Factors associated with discontinuation of anti-retroviral therapy among adults living with HIV/AIDS in Ethiopia: A systematic review protocol

REVIEW QUESTION/OBJECTIVE The aim of this review is to assess the best available evidence regarding risk factors for discontinuation from anti-retroviral therapy in Ethiopia. Specifically, the review will be assessing the association between discontinuation from anti-retroviral therapy and the following: • Socio-demographic and economic factors • Behavioral factors • Clinical factors • Institutional factors INCLUSION CRITERIA Types of participants This review will consider studies reporting on HIV-positive participants aged 15 years and older who have commenced anti-retroviral therapy. Patients who have been transferred out will be excluded. Patients should have at least one follow-up time. If studies include both adult and pediatrics, and are not stratified by age (pediatrics and adults) during analysis, they will be excluded. Besides, if the studies focus on attrition (mortality or discontinuation) and are not stratified by mortality and discontinuation during analysis, the study will also be excluded. Types of exposure This review will consider studies that have examined risk factors for anti-retroviral therapy treatment discontinuation. These include socio-demographic and economic risk factors such as age, sex, income and being dependent on food supplies; behavioral risk factors such as mental status, presence of bereavement, the partner’s HIV status and fear stigma; clinical factors such as isoniazid prophylaxis provision, presence of side effects, baseline CD4 counts and regimen substitution; and institutional risk factors such as distance from the facility and waiting times. Types of outcomes This review will consider studies that include the following outcomes: anti-retroviral therapy treatment discontinuation, i.e. lost to follow up, drop out or defaulting and stopping TRUNCATED AT 250 WORDS.