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Non-Adherence and First Line Antiretroviral Therapy failure among people living with HIV on Antiretroviral Therapy in Bulawayo city, 2016


Martin Tatenda Dzimbanhete
Gerald Shambira
Mufuta Tshimanga
Notion Tafara Gombe
Zanele Hwalima
Chiedza Sibanda
Cleophas Chimbetete

Abstract

Background: The prevalence of first-line ART failure in Bulawayo City, Zimbabwe's second-largest city for the year 2016 was 6.6% higher than the national average of 3.3%. We assessed the association between non-adherence and first-line ART failure persons on ART in Bulawayo City.


Methods: A 1:1 case-control study was done to measure the association between adherence and other risk factors for treatment failure among 169 cases and 169 controls. The Morisky Medication adherence 8-item scale was used to assess self-reported adherence, and non-adherence was defined as having a self-reported score of 1 to 8. Epi info 7 was used for univariate, bivariate, and multivariate analysis.


Results: Persons who were non-adherent to ART were 5 times more likely to experience treatment failure than those who adhered association between non-adherence and treatment failure (OR=5.1, 95% CI 2.9-8.9). The study established that 58% of the cases had good knowledge of adherence to ART compared to 85% of the controls. Stopping medication when feeling worse (AOR=3.5, 95% CI 1.8-7.0) was the most significant independent risk factor for treatment failure.


Conclusions: The study found a strong association between non-adherence and treatment failure. Routine monitoring at every clinic visit of clients on ART should be done to monitor the client's adherence to medication.


Keywords: Non-adherence; First line Antiretroviral Therapy Failure; Bulawayo City.


Journal Identifiers


eISSN: 1729-0503
print ISSN: 1680-6905