Dterminants of Adherence to Antiretrovial Treatment in Shashemene General Hospital
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Date
2007-07
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Addis Abeba university
Abstract
In this study we have investigated the factors of adherence to ART and selected
those factors or variables that can discriminate between adherent and non adherent
patients on ART. Simple structured questionnaire was employed and self reported
adherence measurement was used. Bivariate data analysis was used to investigate
the association of the independent variables adherence to ART using Pearson Chisquare
for categorical variables and parametric and non parametric measure of
association was used for the opinion variables. Further more, Multivariate data
analysis was used to investigate the combination effect of the variables using
Principal component analysis, Factor analysis and Discriminant analysis.
The study sample comprises of 147 HIV patients who receive ART in the
Shashemene General Hospital (SGH).They were interviewed using simple
structured questionnaire. Using self report measure of adherence in the two weeks
of study period 81% of the patients on ART were adherent. Where as 19% of the
patients were non adherent. The mean non adherence percentage was calculated
using only those non adherent patients and it was 81.19%.The major reasons of non
adherence were: forget to take (28.6%), confused how and when to take (17.9%)
and feel depressed (14.2%). The following factors were associated with adherence
to ART using bivariate data analysis: occupation, Education level, Income,
depression, and service hour. However, in the multivariate analysis some of the
variables have been dropped. In multivariate analysis we used only the likert scale
variables. Using principal component analysis and factor analysis four factors were
extracted from the whole study variables. We labeled them as social support, HIV
serostatus disclosure; Home based care and psychological well being. While using
discriminant analysis we identified depression, poor NGO support and HIV
serostatus disclosure as barriers of adherence and no transportation problem, strong
NGO support, good reception in the service area and high CD4 count have been
identified as facilitators of adherence
The mean self reported adherence rate was calculated and was found to be 84.62%.
In addition to this, 81% of the patients are below the 95% threshold value for
adherence. To improve adherence of patients on ART, the current ART program
should strive to manage depression before and after the initiation of ART. Strong
linkage between NGOs which are working in care and support program has to be
established.A collaborative work with the community to increase the awareness of
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ART in the community has to be implemented. Further more intervention on the
service area to improve the service quality and a free transportation or equivalent
method of alleviating the transportation problem has positive impacts on the results
of the program
Description
Keywords
Antiretrovial Tereatment