Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Dec 18;12(12):e0189460.
doi: 10.1371/journal.pone.0189460. eCollection 2017.

Predictors of non-adherence to antiretroviral therapy among HIV infected patients in northern Tanzania

Seleman Khamis Semvua  1   2   3 , Catherine Orrell  2 , Blandina Theophil Mmbaga  1   3   4   5 , Hadija Hamis Semvua  3   5 , John A Bartlett  3   4 , Andrew A Boulle  2
Affiliations

Predictors of non-adherence to antiretroviral therapy among HIV infected patients in northern Tanzania

Seleman Khamis Semvua et al. PLoS One. .

Abstract

Background: Antiretroviral therapy (ART) has been shown to reduce HIV-related morbidity and mortality amongst those living with HIV and reduce transmission of the virus to those who are yet to be infected. However, these outcomes depend on maximum ART adherence, and HIV programs around the world make efforts to ensure optimal adherence. Predictors of ART non-adherence vary considerably across populations and settings with respect to demographic, psychological, behavioral and economic factors. The objective of this study is to investigate risk factors that predict non-adherence to antiretroviral treatment among HIV-infected individuals in northern Tanzania.

Methods: At Kilimanjaro Christian Medical Centre (KCMC), a tertiary and referral hospital in northern Tanzania, we used an existing ART database to randomly select HIV-infected patients above 18 years of age who have been on triple ART for at least two years. We used interviewer administered structured questionnaires to cross-sectionally determine predictors of ART non-adherence. We determined non-adherence through retrospective review of pharmacy drug refill (PDR) records of the interviewed participants using a pharmacy database.

Results: Non-adherence was defined as collecting less than 95% of expected monthly refills in the previous 2 years. Multivariable logistic regression model was used to determine the predictors of non-adherence. Of the 256 patients enrolled mean age was 44 years (SD ± 11) and median CD4 count was 499 cells per microliter (IQR 332-690). Median PDR adherence was 71% (IQR 58%-75%). Non-adherence was associated with younger age and unemployment.

Conclusion: In this setting, adherence strategies could be adapted to address issues facing young adults, and those with household challenges such as unemployment. Further research is required to better understand the potential roles of these factors in suboptimal adherence.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Patient flow schema.
See this image and copyright information in PMC

References

    1. WHO/UNAIDS. GLOBAL AIDS RESPONSE PROGRESS REPORTING 2014; Construction of Core Indicators for monitoring the 2011 United Nations Political Declaration on HIV and AIDS. 2014.
    1. Fang C-T, Hsu H-M, Twu S-J, Chen M-Y, Chang Y-Y, Hwang J-S, et al. Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan. Journal of Infectious Diseases. 2004;190(5):879–85. doi: 10.1086/422601 - DOI - PubMed
    1. WHO. Scaling up antiretroviral therapy in resource-limited settings: treatment guidelines for a public health approach—2006. 2006. - PubMed
    1. Vitoria M, Vella S, Ford N. Scaling up antiretroviral therapy in resource-limited settings: adapting guidance to meet the challenges. Current Opinion in HIV and AIDS. 2013;8(1):12–8. doi: 10.1097/COH.0b013e32835b8123 - DOI - PubMed
    1. HIV/AIDS JUNPo. Global AIDS update 2016. Geneva: UNAIDS; 2016.

MeSH terms

Substances