Patient Preference and Adherence (Dec 2021)

Predictors of Poor Adherence to CART and Treatment Failure at Second-Line Regimens Among Adults in Public Hospitals of Amhara Region, North-Western Ethiopia: A Retrospective Cohort Study

  • Minwagaw MT,
  • Akenie BB,
  • Tewabe DS,
  • Tegegne AS,
  • Beyene TB

Journal volume & issue
Vol. Volume 15
pp. 2855 – 2864

Abstract

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Molalign Tarekegn Minwagaw,1 Betelihem Belete Akenie,1 Desalew Salew Tewabe,1 Awoke Seyoum Tegegne,2 Tariku Belachew Beyene3 1Department of Public Health, Amhara Public Health Institute, Bahir Dar, Ethiopia; 2Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Public Health, Amhara Region Health Bureau, Bahir Dar, EthiopiaCorrespondence: Awoke Seyoum TegegneDepartment of Statistics, Bahir Dar University, Po. Box 79, Bahir Dar, EthiopiaTel +251 918779451Fax + 251 2205927Email [email protected]: Globally, HIV/AIDS has challenged the lives of 36.3 million people and resulted in 17 million orphans. The disease has neither a vaccine nor a cure and the only option currently is highly active antiretroviral therapy. This research was conducted to identify the predictors of poor adherence to CART and treatment failure at second-line regimen among adults living with HIV/AIDS in public hospitals of Amhara region, north-western Ethiopia.Methods: A retrospective cohort study design was conducted on 700 HIV-positive people who were receiving a second-line CART regimen. Participants on second-line regimens who followed their treatment between 2016 and 2019 were considered. Data were extracted from participants’ clinical charts from June 18–July 7, 2020.Results: A multivariate regression analysis indicates that age of patients (OR = 1.025, 95% CI: 1.001– 1.321; p = 0.005), follow-up visits (OR = 0.979, 95% CI: 0.873– 0.998; p < 0.001), CD4 cell count change (OR = 0.9860; 95% CI: 0.835– 0.998; p < 0.01), marital status (OR = 0.973, 95% CI: 0.789– 0.997; p = 0.006), female HIV-infected patients (OR = 0.990; 95% CI: 0.789– 0.999; p < 0.001), rural patients (OR = 1.151; 95% CI 1.065– 1.398; p = 0.004), non-educated adult patients (OR = 1.026, 95% CI: 1.002– 1.198; p = 0.003), existence of social violence (OR = 0.012, 95% CI: 0.008– 0.134; p< 0.01), patients with opportunistic diseases (OR = 1.0345, 95% CI 1.002– 1.142; p = 0.001), CD4 cell count (OR = 0.901, 95% CI: 0.843– 0.995; p = 0.025) and malnutrition (OR = 0.883, 95% CI; 0.762– 0.954; p = 0.001) significantly affected the two response variables.Conclusion: Several variables affected both poor adherence to HAART and treatment failure at second-line regimens in the current investigation. Due attention should be given to aged patients, rural residents, non-educated patients, and patients with other morbidities to be successful with second-line treatment regimens.Keywords: adherence, second-line regimens, bivariate data analysis, treatment failure, HIV/AIDS

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