Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
PLoS One. 2021 Aug 9;16(8):e0255912. doi: 10.1371/journal.pone.0255912. eCollection 2021.
In Ethiopia, nearly one-third of people living with human immunodeficiency viruses do not adhere to antiretroviral therapy. Moreover, information regarding non-adherence and its associated factors among adults on first-line antiretroviral therapy in Northeast Ethiopia is limited. Therefore, this study aimed to assess the level of non-adherence and its associated factors among adults on first-line antiretroviral therapy in North Shewa Zone, Amhara Regional State, Ethiopia.
A facility-based cross-sectional study was conducted on 326 participants selected by systematic random sampling technique from the five randomly selected public health facilities. Data were collected using the questionnaire adapted from the studies conducted previously and the collected data were entered into Epi data version 3.1 and exported to Stata version 14 for further analysis. Multivariable logistic regression analysis was done and an adjusted odds ratio with its corresponding 95% confidence interval was used to declare a statistical significance.
The overall prevalence of non-adherence was 17.4% [95% CI: (12.8%, 21.2%)]. Patients with no formal education [AOR (95% CI) = 5.57 (1.97, 15.88)], those who did not use memory aids to take their medications [AOR (95% CI) = 3.01 (1.27, 7.11)], travel more than 10 kilometers to visit the nearby antiretroviral therapy clinics [AOR (95% CI) = 2.42 (1.22, 25.86)], those who used substance [AOR (95% CI) = 3.57 (1.86, 28.69)], and patients whose medication time interfered with their daily routine activities [AOR (95% CI) = 15.46 (4.41, 54.28) had higher odds of having non-adherence to first-line antiretroviral therapy compared to their counter groups.
The level of non-adherence to first-line antiretroviral therapy was 17.4%, higher compared to WHO's recommendation. Hence, patients counseling focused on avoiding substance use, use memory aids, and adjusting working time with medication schedule are very crucial. Furthermore, the ministry of health and the regional health bureau with other stakeholders should expand antiretroviral therapy service delivery at health facilities that are close to the community to address distance barriers.
在埃塞俄比亚，近三分之一的艾滋病毒感染者未坚持接受抗逆转录病毒治疗。此外，关于东北埃塞俄比亚地区成人一线抗逆转录病毒治疗中不遵医行为及其相关因素的信息有限。因此，本研究旨在评估北谢瓦地区一线抗逆转录病毒治疗成人的不遵医行为及其相关因素。
采用基于设施的横断面研究，在从五个随机选择的公共卫生机构中通过系统随机抽样技术选择的 326 名参与者中进行。数据采用先前研究中改编的问卷收集，收集的数据录入 EpiData 版本 3.1 并导出到 Stata 版本 14 进行进一步分析。采用多变量逻辑回归分析，使用调整后的优势比及其相应的 95%置信区间来表示统计学意义。
总体不遵医率为 17.4% [95%CI:（12.8%，21.2%）]。无正规教育的患者[比值比（95%CI）=5.57（1.97，15.88）]、不使用记忆辅助来服药的患者[比值比（95%CI）=3.01（1.27，7.11）]、前往距离附近抗逆转录病毒治疗诊所超过 10 公里的患者[比值比（95%CI）=2.42（1.22，25.86）]、使用物质的患者[比值比（95%CI）=3.57（1.86，28.69）]和药物时间干扰日常活动的患者[比值比（95%CI）=15.46（4.41，54.28）]与对照组相比，不遵医一线抗逆转录病毒治疗的可能性更高。
与世卫组织的建议相比，一线抗逆转录病毒治疗的不遵医率为 17.4%，更高。因此，针对避免使用物质、使用记忆辅助和调整工作时间与药物计划的患者咨询非常重要。此外，卫生部和地区卫生局与其他利益攸关方应扩大靠近社区的卫生设施提供的抗逆转录病毒治疗服务，以解决距离障碍。
