Assessment of Level of Adherence to Anti Retroviral Therapy among Adult HIV Infected Patients in Mekelle Hospital, Northern Ethiopia

Abstract

Introduction: HIV/AIDS is one of the most destructive epidemics the world has ever witnessed. Non-adherence to the proposed antiretroviral regimen is considered to be one of the greatest dangers to the response to treatment on an individual level and the dissemination of resistant viruses on the community level. An adherent patient is defined as one who takes > 95% of the prescribed doses. Objective: To assess the level of adherence and associated factors among adult HIV/AIDS patients receiving Highly Active Antiretroviral Therapy in Mekelle Hospital, Northern Ethiopia. Methods: A cross sectional study was carried out from January 1, 2013 to July 30, 2013 among 382 adult PLWHA (>=18 years) attending HAART clinic at Mekelle Hospital. Data was collected by a combination of structured questionnaire and document review. The data was entered and cleaned using Epi-Info; transported to SPSS 16.0 version for final analysis. Bivariate and multivariate analyses were performed to identify factors associated with adherence. Results: The rate of self reported adherence in the study based on the Schedule and indicator of the dose, time measurement in the last 7 days was (78.3%). Females were more adhered than males (185(87.7%)). Alcohol users have poor adherence than non alcohol users with 70.5% and 82.2% level of adherence respectively. Sex and educational status of the study participants were significantly associated with level of adherence with AOR (95% CI) of 3.81(2.18, 6.69) and 2.60(1.43, 4.71) respectively. Conclusion: The level adherence we found, 78.2%, is still very low considering the WHO recommendation of 95%. Sex and educational status of the study participants were significantly associated with level of adherence with AOR (95% CI) of 3.81(2.18,6.69) and 2.60(1.43,4.71) respectively. More focus should be given to males and individuals with low educational status to improve level of adherence and to assure the efficacy of HAART in prolonging the life of PLWHA. Adherence is a process, not a single event, and adherence support must, therefore, be integrated into regular clinical follow up. Investigation of factors related with long-term adherence would require longer follow-up than the present study.

Adherence to Antiretroviral Therapy (ART) among People Living With HIV (PLHIV): a cross-sectional survey to measure in selected Public Hospital of Addis Ababa.

“…Patient adherence can be affected by various variables .The adherence of People living with HIV on antiretroviral therapy in Ethiopia is also influenced by multiple factors which include resources, cultural beliefs and practices, access to health facilities, stigmatization and support systems. Nonadherence to the proposed antiretroviral regimen is considered to be one of the main challenges to the response of a person to treatment and to the spread of resistant virus within the community ( 7 ). A large proportion of HIV infected patients in Ethiopia does not achieve the optimal adherence.…”

“…The key reason for non-adherence to ART is patient -related factors, treatment -related factors and health facilities -related factors. Suboptimal adherence to ART is a common phenomenon in SSA Countries and almost all these countries find it difficult to meet the WHO recommended 95% adherence rate (7). HIV and AIDS in Ethiopia continue to be one of the greatest public health obstacles.…”