ehealth digital library

Digital library of
the Tanzania
health
community

Factors Associated with Different Patterns of Nonadherence to HIV Care in Dar es Salaam, Tanzania.

Poles, G., Li, M., Siril, H., Mhalu, A., Hawkins, C., Kaaya, S., Aris, E., Chalamilla, G. and Hirschhorn, L. R. Factors Associated with Different Patterns of Nonadherence to HIV Care in Dar es Salaam, Tanzania. Journal of the International Association of Providers of AIDS Care, 13 (1). pp. 78-84. ISSN 2325-9574

[img]
Preview
PDF
Gabriela_Poles.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (195kB)

Abstract

Health system responsiveness (HSR), a measure of patient health care experience, may influence adherence to HIV/AIDS care and be an important predictor of outcomes. We studied the relationship between HSR, patient factors, and visit nonadherence in 16 President's Emergency Plan for AIDS Relief-supported HIV/AIDS clinics in Dar es Salaam. An HSR survey was administered in 2009, and all clinic visits 1 year following the interviews were analyzed for 720 patients on antiretrovirals (ARVs). Definitions of visit nonadherence were (1) low visit constancy ([VC], no visit in ≥1 quarter), (2) gaps in care (>60 days between visits), (3) no visit in last quarter (VLQ). The relationships between factors were analyzed using multivariate analysis with adjusted odds ratio (AOR) and 95% confidence intervals (CI) reported. Few patients were nonadherent using VLQ (14%) and VC (28%). Gaps in care were more common (49.6%) and associated with younger age (AOR: 3.86 [2.02-7.40]), no explanation of side effects (AOR: 2.21 [1.49-3.28]), and shorter antiretroviral therapy (ART) duration (0-3 months AOR: 1.49 [1.09-2.03]; 3-6 months AOR: 2.44 [1.40-4.25]). No VLQ was associated with younger age (AOR: 3.40 [1.63-7.07]), poor health care worker (HCW) communication (AOR: 4.83 [1.39-16.78]), and less time on ART (0-3 months AOR: 5.04 [2.47-10.30]; 3-6 months AOR: 3.09 [1.72-5.57]). Younger age, poor HCW communication, and shorter ART duration also predicted lower VC, as did higher patient-HCW ratios. The rates of visit nonadherence differed based on the definitions used. Younger age, shorter time on ART, and poor HCW communication predicted lower adherence regardless of the definition. More work is needed to understand the relationship between HSR, patient factors, and different patterns of visit nonadherence and their impact on ART outcomes.

Item Type: Article
Keywords: HIV/AIDS, Resource-limited settings, Health systems, Patient, health care, Relief-supported HIV/AIDS
Subjects: HIV > Surveillance
Divisions: Muhimbili University of Health and Allied Sciences (MUHAS)
Depositing User: Mr Joseph Madata
Date Deposited: 26 Jan 2015 07:19
Last Modified: 26 Jan 2015 07:19
URI: http://ihi.eprints.org/id/eprint/3059

Actions (login required)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics