Adherence and Its Associated Factors Among Adult HIV-Infected Patients on Antiretroviral Therapy in South Western Ethiopia, 2020

Background: Good adherence to antiretroviral therapy (ART) suppresses the viral load, reconstitutes the immune system, and decreases opportunistic infections among HIV-positive patients. However, adherence to ART is still challenging in developing countries such as Ethiopia. The study, therefore, aimed to assess adherence and its associated factors among HIV-positive patients on ART in southern Ethiopia in 2020.

Materials And Methods: A cross-sectional study was conducted among 329 randomly selected participants. A structured questionnaire was used to collect the data through a face-to-face interview from January 23 to February 23, 2020. Data were entered into Epidata 3.1 and exported to SPSS version 21 for analysis. Bivariate and multivariate logistic regressions were used for analysis. A -value of less than 0.05 was considered significant in a multivariate logistic regression analysis.

Results: In total, 274 patients (83.3%) had good adherence to ART, while 16.7% did not adhere. Age between 39 and 49 years old (AOR=0.068, 95% CI 0.008, 0.578), urban residency (AOR=5.186, 95% CI 1.732, 15.529), an educational status of being unable to read and write (AOR=0.097, 95% CI 0.012, 0.771), an educational status of reading and writing with no formal education (AOR=0.056, 95% CI 0.006, 0.532), comorbidity (AOR=0.042, 95% CI 0.013, 0.139), disclosure (AOR=3.583, 95% CI 1.008, 12.739), WHO clinical stage II (AOR=0.098, 95% CI 0.021, 0.453), and CD4 count ≥500 cells/mm (AOR=5.634, 95% CI 1.203, 26.383) were significantly associated with adherence to ART among patients.

Conclusion: The adherence of patients to ART is relatively low compared to other studies conducted in different regions. Age 39-49 years, educational status, comorbidity, and WHO clinical staging were negatively associated with ART adherence. Residency, disclosure, and current CD4 category greater than or equal to 500 cells/mm were positively associated with adherence. Good counseling to patients from rural areas, with low educational status, and with low CD4 counts, and on the importance of disclosure, is recommended and should be given by professionals.