Back ground: East and Southern Africa is the hardest regions hit by the HIV as compared to countries in other parts of the world. Ethiopia is one of the Sub-Saharan Africa with the highest number of people living with HIV. Amhara region is one of the regions in the country in which many people are under medication. The main objective of this research was to identify significant predictors of non-adherence to medication and time to default from treatment for HIV infected patients under HAART.
Methods: A retrospective secondary data were obtained from a random sample of 220 HIV patients under HAART. Separate and joint modelling approaches were conducted in data analysis. Joint modeling was conducted for analysis of non-adherence to medication and the time to default from treatment. In the joint model, a GLMM and Cox PH sub-models were fit together for non-adherence to medication and time to default from treatment.
Results: The significant predictors in current investigation were length of observation time/visiting time [AOR=0.866, p-value=0.0455], female patients [AOR=0.219, p-value=0.0221], patients disclosed the disease [AOR=0.353, p-value=0.0006], patients who got social support [AOR=0.252, p-value=0.0026], patients living with partner [AOR=0.188, p-value=0.029], patients with owner of cell phone [AOR=0.272, p-value=0.0353], urban HIV patients [AOR=0.238, p-value=0.0112), patients with at working functional status [AOR=0.234, p-value=0.0086], patients with normal BMI [AOR=0.921, p-value=0.0003], patients with high CD4 cell count [AOR=0.4106, p-value=0.0025]. On the other hand, male patients, patients who had social violence, those of who had mentally depressed HIV patients, rural patients and those who had additional disease were positively associated with non-adherence to medications and became defaulters from treatment. In current investigation, the joint modeling approach was more adequate as compared to separate model.
Conclusions: Some groups of HIV patients were non-adherent to medication and defaulted from treatment, therefore, such patients need high intervention to be adherent for the prescribed medication and live long in the treatment
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