Adherence to antiretroviral therapy is a major determinant of successful
management of HIV. Poor adherence is associated with development of viral resistance,
virologic failure, and progressive immunosuppression. This project looked at an
association between poor adherence and distance that patients travel to receive ART.
HIV infected patients between 18 and 89 years old receiving ART at 7 health facilities in
Mbeya City, Tanzania were included in the study; pregnant women were excluded.
Generalized Linear Regression and Zero Inflated Poisson models were used for analysis
with age, sex, marital status, WHO HIV stage at ART initiation, and number of visits
adjusted. Results for the primary analysis showed, on average the risk of poor
adherence reduces by approximately 14.8% for every one mile increase in travel
distance to an ART facility (95% CI: 6.8-21.3, p=0.0002). The risk of poor adherence is
20.9% lower for patients younger than 50 years compared to those that are 50 years and
older (95% CI: 5.1-40.5, p=0.007), married patients have 55.3% higher risk of poor
adherence compared to unmarried patients (95% CI: 3.05-131.6, p=0.034), and patients
with WHO HIV stage 1 or 2 at ART initiation have a 22.1% higher risk of poor adherence
compared to patients with WHO HIV stage 3 and 4 at ART initiation (95% CI: 0.0-49.18,
p=0.05).