Abstract:
Background: Food insecurity is both cause and consequence of deleterious clinical
outcome among PLHIV associating with CD4 decline, lowered BMI, viral RNA
suppression, increased opportunistic infections, hospitalization and reduced quality of
life.Non adherence to ART is predictor of progression to AIDS and death.Little is
known as food insecurity is predictor of non adherence and their relations was not
studied well yet.
Objectives: To assess the prevalence of ARV adherence and associated factors with
peculiarity of household food insecurity among HIV infected individuals, receiving
highly active antiretroviral therapy in Ambo General Hospital, Oromia, Western
Ethiopia, 2017
Methods: Facility based cross-sectional study employing both quantitative and
qualitative methods was conducted from January 20 to April 21st/2017.A sample of 383
was randomly selected based on inclusion criteria.20PLHIV for FGD and 6 for IDI were
purposively recruited from different key informants.Data were checked for its
completeness and double entered to Epidata version 3.1 after crosscheck, transported to
SPSS version 21.0 for analysis. To identify factors associated, logistic regressions were
used at p<0.05 for both candidate and multivariable regression.Finding was presented
using tables, narratives and descriptive numerical summaries and qualitative triangulated
with quantitative result.
Results:The response rate was 97.9%. The prevalence of food insecurity was
78.4%.The level of adherence to ART was 80.2% (in self report) and 82.4% (in
pillcounts). Factors positively associated with non adherence were food insecurity
(AOR:3.1;CI:1,8.3),depression(AOR:2.2;CI:1,4),unmarried(AOR:0.08;CI :0.03,0.18),
alcohol(AOR:2.19;CI:1.16,4.54),unsatisfaction(AOR:2.14;CI:1.1,4),TB(AOR:2.2;CI:1.1
,4),over one month dose refill schedule (AOR:2.5;CI:1,5.8),drugs side
effects(AOR:1.9;CI:1,3.7) and belief of drugs disrupted my life so worry to be
dependent of drugs(AOR:2.1;CI:1.1,4).
Conclusion and Recommendation: The level of adherence to medication was suboptimal and more serious among food insecure, un satisfied with service, TB patients,
fear of side effects, being single, depressed, bad belief on drugs, alcohol and more than
month refills. Others Social, clinical, personal factors were not associated with non
adherence. Individual patients, policy makers and managers, professionals, adherence
supporters with case manager and researchers were recommended
