Introduction
Methods
Study design, area, and period
Study subjects
Data collection
Assessments
Adherence
Readiness
Statistical analysis
Results
Socio-demographic characteristics
Socio demographic characteristics | Felege Hiwot Hospital | Gondar University Hospital | Total | |||
---|---|---|---|---|---|---|
Number
|
Percent
|
Number
|
Percent
|
Number
|
Percent
| |
Sex
| ||||||
Male | 98 | 38.9 | 96 | 38.1 | 194 | 38.5 |
Female | 154 | 61.1 | 156 | 61.9 | 310 | 61.5 |
Age group (Years)
| ||||||
18 - 24 | 11 | 4.4 | 28 | 11.1 | 39 | 7.7 |
25 - 34 | 95 | 37.7 | 102 | 40.5 | 197 | 39.1 |
35 - 44 | 109 | 43.3 | 83 | 32.9 | 192 | 38.1 |
45 - 54 | 28 | 11.1 | 33 | 13.1 | 61 | 12.1 |
≥55 | 9 | 3.6 | 6 | 2.4 | 15 | 3.0 |
Address
| ||||||
Urban | 217 | 86.1 | 235 | 93.3 | 452 | 89.7 |
Rural | 35 | 13.9 | 17 | 6.7 | 52 | 10.3 |
Educational status
| ||||||
Illiterate | 70 | 27.8 | 68 | 27.0 | 138 | 27.4 |
Read and write | 20 | 7.9 | 21 | 8.3 | 41 | 8.1 |
Primary school | 77 | 30.6 | 44 | 17.5 | 121 | 24.0 |
Secondary school | 65 | 25.8 | 92 | 36.5 | 157 | 31.2 |
Diploma and above | 20 | 7.9 | 27 | 10.7 | 47 | 9.3 |
Marital status
| ||||||
Single | 27 | 10.7 | 47 | 18.7 | 74 | 14.7 |
Married | 113 | 44.8 | 111 | 44.0 | 224 | 44.4 |
Divorced | 47 | 18.7 | 52 | 20.6 | 99 | 19.6 |
Widowed | 65 | 25.8 | 42 | 16.7 | 107 | 21.2 |
Monthly income (USD)
| ||||||
< 45.25 | 113 | 44.8 | 141 | 56.0 | 254 | 50.4 |
45.25 - 90.41 | 3 | 1.2 | 6 | 2.4 | 9 | 1.8 |
> 90.41 | 79 | 31.3 | 53 | 21.0 | 132 | 26.2 |
Unstated | 57 | 22.6 | 52 | 20.6 | 109 | 21.6 |
Religion
| ||||||
Christian | 229 | 90.9 | 242 | 96.0 | 471 | 93.5 |
Muslim | 23 | 9.1 | 10 | 4.0 | 33 | 6.5 |
Ethnicity
| ||||||
Amhara | 246 | 97.6 | 242 | 96.0 | 488 | 96.8 |
Tigre | 6 | 2.4 | 3 | 1.2 | 9 | 1.8 |
Oromo | - | - | 2 | 0.8 | 2 | 0.4 |
Others | - | - | 5 | 2.0 | 5 | 1.0 |
Occupation
| ||||||
Merchant | 35 | 13.9 | 38 | 15.1 | 73 | 14.5 |
Farmer | 18 | 7.1 | 16 | 6.3 | 34 | 6.7 |
Student | 5 | 2.0 | 12 | 4.8 | 17 | 3.4 |
Government employee | 48 | 19.0 | 42 | 16.7 | 90 | 17.9 |
Daily labourer | 56 | 22.2 | 58 | 23.0 | 114 | 22.6 |
NGO employee | 25 | 9.9 | 25 | 9.9 | 50 | 9.9 |
Others | 65 | 25.8 | 61 | 24.2 | 126 | 25.0 |
Substance use
| ||||||
Yes | 28 | 11.1 | 8 | 3.2 | 36 | 7.1 |
No | 224 | 88.9 | 244 | 96.8 | 468 | 92.9 |
Treatment, clinical, psychosocial and health service related variables
Clinical and Psychosocial variables | Felege Hiwot Hospital | Gondar University Hospital | Total | |||
---|---|---|---|---|---|---|
Number
|
Percent
|
Number
|
Percent
|
Number
|
Percent
| |
Duration of treatment (months)
| ||||||
3 - 6 | 34 | 13.5 | 69 | 27.4 | 103 | 20.4 |
7 - 12 | 47 | 18.7 | 68 | 27.0 | 115 | 22.8 |
13 -18 | 31 | 12.3 | 22 | 8.7 | 53 | 10.5 |
19 - 24 | 47 | 18.7 | 49 | 19.4 | 96 | 19.0 |
≥ 25 | 93 | 36.9 | 44 | 17.5 | 137 | 27.2 |
HIV status disclosure
| ||||||
Yes | 230 | 91.3 | 200 | 79.4 | 430 | 85.3 |
No | 22 | 8.7 | 52 | 20.6 | 74 | 14.7 |
Treatment side effects
| ||||||
Yes | 61 | 24.2 | 138 | 54.8 | 199 | 39.5 |
No | 191 | 75.8 | 114 | 45.2 | 305 | 60.5 |
Clinical follow up
| ||||||
Monthly | 13 | 5.2 | 95 | 37.7 | 108 | 21.4 |
Every two months | 8 | 3.2 | 91 | 36.1 | 99 | 19.6 |
Every three months | 91 | 36.1 | 44 | 17.5 | 135 | 26.8 |
Variable | 140 | 55.6 | 22 | 8.7 | 162 | 32.1 |
Perceived access to Pharmacy
| ||||||
Yes | 248 | 98.4 | 205 | 81.3 | 453 | 89.9 |
No | - | - | 17 | 6.7 | 17 | 3.4 |
Not sure | 4 | 1.6 | 30 | 11.9 | 34 | 6.7 |
Belief on HAART benefits
| ||||||
Yes | 250 | 99.2 | 245 | 97.2 | 495 | 98.2 |
No | - | - | 5 | 2.0 | 5 | 1.0 |
I doubt | 2 | 0.8 | 2 | 0.8 | 4 | 0.8 |
Contact with psychiatric care services
| ||||||
Yes | 16 | 6.3 | 43 | 17.1 | 59 | 11.7 |
No | 236 | 93.7 | 209 | 82.9 | 445 | 88.3 |
Perceived satisfaction with HCP
| ||||||
Yes | 242 | 96.0 | 234 | 92.9 | 476 | 94.4 |
No | - | - | 13 | 5.2 | 13 | 2.6 |
Not sure | 10 | 4.0 | 5 | 2.0 | 15 | 3.0 |
Having goals
| ||||||
Yes | 249 | 98.8 | 236 | 93.7 | 485 | 96.2 |
No | 3 | 1.2 | 16 | 6.3 | 19 | 3.8 |
Comfortable when taking HAART in front of others
| ||||||
Yes | 124 | 49.2 | 125 | 49.6 | 249 | 49.4 |
No | 128 | 50.8 | 127 | 50.4 | 255 | 50.6 |
Self reported nonadherence and nonreadiness to HAART among the study subjects
Variables | Felege Hiwot Hospital | Gondar University Hospital | Total | |||
---|---|---|---|---|---|---|
Number
|
Percent
|
Number
|
Percent
|
Number
|
Percent
| |
Adherence status
| ||||||
Adherent | 231 | 91.7 | 186 | 73.8 | 417 | 82.7 |
Nonadherent | 21 | 8.3 | 66 | 26.2 | 87 | 17.3 |
Readiness status
| ||||||
Ready | 242 | 96.0 | 192 | 76.2 | 434 | 86.1 |
Not ready | 10 | 4.0 | 60 | 23.8 | 70 | 13.9 |
Motivation to take HAART
| ||||||
Not at all motivated | 1 | 0.4 | 10 | 4.0 | 11 | 2.2 |
Partially motivated | 18 | 7.1 | 56 | 22.2 | 74 | 14.7 |
Highly motivated | 233 | 92.5 | 186 | 73.8 | 419 | 83.1 |
Reasons for nonadherence
| ||||||
Drug side effects | 4 | 19.1 | 23 | 34.9 | 27 | 31.0 |
Other health problems | 6 | 28.6 | 13 | 19.7 | 19 | 21.8 |
Getting a relief | 1 | 4.8 | 4 | 6.1 | 5 | 5.75 |
Drug scarcity | 2 | 9.5 | 2 | 3.0 | 4 | 4.6 |
Others | 8 | 38.1 | 24 | 36.4 | 32 | 36.8 |
Reasons for nonreadiness to HAART
| ||||||
Anxiety | - | - | 31 | 51.7 | 31 | 44.3 |
Hopelessness | 8 | 80.0 | 11 | 18.3 | 19 | 27.1 |
Confusion | - | - | 14 | 23.3 | 14 | 20.0 |
Denial | 2 | 10.0 | 1 | 1.7 | 3 | 4.3 |
Others | - | - | 3 | 5.0 | 3 | 4.3 |
Determinants of patients' nonadherence and nonreadiness to HAART
Determinants | Adherence status | Adjusted OR** | 95% CI | P-Values | ||
---|---|---|---|---|---|---|
Nonadherent
N (%)
|
Adherent
N (%)
|
Lower
|
Upper
| |||
Treatment side effects
| ||||||
No* | 34 (39.1) | 271 (65.0) | 1.0 | -- | -- | -- |
Yes | 53 (60.9) | 146 (35.0) | 1.4 | 0.8 | 2.5 | 0.04 |
Readiness to HAART
| ||||||
Ready* | 46 (52.9) | 388 (93.0) | 1.0 | -- | -- | -- |
Not ready | 41 (47.1) | 29 (7.0) | 8.9 | 4.8 | 16.7 | <0.001 |
Contact with psychiatric care services
| ||||||
No* | 69 (79.3) | 376 (90.2) | 1.0 | -- | -- | -- |
Yes | 18 (20.7) | 41 (9.8) | 2.2 | 1.1 | 4.5 | 0.02 |
Having goals
| ||||||
Yes* | 76 (87.4) | 409 (98.1) | 1.0 | -- | -- | -- |
No | 11 (12.6) | 8 (1.9) | 3.5 | 1.1 | 10.8 | 0.03 |
Variables | Readiness status | Adjusted OR** | 95% CI | P-Values | ||
---|---|---|---|---|---|---|
Not ready
N (%)
|
Ready
N (%)
|
Lower
|
Upper
| |||
Sex
| ||||||
Male* | 25 (35.7) | 169 (38.9) | 1.0 | -- | -- | -- |
Female | 45 (64.3) | 265 (61.1) | 1.1 | 0.7 | 1.9 | 0.636 |
HIV status disclosure
| ||||||
Yes* | 55 (78.6) | 375 (86.4) | 1.0 | -- | -- | -- |
No | 15 (21.4) | 58 (13.6) | 1.9 | 1.1 | 3.5 | 0.04 |
Contact with psychiatric care services
| ||||||
No* | 58 (82.9) | 387 (89.2) | 1.0 | -- | -- | -- |
Yes | 12 (17.1) | 47 (10.8) | 1.8 | 0.9 | 3.6 | 0.101 |