Adherence to Antiretroviral Therapy and Factors Associated among Adult HIV Positives in Public Hospitals of Hawassa City, Sidama, Ethiopia, 2024

Background: HIV/AIDS continues to be a significant global health issue, although highly active Antiretroviral Therapy (HAART) has transformed it into a manageable chronic illness. In Ethiopia, while access to ART has improved, understanding of adherence levels and the factors that affect them remains insufficient in many developing countries, including Ethiopia. The persistence of high virological failure rates indicates that there are still challenges in achieving effective viral suppression. Many existing studies often depend on document analyses, overlooking a thorough examination of adherence-related factors. This research seeks to address this gap by evaluating adherence rates and identifying crucial predictive factors among HIV-positive adults in public hospitals. Objective: to assess level of adherence to antiretroviral therapy and factors associated among adult HIV positive individuals in public hospitals of Hawassa City, Sidama, Ethiopia in 2024. Method: An Institution-based cross-sectional study was conducted among 333 randomly selected adults at an ART clinic in public hospitals from Nov 10 to Dec 30, 2024. Participants were chosen using stratified sampling from six health facilities. Data were collected via structured questionnaires by six data collectors under two supervisors. Adherence was assessed retrospectively using self-reports/pill counts, with <5 missed doses considered fair to good adherence. Data were coded, cleaned, and analyzed using SPSS Version 26. Descriptive statistics, bivariable, and multivariable logistic regression models were used to identify factors affecting adherence reported with Adjusted odds ratios (AOR) with 95% CI and with p < 0.05. Results: The level of adherence to ART among adult HIV-positive individuals was 261 (79.6%), 95% CI (75.0 - 83.7). The level was lower than the standard set by WHO. Some of the factors for low adherence to ART were No Formal Education AOR=3.225, 95%CI (1.237, 8.409) and traveled far away from home in the last month had AOR=2.806, 95%CI (1.354, 5.817). Conclusions: The analyses showed that the adherence rate to ART among the study population was lower than the standard set by the WHO. This low adherence level was linked to factors such as traveling a long distance from home in the past month, a lack of formal education, and other individual-related issues. This highlights the significance of counseling HIV/AIDS patients both before they start ART and during follow-up appointments to ensure they stick to their medication regimen, thereby preventing missed doses, health complications, co-morbidities, and drug resistance in the area studied. A few key reasons for the relatively low adherence to ART observed in the study participants likely include the absence of formal education, forgetfulness, extended travel away from home, and the experience of side effects.