Abstract:

Background: Treatment adherence is critical in the management of patients receiving antiretroviral therapy (ART).

Objective: To investigate determinant of treatment adherence and health-related outcomes after ART initiation in Windhoek, Namibia.

Methods: We used data from retrospective cohort from January 2010 to December 2015. We defined ART adherence at 95%, while non-adherence at <95% . We examined two outcomes: viral suppression and body weight at 6 and 12 months.. We then investigated the relationship between patient individual outcomes and treatment adherence. We applied multivariate binary and multinomial logistic regression models to examine the determinants of ART adherence and outcomes.

Results: Of 943 patients on ART, 58.9% were female, 82.1% aged between 25 to 49 years old and 86.6% ever married. Viral suppression at 6 months (p<0.000), and 12 months (p<0.000), and patients’ body weight at 6 months (p = 0.009) were significant more pronounced with ART adherence.. Regarding determinants of ART adherence, the results showed age between 25 and 29 years, and married was associated with higher adherence (OR=1.94, CI: 1.12-3.14). Patients at WHO clinical stage-I were more likely to adhere to treatment (OR=1.28, 95% CI: 1.01-1.73), while those at clinical stage-II were less likely (OR=0.41, 95% CI: 0.18-0.91, p-value = 0.028).

Conclusion: ART adherence leads to better outcomes.. Both demographic and clinical factors were associated with ART adherence. Future research should consider evaluating the effect of adherence to an extended coverage of clinics, and allow collecting more detailed factors that are associated with treatment adherence.

Keywords: HIV; Antiretroviral Therapy; ART adherence; viral suppression; multinomial logistic regression.

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