Level of non-adherence and associated factors among adult HIV patients on antiretroviral therapy in Nyamasheke district: a cross-sectional study

Abstract

Introduction: Antiretroviral therapy (ART) has been crucial in managing HIV, but its success heavily relies on patient adherence. In sub-Saharan countries, including Rwanda, adherence remains a challenge. Moreover, adult HIV patients count for the most clients on ART in Rwanda with 3.8 % of them in Nyamasheke District. However information regarding adherence to ART among these patients is limited. This study aimed to assess the level of non-adherence to ART and its associated factors among adult HIV patients in Nyamasheke District.

Methods: A cross-sectional study was conducted with 416 participants randomly selected from 22 health facilities. Data was collected through medical record reviews and interviews. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with non-adherence. Data management was done with Ms Excel and analyzed using Stata version 16.

Results: Of the 416 participants, 92.5% had adherence levels of 95% or higher, indicating adherence to ART in the past month. However, factors such as age of 15-24 years (adjusted odds ratio [AOR]:5.76, 95% C.I 1.68 - 19.73), , shorter duration on ART (<5 years) (AOR:3.1,95% C.I 1.11– 8.68), being unstable patients(Patients who attend clinical visits every three months and drugs pick up every month) (AOR:4.08, 95% C.I 1.54 – 10.83) , alcohol consumption (AOR: 4.42,95% C.I 1.79 – 10.9), and forgetfulness(AOR:4.53,95% C.I 1.34. – 15.22) were significantly associated with non-adherence among adult HIV patients.

Conclusion: The overall level of adherence found in this study was lower than the WHO standard, underlining the importance of addressing these factors to improve adherence rates and treatment outcomes. The study highlights the need for more intensive counselling and regular follow-up, particularly for HIV patients during their early period on medication, those in unstable conditions, and those who consume alcohol