Determinants of Defaulting from Antiretroviral Therapy Treatment in Nekemte Hospital, Eastern Wollega Zone, Western Ethiopia

Abstract

Background: The prognosis of patients with HIV in Sub-Africa has improved with the widespread use of antiretroviral therapy. Despite this success, defaulting fro m antiretroviral therapy is one of the major challenges in resource-limited settings. There are limited data on determinants of defau lting fro m antiretroviral therapy in Ethiop ia. Therefore the aim of this study is to assess determinants of defaulting fro m antiretroviral treat ment in Nekemte Hospital, West Ethiopia. Method: A case control study was used. The study covered 118 cases and 118 controls. Cases were individuals who had missed two or more clin ical appointments (i.e. had not been seen for the last 2 months); controls were individuals who were rated as excellent adherers by the providers. Data were co llected fro m patient records, and by telephone call and home visit to identify the factors associated with for defaulting. The logistic regression model was fitted by using back ward elimination technique to identify independent predictors of antiretroviral treat ment defaulting. Result: After controlling for possible confounders, living far fro m the facility (out of the town) (AOR=4.1; 95%CI 1.86 to 9.42), dependent patients for source of food(AOR=13.9; 95%CI 4.23 to 45.99), patients with mental status not at ease(AOR=4.7; 95%CI 1.65 to 13.35), patients whose partners were HIV negative(A OR=5.1; 95%CI 1.59 to 16.63), patients whose partners HIV status were unknown or not tested(AOR=2.8; 95%CI 1.23 to 6.50) and patients that fear stigma (AOR=8.3; 95%CI 2.88 to 23.83) were statistically significant association. Conclusion: In this study, those who were liv ing out of the town or far fro m the facility, whose partner's HIV status was negative or unknown, who were stig matized and mental ill had a h igher chance of defaulting fro m ART treat ment. So, efforts to reduce defualting fro m ART should focus on addressing these risk factors.