Dibaba Diriba, Kajela Gemechu, Chego Melese, Ermeko Tilahun, Zenbaba Demisu, Hailu Sintayehu, Kasim Jeylan, Abdulkadir Adem
Public Health Department, MaddaWalabu University Goba Referral Hospital, Goba, Oromia, Ethiopia.
Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia.
HIV AIDS (Auckl). 2021 Dec 15;13:1067-1078. doi: 10.2147/HIV.S327784. eCollection 2021.
Many studies investigating antiretroviral treatment (ART) adherence found the majority of patients had suboptimal adherence for a variety of different reasons. The study aimed to compare the ART adherence level and associated factors among adult human immune deficiency virus (HIV) positive patients on both care models in selected hospitals.
An institution-based comparative cross-sectional study was conducted among 463 HIV positive patients on ART. The study samples were selected using systematic random sampling, and pretested semi-structured interviewer administered questionnaire was used to collect data. Binary and multivariable logistic regression analyses were used to see the association between outcome and predictors using odds ratio with a 95% confidence interval to estimate the strength of the association.
The study had a response rate of 445 (96.1%). Of the study participants, 325 (73%) and 120 (27%) were from the routine and appointment spacing models, respectively. Patients on the appointment spacing model had higher levels of optimum adherence (87.5% vs 74.27%, respectively; p = 0.006). Patients' satisfaction with health service delivery (OR = 0.31, 95%: CI 0.11-0.84), antiretroviral drug dosage taken per day (OR = 3, 95%: CI 1.16-8.1), disclosure of HIV status (OR = 0.30, 95%: CI 0.09-0.93), distance from patient residency to health facility (OR = 0.11, 95%: CI 0.03-0.34), the memory aids used (OR = 0.02, 95%: CI 0.01-0.05), and type of HIV/AIDS care model (OR= 0.24, 95%: CI 0.1-0.6) were factors significantly associated with ART adherence level.
ART patients on the appointment spacing model had higher optimum ART adherence levels than those on the routine schedule due to factors like satisfaction status, disclosure status, type of memory aid used, type of ART care model used, and distance from the care facility. Therefore, promoting adherence enablers and alleviating barriers of ART adherence will improve ART adherence levels.
许多调查抗逆转录病毒治疗（ART）依从性的研究发现，大多数患者由于各种不同原因依从性欠佳。该研究旨在比较选定医院中两种护理模式下成年人类免疫缺陷病毒（HIV）阳性患者的ART依从性水平及相关因素。
对463名接受ART的HIV阳性患者进行了一项基于机构的比较横断面研究。研究样本采用系统随机抽样选取，并使用预先测试的半结构化访谈问卷收集数据。采用二元和多变量逻辑回归分析，以优势比和95%置信区间来观察结果与预测因素之间的关联，以估计关联强度。
该研究的应答率为445（96.1%）。在研究参与者中，分别有325名（73%）和120名（27%）来自常规模式和预约间隔模式。采用预约间隔模式的患者具有更高水平的最佳依从性（分别为87.5%和74.27%；p = 0.006）。患者对医疗服务提供的满意度（OR = 0.31，95%：CI 0.11 - 0.84）、每日服用的抗逆转录病毒药物剂量（OR = 3，95%：CI 1.16 - 8.1）、HIV感染状况的披露（OR = 0.30，95%：CI 0.09 - 0.93）、患者居住地到医疗机构的距离（OR = 0.11，95%：CI 0.03 - 0.34）、使用的记忆辅助工具（OR = 0.02，95%：CI 0.01 - 0.05）以及HIV/AIDS护理模式类型（OR = 0.24，95%：CI 0.1 - 0.6）是与ART依从性水平显著相关的因素。
由于满意度状况、披露状况、使用的记忆辅助工具类型、使用的ART护理模式类型以及到护理机构的距离等因素，采用预约间隔模式的ART患者比按常规时间表就诊的患者具有更高的最佳ART依从性水平。因此，促进依从性促进因素并减轻ART依从性障碍将提高ART依从性水平。
