Factors Affecting Levels of Antiretroviral Drug Adherence among Adult Patient Living with HIV in Public Health Facilities of Arba Minch Town, Southern Ethiopia: Using Cumulative Logit Model

Background: Adherence to antiretroviral therapy is essential to reduce the multiplication of the virus and improve disease outcomes. The studies have reported a range of factors influencing antiretroviral therapy adherence at various levels. Almost all studies were modeling the factors based on binary categorization of the adherence.

Objective: This study intended to determine the adherence level and its associated factors to antiretroviral therapy among adult people living with human immunodeficiency virus.

Methods: This study was a cross-sectional study that employed among 391 adult patients that were selected by simple random sampling. The cumulative Logit model was used to examine the associations between the outcome of antiretroviral therapy adherence and independent variables.

Results: The study participants with good level of antiretroviral therapy adherence (67.77%) were approximately four times higher than study participants with fair (17.39%) and good (14.83%) adherence levels. As the duration on ART changed from ≤12 months to >12 months, the odds of high adherence/less adherence increased with approximately 61% (p = 0.0347) across the full scale of adherence levels. The estimated odds of patients with a CD4 ≥ 200cells/mm3 was 1.65 (p = 0.0279) times toward poor level of antiretroviral therapy adherence than the estimated odds of patients with CD4 < 200cells/mm3. Study participants who have single marital status tending to have more poor level of adherence to antiretroviral therapy than patients with married marital status (p = 0.0003).

Conclusion: Levels of adherence to the antiretroviral therapy is significantly determined by the duration on antiretroviral therapy, the number of CD4 counts, the types of initial antiretroviral therapy regimens and the marital status of adult people living with HIV/AIDS.