TITLE:
Factors Associated with Non-Adherence to Antiretroviral Therapy among People Living with HIV Receiving Care in Military Health Facilities in Côte d’Ivoire
AUTHORS:
Leynouin Franck-Olivier Te Bonle, N’Guessan Aimé Brou, Maxime Konan Yeboue, Manzan Didier Ghislain Adingra, Geneviève Irie-N’Guessan
KEYWORDS:
HIV, Antiretroviral Therapy, Medication Adherence, HIV-Related Stigma
JOURNAL NAME:
World Journal of AIDS,
Vol.16 No.3,
September
22,
2026
ABSTRACT: Introduction: Non-adherence to antiretroviral therapy remains a barrier to achieving and maintaining virological suppression. This study aimed to explore factors associated with antiretroviral therapy non-adherence among people living with HIV receiving care in military health facilities in Côte d’Ivoire. Methods: A multicentre cross-sectional study was conducted among 213 people living with HIV receiving antiretroviral therapy. Adherence was assessed using a composite criterion combining good self-reported adherence and an undetectable viral load. Sociodemographic, socioeconomic, treatment-related, healthcare-related, and psychosocial factors, including HIV-related stigma, were explored using unadjusted bivariate analyses. The Benjamini-Hochberg procedure was applied within families of related variables to control the false discovery rate. Results: Based on the composite criterion, 28.2% of participants were classified as non-adherent, whereas 82.6% had good self-reported adherence and 81.2% met the predefined undetectable viral load threshold. After correction for multiple comparisons, adherence remained associated with the ability to meet basic needs, circumstances of HIV testing, ART duration, concomitant treatment for a chronic condition, and several psychosocial dimensions. Associations with access to support services, confidentiality or management of medical records, guilt, and worthlessness did not remain statistically significant after correction. No association was found with sociodemographic characteristics or experiences of discrimination in healthcare settings. Conclusion: Among people living with HIV receiving care in the military health facilities included in this study, ART adherence appeared to reflect socioeconomic, psychosocial, and treatment-related circumstances beyond medication-taking behaviour alone. These findings support a person-centred approach to adherence, while healthcare support and confidentiality warrant further investigation.