Determinants of adherence to anti-retroviraltherapy (ART): protocols in public hospitals in Addis Ababa, Ethiopia

Abstract

In Ethiopia, Antiretroviral Therapy is given free of charge. Lifelong adherence to ART is crucial to upgrade the patients’ health condition and to safeguard the growth of mutated strains of the human immunity deficiency viruses that are ART resistant. A person with ART resistant strains of HIV can spread these to other people, who need more expensive ART with more serious side effects. The purpose of the study is to improve the level of adherence to different ART protocols in three public hospitals of Addis Ababa.The study population is people living with HIV/AIDS who are 18 years and above, and were enrolled in ART treatment from outpatient health clinics at three selected in Addis Ababa, public hospitals. The study began with an explanatory qualitative phase utilizing three focus group discussions and 44 in-depth interviews with people living with HIV (PLHIV), peer educators, health care providers, family social supporters and policy makers. The Qualitative data were analyzed using the ATLAS-the 8 software. Among 385 HIV+ patients, a cross-sectional quantitative research was carried out. Data were collected through a structured questionnaire on a randomly selected sample of the study population. Quantitative data were analyzed using SPSS 22 version. Both qualitative and quantitative data were collected from January to May 2019.Adherence to ART in this finding using the modified Adult AIDS Clinical Trials Group instrument was 86.9%. The qualitative finding also included variables for the conceptual framework and instrument development on-adherence has been substantially associated with depression, alcohol use, and forgetfulness to take medicine, being busy, faith, stigma and discrimination, side effects of medication and low quality of information from health care professionals . In order to increase the degree of adherence to ART, strategies were developed on the basis of the findings. Effective implementation of the proposed strategies depends onthe help of the Ministry of Health and Regional Health Bureau in terms of funding and the willingness of health care providers to adhere to the proposed measures. Intervention research is required to assess the efficacy of strategies proposed.