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Abstract

Adherence to antiretroviral treatment (ART) is vital for successful human immunodeficiency virus (HIV) treatment and can be enhanced through intervention. Identifying factors leading to non-adherence can guide efforts to improve adherence. We aimed to investigate adherence to treatment and related factors in people who live with HIV (PLHIV). This nested case-control study was performed in Fars province in Iran in 2023. Data was collected from the clinical paper records of patients. We used risk set sampling to select controls from the PLHIV. Adherence status was calculated as a percentage by dividing the total doses taken by the total doses prescribed. The result was then categorized into two groups: good (>=95%) and poor (<95%). We used conditional logistic regression to identify factors associated with adherence to treatment using the STATA software (version 16). we included 1437 eligible PLHIV in our study. The rate of treatment adherence was about 30.68%. HIV infection through unsafe sex (OR = 3.40, 95% CI = 1.67-4.06), prison history (OR = 2.45, 95% CI = 1.56-5.30), addiction (OR = 3.86, 95% CI = 2.80-5.35), and infections such as tuberculosis (OR = 3.22, 95% CI = 2.29-4.20) and hepatitis C (OR = 2.43, 95% CI = 2.09-3.89) increase the odds of non-adherence to treatment. The rate of non-adherence to treatment is considerable. To treatment of PLHIV more effective, reducing HIV transmission and the number of AIDS-related deaths, improving the treatment adherence rate seems necessary. It is recommended to plan for tailored treatment and counseling based on patient records, such as incarceration history, transmission route, and co-morbidities.