Methods

An unmatched 1: 2 case-control study with 68 cases using simple random sampling. A case was defined as an ART patient who failed to achieve increase in CD4 count of 100cell/mm 3 in one year. Controls are those with adequate immunological response. Questionnaires were administered for socio-demographic and adherence-related information. Bivariate and multivariable logistic regression was done using Epi Info at 95% Confidence Interval (CI) and precision of 5%.

Results

A total of 204 patients were enrolled, mean age of cases was 36 (Standard Deviation Sd= 8.8), n= 68 and controls 37 (Sd= 9.8), n= 136. Of enrollees, 69.6%(142) were females. Mean duration on ART was 4.9 years for cases and 4.5 years for controls (standard deviation=±2.2 years). The commonest reason for missing drugs was forgetfulness (58% cases). On multivariate analysis, having formal education (Adjusted Odds Ratio [aOR]= 3.03, 95% CI= 1.5-6.0) and income above minimum wage,(aOR= 2.38, 95% CI= 1.06-4.76) were independently associated with non-adherence. The commonest reason for missing drugs was forgetfulness (58% cases).

Conclusion

In conclusion, educated people and those with higher income were more likely to be non-adherent and should be the focus of adherence counseling. Some form of reminders like use of telephone should be adopted to address forgetfulness.