Influence of food insecurity on adherence to anti-retroviral therapy (art) among people receiving highly active antiretroviral drugs at ambo general hospital, oromia region, central Ethiopia, 2017: a cross- sectional study

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