct this study. Systematic random sampling technique was used to
select participants for the quantitative assessment. A total of 528 people living with
HIV/AIDS and treated with highly active antiretroviral drugs were involved to examine
sets of variables using an interview method and card review to address some variables.
Result : Out of the 528 participants, 312(59.1%) were females. The mean age was
36 + 9.5 years and ranged from 18 to 75 years. The adherence level based on seven days
recall self-reported dose adherence was 94.5%. Independent predictors of HAART
adherence reported in this study included: residence i.e. living in urban areas was (AOR:
4.348; 95% CI: 1.725,10.960; p =0.002) times more likely to be adherent than living in rural
areas, and the odds of satisfaction obtained from health change after starting ART(AOR:
6.967; 95%CI: 1.03,37.251; p=0.023) higher than odds of no satisfaction. Presence of child
under their care(AOR:0.227; 95% CI: 0.103, 0.742; p=0.011) times less likely to adhere than
absence of child under care and substance and alcohol users(AOR: 0.325; 95%CI: 0.11,0.951;
p=0.040) times less likely to adhere than non-users. This study also showed that being away
from home, busy with other things, forgetting, lack of transportation were common causes for
missing of doses to the study participants.
Conclusion and Recommendation: The result of this study showed that living in rural
areas and absence of satisfaction obtained from health change after starting of antiretroviral
treatment, presence of children under care and substance use were negative predictors for
adherence. Therefore, emphasis should be given on these factors to improve adherence.
Description
Keywords
HIV/AIDS,Antiretroviral Therapy