Socio-Demographic, Economic and Clinical Predictors for HAART Adherence Competence in HIV-Positive Adults at Felege Hiwot Teaching and Specialized Hospital, North West Ethiopia

Abstract

Background Currently, around 36.7 million people in the world are living with HIV. Among these, 52% are living in sub-Saharan Africa. The main objective of this study was to identify socio-demographic economic and clinical factors associated with HAART adherence competence in successive visits among adult HIV patients after commencement of their treatment. Methods A retrospective cohort study design was conducted on a random sample of 792 treatment attendants. The samples were selected using stratified random samples technique considering their residence area as strata. Secondary data were used in this study. Structural equation modeling (SEM) was applied to identify predictors of HAART adherence competence over time. Results In this longitudinal study, factors affecting long-term HAART adherence competence in successive visits were identified. Among the predictors, marital status (mean = 3.97, variance = 0.6, p = 0.021), level of disclosure of the disease (mean = 6.24, variance = 0.29, p = 0.012), residence area (mean = 3.97, variance = 0.6, p = 0.021), level of education (mean = 2.04, variance= 0.81, p = 0.012), ownership of cell phone (mean = 2.99, variance = 0.68, p = 0.034), household income (mean = 6.37, variance = 0.53, p = 0.002), age of patients (mean = –2.78, variance = 56.64, p = 0.023), sex of patients (mean = –1.25, variance = 0.88, p = 0.036), weight (mean = –2.89, 42.36, p = 0.001), initial CD4 cell count (mean = 2.57, variance = 158.48, p = 0.015) and WHO stages (mean = 2.37, variance = 0.78, p = 0.026) were directly associated with retention of medication care. On the other hand, medication care was significantly and independently associated with longitudinal adherence competence. Conclusion The outcome variable in successive visits increased with the number of follow-up visits, but the rate of increase was different for different groups, such as urban and rural, and for those patients disclosing and not disclosing the disease to family members. An integrated health-related education should be given for non-adherent patients like rural residents, patients living without partners, patients with no cell phone and aged patients.