Adherence to Antiretroviral Therapy in Currently Changed Treatment Guideline on People Living with HIV/AIDS at Bishofitu Hospital, East Shoa, 2011. Ethiopa.
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Date
2011-01
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Addis Abeba Universty
Abstract
Background:
Adherence to antiretroviral therapy (ART) is crucial to ensure viral suppression, decrease the risk of
disease progression and drug resistance. Non-adherence to ART, likewise, is common in all groups of
treated individuals & lack of strict adherence to ART is considered to be one of the key challenges to
AIDS care worldwide.
Objective:
To assess adherence to ART on currently changed guideline and factors associated with it among
People Living with HIV/AIDS (PLWHA) attending ART unit at Bishofitu Hospital.
Method:
A cross sectional survey of 317 clients attending for ART at Bishofitu Hospital was carried out using
both quantitative & qualitative design method. Using a structured and pre-tested questionnaire, data on
drug adherence and other variables was collected through in-depth interview, peer educators FGD,
patient’s self report (interview), pill count and by reviewing their clinical records. The nurse & ART
Clinician who are working in the ART unit were involved in data collection after being trained. Ethical
clearance was obtained from concerned bodies and consent was sought from the study subjects.
Adherence is defined as the number of doses taken divided by the number of doses prescribed over a
given period. It is considered as good if the patient took ≥ 95% of the prescribed doses correctly. Odds
ratio was done to determine the strength of association for different variables.
Major Findings
The overall prevalence of HAART adherence was found to be, 398(95.4%) in this study. The highest
proportion, 61 % of patients missed or delayed their doses due to simply forgetting & 47.4% due to
being away from home & 29.4% being too busy. Independent positive predictors of HAART non
adherence reported in this study comprise:-the participants who had: PLWHA’s residency far from
Bishofitu hospital (>47 KM.), depression feelings , ART eligibility knowledge, medication adverse
effect, history active substance uses, no adequate social support & one or two children under their care
in the final adjusted multivariate analysis.
Conclusions & Recommendations:
The prevalence of ART adherence among clients using currently changed single combined
fixed dose in this study was found higher than most studies done in developed countries & even
much higher than the findings of other studies in Ethiopia. From these, we can infer that single &
simplified ART has reduced the pill burden & helped the clients to take it at ease & this has increased
the level of adherence behavior of clients, therefore continuous effort should be made to increase
clients’ awareness to maintain the best level of adherence outcomes.
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Keywords
Adherence to Antiretroviral Therapy in Currently Changed