Statistical analysis of factors for non-adherence to antiretroviral therapy in people living with HIV/AIDS in Tanzania: a case study of Dar es Salaam region

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Date
2010
Journal Title
Journal ISSN
Volume Title
Publisher
University of Dar es Salaam
Abstract
Tanzania is among the nations that are highly affected by HIV/AIDS epidemic. Invention of ARVs brought hope of extended life to people living with HIV/AIDS (PLHA). However, that hope cannot be a reality if adherence to antiretroviral therapy (ART) is not optimal. We need to determine significant factors responsible for non-adherence and device ways to optimize adherence to ART in Tanzania.The study was undertaken at three treatment and care clinics in Dar es Salaam. A sample of 197 individuals on ARV and 30 health care providers were interviewed and 377 patients’ records were reviewed. Variables that were included in the analysis were age, sex, awareness, costs, side effects, and stigma. Logistic regression analysis techniques were used to determine the significance of each factor to non-adherence. Survival analysis techniques were used to estimate mean survival time for individuals on ARV.The sample comprised of 76 % females and 24% males, with mean age 34. About 74% of individuals on ARV were aged between 25 – 45 years. Individuals on ARV recommended factors responsible for non-adherence as lack of awareness 63.5%, stigma 56%, side effects 53.3%, and costs 28%. Other factors were being busy 25.4%, away from home 21.3%, forgetting 12.2% and ARVs out of stock 10.2%. Proportion of PLHA lost to follow up was 26%. Awareness and side effects were found to be statistically significant, with p-values of 0.042 and 0.068 respectively ( = 0.1). The median survival time for individuals on ARV was 42 months (95% CI: 41–44) with survival rate of above 0.7. Log-rank test showed significant differences between the male and female on having a shorter time to death. Results shows that there are more females on ART than males, possible reasons for this might be that men are reluctant to go for HIV test and be enrolled in ART or because of ongoing program of testing all pregnant women or may be more women are infected than men. Lack of awareness was seen to be more important in contributing to non-adherence with a Wald statistic value of 4.149; this suggests devising ways to raise awareness to tackle this problem among other factors. Females seemed to survive longer than males; this might be due to the reason that females adhere more to ART than males. The results of the study suggests more efforts in raising awareness which is gender specific (especially for men), policy changes to integration of services for patients on ART and PLHA in general, and developing user friendly guidelines on treatment regimens for PLHA.
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Available in print
Keywords
antiretroviral therapy, HIV/AIDS, Tanzania
Citation
Baltazary, G. (2010) Statistical analysis of factors for non-adherence to antiretroviral therapy in people living with HIV/AIDS in Tanzania: a case study of Dar es Salaam region. Master dissertation, University of Dar es Salaam. Available at http://41.86.178.3/internetserver3.1.2/search.aspx?formtype=advanced