Assessment of ART adherence at Dilla Hospital from March to April 2009, Southern Ethiopia

Abstract

Background: Ethiopia introduced ART (Anti-retroviral therapy) relatively recently, in 2004. However, the effectiveness of the intervention has not been evaluated. The objective of this study was to assess the level of adherence among patients enrolled to ART in Dilla Hospital and determining factors for non-adherence. Method: A cross-sectional study with internal comparison was conducted among AIDS patients receiving antiretroviral treatment at Dilla Hospital Systematic sampling method was used to draw study subjects. Total of 348 study subjects were participated in the study. Data collection was done from March 20 to April 19, 2009 using structured questionnaires. Then it was analyzed using EPI-info and SPSS 15.0 version. Result: The level of ART adherence at Dilla hospital based on multi-method assessment was 77%, while single method alone shown (Self-report 292(83.9%), PIT 291(83.6%) and Pill count 276(79.3%). Disclosure HIV status, knowledge about ART adherence, presence of social support were associated with ART adherence level AOR (95% C.I) = 4.041(1.721, 9.491), 62.960(23.475, 168.860), and 3.516(1.362, 9.077) respectively. Conclusion and Recommendations: The lower level of ART adherence is critical problem and poses challenges on expansion of ART service because of it consequence such as emerging drug resistance virus which could divert the benefit of ART with high morbidity and mortality. An effort should be done for fighting stigma and discrimination through participation of CBOs (Community Based Organizations), cultural structures like Idirs and strengthens PLHIV association. Encouraging patients in order to involve family members before and after initiation of ART treatment is also an important strategy to reduce non-adherence factors.