Figure 1
Recruitment of the study participants.
Table 1
Association between patient-related factors and adherence to ART in PLWHA.
| PREDICTORS | UNADJUSTED | P-VALUE | ADJUSTED | P-VALUE |
|---|---|---|---|---|
| OR (95% CI) | OR (95% CI) | |||
| Sex | ||||
| Male | Ref | Ref | ||
| Female | 1.142 (0.822–1.588) | 0.429 | 2.023 (1.107–3.698) | 0.022 |
| HIV-risky behavior | ||||
| Blood transfusion | Ref | Ref | ||
| Intravenous drug users | 3.607 (1.656–7.853) | 0.001 | 2.861 (1.216–6.732) | 0.016 |
| Heterosexuality | 1.584 (0.782–3.207) | 0.202 | 1.388 (0.645–2.986) | 0.402 |
| MSM | 1.337 (0.600–2.980) | 0.478 | 1.282 (0.513–3.097) | 0.58 |
| Unknown risk/ other risks | 1.183 (0.535–2.617) | 0.678 | 1.083 (0.473–2.480) | 0.851 |
| Patient satisfaction with the care provided at the HIV clinic | ||||
| Satisfied | Ref | Ref | ||
| Unsatisfied | 1.860 (1.315–2.630) | < 0.001 | 1.970 (1.274–3.048) | 0.002 |
| Education | ||||
| University or higher | Ref | Ref | ||
| Illiteracy, read and write | 2.196 (1.325–3.640) | 0.002 | 1.850 (1.030–3.323) | 0.04 |
| ≤12 years of education | 1.531 (1.085–2.160) | 0.015 | 1.337 (0.913–1.957) | 0.136 |
| Employment | ||||
| Student or employee | Ref | Ref | ||
| Unemployed | 1.905 (1.128–3.218) | 0.016 | 1.677 (0.920–3.058) | 0.092 |
| Owner | 1.328 (0.847–2.080) | 0.216 | 1.407 (0.875–2.261) | 0.159 |
| Housewife or retired | 1.009 (0.699–1.455) | 0.963 | 0.729 (0.404–1.314) | 0.293 |
[i] ~80% is the cutoff level of “Good adherence.”
[ii] ART: antiretroviral therapy
[iii] MSM = Men who have sex with men
[iv] OR: odds ratio
[v] Ref: reference
[vi] p < 0.1 is set as a level of significance.
Table 2
Association between healthcare-related factors and adherence to ART in PLWHA.
| HEALTHCARE-RELATED FACTORS | GOOD ADHERENCE | POOR ADHERENCE | UNADJUSTED | P- VALUE |
|---|---|---|---|---|
| N (%) | N (%) | OR (95% CI) | ||
| Duration of treatment | 0.182 | |||
| 2–4 years | 286 (69.6) | 125 (30.4) | Ref | |
| <2 years | 63 (62.4) | 38 (37.6) | 1.38 (0.88–2.17) | |
| >4 years | 169 (63.8) | 96 (36.2) | 1.30 (0.91–1.80) | |
| Number of tablets | 0.575 | |||
| > 2 | 61 (69.3) | 27 (30.7) | Ref | |
| 2 | 457 (66.3) | 232 (33.7) | 1.15 (0.71–1.85) | |
| Patient satisfaction with the care provided at the clinic | < 0.001 | |||
| Satisfied | 422 (69.9) | 182 (30.1) | Ref | |
| Unsatisfied | 96 (55.5) | 77 (44.5) | 1.86 (1.32–2.63) | |
| Patient satisfaction with pharmacist service | 0.067 | |||
| Satisfied | 512 (67.1) | 251 (32.9) | Ref | |
| Neutral | 6 (42.9) | 8 (57.1) | 2.72 (0.93–7.92) |
[i] ~ 80% is the cutoff level of “Good adherence.”
[ii] ART: antiretroviral therapy
[iii] OR: odds ratio
[iv] Ref: reference
[v] p < 0.1 is set as a level of significance.
Table 3
Adherence to ART in relation to stigma subscales.
| SCORES OF THE SUBSCALE | GOOD ADHERENCE | POOR ADHERENCE | P-VALUE |
|---|---|---|---|
| N (%) | N (%) | ||
| 1–Personal stigma | 0.616 a | ||
| P1– Some people avoid touching me when they find out I have HIV. | |||
| – Doesn’t happen/Rare | 209 (63.0) | 123 (37.0) | 0.790 b |
| – Sometimes/Always | 51 (64.6) | 28 (35.4) | |
| P2– People I care about stop calling after knowing that I have HIV. | |||
| – Doesn’t happen/Rare | 221 (62.3) | 134 (37.7) | 0.286 b |
| – Sometimes/Always | 39 (69.6) | 17 (30.4) | |
| P3–I lost my friends because I told them that I have HIV. | |||
| – Doesn’t happen/Rare | 222 (62.5) | 133 (37.5) | 0.348 b |
| – Sometimes/Always | 38 (69.1) | 17 (30.9) | |
| 2–Disclosure concerns | 0.343 a | ||
| D1–Telling anyone that I have HIV is a risk. | |||
| – Doesn’t happen/Rare | 5 (45.5) | 6 (54.5) | 0.194 b |
| – Sometimes/Always | 512 (67.0) | 252 (33.0) | |
| D2–I work hard to keep my HIV a secret. | |||
| – Doesn’t happen/Rare | 5 (50.0) | 1 (50.0) | 0.314 b |
| – Sometimes/Always | 513 (66.9) | 254 (33.1) | |
| D3– I am very careful about telling anyone I have HIV (work). | |||
| – Doesn’t happen/Rare | 1 (50.0) | 1 (50.0) | 0.547 b |
| – Sometimes/Always | 374 (67.4) | 181 (32.6) | |
| 3–Concerns about public attitudes | 0.477 a | ||
| C1–People with HIV are treated like outcasts. | |||
| – Doesn’t happen/Rare | 8 (72.7) | 3 (27.3) | 0.759 b |
| – Sometimes/Always | 502 (66.2) | 256 (33.8) | |
| C2–Most people believe that a person who has HIV is a badly behaving person. | |||
| – Doesn’t happen/Rare | 3 (60.0) | 2 (40.0) | 1.000 b |
| – Sometimes/Always | 514 (66.7) | 257 (33.3) | |
| C3–Most people are not comfortable around someone who has HIV. | |||
| – Doesn’t happen/Rare | 10 (76.9) | 3 (23.1) | 0.559 b |
| – Sometimes/Always | 500 (66.1) | 256 (33.9) | |
| 4–Negative self–image | |||
| N1–I feel guilty because I have HIV. | –0.082 a | ||
| – Doesn’t happen/Rare | 240 (70.4) | 101 (29.6) | 0.052 b |
| – Sometimes/Always | 278 (63.8) | 158 (36.2) | |
| N2–People’s attitudes toward HIV make me feel worse about myself. | |||
| – Doesn’t happen/Rare | 83 (63.4) | 48 (36.6) | 0.339 b |
| – Sometimes/Always | 423 (67.7) | 202 (32.3) | |
| N3–I feel that I am not as good as others because I have HIV. | |||
| – Doesn’t happen/Rare | 99 (62.7) | 59 (37.3) | 0.247 b |
| – Sometimes/Always | 416 (67.5) | 200 (32.5) |
[i] a: by Mann–Whitney U test
[ii] b: by Pearson Chi-Square test
[iii] ~ 80% is the cutoff level of “Good adherence.”
[iv] ART; antiretroviral therapy
[v] p < 0.1 is set as a level of significance.
Table 4
Predictors of poor adherence to ART in PLWHA.
| PREDICTORS | UNADJUSTED | P-VALUE | ADJUSTED | P-VALUE |
|---|---|---|---|---|
| OR (95% CI) | OR (95% CI) | |||
| Sex | ||||
| Male | Ref | Ref | ||
| Female | 1.142 (0.822–1.588) | 0.429 | 2.023 (1.107–3.698) | 0.022 |
| HIV-risky behavior | ||||
| Blood transfusion | Ref | Ref | ||
| Intravenous drug users | 3.607 (1.656–7.853) | 0.001 | 2.861 (1.216–6.732) | 0.016 |
| Heterosexuality | 1.584 (0.782–3.207) | 0.202 | 1.388 (0.645–2.986) | 0.402 |
| MSM | 1.337 (0.600–2.980) | 0.478 | 1.282 (0.513–3.097) | 0.58 |
| Unknown risk/other risks | 1.183 (0.535–2.617) | 0.678 | 1.083 (0.473–2.480) | 0.851 |
| Patient satisfaction with the care provided at the HIV clinic | ||||
| Satisfied | Ref | Ref | ||
| Unsatisfied | 1.860 (1.315–2.630) | < 0.001 | 1.970 (1.274–3.048) | 0.002 |
| Education | ||||
| University or higher | Ref | Ref | ||
| Illiteracy, read and write | 2.196 (1.325–3.640) | 0.002 | 1.850 (1.030–3.323) | 0.04 |
| ≤12 years of education | 1.531 (1.085–2.160) | 0.015 | 1.337 (0.913–1.957) | 0.136 |
| Employment | ||||
| Student or employee | Ref | Ref | ||
| Unemployed | 1.905 (1.128–3.218) | 0.016 | 1.677 (0.920–3.058) | 0.092 |
| Owner | 1.328 (0.847–2.080) | 0.216 | 1.407 (0.875–2.261) | 0.159 |
| Housewife or retired | 1.009 (0.699–1.455) | 0.963 | 0.729 (0.404–1.314) | 0.293 |
[i] – Variables initially included in multivariate logistic regression using the Enter method were age category, sex, marital status, potential HIV mode of transmission, number of tablets, duration of treatment, satisfaction with the clinic, satisfaction with the pharmacy, education level, residence, median score of the total stigma score, question no. 23, and employment.
[ii] – 10.2% of the variance of bad adherence to ART is explained by significant independent variables included in the model (Nagelkerke R2 = 0.102);
[iii] Model Summary: X2 =59.414, p < 0.001;
[iv] Hosmer–Lemeshow: X2 = 9.751, p = 0.283
[v] ~80% is the cutoff level of “Good adherence.”
[vi] ART: antiretroviral therapy
[vii] OR: odds ratio
[viii] Ref: reference
[ix] p < 0.1 is set as a level of significance.