Abstract:
Background: Although the goal of achieving ‘as close as possible to universal access to
treatment for all those who need it by 2010 has been stated in 2005(1), the implementation of
successful treatment programs remain a challenge in Sub-Saharan Africa. One of the major
challenges in AIDS treatment programs is adherence. There is little evidence as to why some
ARV users do not achieve optimal adherence rates in ART centers in Ethiopia.
Study Objectives: The objective of this study was to identify structural and patient-related
factors to ART adherence and to assess the quality of the process involved in providing ART
services for patients attending the selected sites.
Study Methods: The study utilized a qualitative study design using semi-structured interviews,
in-depth interviews and observational methods
Results: Cost of transport to ART centers, lack of adequate food/nutrition, and stigma and
discrimination were among the factors which adversely affect adherence. Missing and/or
delaying in taking the ARVs doses due to work load, travel, forgetfulness and lack of disclosure
were among the factors contributing to poor adherence. Disclosure supports adherence and most
of the ARV users had disclosed their HIV positive status at least to one family member. On the
other hand, most of the clients expressed their satisfaction with the new fixed dose combination
(FDC) ARVs regimen, by stating that it is easier to take, so that it contributes to adhere better
compared to the previous ARVs regimen.
Conclusion and recommendations: Lack of food and stigma and discrimination are among the
major factors affecting adherence. Re-designing food support programs and enhanced social
mobilization are among the recommendations.
