Antiretroviral treatment adherence and its correlates in Addis Ababa, Ethiopia

Abstract

Objective: To assess the degree of adherence with highly active antiretroviral therapy (HAART), and its correlates among adults with HIV/AIDS in Addis Ababa.

Patients and methods: Cross-sectional survey of consecutive patients attending three ART centers in Addis Ababa complemented by semi-structured audiotaped in-depth interviews with 10 purposively sampled patients on HAART Treatment adherence was defined as self-report of taking > or =95% of therapy correctly in a specified time period, depression measured using Beck's depression inventory, clinical data recorded by reviewing patients' charts, and knowledge about HAART assessed by questions in "Yes"/"No "format.

Results: 431 patients on HAART responded 81.2% of patients were > or =95% adherent by self report in the week before the assessment. The major reasons for non-adherence were: being too busy or simply forgot (33.9%) and being away from home (27.5%). Correlates of adherence included having regular follow-up, not being depressed having no side effects, a regimen that fitted the daily routine and satisfaction with the relationship with doctors.

Conclusions: Self-reported adherence in our study was higher than that seen in developed countries. Recommendations to improve adherence include: provision of regular follow-up for patients, management of depression, forewarning of side effects of HAART, and creating medication schedules appropriate to patients' daily routines.