Factors Associated with Untimely Antiretroviral Drug Pick-up by Patients in Bindura District.

Abstract

Introduction Timely antiretroviral drug pick up is one of the early warning indicators for monitoring HIV drug resistance. Timely antiretroviral drug pick up is essential in the prevention of emergence of HIV drug resistance. The scale up of ART programme is not directly proportional to clients picking their drugs on time. This study sought to establish ART drug pick up patterns of ART clients, prevalence of untimely drug pick up and the associated factors. Methods: The study was an analytic cross-sectional study. Two hundred and seventy-seven (277) respondents were randomly selected from attendees of ART clinics at ART sites. Interviewer-administered pretested questionnaires were used to collect data. Epi info version 3.5.1 was used to create frequencies and proportions were calculated as well as Odds ratios to determine associations. Logistic regression analysis was done to identify independent risk factors and to control for confounding variables. Results: Two hundred and seventy-seven (277) ART clients were included in the study. The prevalence of untimely drug pick up was 40.4%. The median number of times participants missed drug pick on time in the past 12 months was 1 (Q1=1; Q3=2) and the main reason for not picking up drugs on time was social problems like attending funerals and not having bus fares. Those who had short time (0-6 months) on treatment [POR = 0.45 (95% CI; 0.27 - 0.77)] and having one month or less supply [POR = 0.50 (95% CI: 0.30 - 0.81)] were significantly associated with a lower likeliness of missing drug pick up time. Barriers such as adverse effects [AOR = 1.84 (95% CI: 1.13 - 3.01)], user fees [AOR = 1.96 (95% CI: 1.06 - 3.60)], and long distances to ART sites [AOR 1.96 (95% CI: 1.11 – 3.47)] were significantly associated with high likeliness of missing drug pick up time. These factors remained statistically significant on logistic regression analysis and stratified analysis showed that age was modifying the relationship between distance and drug pick up time. Conclusion and Recommendations ART clients were mainly missing drug pick up time due to long distance to ART sites, user fees and adverse effects to drugs. The District Health Executive need to scale up ART outreach in order to provide services for those who stay far away from ART sites.