Disparities in antiretroviral therapy adherence among selected adult subpopulations with HIV/AIDS in Tanzania: Analysis of a population-based survey, 2022/23

Adherence is a critical component of successful HIV treatment among people living with HIV/AIDS. Yet, there is improvement in the level of adherence, but disparities are exhibited among subpopulations of adults living with HIV/AIDS. The objective of this study was to assess the disparity of the treatment adherence of selected subpopulations among HIV adult patients in Tanzania. We used a cross-sectional survey of 1427 adults living with HIV/AIDS from 31 regions in Tanzania. A two-stage stratified cluster design was used in this survey and included jackknife replicate sampling weights. Frequency tables displaying frequencies, weighted proportions, and confidence intervals were employed to depict socio-demographics by treatment adherence. Treatment adherence was the outcome variable, defined as a binary response that categorized self-reported adherence to ART at the 95% threshold: (1) "Missed 0 or 1 day," which described high adherence, and (0) "Missed 2 or more days," which showed low adherence. Rao-Scott chi-square was used to produce the weighted proportions of the adherence within subpopulations. Also, we used the Adjusted Wald Test to examine whether or not the subpopulations are similar to or different in terms of their level of treatment adherence. The results showed a significant difference in treatment adherence between the selected subpopulations. The majority of the chosen subpopulations, including those based on age, sex, marital status, and level of education, were found to have disparities in the level of treatment adherence. However, the study also revealed no disparities in treatment adherence between employed and unemployed HIV patients, divorced and widowed, age groups of 35-44, and those of 45 and 54. The study's findings revealed considerable disparities in treatment adherence between various subpopulations. These findings emphasize the necessity for specifically developed interventions to address these disparities to attain better health outcomes among adults living with HIV/AIDS.