Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
Department of Midwifery, College Of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
BMJ Open. 2022 Jan 3;12(1):e056009. doi: 10.1136/bmjopen-2021-056009.
This study aims to identify levels of adherence to antiretroviral therapy (ART) drugs and factors associated with them in Northwest Ethiopia. We hypothesise that in the era of COVID-19, there would be suboptimal adherence to ART drugs.
An observational cross-sectional study was conducted. Factors associated with the level of adherence were selected for multiple logistic regressions at a p value of less than 0.2 in the analysis. Statistically significant associated factors were identified at a p value less than 0.05 and adjusted OR with a 95% CI.
The study was conducted in one specialised hospital and three district hospitals found in the South Gondar zone, Northwest Ethiopia.
About 432 people living with HIV/AIDS receiving highly active ART in South Gondar zone public hospitals and who have been on treatment for more than a 3-month period participated in the study.
Levels of adherence to ART drugs and their associated factors.
Among 432 study participants, 81.5% (95% CI: 78% to 85.2%) of participants were optimally adherent to ART drugs. Determinants of a low level of adherence: stigma or discrimination (OR=0.4, p=0.016), missed scheduled clinical visit (OR=0.45, p=0.034), being on tuberculosis treatment (OR=0.45, p=0.01), recent CD4 cell count less than 500 cells/mm (OR=0.3, p=0.023) and patients who had been on WHO clinical stage III at the time of ART initiation (OR=0.24, p=0.027) were factors significantly associated with adherence to ART drugs.
Level of adherence was relatively low compared with some local studies. The intervention targeted to reduce discrimination, counselling before initiation of treatment and awareness regarding compliance is advised to improve adherence to antiretroviral regimens.
本研究旨在确定在埃塞俄比亚西北部抗逆转录病毒疗法（ART）药物的依从水平以及与之相关的因素。我们假设在 COVID-19 时代，ART 药物的依从性会不理想。
本研究采用观察性横断面研究。在分析中，将在 p 值<0.2 的情况下选择与依从水平相关的因素进行多变量逻辑回归。在 p 值<0.05 时确定有统计学意义的相关因素，并使用 95%CI 进行调整后的 OR。
该研究在埃塞俄比亚西北部南贡德尔地区的一家专科医院和三家区医院进行。
约 432 名在南贡德尔地区公立医院接受高效抗逆转录病毒治疗并已接受治疗超过 3 个月的艾滋病毒/艾滋病感染者参加了这项研究。
ART 药物的依从水平及其相关因素。
在 432 名研究参与者中，81.5%（95%置信区间：78%至 85.2%）的参与者对 ART 药物的依从性良好。依从性低的决定因素包括：耻辱感或歧视（OR=0.4，p=0.016）、错过预约的临床就诊（OR=0.45，p=0.034）、正在接受结核病治疗（OR=0.45，p=0.01）、最近的 CD4 细胞计数低于 500 个细胞/mm（OR=0.3，p=0.023）和在开始 ART 时处于世界卫生组织临床阶段 III 的患者（OR=0.24，p=0.027）是与 ART 药物依从性显著相关的因素。
与一些本地研究相比，依从水平相对较低。建议采取针对减少歧视、治疗前咨询和提高对依从性的认识的干预措施，以提高抗逆转录病毒方案的依从性。
