Some factors associated with non-adherence to antiretroviral therapy (ART) in people living with HIV/AIDS (PLHA) in Tanzania: a case study of Dar es Salaam region

• Published in: East African journal of public health Vol. 8; no. 4; pp. 237 - 246
• Main Authors: Baltazary, Gasper, Akarro, Rocky R J, Mussa, A S
• Format: Journal Article
• Language: English
• Published: Tanzania 01.12.2011
• Subjects: Adult; Anti-Retroviral Agents - therapeutic use; Female; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Health Surveys; HIV Infections - drug therapy; HIV Infections - psychology; Humans; Logistic Models; Male; Medication Adherence - psychology; Middle Aged; Pregnancy; Risk Factors; Sex Factors; Socioeconomic Factors; Surveys and Questionnaires; Survival Analysis; Tanzania - epidemiology; Tanzania
• ISSN: 0856-8960

Tanzania is one of the nations that are highly affected by HIV/AIDS epidemic. Invention of ARVs (Anti -Retroviral) brought hope of extended life to people living with HIV/AIDS (PLHA). Though ARV's are administered in several clinics particularly in Dar es Salaam, there is a problem to adherence. Some factors associated with non-adherence are investigated and ways to optimize adherence are suggested. This study was undertaken at three treatment and care clinics in Dar es Salaam. A sample of 197 individuals on ARV and 30 health care providers were interviewed. The sample comprised of 76 % females and 24% males, with mean age 34. About 74% of individuals on ARV were aged between 25 - 45 years. Logistic Regression and survival analysis models were used in the analysis. Individuals on ARV recommended factors responsible for non-adherence as lack of awareness 63.5%, stigma 56%, side effects 53.3%, and costs 28%. Other factors were being busy 25.4%, away from home 21.3%, forgetting 12.2% and ARVs out of stock 10.2%. Proportion of PLHA lost to follow up was 26%. Awareness and side effects were found to be statistically significant, with p-values of 0.042 and 0.068 respectively (alpha = 0.1). The median survival time for individuals on ARV was 42 months (95% CI: 41-44) with survival rate of above 0.7. Log-rank test showed significant differences between the male and female on having a shorter time to death. Females seemed to survive longer than males suggesting that females adhere more to ART than males. This calls for emphasis on HIV/AIDS education to the society especially to sensitize men. Another suggestion is that when a woman gets pregnant, both the expectant mother and father should attend maternal clinic so that they both take HIV test so as to increase man's participation.