Haile Hantalo Admasu, Tantu Arusi Temesgen, Kolato Koche Sitotaw
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
AIDS Res Hum Retroviruses. 2023 Oct;39(10):518-524. doi: 10.1089/AID.2022.0100. Epub 2023 Jun 26.
Early antiretroviral therapy (ART) initiation is WHO recommendation to fasten viral suppression and for prevention of further viral transmission sexually. There is no evidence showing the level of adherence to ART after initiation of the universal test and treat (UTT) strategy in Ethiopia, including study area. This study was aimed to determine the level of ART adherence and associated factors among HIV/AIDS patients in context of UTT strategy. A health facility-based study was conducted on 352 people living with HIV who started their ART follow-up after application of UTT strategy in Ethiopia from April 15 to June 5, 2020. Systematic random sampling method was used to select the study participants. Interviewer administered questionnaire was used to collect data and the collected data were entered directly in to SPSS version 21 and analyzed. Both bivariate and multivariate logistic regression analyses were carried out. Strength and direction of association was determined by using adjusted odds ratio (AOR) with 95% confidence interval. The total 352 participants included the study. The overall level of adherence was 290 (82.4%). Commonly used ART regimen was TDF +3TC+EFV, 201 (57.1%). In bivariate analysis, type of health institutions, crude odds ratio (COR) = 2.934 (1.388-6.200), age level of 18-27 years, COR = 0.357 (0.133-0.959), current viral load of 3log scale, COR = 0.357 (0.133-0.959), and change of ART medication, COR = 8.088 (1.973-33.165) were associated with medication adherence. Health institution type AOR = 2.615 (1.147-5.9600) and change of ART medication, AOR = 7.267 (1.683-31.384) were independent predictors of ART adherence. Low level of ART adherence was detected in this study. It was below the recommended good adherence standard and 90-90-90 target strategy. Therefore, patients should get adequate and comprehensive ART adherence counseling before initiation of ART treatment and during the follow-up time.
早期启动抗逆转录病毒疗法（ART）是世界卫生组织的建议，目的是加快病毒抑制并预防性传播。在埃塞俄比亚，包括本研究地区在内，没有证据表明在实施普遍检测与治疗（UTT）策略后ART的依从水平。本研究旨在确定UTT策略背景下HIV/AIDS患者的ART依从水平及相关因素。2020年4月15日至6月5日在埃塞俄比亚对352名开始接受ART随访的HIV感染者进行了一项基于医疗机构的研究。采用系统随机抽样方法选择研究参与者。通过访谈员管理的问卷收集数据，并将收集到的数据直接录入SPSS 21版进行分析。进行了双变量和多变量逻辑回归分析。关联的强度和方向通过使用调整后的比值比（AOR）及95%置信区间来确定。共纳入352名参与者进行研究。总体依从水平为290人（82.4%）。常用的ART方案是替诺福韦酯（TDF）+拉米夫定（3TC）+依非韦伦（EFV），共20例（57.1%）。在双变量分析中，医疗机构类型，粗比值比（COR）=2.934（1.388 - 6.200）；年龄在18 - 27岁，COR = 0.357（0.133 - 0.959）；当前病毒载量为3log级别，COR = 0.357（0.133 - 0.959）；以及ART药物变更，COR = 8.088（1.973 - 33.165）与药物依从性相关。医疗机构类型AOR = 2.615（1.147 - 5.9600）以及ART药物变更，AOR = 7.267（1.683 - 31.384）是ART依从性的独立预测因素。本研究中检测到ART依从水平较低。低于推荐的良好依从标准和90 - 90 - 90目标策略。因此，患者在开始ART治疗前及随访期间应获得充分且全面的ART依从性咨询。
