International Journal of Africa Nursing Sciences (Jan 2023)
Non-adherence to antiretroviral therapy and associated factors among adult HIV patients in Somali region public Hospitals, eastern Ethiopia
Abstract
Background: Antiretroviral adherence is defined as an individual's behaviors such as taking medications, following a diet, and/or making lifestyle changes that are consistent with agreed-upon recommendations from a health care provider. For antiretroviral therapy (ART), a high level of consistent adherence is required to suppress viral replication, improve immunological and medical outcomes, reduce the threat of emerging antiretroviral drug resistance, and reduce the risk of HIV transmission. Objective: To assess non-adherence to antiretroviral therapy and associated factors among adult HIV patients in Somali region public hospitals, eastern Ethiopia. Methods and materials: Research participants of 405 were studied in Jigjiga and Godey public hospitals at ART clinics from January 1st to June 30th, 2022, and interviewed consecutively until the set proportion was met in each hospital, using a facility-based cross-sectional study design. A pretested, semi-structured English questionnaire was used to collect data on socio-demographic variables, while a card review of the patient's medications, clinical stage, viral load, and CD4 count was performed. The information was coded and entered into Epidata version 3.1, then exported and analyzed with SPSS v20. To determine the relationship between the outcome variable and the independent factors, bivariate logistic regression was used, with a value of < 0.25 regarded as a candidate for multivariate logistic regression. Using multivariable logistic regression analysis, odds ratios with 95 percent confidence intervals were calculated to discover characteristics related to study participants' antiretroviral therapy (ART) non-adherence. A p-value of less than 0.05 was considered statistically significant. Result: The non-adherence rate was 19.3 % with a (95 % CI (15, 23.6), current CD4 count of 200–499 cells/mm3 [AOR = 2.007, CI = 1.051, 3.831], alcohol drinking [AOR = 2.613, CI = 1.105, 6.181], merchants [AOR = 4.726, CI = 1.249, 17.877], medication side effects [AOR = 5.817, CI = 2.858, 11.840], and age category of 25–44 years [AOR = 2.752, CI = 1.020, 7.426] were independent predictors of non-adherence to antiretroviral therapy. Conclusion: The outcome of non-adherence is high, and the factors associated with it are age, occupation, CD4 count, alcohol consumption, and medication side effects.
