Non-Adherence and First Line Antiretroviral Therapy failure among people living with HIV on Antiretroviral Therapy in Bulawayo city, 2016.

BACKGROUND: The prevalence of first-line ART failure in Bulawayo City, Zimbabwe's second-largest city for the year 2016 was 6.6% higher than the national average of 3.3%. We assessed the association between non-adherence and first-line ART failure persons on ART in Bulawayo City. METHODS: A 1:1 case-control study was done to measure the association between adherence and other risk factors for treatment failure among 169 cases and 169 controls. The Morisky Medication adherence 8-item scale was used to assess self-reported adherence, and non-adherence was defined as having a self-reported score of 1 to 8. Epi info 7 was used for univariate, bivariate, and multivariate analysis. RESULTS: Persons who were non-adherent to ART were 5 times more likely to experience treatment failure than those who adhered association between non-adherence and treatment failure (OR=5.1, 95% CI 2.9-8.9). The study established that 58% of the cases had good knowledge of adherence to ART compared to 85% of the controls. Stopping medication when feeling worse (AOR=3.5, 95% CI 1.8-7.0) was the most significant independent risk factor for treatment failure. CONCLUSIONS: The study found a strong association between non-adherence and treatment failure. Routine monitoring at every clinic visit of clients on ART should be done to monitor the client's adherence to medication.