Factors associated with adherence to Antiretroviral Therapy (ART) among adult people living with HIV and attending their clinical care, Eastern Ethiopia

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Abstract
To attain a successful treatment outcome, Antiretroviral Therapy (ART) treatment for people living with HIV requires more than 95 % adherence level. The adherence level varies depending on different population contexts. Thus, the objective of this study was to investigate ART adherence level among HIV positive patients attending their clinical care in public health facilities in Harar and Dire Dawa, Eastern Ethiopia. We conducted a cross-sectional study among 626 ART attendees. Data were collected using a structured questionnaire with a face-to-face interview. ART adherence was considered when taking all antiretroviral treatment in a correctly prescribed doses at a right time (no dose missed or delayed for greater than or equal to 90 min) in the week prior to the study. Multivariable logistic analysis was applied to examine the association between the dependent and independent variables. Statistical significance was set at p-value <0.05. The level of ART adherence was 85 %. Adherence was more likely among patients of 35–44 years (AOR = 2.39; 95 % CI = 1.15–5.01), had monthly income of 501.00–999.00 Ethiopian Birr (ETB) (AOR = 6.73; 95 % CI = 2.71–16.75), no history of opportunistic infection (AOR = 2.81; 95 % CI = 1.47–5.36), and had good family support (AOR = 2.61; 95 % CI = 1.45–4.72). However, those who did not disclose their sero-status (AOR = 0.45; 95 % CI = 0.21–0.97) and did experience depression (AOR = 0.36; 95 % CI = 0.21–0.61) were less likely adherent than their counter parts. The level of ART adherence was sub-optimal. Concerted and collaborative efforts through effective and efficient interventions are needed in view of the identified factors in order to improve the adherence level.

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