Adherence to antiretroviral therapy and associated factors among HIV positive adults attending care and treatment in University of Gondar Referral Hospital, Northwest Ethiopia

Abstract

Background: Antiretroviral therapy has an impressive clinical effect on the human immunodeficiency virus although its effectiveness depends mainly on the adherence of patients to the therapy. Therefore, this study aimed to assess adherence status and associated factors of antiretroviral therapy among HIV infected adults on ART at the University of Gondar Referral Hospital, northwest Ethiopia. Methods: An institutional based cross-sectional study was conducted from May to June 2015. The systematic random sampling technique was used to select 440 study participants. Data collected using an intervieweradministered questionnaire was entered using EPI Info version 7 and analyzed using SPSS version 20. Both bivariate and multivariate logistic regression analyses were done. In the multivariate analysis, variables with P-value ≤ 0.05 were considered statistically significant between independent variables and the outcome variable (medication adherence). Adjusted odds ratio (AOR) with a 95% confidence interval was used to determine the strength and direction of the association. Results: A total of 440 participants were included in the study. The mean age of participants was 36.09 (SD±8.09) years. The overall rate of adherence to ART was 88.2% (95% CI=85.2, 91.1). Urban residence (AOR=6.99, 95% CI: 2.30, 21.27), no co-morbidity (AOR=0.13, 95% CI: 0.05, 0.33), knowledge about HIV and ART (AOR=7.54, 95% CI: 2.69, 21.15), and disclosed HIV status to partners (AOR=3.65 (1.06, 12.61) and CD4 count of ≥ 500mm 3 (AOR=3.91, 95% CI: 1.19, 12.81) were significantly associated with adherence. Conclusion: In this study, the rate of adherence to antiretroviral therapy was low compared to WHO standard. Prevention of co-morbidities, improving knowledge through health education, providing strong drug adherence counseling with more emphasis on the rural community, and encouraging HIV positive individuals to disclose their HIV status are crucial for ART adherence.