Background:
One way of addressing malnutrition among HIV/AIDS patients is through the Food by Prescription
program (FBP) and many studies have explained the treatment outcomes after therapeutic food supplementation,
though available evidences on adherence levels and factors associated with these sorts of programs are limited.
The findings of this study would therefore contribute to the existing knowledge on adherence to Ready-to-Use
Therapeutic/Supplementary Food (RUF) in Ethiopia.
Methods:
A facility-based, cross-sectional study supplemented with qualitative methods was conducted among 630
adult HIV + patients. Their level of adherence to RUF was measured using the Morisky 8-item Medication Adherence
Scale (MMAS-8). The total score on the MMAS-8 ranges from 0 to 8, with scores of <6, 6 to <8, and 8 reflecting low,
medium, and high adherence, respectively. Patients who had a low or a moderate rate of adherence were considered
non-adherent.
Results:
The level of adherence was found to be 36.3% with a 95.0% response rate. With the exception of the
educational status, other socio-demographic variables had no significant effect on adherence. Those who knew the
benefits of the FBP program were 1.78 times more likely to adhere to the therapy than the referent groups. On the
other hand, patients who were not informed on the duration of the treatment, those prescribed with more than
2 sachets/day and had been taking RUF for more than 4 month were less likely to adhere. The main reasons for
non-adherence were not liking the way the food tasted an
d missing follow-up appointments. Stigma and sharing
and selling food were the other reasons, as deduced from the focus group discussion (FGD) findings.
Conclusion:
The observed level of adherence to the FBP program among respondents enrolled in the intervention
program was low. The major factors identified with a low adherence were a low level of education, poor knowledge
on the benefits of RUF, the longer duration of the program, consuming more than two prescribed sachets of RUF per
day, and not being informed about the duration of the treatment. Therefore, counseling patients on the program
’
s
benefits, including the treatment plans, would likely contribute to improved adherence.