Adherence to antiretroviral therapy and its associated factors among HIV positive patients in Nekemte public health institutions, West Ethiopia

Background: Adherence to antiretroviral therapy is a powerful predictor of survival of HIV positive patients. The rate of non-adherence to antiretroviral therapy remains high in developing countries, even though it is not well documented in the study area. Hence, this study aimed to assess the level of adherence to antiretroviral therapy and associated factors among HIV positive patients.

Materials and methods: An institution based cross-sectional study was conducted among 383 HIV positive patients. Respondents were selected by systematic random sampling technique. A pre-tested and structured questionnaire was used to collect data. The data were entered to Epi-Info and exported to SPSS for further analysis.

Results: The self-reported adherence level in this study was 89.3%. Common reasons of being non-adherent were: being busy [2.6%], simply forgetting [7.3%], and being away from home [4.7%]. Adherence was more likely common among patients who lived _30 km far from health care facilities [AOR = 16.031, 95% CI: 2.428, 11.483], had normal mood [AOR = 5.722, 95% CI: 1.492, 21.945], had not an opportunistic infection [AOR = 6.910, 95% CI: 1.980, 24.112], whereas less likely among those who had college and above education [AOR = 0.10, 95% CI: 0.013, 0.348] and malnutrition [AOR = 0.270, 95% CI: 0.079, 0.919].

Conclusions: Self-reported adherence in this study was higher than that seen in developing countries. Management of depression and opportunistic infections using an alarm clock, nutrition education, encouragement of social support and counseling of the patient to attend their follow up at nearer health care facilities are recommended to improve the adherence level.