Belete Nigus Kabtu, Gadore Tesfaye Feleke, Assefa Darik Temesgen, Teshale Manaye Yihune, Sorrie Muluken Bekele, Tariku Eshetu Zerihun
School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
BMJ Open. 2025 Jan 15;15(1):e082874. doi: 10.1136/bmjopen-2023-082874.
Undernutrition is a common issue for HIV and other immune suppressed patients. Approximately 462 million people worldwide living with HIV are experiencing undernutrition, with sub-Saharan Africa having the highest prevalence. Good adherence to antiretroviral therapy (ART) indirectly helps prevent undernutrition by suppressing viral load, increasing CD4 count, preventing viral resistance, enhancing immune reconstitution and delaying disease progression in HIV patients. This study aims to assess the association between poor drug adherence and undernutrition among adult HIV patients in southern Ethiopia.
An institution based cross sectional study design was used.
The study was conducted in 406 randomly selected adult HIV patients from Gamo zone public health facilities.
The data were collected by a trained data collector using a structured interviewer administered questionnaire, patient record review and physical measurements. Binary logistic regression was run to select candidate variables, and a multivariable logistic regression model was used to assess the association between undernutrition and poor drug adherence, as well as other variables. A p value <0.05 with 95% CI was considered statistically significant.
The magnitude of undernutrition was 28% (95% CI 24.0 to 33). Being a male patient (AOR 2.0, 95% CI 1.243 to 3.573), poor ART drug adherence (AOR 3.6, 1.815 to 7.428) and consuming <5 food groups (AOR 4.8, 2.901 to 8.265) were significantly associated with undernutrition among adult HIV patients.
Poor drug adherence was significantly associated with undernutrition. Also, sex and dietary diversity were identified as predictors for undernutrition among adult HIV patients. Therefore, effectively managing poor drug adherence, nutritional supplements and communicating behavioural change implications are critical for successfully preventing undernutrition.
营养不良是艾滋病毒感染者和其他免疫抑制患者的常见问题。全球约有4.62亿艾滋病毒感染者存在营养不良问题，撒哈拉以南非洲地区的患病率最高。良好地坚持抗逆转录病毒疗法（ART）通过抑制病毒载量、增加CD4细胞计数、预防病毒耐药性、增强免疫重建以及延缓艾滋病毒患者的疾病进展，间接有助于预防营养不良。本研究旨在评估埃塞俄比亚南部成年艾滋病毒患者中药物依从性差与营养不良之间的关联。
采用基于机构的横断面研究设计。
该研究在从加莫地区公共卫生设施中随机选取的406名成年艾滋病毒患者中进行。
数据由经过培训的数据收集者通过结构化访谈问卷、患者记录审查和身体测量来收集。进行二元逻辑回归以选择候选变量，并使用多变量逻辑回归模型评估营养不良与药物依从性差以及其他变量之间的关联。p值<0.05且95%置信区间被认为具有统计学意义。
营养不良的发生率为28%（95%置信区间24.0至33）。成年艾滋病毒患者中，男性患者（调整后比值比[AOR]为2.0，95%置信区间1.243至3.573）、抗逆转录病毒疗法药物依从性差（AOR为3.6，1.815至7.428）以及食用食物种类少于5种（AOR为4.8，2.901至8.265）与营养不良显著相关。
药物依从性差与营养不良显著相关。此外，性别和饮食多样性被确定为成年艾滋病毒患者营养不良的预测因素。因此，有效管理药物依从性差的问题、提供营养补充剂以及传达行为改变的影响对于成功预防营养不良至关重要。
