Background
Methods
Study setting
Study design and participants
Sampling
Definition of adherence
Measurement
Data collection
Data analysis
Results
Socio-demographics
Variables | Number | Percent |
---|---|---|
Gender | ||
Male | 113 | 37.7 |
Female | 187 | 62.3 |
Age in years | Mean ± SD: 41.3 ± 8.7 | |
< 35 | 79 | 26.3 |
35-45 | 136 | 45.3 |
≥ 46 | 85 | 28.3 |
Marital status | ||
Single | 18 | 6.0 |
Married/cohabiting | 163 | 54.3 |
Separated/divorced/widowed | 119 | 39.7 |
Education | ||
No formal education | 34 | 11.3 |
Primary school | 128 | 42.7 |
Secondary school | 84 | 28.0 |
High school | 40 | 13.3 |
Graduate level | 14 | 4.7 |
Occupation | ||
Own business/ Officer | 62 | 20.7 |
Housewife/Unemployed | 75 | 25.0 |
Causal workers | 163 | 54.3 |
Health status and behaviour variables
Variables | Number | Percent |
---|---|---|
Duration on ART | Mean ± SD: 4.3 ± 2.1 | |
< 1 year | 25 | 8.3 |
1-3 year | 147 | 49.0 |
> 3 year | 128 | 42.7 |
Recent CD4 (cells/mm3) | Mean ± SD: 517.5 ± 263.3 | |
< 500 | 158 | 52.7 |
500-1000 | 122 | 40.7 |
> 1000 | 20 | 6.7 |
HIV medication | ||
ART first line drugs | 277 | 92.3 |
ART second line drugs | 23 | 7.7 |
ART Regimen | ||
TDF/ABC + 3TC + EFV (one time/day) | 171 | 57.0 |
AZT/ABC + 3TC + NVP/LPV/r (2 times/day) | 129 | 43.0 |
Co-morbid diseases | ||
Absence of co-morbidity | 248 | 82.7 |
Presence of co-morbidity | 52 | 17.3 |
Past month alcohol use | 50 | 16.7 |
Smokes tobacco daily | 27 | 9.0 |
Smokeless tobacco use daily | 37 | 12.3 |
Disclosure of HIV status to others | 241 | 80.3 |
Moderate to severe depressive symptoms | 23 | 7.7 |
Internalized stigma (Range:0-7) | Mean ± SD | 2.7 ± 2.3 |
No stigmatization | 67 | 22.3 |
Low stigmatization | 132 | 44.0 |
High stigmatization | 101 | 33.7 |
Social support (Range 3-12) | Mean ± SD | 9.7 ± 2.0 |
Less | 194 | 64.7 |
High | 106 | 35.3 |
Sex functioning among male respondent (n = 107) (Range 5-25) | Mean ± SD: 18.9 ± 2.7 | |
No erectile dysfunction (ED) | 49 | 45.8 |
Mild ED | 44 | 41.1 |
Mild to moderate ED | 14 | 13.1 |
Descriptive statistics on the information-motivation-Behavioural skills ART adherence model
Variables | N or Mean | % or SD |
---|---|---|
IMB adherence informationa
| Mean ± SD | 4.0 ± 2.2 |
Low | 122 | 40.7 |
Moderate | 90 | 30.0 |
High | 88 | 29.3 |
IMB adherence motivationa
| Mean ± SD | 8.7 ± 1.5 |
Low | 54 | 18.0 |
Moderate | 118 | 39.3 |
High | 128 | 42.7 |
IMB behavioral skillsa
| Mean ± SD | 11.7 ± 1.4 |
Low | 111 | 37.0 |
Moderate | 91 | 30.3 |
High | 98 | 32.7 |
Descriptives of ART adherence
Variable | Number | Percent |
---|---|---|
30 days VAS | ||
≥ 95% adherence | 252 | 84.0 |
< 95% adherence | 48 | 16.0 |
Self-report 4 days recall dose adherence | ||
Adherence | 271 | 90.3 |
Non-adherence | 29 | 9.7 |
Reasons for missed medication (n = 130) | ||
Busy | 69 | 23.0 |
Away home | 53 | 17.7 |
Forget | 37 | 12.3 |
Change in daily routine | 23 | 7.7 |
Asleep | 15 | 5.0 |
Sick | 13 | 4.3 |
Not want others to notice | 8 | 2.7 |
Side effects | 6 | 2.0 |
Too many pills | 4 | 1.3 |
Problems with taking pill | 4 | 1.3 |
Depressed | 3 | 1.0 |
Feel toxic | 2 | 0.7 |
Ran out of pills | 2 | 0.7 |
Associations with ART non-adherence in the past 30 days
Variable | n | % | COR (95% CIs) |
P-value | AOR (95% CIs) |
P-value |
---|---|---|---|---|---|---|
Gender | ||||||
Female | 25 | 13.4 | 1 (Reference) | |||
Male | 23 | 20.4 | 1.66 (0.89-3.09) | 0.112 | ||
Age (years) | ||||||
< 35 | 16 | 20.3 | 1 (Reference) | |||
36-45 | 20 | 14.7 | 0.68 (0.33-1.40) | 0.295 | ||
46 and above | 12 | 14.1 | 0.65 (0.29-1.47) | 0.299 | ||
Marital status | ||||||
Single | 5 | 27.8 | 1 (Reference) | |||
Married/cohabiting | 28 | 17.2 | 0.54 (0.18-1.63) | 0.275 | --- | |
Separated/divorced/ widowed | 15 | 12.6 | 0.38 (0.12-1.20) | 0.099 | ||
Education | ||||||
Primary and less | 24 | 14.8 | 1 (Reference) | |||
Secondary and above | 24 | 17.4 | 1.21 (0.65-2.25) | 0.544 | --- | |
Occupation | ||||||
Housewife/student/unemployed | 8 | 10.7 | 1 (Reference) | |||
Own business/officers | 15 | 24.2 | 2.67 (1.05-6.81) | 0.039 | 1.43 (0.54-3.82) | 0.474 |
Casual worker | 25 | 15.3 | 1.52 (0.65-3.54) | 0.335 | 1.34 (0.44-4.98) | 0.789 |
Duration on ART | ||||||
> 3 years | 26 | 20.3 | 1 (Reference) | |||
1-3 years | 18 | 12.2 | 0.55 (0.28-1.05) | 0.071 | --- | |
< 1 year | 4 | 16.0 | 0.75 (0.24-2.37) | 0.620 | ||
Recent CD4 count | ||||||
≥ 500-1000 | 23 | 16.2 | 1 (Reference) | |||
< 500 | 25 | 15.8 | 0.97 (0.52-1.80) | 0.930 | --- | |
HIV medication | ||||||
ART first line drugs | 45 | 16.2 | 1 (Reference) | |||
ART second line drugs | 3 | 13.0 | 0.77 (0.22-2.71) | 0.688 | --- | |
ART regimen | ||||||
TDF/ABC + 3TC + EFV | 23 | 13.5 | 1 (Reference) | |||
AZT/ABC + 3TC + NVP/LPV/r | 25 | 19.4 | 1.55 (0.83-2.87) | 0.167 | --- | |
Diagnosis of chronic disease | ||||||
No chronic disease | 42 | 16.9 | 1 (Reference) | |||
Has chronic disease | 6 | 11.5 | 1.56 (0.63-3.90) | 0.338 | --- | |
IMB adherence information | ||||||
Low | 13 | 10.7 | 1 (Reference) | 1 (Reference) | ||
Moderate | 23 | 25.6 | 2.87 (1.37-6.06) | 0.005 | 1.96 (0.67-5.74) | 0.222 |
High | 12 | 13.6 | 1.32 (0.57-3.06) | 0.511 | 0.58 (0.17-1.96) | 0.380 |
IMB adherence motivation | ||||||
Low | 7 | 13.0 | 1 (Reference) | |||
Moderate | 18 | 15.3 | 1.21 (0.47-3.09) | 0.693 | --- | |
High | 23 | 18.0 | 1.47 (0.59-3.67) | 0.408 | ||
IMB adherence behavioural skills | ||||||
Low | 24 | 21.6 | 1 (Reference) | 1 (Reference) | ||
Moderate | 13 | 14.3 | 0.60 (0.29-1.27) | 0.183 | 0.37 (0.13-1.07) | 0.066 |
High | 11 | 11.2 | 0.45 (0.21-0.99) | 0.048 | 0.31 (0.10-0.94) | 0.039 |
Past month alcohol use (base = no) | 13 | 26.0 | 2.16 (1.04-4.46) | 0.038 | 0.80 (0.25-2.55) | 0.702 |
Smokes tobacco daily (base = no) | 16 | 28.1 | 2.57 (1.29-5.12) | 0.007 | 2.38 (0.85-6.65) | 0.098 |
Smokeless tobacco use daily (base = no) | 23 | 25.3 | 2.49 (1.32-4.68) | 0.005 | 3.22 (1.28-8.12) | 0.013 |
Non-disclosure of HIV status to others (base = yes) | 3 | 5.1 | 0.23 (0.07-0.78) | 0.018 | 0.07 (0.01-0.69) | 0.022 |
Low social support (base = high) | 32 | 16.5 | 1.11 (0.58-2.14) | 0.752 | --- | |
Internalized stigma | ||||||
No stigmatization | 8 | 11.9 | 1 (Reference) | |||
Low stigmatization | 26 | 19.7 | 1.80 (0.77-4.25) | 0.174 | --- | |
High stigmatization | 14 | 13.9 | 1.19 (0.47-3.01) | 0.718 | ||
Partner who is not on ART | 19 | 23.2 | 3.34 (1.58-7.07) | 0.002 | 4.25 (1.70-10.64) | 0.002 |
Moderate to severe depression symptoms (base = no) | 4 | 17.4 | 1.12 (0.36-3.44) | 0.850 | --- | |
Erectile dysfunction among male respondents (base = no) | 15 | 25.9 | 6.00 (1.61-22.42) | 0.008 | 15.14 (1.41-162.66) | 0.025 |