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September 10, 2025

Factors Associated with Non-Adherence to Antiretroviral Therapy Among HIV Patients at Kibungo Referral Hospital, Rwanda.

Key Points

The non-adherence rate to antiretroviral therapy among HIV patients was found to be 13%.
Patients without tertiary education were over 8 times more likely to be non-adherent to ART.
Factors such as stigma and perceived ineffectiveness of ART were significantly linked to non-adherence.
Interventions targeting education and structured support systems are essential for improving adherence rates.

Abstract

Abstract Background: It has been demonstrated that antiretroviral therapy improves health and lengthens the life of HIV positive individuals. For those living with HIV, attaining optimal adherence is turning out to be the largest obstacle. The purpose of this research was to determine how often antiretroviral therapy non-adherence is among HIV patients who visit Rwanda's Kibungo Referral Hospital. Methods: This study utilized a quantitative, cross-sectional design. Data collection was conducted from March 25th to April 30, 2024, with a sample size of 396 HIV patients on ART at Kibungo Referral Hospital. Inclusion criteria included patients aged 18 years and older who had been on ART for six months, while exclusion criteria included lack of consent and hospitalized patients. A structured questionnaire was used. The Fisher exact test and logistic regression were employed to analyze associations, with significance set at p < 0.05 and 95% CI. Findings: The findings showed that the overall non-adherence rate to ART was 13% while the adherence rate was 87%. Also, patients without tertiary education are significantly more likely to be non-adherent to ART compared to those with tertiary education (AoR: 8.232, 95% CI: 4.124-17.217, P-value: <0.001). Patients who experience stigma are more likely to be non-adherent to ART (AoR: 2.148, 95% CI: 1.032-6.689, P-value: 0.015). Patients who perceive ART as ineffective are significantly more likely to be non-adherent (AoR: 9.333, 95% CI: 2.108-20.638, P-value: <0.001. Patients who do not integrate ART into their daily routines are significantly more likely to be non-adherent (AoR: 11.180, 95% CI: 5.879-28.338, P-value: <0.001). There is no significant association between not setting an alarm and non-adherence. Conclusion: The study found a high non-adherence rate to ART among HIV patients at Kibungo Referral Hospital, linked to factors such as younger age, lack of tertiary education, stigma, and perceived ineffectiveness of ART. It recommends implementing structured support systems and targeted interventions to improve adherence and health outcomes for these patients. Key words: Prevalence, Factor, Non-Adherence, Antiretroviral Therapy

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