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3rd International AIDS Society Conference on HIV Pathogenesis and TreatmentRio de Janeiro - July 24 - 27, 2005 |
FACTORS ASSOCIATED WITH ART NONADHERENCE IN DAR ES SALAAM: FINDINGS FROM A CROSS-SECTIONAL STUDY, JUNE - AUGUST 2004
IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. MoPp0301
Ndayanga P.O.1, Kwesigabo G.2, Mugusi F.3, Majigo M.2, Almeida A.3, Munubhi E.2
1Interchurch Medical Assistance, Dar Es Salaam, United Republic of Tanzania, 2Muhimbili University College Of Health Sciences, Dar Es Salaam, United Republic of Tanzania, 3Muhimbili National Hospital, Dar Es Salaam, United Republic of Tanzania
INTRODUCTION: A number of factors including sociodemographic and behavioural characteristics as well as provider related factors have been reported to influence nonadherence to ART. The objective of this study was to determine the factors associated with nonadherence to ART so as to provide an entry point to the interventions.
METHOD: A cross-sectional study of consecutive attendees at Muhimbili National Hospital and Regency Medical Centre HIV clinics, who were on ARVs, was conducted from June to August 2004. A face-to-face interview using a semi-structured standard questionnaire was used to obtain the necessary information. Sociodemographic and other behavioural characteristics were treated as explanatory variables whereas missing/not missing dose(s) was treated as outcome variable during analysis. Bivariate analysis examined the association and strength of relationship between explanatory and outcome variables using the 95%CI around proportions.
RESULTS: Three hundred and four patients were recruited into the study. Fifty six of them (18.4%) reported to had missed dose(s) in the previous month. Not knowing the consequences of intermittent dosing was highly associated with ART nonadherence (95%CI 35.5-62.77 vs. 8.06-16.45). Taking alcohol and using alternative medicines were other factors strongly associated with nonadherence (31.62-55.23 vs. 7.20-15.67 and 36.77-65.05 vs. 8.27-16.64 respectively). Sociodemographic characteristics and serostatus disclosure were not significantly associated with ART nonadherence. The most frequent reasons for missing dose(s) were delayed refill, related to poor logistics at clinics (59%) and economic constraints (23%).
CONCLUSION: Sociodemographic characteristics and serostatus disclosure are not predictive of ART adherence. Alcohol intake and using alternative medicines contribute to nonadherence. Providers contribute significantly to ART nonadherence by failing to adequately educate their clients on the effects of nonadherence and by poor plans of ARVs refill. Both patients and providers should be targeted by interventions aimed at improving adherence to ART.
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Clinical | MoPp0301 | Protas Oscar Ndayanga
12.7 239 12.7 Adherence
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