Determinants of Adherence to Antiretroviral Treatment in Shashemene General Hospital

Abyiot, Teklu (2007) Determinants of Adherence to Antiretroviral Treatment in Shashemene General Hospital. Masters thesis, Addis Ababa University.

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Abstract

In this study we have investigated the factors of adherence to ART and selected those factors or variables that can discriminate between adherent and non adherent patients on ART. Simple structured questionnaire was employed and self reported adherence measurement was used. Bivariate data analysis was used to investigate the association of the independent variables adherence to ART using Pearson Chisquare for categorical variables and parametric and non parametric measure of association was used for the opinion variables. Further more, Multivariate data analysis was used to investigate the combination effect of the variables using Principal component analysis, Factor analysis and Discriminant analysis. The study sample comprises of 147 HIV patients who receive ART in the Shashemene General Hospital (SGH).They were interviewed using simple structured questionnaire. Using self report measure of adherence in the two weeks of study period 81% of the patients on ART were adherent. Where as 19% of the patients were non adherent. The mean non adherence percentage was calculated using only those non adherent patients and it was 81.19%.The major reasons of non adherence were: forget to take (28.6%), confused how and when to take (17.9%) and feel depressed (14.2%). The following factors were associated with adherence to ART using bivariate data analysis: occupation, Education level, Income, depression, and service hour. However, in the multivariate analysis some of the variables have been dropped. In multivariate analysis we used only the likert scale variables. Using principal component analysis and factor analysis four factors were extracted from the whole study variables. We labeled them as social support, HIV serostatus disclosure; Home based care and psychological well being. While using discriminant analysis we identified depression, poor NGO support and HIV serostatus disclosure as barriers of adherence and no transportation problem, strong NGO support, good reception in the service area and high CD4 count have been identified as facilitators of adherence The mean self reported adherence rate was calculated and was found to be 84.62%. In addition to this, 81% of the patients are below the 95% threshold value for adherence. To improve adherence of patients on ART, the current ART program should strive to manage depression before and after the initiation of ART. Strong linkage between NGOs which are working in care and support program has to be established.A collaborative work with the community to increase the awareness of ART in the community has to be implemented. Further more intervention on the service area to improve the service quality and a free transportation or equivalent method of alleviating the transportation problem has positive impacts on the results of the program.

Item Type:	Thesis (Masters)
Subjects:	H Social Sciences > H Social Sciences (General) H Social Sciences > HA Statistics R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RM Therapeutics. Pharmacology
Divisions:	Africana
Depositing User:	Selom Ghislain
Date Deposited:	18 Jun 2018 11:30
Last Modified:	18 Jun 2018 11:30
URI:	http://thesisbank.jhia.ac.ke/id/eprint/4330

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