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ASSESSMENT OF FACTORS INFLUENCING ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG ADULTS IN ADDIS ABABA, Esmael Wabela, MD., MPH.,  Federal Ministry of Health, Addis Ababa; Yemane Berhan MD., PhD., Addis Continental Institute of Public Health, Addis Ababa.

Abstract                                          

One of the major challenges in AIDS treatment programs is adherence. There is little evidence as to why some ARV users do not achieve optimal adherence rates in ART centers in Ethiopia.

Objectives: The objective of this study was to identify structural and patient-related factors to ART adherence and to assess the quality of the process involved in providing ART services for patients attending the selected sites; Zewditu Hospital and Bole HC.

Methods: The study utilized a qualitative study design using semi-structured interviews, in-depth interviews and observational methods. The sample size was 51, with two health facility observation (Zewditu and Bole).Out of the total sample size; thirty four were ART clients, three were ART user Key Informants and the rest fourteen were ART staff from Zewditu Hospital and Bole HC.

Results: Cost of transport to ART centers, lack of adequate food/nutrition, and stigma and discrimination were among the factors which adversely affect adherence. Missing and/or delaying in taking the ARVs doses due to work load, travel, forgetfulness and lack of disclosure were among the factors contributing to poor adherence. Disclosure supports adherence and most of the ARV users had disclosed their HIV positive status at least to one family member.  On the other hand, most of the clients expressed their satisfaction with the new fixed dose combination (FDC) ARVs regimen.

Conclusion and recommendations: The costs involved in terms of transport and other overhead costs, lack of food and stigma and discrimination were among the major factors affecting adherence.  Recommendations include: 1- Re-designed Food support program and other care and support programs 3- Pill count