Highly active antiretroviral therapy adherence and its determinants in selected hospitals from south and central...

To determine the adherence rate and its determinants among people living with HIV/AIDS on highly active antiretroviral therapy (HAART) in selected governmental hospitals from central and south Ethiopia.

A cross-sectional study involving both qualitative and quantitative methods was conducted between August and October 2007 in Yirgalem, Hawassa, and Shashemene Hospitals. Quantitative data collection techniques include patient self-report and unannounced pill count and the qualitative methods employed were focus group discussions (FGDs), semi-structured interviews, and observations of health facilities.

Whereas females accounted for 56.4% (238), male participants were 43.6% (184) of the total participants. Adherence rate was 93.1% using 15-days self-report, but the rate came down to 88.1% when calculated using the unannounced pill count method (n = 90). Multivariate analysis revealed that being unmarried (OR = 0.119, CI = 0.016-0.901, p = 0.039), unemployment (OR = 0.011, CI = 0.000-0.288, p = 0.007); failure to disclose HIV status (OR = 0.433, CI = 0.198-0.949, p = 0.037); lack of support from family (OR = 0.393, CI = 0.163-0.947, p = 0.037); or others (OR = 0.332, CI = 0.144-0.845, p = 0.043); alcohol drinking (OR = 0.210, CI = 0.071-0.617, p = 0.003); treatment regimen, stavudine(40)-lamuvidine-nevirapine (OR = 0.174, CI = 0.033-0.923, p = 0.040), azathymidine-lamuvidine-nevirapine (OR = 0.172, CI = 0.034-0.867, p = 0.033) and dosing three times daily (OR = 0.073, CI = 0.018-0.290, p = 0.000) regimens were found to be associated with non-adherence. Moreover, time since diagnosis was associated with adherence, as those tested HIV-positive >or= 6 months prior to date of interview (OR = 4.064, CI = 1.23-19.316, p = 0.047) had better adherence rate.

The adherence rate obtained in this study was higher than the rates seen in developed countries despite the fact that many of the participants live in very poor conditions.