Background: Antiretroviral therapy (ART) requires high-level (> 95%) adherence. Kenya is rolling out ART access\r\nprogrammes and, issue of adherence to therapy is therefore imperative. However, published data on adherence to\r\nART in Kenya is limited. This study assessed adherence to ART and identified factors responsible for non adherence\r\nin Nairobi.\r\nMethods: This is a multiple facility-based cross-sectional study, where 416 patients aged over 18 years were\r\nsystematically selected and interviewed using a structured questionnaire about their experience taking ART.\r\nAdditional data was extracted from hospital records. Patients were grouped into adherent and non-adherent based\r\non a composite score derived from a three questions adherence tool developed by Center for Adherence Support\r\nEvaluation (CASE). Multivariate regression model was used to determine predictors of non-adherence.\r\nResults: Overall, 403 patients responded; 35% males and 65% females, 18% were non-adherent, and main (38%)\r\nreason for missing therapy were being busy and forgetting. Accessing ART in a clinic within walking distance from\r\nhome (OR = 2.387, CI.95 = 1.155-4.931; p = 0.019) and difficulty with dosing schedule (OR = 2.310, CI.95 = 1.211-\r\n4.408, p = 0.011) predicted non-adherence.\r\nConclusions: The study found better adherence to HAART in Nairobi compared to previous studies in Kenya.\r\nHowever, this can be improved further by employing fitting strategies to improve patients� ability to fit therapy in\r\nown lifestyle and cue-dose training to impact forgetfulness. Further work to determine why patients accessing\r\ntherapy from ARV clinics within walking distance from their residence did not adhere is recommended.
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