Determinants of non-adherence to antiretroviral therapy in adult hospitalized patients, Northwest Ethiopia

Abstract

AimThe aim of this study was to assess the rate of antiretroviral therapy (ART) adherence and to identify any determinants among adult patients.MethodsA cross-sectional study was conducted on 351 ART patients in the ART clinic of the University of Gondar referral hospital. Data were collected by a pretested interviewer-administered structured questionnaire from May to June 2014. Multivariate logistic regression was used to determine factors significantly associated with adherence.ResultsOf 351 study subjects, women were more predominant than men (64.4% versus 35.6%). Three hundred and forty (96.9%) patients agreed and strongly agreed that the use of ART is essential in their life, and approximately 327 (93.2%) disclosed their sero-status to family. Seventy-nine (22.5%) participants were active substance users. The level of adherence was 284 (80.9%). Three hundred forty-one (97.2%) respondents had good or fair adherence. Among the reasons for missing doses were forgetfulness (29 [43.3%]), missing appointments (14 [20.9%]), running out of medicine (9 [13.4%]), depression, anger, or hopelessness (4 [6.0%]), side effects of the medicine used (2 [3.0%]), and nonbelief in the ART (2 [3.0%]). The variables found significantly associated with non-adherence were age (P-value 0.017), employment (P-value 0.02), HIV disclosure (P-value 0.04), and comfortability to take ART in the presence of others (P-value 0.02).ConclusionFrom this study, it was determined that forgetfulness (43.3%) was the most common reason for missing doses. Also, employment and acceptance in using ART in the presence of others are significant issues observed for non-adherence. Hence, the ART counselor needs to place more emphasis on the provision and use of memory aids.

Patient Factors Influencing Adherence to ART Treatment among HIV/AIDS Patients in Embu Teaching and Referral Hospital Comprehensive Care Clinic

“…Similar findings were made in Ethiopia where it was observed that unemployed patients were more likely to be depressed and less likely to socialize, leading to miss appointments and access to health care [23]. Similar findings were also made in Cameron where it was reported that adherence was high among employed patients as compared to unemployed patients [24].…”

Factors Associated with Non-Adherence to Antiretroviral Treatment in Adults at Keetmanshoop District State Hospital in Namibia

“…Some of the reasons mentioned in this study, for example forgetfulness, transport problems and work commitments are similar to those reported in other studies [5,8,9]. However, while lack of food was mentioned in this study as reason for missed dose, in Northern Namibia, lack of food was not revealed as a reason for missed doses [9].…”

“…Given the large number of patients whose HIV infection will progress to AIDS if adherence is suboptimal, research is urgently needed to determine factors influencing adherence so that the most effective interventions to ensure adherence in African cohorts can be employed [4]. In a study in Ethiopia, 26.5% of the respondents had sub optimal adherence [5]. Locally, a recent study from Northern Namibia reported that 22% of respondents were non-adherent measured by pill count assessment.…”

Factors Associated with Non-Adherence to Antiretroviral Therapy among Adults living with HIV/AIDS in Arsi Zone, Oromia

“…A study done in North-West Ethiopia showed that the reasons for missing doses were forgetfulness (43.3%) and side-effect of antiretroviral therapy drugs (3%) [27]. Study done in Addis Ababa, Ethiopia showed that the major reasons for non-adherence include simply forgot which was 33.9% [37].…”

“…However, study done in North-West Ethiopia found that among reasons for missing doses were forgetfulness 29 (43.3%) and side-effect of antiretroviral therapy drugs 2 (3%) [27].…”