title: Determinants of non-adherence to antiretroviral therapy in adult hospitalized patients, Northwest Ethiopia.
abstract: OBJECTIVE
  The aim of this study was to assess the rate of antiretroviral therapy (ART) adherence and to identify any determinants among adult patients.
  
  
  METHODS
  A cross-sectional study was conducted on 351 ART patients in the ART clinic of the University of Gondar referral hospital. Data were collected by a pretested interviewer-administered structured questionnaire from May to June 2014. Multivariate logistic regression was used to determine factors significantly associated with adherence.
  
  
  RESULTS
  Of 351 study subjects, women were more predominant than men (64.4% versus 35.6%). Three hundred and forty (96.9%) patients agreed and strongly agreed that the use of ART is essential in their life, and approximately 327 (93.2%) disclosed their sero-status to family. Seventy-nine (22.5%) participants were active substance users. The level of adherence was 284 (80.9%). Three hundred forty-one (97.2%) respondents had good or fair adherence. Among the reasons for missing doses were forgetfulness (29 [43.3%]), missing appointments (14 [20.9%]), running out of medicine (9 [13.4%]), depression, anger, or hopelessness (4 [6.0%]), side effects of the medicine used (2 [3.0%]), and nonbelief in the ART (2 [3.0%]). The variables found significantly associated with non-adherence were age (P-value 0.017), employment (P-value 0.02), HIV disclosure (P-value 0.04), and comfortability to take ART in the presence of others (P-value 0.02).
  
  
  CONCLUSIONS
  From this study, it was determined that forgetfulness (43.3%) was the most common reason for missing doses. Also, employment and acceptance in using ART in the presence of others are significant issues observed for non-adherence. Hence, the ART counselor needs to place more emphasis on the provision and use of memory aids.
authors.affiliation: Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia.
authors.forename: Bayew
authors.initials: B
authors.lastname: Tsega
authors.affiliation: Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia.
authors.forename: Bhagavathula Akshaya
authors.initials: BA
authors.lastname: Srikanth
authors.affiliation: Department of Pharmacology, School of Pharmacy - College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Zewdneh
authors.initials: Z
authors.lastname: Shewamene
keywords: Africa; Ethiopia; adherence; antiretroviral therapy; determinants