Factors influencing haart nonadherence among HIV patients attending public and private hospitals in Dar es Salaam, Tanzania

Abstract

HIV / AIDS remains to be one of the most gravious tragedies of human kind. Sub- Saharan Africa, the part of the world with the most crippled economy, suffers most from this pandemic. The use of HAAR T since mid 1990s has showed a significant improvement in morbidity <.. and mortality from HIV / AIDS in the developed world. High level of HAART adherence (>95%) is required for a patient to have a significant decrease in viral load. HAAR T nonadherence has been associated with higher risk of drug interactions and development of HIV strains resistant to ARV s. In Tanzania, treatment of patients using HAART was still in its infancy as only few physicians were competent to initiate and monitor patients properly. In the past two years, however, a good number of HIV patients have been started on HAART; some under suboptimal "care". A cross sectional study was conducted among 304 (females 201 (66.1 %), males 103(33.9%), mean age; 38.5 years, range; 18-66 years) HIV patients on HAART

Vlll attending at public and private clinics in Dar es Salaam from June to August 2004, to establish the extent of nonadherence and point out the associated factors. The consecutive attendees at the two clinics who were on HAART were interviewed to obtain sociodemographic characteristics and other behavioral factors after an informed consent. Ethical clearance was obtained from the ethical committee of Muhimbili University College of Health Sciences. Data were analyzed using EPI info version 6.04. Taking nonadherence was found among 18.4% of the study patients, while 12.8% had timing nonadherence. Taking alcohol, use of alternative treatment, lack of knowledge on consequences of nonadherence and a pill count of less than one were highly associated with HAART noadherence. Sociodermographic characteristics were not significantly associated with HAART nonadherence and therefore they are not predictive. It is recommended that interventions to improve adherence should target everyone on HAART, and the provider, to ensure proper preparation of the patient before initiation of the treatment.