title: Some factors associated with non-adherence to antiretroviral therapy (ART) in people living with HIV/AIDS (PLHA) in Tanzania: a case study of Dar es Salaam region.
abstract: OBJECTIVE
  Tanzania is one of the nations that are highly affected by HIV/AIDS epidemic. Invention of ARVs (Anti -Retroviral) brought hope of extended life to people living with HIV/AIDS (PLHA). Though ARV's are administered in several clinics particularly in Dar es Salaam, there is a problem to adherence. Some factors associated with non-adherence are investigated and ways to optimize adherence are suggested.
  
  
  METHODS
  This study was undertaken at three treatment and care clinics in Dar es Salaam. A sample of 197 individuals on ARV and 30 health care providers were interviewed. The sample comprised of 76 % females and 24% males, with mean age 34. About 74% of individuals on ARV were aged between 25 - 45 years. Logistic Regression and survival analysis models were used in the analysis.
  
  
  RESULTS
  Individuals on ARV recommended factors responsible for non-adherence as lack of awareness 63.5%, stigma 56%, side effects 53.3%, and costs 28%. Other factors were being busy 25.4%, away from home 21.3%, forgetting 12.2% and ARVs out of stock 10.2%. Proportion of PLHA lost to follow up was 26%. Awareness and side effects were found to be statistically significant, with p-values of 0.042 and 0.068 respectively (alpha = 0.1). The median survival time for individuals on ARV was 42 months (95% CI: 41-44) with survival rate of above 0.7. Log-rank test showed significant differences between the male and female on having a shorter time to death. Females seemed to survive longer than males suggesting that females adhere more to ART than males.
  
  
  CONCLUSIONS
  This calls for emphasis on HIV/AIDS education to the society especially to sensitize men. Another suggestion is that when a woman gets pregnant, both the expectant mother and father should attend maternal clinic so that they both take HIV test so as to increase man's participation.
authors.affiliation: Department of Statistics, University of Dar es Salaam, P.O. Box 35047 Dar es Salaam, Tanzania.
authors.forename: Gasper
authors.initials: G
authors.lastname: Baltazary
authors.forename: Rocky R J
authors.initials: RR
authors.lastname: Akarro
authors.forename: A S
authors.initials: AS
authors.lastname: Mussa
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013636:Tanzania / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents