Table 1.
Bivariable and Multivariable Ordinal Logistic Regression Analysis of Adherence to Antiretroviral Therapy Among HIV-Positive Adolescents and Adults in Tigray Region, North Ethiopia, 2015–2019 (N = 19,525)
| Variables | Category | ART Adherence | Total | COR (95% CI) | AOR (95% CI) | ||
|---|---|---|---|---|---|---|---|
| Poor, n (%) | Fair, n (%) | Good, n (%) | |||||
| Age | 15–19 | 13 (4.55) | 23 (3.19) | 384 (2.07) | 420 (2.15) | 1 (Ref.) | 1 (Ref.) |
| 20–24 | 11 (3.85) | 15 (2.08) | 529 (2.86) | 555 (2.84) | 1.91 (1.13, 3.22)* | 1.55 (0.91, 2.62) | |
| 25–29 | 31 (10.84) | 65 (9.00) | 1736 (9.38) | 1832 (9.38) | 1.70 (1.14, 2.54)** | 1.33 (0.88, 2.01) | |
| 30–34 | 58 (20.28) | 119 (16.48) | 3539 (19.11) | 3716 (19.03) | 1.88 (1.29, 2.74)*** | 1.54 (1.04, 2.26)* | |
| 35–39 | 53 (18.53) | 163 (22.58) | 4014 (21.68) | 4230 (21.66) | 1.75 (1.21, 2.54)** | 1.47 (1.01, 2.15)* | |
| 40–44 | 56 (19.58) | 167 (23.13) | 3490 (18.85) | 3713 (19.02) | 1.48 (1.02, 2.14)* | 1.32 (0.90, 1.93) | |
| 45–49 | 28 (9.79) | 69 (9.56) | 2051 (11.08) | 2148 (11.00) | 1.99 (1.34, 2.97)*** | 1.87 (1.24, 2.83)** | |
| 50+ | 36(12.59) | 101 (13.99) | 2774 (14.98) | 2911 (14.91) | 1.91 (1.30, 2.81)*** | 1.68 (1.13, 2.50)* | |
| Gender | Female | 158 (55.24) | 412 (57.06) | 12,296 (66.40) | 12,866 (65.90) | 1 (Ref.) | 1 (Ref.) |
| Male | 128 (44.76) | 310 (42.94) | 6221 (33.60) | 6659 (34.10) | 0.66 (0.58, 0.75)*** | 0.75 (0.65, 0.87)*** | |
| Pregnant mother | No | 157 (99.37) | 410 (99.51) | 12,204 (99.25) | 12,771 (99.26) | 1 (Ref.) | |
| Yes | 1 (0.63) | 2 (0.49) | 92 (0.75) | 95 (0.74) | 1.42 (0.45, 4.51) | ||
| Lactating mother | No | 155 (98.10) | 402 (97.57) | 12,107 (98.46) | 12,664 (98.43) | 1 (Ref.) | |
| Yes | 3 (1.90) | 10 (2.43) | 189 (1.54) | 202 (1.57) | 0.67 (0.38, 1.18) | ||
| Facility ownership | Government | 277 (96.85) | 661 (91.55) | 17,733 (95.77) | 18,671 (95.63) | 1 (Ref.) | |
| NGO | 9 (3.15) | 61 (8.45) | 770 (4.16) | 840 (4.30) | 0.59 (0.46, 0.76) | ||
| Private | 0 | 0 | 14 (0.08) | 14 (0.07) | – | ||
| Facility type | Clinic | 0 | 0 | 43 (0.23) | 43 (0.22) | ||
| Health center | 69 (24.13) | 134 (18.56) | 5479 (29.59) | 5682 (29.10) | 1.05 (0.77, 1.41) | ||
| Primary hospital | 28 (9.79) | 81 (11.22) | 2022 (10.92) | 2131 (10.91) | 0.72 (0.52, 1.002) | ||
| General hospital | 163 (56.99) | 461 (63.85) | 9205 (49.71) | 9829 (50.34) | 0.57 (0.43, 0.76)*** | 0.52 (0.39, 0.69)*** | |
| Referral hospital | 16 (5.59) | 40 (5.54) | 1443 (7.79) | 1499 (7.68) | 1 (Ref.) | ||
| Other | 10 (3.50) | 6 (0.83) | 325 (1.76) | 341 (1.75) | 0.77 (0.44, 1.38) | ||
| Service provided at defense facility | No | 276 (96.50) | 692 (95.84) | 17,882 (96.57) | 18,850 (96.54) | 1 (Ref.) | |
| Yes | 10 (3.50) | 30 (4.16) | 635 (3.43) | 675 (3.46) | 0.86 (0.62, 1.19) | ||
| WHO staging | I | 220 (76.92) | 582 (80.61) | 17,027 (91.95) | 17,829 (91.31) | 1 (Ref.) | 1 (Ref.) |
| II | 23 (8.04) | 64 (8.86) | 688 (3.72) | 775 (3.97) | 0.37 (0.30, 0.47)*** | 0.47 (0.36, 0.60)*** | |
| III | 28 (9.79) | 50 (6.93) | 330 (1.78) | 408 (2.09) | 0.20 (0.15, 0.25)*** | 0.25 (0.19, 0.34)*** | |
| IV | 15 (5.24) | 26 (3.60) | 472 (2.55) | 513 (2.63) | 0.54 (0.39, 0.75)*** | 0.57 (0.41, 0.81)** | |
| Viral load test reason | First at 6 months | 177 (61.89) | 427 (59.14) | 11,355 (61.32) | 11,959 (61.25) | 1 (Ref.) | 1 (Ref.) |
| Routine annual VL test | 37 (12.94) | 175 (24.24) | 5820 (31.43) | 6032 (30.89) | 1.47 (1.25, 1.72)*** | 1.40 (1.19, 1.65)*** | |
| Suspected ART failure clinical | 0 | 4 (0.55) | 46 (0.25) | 50 (0.26) | 0.63 (0.23, 1.75) | ||
| Suspected ART failure– immunological | 8 (2.8) | 8 (1.11) | 65 (0.35) | 81 (0.41) | 0.21 (0.12, 0.36)*** | 0.45 (0.24, 0.82)** | |
| Suspected ART failure – initial viral load | 56 (19.58) | 92 (12.74) | 943 (5.09) | 1091 (5.59) | 0.33 (0.28, 0.41)*** | 0.55 (0.44, 0.69)*** | |
| Not indicated in the form | 8 (2.8) | 16 (2.22) | 288 (1.56) | 312 (1.60) | 0.64 (0.42, 0.97)* | 0.62 (0.41, 0.94) | |
| Viral load status | Suppressed | 123 (43.01) | 413 (57.20) | 13,836 (74.72) | 14,372 (73.61) | 1 (Ref.) | 1 (Ref.) |
| Non-suppressed | 163 (56.99) | 309 (42.80) | 4681 (25.28) | 5153 (26.39) | 0.38 (0.34, 0.43)*** | 0.54 (0.47, 0.63)*** | |
| Regimen | 1c (AZT–3TC–NVP) | 85 (29.72) | 222 (30.75) | 5525 (29.84) | 5832 (29.87) | 1 (Ref.) | 1 (Ref.) |
| 1d (AZT–3TC–EFV) | 28 (9.79) | 85 (11.77) | 1794 (9.69) | 1907 (9.77) | 0.88 (0.71, 1.10) | ||
| 1e (TDF–3TC–EFV) | 141 (49.30) | 309 (42.80) | 8940 (48.28) | 9390 (48.09) | 1.10 (0.95, 1.28) | ||
| 1f (TDF–3TC–NVP) | 29 (10.14) | 90 (12.47) | 2023 (10.93) | 2142 (10.97) | 0.95 (0.76, 1.18) | ||
| 1g (ABC–3TC–EFV) | 0 | 0 | 6 (0.03) | 6 (0.03) | – | ||
| 1h (ABC–3TC–NVP) | 0 | 1 (0.14) | 6 (0.03) | 7 (0.04) | 0.35 (0.04, 2.88) | ||
| 2a (ABC–ddl–LPV/R), 2c (TDF–ddl–LPV/R), 2d (TDF–ddl–NFV) and 2g (TDF–3TC–LPV/r) | 0 | 0 | 12 (0.06) | 12 (0.06) | – | ||
| 2f (AZT–3TC–ATV/r) | 0 | 3 (0.42) | 59 (0.32) | 62 (0.32) | 1.11 (0.35, 3.55) | ||
| 2h (TDF–3TC–ATV/R) | 3 (1.05) | 12 (1.66) | 152 (0.82) | 167 (0.86) | 0.57 (0.33, 0.98)* | 1.04 (0.59, 1.83) | |
| Baseline CD4 count | <200 | 164 (57.34) | 392 (54.29) | 9131 (49.31) | 9687 (49.61) | 1 (Ref.) | 1 (Ref.) |
| 200–499 | 103 (36.01) | 250 (34.63) | 7252 (39.16) | 7605 (38.95) | 1.25 (1.09, 1.43)** | 1.03 (0.88, 1.21) | |
| 500 and above | 19 (6.64) | 80 (11.08) | 2134 (11.52) | 2233 (11.44) | 1.32 (1.06, 1.64)* | 0.95 (0.71, 1.27) | |
| Recent CD4 count | <200 | 88 (30.77) | 206 (28.53) | 2749 (14.85) | 3043 (15.59) | 1 (Ref.) | 1 (Ref.) |
| 200–499 | 125 (43.71) | 325 (45.01) | 8459 (45.68) | 8909 (45.63) | 2.01 (1.73, 2.35)*** | 1.45 (1.21, 1.74)*** | |
| 500 and above | 73 (25.52) | 191 (26.45) | 7309 (39.47) | 7573 (38.79) | 2.96 (2.50, 3.52)*** | 1.84 (1.47, 2.32)*** | |
| Immunological response compared to baseline | Negative | 80 (27.97) | 180 (24.93) | 3279 (17.71) | 3539 (18.13) | 1 (Ref.) | 1 (Ref.) |
| No change | 6 (2.10) | 12 (1.66) | 232 (1.25) | 250 (1.28) | 0.72 (0.43, 1.21) | ||
| Positive response | 200 (69.93) | 530 (73.41) | 15,006 (81.04) | 15,736 (80.59) | 1.63 (1.41, 1.89)*** | 1.14 (0.93, 1.40) | |
Notes: *P-value ≤ 0.05; **P-value ≤ 0.01; ***P-value ≤ 0.001.
Abbreviations: 3TC, lamivudine; ABC, abacavir; AOR, adjusted odds ratio; ART, antiretroviral therapy; ATV/r, atazanavir/ritonavir; AZT, azidothymidine; CD4, cluster of differentiation 4; COR, crude odds ratio; ddl, didanosine; EFV, efavirenz; LPV/R, lopinavir/ritonavir; n, number; NFV, nelfinavir; NGO, non-governmental organization; NVP, nevirapine; P-value, precession value; Ref., reference; TDF, tenofovir disoproxil fumarate; WHO, World Health Organization; VL, viral load.