Assessment of knowledge, attitudes, and practices toward dolutegravir-based regimens among patients receiving antiretroviral therapy at Bule Hora University Teaching Hospital, Ethiopia, 2024

Assessment of knowledge, attitudes, and practices toward dolutegravir-based regimens among patients receiving antiretroviral therapy at Bule Hora University Teaching Hospital, Ethiopia, 2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Assessment of knowledge, attitudes, and practices toward dolutegravir-based regimens among patients receiving antiretroviral therapy at Bule Hora University Teaching Hospital, Ethiopia, 2024 Aliyi Gerina, Woyesa Elema, Kedir Husen, Bahiru Bergene This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7759122/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Human immunodeficiency virus (HIV) remains a major global health challenge. In 2018, an estimated 37.9 million people were living with HIV/AIDS worldwide, of whom 95% were adults. Approximately 1.7 million new infections occurred, and one million people died from AIDS-related illnesses. Dolutegravir (DTG) has emerged as a preferred antiretroviral drug due to its high efficacy, safety profile, and strong barrier to resistance. Current WHO guidelines recommend DTG-based antiretroviral therapy as the preferred first-line regimen, particularly in resource-limited settings. Objective: To assess the knowledge, attitudes, and practices (KAP) of patients receiving antiretroviral therapy toward dolutegravir-based regimens at Bule Hora University Teaching Hospital, Ethiopia. Methods: A facility-based cross-sectional study was conducted from September 1 to October 31, 2024. A total of 308 patients receiving dolutegravir-based antiretroviral regimens were included. Data were collected using structured questionnaires and analyzed to determine levels of knowledge, attitudes, and practices. Results: Among the 308 participants, 171 (55.5%) were female and 166 (53.9%) were older than 35 years. A considerable proportion, 118 (38.3%), had no formal education. More than half of the respondents 178 (57.8%) resided in urban areas. Most were married 182 (59.1%), while the majority reported never smoking 297 (96.4%) or consuming alcohol 287 (93.2%). Overall, patients demonstrated fair to poor knowledge about DTG-based regimens, with nearly one-fourth showing poor knowledge. Despite some negative attitudes, many patients reported good practices toward DTG-based therapy. Conclusion: The study revealed gaps in knowledge and attitudes toward dolutegravir-based regimens among patients on antiretroviral therapy, despite relatively good treatment practices. Strengthening patient education and counseling is essential to improve knowledge and foster positive attitudes, which may enhance treatment adherence and outcomes. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Dolutegravir antiretroviral therapy knowledge attitudes practices Ethiopia Introduction Human immunodeficiency virus (HIV) remains a major global health challenge. In 2018, an estimated 37.9 million people were living with HIV/AIDS worldwide, 95% of whom were adults. That same year, 1.7 million people were newly infected, and nearly one million died of AIDS-related illnesses ( 1 ). In 2021, 1.5 million new HIV infections and 650,000 HIV-related deaths were reported, with sub-Saharan Africa bearing the greatest burden, accounting for nearly three-quarters of cases and deaths ( 2 ). Ethiopia reported its first case of HIV in 1984. Since then, HIV/AIDS has become a critical public health concern, prompting the government to declare a public health emergency in 2002. By 2007, adult HIV prevalence was estimated at 2.1% ( 3 ). According to 2021 UNAIDS national estimates, 616,105 people in Ethiopia were living with HIV, of whom 479,613 were adults, adolescents, and children receiving antiretroviral therapy ( 2 ). HIV progressively destroys immune cells, leading to immunodeficiency and increased susceptibility to opportunistic infections. If untreated, the disease advances to acquired immunodeficiency syndrome (AIDS), the most severe stage of infection ( 4 ). Advances in HIV treatment have significantly improved survival and reduced global incidence, yet adherence to ART remains critical to achieving long-term viral suppression and preventing resistance ( 5 ). Studies in Ethiopia have shown that adherence rates vary between 70% and 95% across regions ( 6 ). Adherence is influenced by demographic, cultural, social, and health system factors, including stigma, supply chain interruptions, limited resources, and patient-related barriers such as low knowledge or negative attitudes toward ART ( 7 , 8 ). As HIV has become a chronic condition managed largely in outpatient settings, patients’ self-care practices and understanding of therapy have become increasingly important ( 9 ). In 2016, the World Health Organization recommended dolutegravir (DTG)-based ART (tenofovir disoproxil fumarate + lamivudine + dolutegravir) as the preferred first-line regimen, replacing efavirenz-based therapy ( 10 ). DTG is favored due to its efficacy, tolerability, limited drug–drug interactions, and high barrier to resistance ( 11 ). Despite these advantages, the pharmacological properties of ART alone do not ensure treatment success; patients’ knowledge, attitudes, and practices (KAP) play a crucial role in adherence and outcomes. Lack of awareness, misconceptions, and concerns about long-term use or side effects may compromise adherence, while positive practices support sustained viral suppression ( 12 , 13 ). In Ethiopia and other resource-limited settings, DTG has only recently been introduced, and there is limited evidence on patients’ knowledge, perceptions, and practices regarding this regimen. Understanding these factors is essential for designing targeted educational and psychosocial interventions to address barriers, improve adherence, and optimize treatment outcomes. This study therefore aims to assess the knowledge, attitudes, and practices of patients on DTG-based regimens at Bule Hora University Teaching Hospital. By identifying gaps and misconceptions, the findings will inform strategies to strengthen patient-centered HIV care, support public health goals of reducing transmission, and enhance the long-term effectiveness of ART programs. Methods Study area and period The study was conducted from September 1 to October 31, 2024 at Bule Hora University Teaching Hospital (BHUTH), located 474 km southeast of Addis Ababa in the West Guji Zone of Oromia Region, Ethiopia. BHUTH provides a wide range of medical services, including an antiretroviral therapy (ART) clinic, and serves as a referral center for surrounding health facilities. Study design A facility-based cross-sectional study was employed. Source population All patients living with HIV who were receiving ART with dolutegravir (DTG)-based regimens at BHUTH. Study population Patients on DTG-based ART regimens at BHUTH during the study period who met the eligibility criteria. Eligibility criteria Inclusion criteria: Patients receiving ART with DTG-based regimens. Exclusion criteria: Patients with incomplete demographic or clinical information. Patients unable to participate in interviews due to physical, cognitive, or communication limitations. Sample size determination The required sample size for study was calculated by statically formula (confidential interval approach) using the simple population proportion formula. $$\:\text{n}=\frac{(\text{Z}\:{\alpha\:}/2)2\:\text{p}\:(1-\text{p})}{{\text{d}}^{2}}$$ Where; n = initial sample size p = 50% (0.5; proportion of KAP ART to ward DTG based regimen in the study area from a similar survey ( 14 ). Z = the standard normal value at (1- α) % confidence level and α is mostly 5%, i.e. with 95% Confidence level d = the margin of sample error tolerated So using the above formula, initial sample size, n = 384 Since the total population is < 10,000 which is 1567 (patient on ART in BHUTH at ART clinic); the final sample size by using reduction formula: NF = 308 Where NF = final sample size included in the reviews N = study population n = initial sample size The study was conducted on 308 patients receiving ART to ward DTG-based regimens who were under follow-up at the ART Clinic of BHUTH. Sampling Techniques Systematic sampling technique was followed for study subject identification. This sampling interval was explained using the formula: K = N/n, where: K = the sampling interval used to select every K th item/ subject from the sampling frame. N = total population size of patients with HIV in Bule Hora University Teaching Hospital = 1,567, n = sample size (n = 308 patients). Therefore K = 1657/308 = 5.08 ~ 5. Systematic sampling technique was used to select every 5th patient from the total sample frame of 1,567 HIV-positive patients who had receiving antiretroviral therapy to ward dolutegravir-based regimens who were under follow-up at the ART Clinic to compose the 308 patients as the sample size. Data collection and management Data were collected using a structured interviewer-administered questionnaire adapted from prior KAP studies in HIV and ART ( 15 , 16 ). The tool was developed in English, translated into Amharic and Afan Oromo, and back-translated to English for consistency. The questionnaire consisted of five sections: Socio-demographic and clinical information, Four items on knowledge of DTG-based regimens, Four items assessing attitudes toward DTG-based regimens, Five items assessing practices toward DTG-based regimens, ART history and related factors Data collection was conducted by three trained health professionals. Data quality control A pre-test was conducted on 5% of the sample at a nearby health facility, and necessary modifications were made. Daily supervision and completeness checks were performed by the principal investigator. Data processing and analysis Data were entered and analyzed using SPSS version 27. Descriptive statistics, including frequencies and percentages, were used to summarize the findings. Study variables Independent variables Socio-demographic characteristics, pregnancy status, co-morbidities, and presence of opportunistic infections. Dependent variables Knowledge, attitudes, and practices toward DTG-based regimens Operational definitions Knowledge Understanding and awareness of DTG-based regimens, including purpose, benefits, side effects, and correct use ( 10 ). Attitude Beliefs, feelings, and perceptions toward DTG-based regimens ( 10 ). Practice Actual behaviors and actions regarding the use of DTG-based regimens ( 10 ). Regimen Combination of three or more antiretroviral drugs. DTG-based regimen Any ART regimen that contains dolutegravir. HAART Use of a combination of three or more antiretroviral drugs for treating HIV infection ( 10 ). HAART toxicity Adverse effects associated with HAART, such as gastrointestinal disturbances or central nervous system abnormalities ( 10 ). Ethical considerations Ethical approval was obtained from Institute of Health, Bule Hora University (Ref. No: BHU/IoH/ERC/0390/67/2024). Permission letters were submitted to BHUTH administration. Verbal informed consent was obtained from all participants after explaining the study purpose. Confidentiality and anonymity were ensured throughout the study, in accordance with the Declaration of Helsinki. Results Socio-demographic characteristics A total of 308 patients on antiretroviral therapy (ART) with dolutegravir (DTG)–based regimens participated in the study. All eligible patients completed the questionnaire, yielding a 100% response rate. Of the respondents, 171 (55.5%) were female. The majority, 167 (54.2%), were aged above 35 years. A significant proportion, 118 (38.3%), had no formal education, and more than half, 178 (57.8%), resided in urban areas. Most participants were married 182 (59.1%), had never smoked 297 (96.4%), and had never consumed alcohol 287 (93.2%) (Table 1 ). Table 1 Socio-demographic characteristics of patients on ART at BHUTH, 2024 (n = 308). Characteristics Category Frequency Percentage Age 5–12 1 (0.3%) 13–17 2 (0.6%) 18–25 59 (19.2%) 26–35 79 (25.6%) Above 35 167 (54.2%) Sex Male 137 (45.5%) Female 171 (55.5%) MaritalStatus Single 62 (20.1%) Married 182 (59.1%) Divorced 49 (15.9%) Widowed 15 (4.9%) Level of Education Illiterate 118 (38.3%) Primary school 112 (36.4%) Secondary school 56 (18.2%) Tertiary 22 (7.1%) Residency Urban 178 (57.8%) Rural 130 (42.2%) Occupation: Government employees 31 (10.1% Farmer 90 (29.2%) Merchant 95 (30.8%) Students 31 (10.1%) Others 61 (19.8%) Patient ethnicity Oromo 288 (93.5%) Amhara 8 (2.6%) SNNPR 11 (3.6%) Others 1 (0.3%) Duration of Antiretroviral Less than 1 year 25 (8.1%) 1–2 Year 47 (15.3%) 3–5 Year 87 (28.2%) More than 5 Year 149 (48.4%) Patient smoking status Yes 11 (3.6%) No 297 (96.4%) Patient alcohol taking status Yes 21 (6.8%) No 287 (93.2%) Knowledge of DTG-based regimens Overall, 184 (59.7%) respondents had heard of DTG-based regimens, while 124 (40.3%) had not. Among those who were aware, healthcare providers were the main source of information 110 (59.8%), followed by friends or family 64 (34.8%) and media 10 (5.4%). Regarding perceived benefits, 59 (19.2%) participants believed DTG-based regimens were more effective than other ART regimens, 37 (12.0%) thought they had fewer side effects, 142 (46.1%) recognized the once-daily dosing advantage, and 56 (18.2%) noted that DTG can be safely used during pregnancy. In terms of overall knowledge levels, 57 (18.5%) participants demonstrated excellent knowledge, 89 (28.9%) good knowledge, 88 (28.6%) fair knowledge, and 74 (24.0%) poor knowledge. These findings reveal substantial gaps in patient awareness and highlight the need for targeted health education (Table 2 ). Table 2 Knowledge about DTG-based regimens among patients on ART at BHUTH, 2024 (n = 308). Type Response n (%) Have you heard about Dolutegravir-based regimens? Yes No 184 (59.7) 124 (40.3) If yes where did you first heard about Dolutegravir-based regimens? Healthcare provider Friends/Family Media 110 (59.8) 64 (34.8) 10 (5.4) Which of the following statements about Dolutegravir-based regimens do you believe to be true? It is more effective than other ART regimens It has fewer side effects It is taken once daily It can be used by Pregnant women I don’t know 59 (19.2) 37 (12.0 ) 142 (46.1) 56 (18.2) 14 (4.5) How would you rate your overall knowledge of Dolutegravir-based regimens? Excellent Good Fair Poor 57(18.5) 89(28.9) 88(28.6) 74(24.0) Attitudes toward DTG-based regimens A majority of participants, 230 (74.7%), reported positive attitudes toward switching to DTG-based regimens, while 71 (23.1%) expressed neutral views and only 7 (2.3%) held negative beliefs. When asked about quality-of-life benefits, 256 (83.1%) agreed that DTG-based regimens could improve their well-being, while 47 (15.3%) were neutral and 5 (1.6%) disagreed. The main concern raised by patients was drug availability 195 (63.3%), followed by efficacy 47 (15.3%) and side effects 12 (3.9%). A smaller group 54 (17.5%) reported no concerns. Encouragingly, most patients 253 (82.1%) expressed confidence in their ability to adhere to DTG-based therapy. However, 49 (15.9%) were neutral, and 6 (1.9%) reported lacking confidence (Table 3 ). Table 3 Attitudes toward DTG-based regimens among patients on ART at BHUTH, 2024 (n = 308). Type Response n (%) How do you feel about switching to a Dolutegravir-based regimen? Positive Negative Neutral 230 (74.7) 7 (2.3) 71 (23.1) What are your main concerns about Dolutegravir-based regimens? Efficacy Side effects Availability I have no concerns 47 (15.3) 12 (3.9) 195 (63.3) 54 (17.5) Do you believe Dolutegravir-based regimens will improve your quality of life? Agree Disagree Neutral 256 (83.1) 5 (1.6) 47 (15.3) How confident are you in your ability to adhere to a Dolutegravir-based regimen? Confident Not confident Neutral 253 (82.1) 6 (1.9) 49 (15.9) Practices related to DTG-based regimens Nearly all participants 288 (93.5%) reported taking their medication as prescribed, while 15 (4.9%) admitted to occasional non-adherence, and 5 (1.6%) were unsure. Thirty participants (9.7%) experienced side effects while on DTG-based regimens. The most commonly reported adverse effects were fatigue 11 (36.7%), nausea 9 (30%), headache 4 (13.3%), diarrhea 2 (6.7%), and other unspecified symptoms 4 (13.3%). Among those experiencing side effects, only 8 (26.7%) reported them to healthcare providers, while 6 (20%) used home remedies and 16 (53.3%) employed other coping mechanisms. None reported discontinuing or adjusting medication on their own (Table 4 ). Table 4 Practices related to DTG-based regimens among patients on ART at BHUTH, 2024 (n = 308). Type Response n (%) Are you currently taking a Dolutegravir-based regimen? Yes No 308 (100%) 0 How often do you take your current ART as prescribed? Always Sometimes Not sure 288 (93.5%) 15 (4.9%) 5 (1.6%) Do you experience any side effects from your current ART? Yes No 30 (9.7%) 278 (90.3%) If yes, what is the most common side effect you experience? Nausea Fatigue Headache Diarrhea Other 9 (30%) 11(36.7%) 4 (13.3%) 2 (6.7%) 4 (13.3%) How do you manage side effects if they occur? Report to healthcare provide Use home remedies Adjust medication schedule Stop taking the medication Other method 8 (26.7%) 6 (20%) 0 0 16 (53.3%) Discussion This study assessed the knowledge, attitudes, and practices (KAP) of patients receiving antiretroviral therapy (ART) toward dolutegravir (DTG)–based regimens at Bule Hora University Teaching Hospital, southeast Ethiopia. Approximately one-fourth of participants demonstrated low levels of knowledge regarding DTG-based ART, which is comparable to findings from a study conducted in Nepal ( 14 ). In the current study, 74 (24.0%) participants exhibited poor knowledge about ART. This contrasts with a study in southwest Nigeria, where 237 (72%) participants had poor knowledge ( 17 ). Conversely, our results were substantially higher than reports from North Korea 102 (11.9%) and a Nigerian treatment clinic 200 (16.3%) ( 18 , 19 ). These discrepancies may be attributed to differences in educational level, sample size, and study design; for instance, the Nigerian clinic study had a larger sample and employed a retrospective cross-sectional design. Poor knowledge of ART has been consistently associated with suboptimal adherence ( 20 ). In this study, many participants demonstrated fair or poor knowledge, reflecting insufficient counseling on DTG regimens, their benefits, and the importance of adherence provided by healthcare professionals in the clinic ( 10 ). Notably, 124 (40.3%) participants were unaware of the names of their ART regimens, which is higher than the 63 patients reported at Tikur Anbessa Specialized Hospital ( 21 ). This gap likely reflects limited information from doctors, pharmacists, or ART counselors and may be influenced by socio-economic factors. Regarding attitudes, most participants expressed positive perceptions of DTG-based regimens, consistent with findings from southwest Nigeria, where participants preferred DTG over efavirenz-based regimens ( 22 ). In terms of practices, only 30 (9.7%) participants reported experiencing side effects, while 278 (90.3%) were unsure of how to manage adverse effects. These rates are higher than those reported in Ghana 90 (58%) and Debre Elias Health Center, Ethiopia 302 (36%) ( 23 , 24 ). The discrepancy may be explained by insufficient counseling by healthcare providers regarding side effect management. The most commonly reported adverse effects included fatigue (36.7%), nausea (30%), headache (13.3%), diarrhea (6.7%), and other unspecified effects (13.3%). These findings differ slightly from studies conducted in Medan, Indonesia ( 25 ), possibly due to heterogeneous patient practices, socio-economic status, and variability in counseling by physicians, pharmacists, and nurses regarding ART intake. Overall, the study highlights that while attitudes toward DTG-based regimens were predominantly positive, knowledge gaps remain, and patient practices regarding side effect management require reinforcement. Targeted educational interventions and regular counseling may improve adherence and clinical outcomes. Limitations The study has several limitations: It employed a single-center design, limiting generalizability. The sample size was relatively small. Data were collected via self-reported interviews, which may introduce reporting bias. The study period was short. Many participants were illiterate, which may have affected comprehension and response accuracy. Conclusion This study demonstrates that among patients on DTG-based regimens, knowledge levels were generally fair to poor, with nearly one-fourth exhibiting poor knowledge. While attitudes toward ART were largely positive, accurate knowledge regarding regimen benefits, side effects, and adherence strategies was insufficient. Practices related to adherence were generally good, although management of adverse effects was suboptimal. These findings underscore the need for continuous patient education and counseling to optimize ART effectiveness. Recommendations Based on the findings, the study recommends: Bule Hora University Teaching Hospital should provide targeted counseling regarding ART, including DTG-based regimens, their benefits, and side effect management. Healthcare professional’s doctors, nurses, and pharmacists should routinely assess patients’ knowledge, attitudes, and practices during follow-up visits. Educational interventions should be developed to address identified knowledge gaps and misconceptions to improve adherence and treatment outcomes. Declarations Ethics Approval and Consent to Participate Ethical clearance was obtained from the Bule Hora University, Institute of Health (Ref. No: BHU/IoH/ERC/0390/67/2024). Permission was also obtained from the hospital administration and relevant officials. Verbal informed consent was obtained from all participants after explaining the purpose and procedures of the study. Confidentiality and privacy were maintained throughout the study. Consent for Publication Not applicable. No individual person’s data in any form (including individual details, images, or videos) are included in this manuscript. Competing Interests The authors declare that they have no competing interests. Clinical trial number: Not Applicable Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Author Contribution Aliyi Gerina conceptualized the study, designed the methodology, supervised data collection, analyzed and interpreted the data, and drafted the manuscript. Woyesa Elema were advising the entire research paper and drafting of manuscript. Kedir Husen, and Bahiru Bergene were involved in the data collection. They were also involved in data analysis and interpretation of the data. All authors read and approved the final manuscript. Acknowledgement The authors would like to thank the study participants, Bule Hora University Teaching Hospital staff, and data collectors for their cooperation and support during the study. Availability of Data and Materials The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. References Global, H. AIDS statistics—2018 fact sheet (UNAIDS, 2019). Heath, K., Levi, J. & Hill, A. The Joint United Nations Programme on HIV/AIDS 95-95-95 targets: worldwide clinical and cost benefits of generic manufacture. Aids 35 (Supplement 2), S197–S203 (2021). ETHIOPIA I, Federal, H. I. V. A. I. D. S. & Prevention and Control Office Federal Ministry of Health July 2007. (2007). Organization, W. H. World health statistics 2020. (2020). Deeks, S. G., Lewin, S. R. & Havlir, D. V. The end of AIDS: HIV infection as a chronic disease. lancet 382 (9903), 1525–1533 (2013). Gelaw, Y. & Abateneh, A. Ocular morbidity among refugees in Southwest Ethiopia. Ethiop. J. health Sci. 24 (3), 227–234 (2014). Ware, N. C., Wyatt, M. A. & Bangsberg, D. R. Examining theoretic models of adherence for validity in resource-limited settings: a heuristic approach. JAIDS J. Acquir. Immune Defic. Syndr. 43 , S18–S22 (2006). Bezabhe, W. M. et al. Barriers and facilitators of adherence to antiretroviral drug therapy and retention in care among adult HIV-positive patients: a qualitative study from Ethiopia. PloS one . 9 (5), e97353 (2014). Rotheram-Borus, M. J., Swendeman, D. & Chovnick, G. The past, present, and future of HIV prevention: integrating behavioral, biomedical, and structural intervention strategies for the next generation of HIV prevention. Ann. Rev. Clin. Psychol. 5 (1), 143–167 (2009). Organization, W. H. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach June 2013. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach June 20132013. p. 272-. Vitoria, M. et al. The transition to dolutegravir and other new antiretrovirals in low-income and middle-income countries: what are the issues? Aids 32 (12), 1551–1561 (2018). Okeke, N. L., Ostermann, J. & Thielman, N. M. Enhancing linkage and retention in HIV care: a review of interventions for highly resourced and resource-poor settings. Curr. HIV/AIDS. Rep. 11 (4), 376–392 (2014). Forleo, C. et al. Targeted next-generation sequencing detects novel gene–phenotype associations and expands the mutational spectrum in cardiomyopathies. PloS one . 12 (7), e0181842 (2017). Shrestha, S. et al. Knowledge, attitude, practice, and adherence to antiretroviral therapy among people living with HIV in Nepal. AIDS Res. Treat. 2023 (1), 7292115 (2023). Adejumo, O. A., Malee, K. M., Ryscavage, P., Hunter, S. J. & Taiwo, B. O. Contemporary issues on the epidemiology and antiretroviral adherence of HIV-infected adolescents in sub‐Saharan Africa: a narrative review. J. Int. AIDS. Soc. 18 (1), 20049 (2015). Charan, J. & Biswas, T. How to calculate sample size for different study designs in medical research? Indian J. Psychol. Med. 35 (2), 121–126 (2013). Umar, D. et al. Impact of tenofovir/lamivudine/dolutegravir (Tld) on the health-related quality of life and clinical outcomes of HIV/AIDS patients at a tertiary health facility in Niger state. (2020). Kim, G. S., Kwon, S., Kim, L. & Baek, S. Exploring barriers to the HIV care continuum among people living with HIV in South Korea: a cross-sectional descriptive study. AIDS care . 37 (9), 1482–1492 (2025). Osuagwu, T. R. Behavioural change communication and response to Nigeria’s 2024 cholera outbreak: sustainable solution at last? Health New. Media Res. 9 (1), 84 (2025). UNAID D, Global, H. I. V. & AIDS statistics—2018 fact sheet. &. UNAIDS org (2018). http://www/unaids/org/en/resources/fact-sheet)[Accessed August 8 2018] Export Citation. Fernandez, R. K., Gupta, C. & Kalthur, S. G. Age-related histological changes in vena caval system of human foetus and adult: a comparative study. Ethiop. J. health Sci. ; 30 (3). (2020). Eley, B. Journal of the African Society for Paediatric Infectious Diseases. Bulletin was held on. (2022). Birmeka, M., Bekele, D. & Anteneh, M. HIV incidence, knowledge, attitude and practices of HIV/AIDS and antiretroviral therapy use in HIV-infected patients at Debre Elias district, North West Ethiopia. Healthc. Low-Resource Settings ; 12 (2). (2024). Benya, P. D. et al. Pulsed electromagnetic field (PEMF) transiently stimulates the rate of mineralization in a 3-dimensional ring culture model of osteogenesis. PLoS One . 16 (2), e0244223 (2021). Thangaraju, P., Kumar, A. & Venkatesan, S. Vigilance in selection of low-dose versus high-dose steroids in COVID-19. Int. J. Infect. Dis. 109 , 54 (2021). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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06:10:43","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":82513,"visible":true,"origin":"","legend":"","description":"","filename":"2dd3dbda84b9459f8aa3d00fc96da8f81structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7759122/v1/4aa36ddca67d2ae3b4d68f87.xml"},{"id":92693319,"identity":"8932f1f1-8fc5-4b9c-b82a-ed1d94da15b7","added_by":"auto","created_at":"2025-10-03 06:10:42","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":92034,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7759122/v1/2fe41e6c422b49ce74d164f4.html"},{"id":104797020,"identity":"cfc89a2e-47d6-4ede-b879-44c64d58b65d","added_by":"auto","created_at":"2026-03-17 09:43:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1003627,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7759122/v1/f8f4e469-b6c8-4cfd-b904-e732cfd47bd5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of knowledge, attitudes, and practices toward dolutegravir-based regimens among patients receiving antiretroviral therapy at Bule Hora University Teaching Hospital, Ethiopia, 2024","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHuman immunodeficiency virus (HIV) remains a major global health challenge. In 2018, an estimated 37.9\u0026nbsp;million people were living with HIV/AIDS worldwide, 95% of whom were adults. That same year, 1.7\u0026nbsp;million people were newly infected, and nearly one million died of AIDS-related illnesses (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In 2021, 1.5\u0026nbsp;million new HIV infections and 650,000 HIV-related deaths were reported, with sub-Saharan Africa bearing the greatest burden, accounting for nearly three-quarters of cases and deaths (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eEthiopia reported its first case of HIV in 1984. Since then, HIV/AIDS has become a critical public health concern, prompting the government to declare a public health emergency in 2002. By 2007, adult HIV prevalence was estimated at 2.1% (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). According to 2021 UNAIDS national estimates, 616,105 people in Ethiopia were living with HIV, of whom 479,613 were adults, adolescents, and children receiving antiretroviral therapy (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eHIV progressively destroys immune cells, leading to immunodeficiency and increased susceptibility to opportunistic infections. If untreated, the disease advances to acquired immunodeficiency syndrome (AIDS), the most severe stage of infection (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Advances in HIV treatment have significantly improved survival and reduced global incidence, yet adherence to ART remains critical to achieving long-term viral suppression and preventing resistance (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eStudies in Ethiopia have shown that adherence rates vary between 70% and 95% across regions (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Adherence is influenced by demographic, cultural, social, and health system factors, including stigma, supply chain interruptions, limited resources, and patient-related barriers such as low knowledge or negative attitudes toward ART (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). As HIV has become a chronic condition managed largely in outpatient settings, patients\u0026rsquo; self-care practices and understanding of therapy have become increasingly important (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn 2016, the World Health Organization recommended dolutegravir (DTG)-based ART (tenofovir disoproxil fumarate\u0026thinsp;+\u0026thinsp;lamivudine\u0026thinsp;+\u0026thinsp;dolutegravir) as the preferred first-line regimen, replacing efavirenz-based therapy (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). DTG is favored due to its efficacy, tolerability, limited drug\u0026ndash;drug interactions, and high barrier to resistance (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Despite these advantages, the pharmacological properties of ART alone do not ensure treatment success; patients\u0026rsquo; knowledge, attitudes, and practices (KAP) play a crucial role in adherence and outcomes. Lack of awareness, misconceptions, and concerns about long-term use or side effects may compromise adherence, while positive practices support sustained viral suppression (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn Ethiopia and other resource-limited settings, DTG has only recently been introduced, and there is limited evidence on patients\u0026rsquo; knowledge, perceptions, and practices regarding this regimen. Understanding these factors is essential for designing targeted educational and psychosocial interventions to address barriers, improve adherence, and optimize treatment outcomes.\u003c/p\u003e\u003cp\u003eThis study therefore aims to assess the knowledge, attitudes, and practices of patients on DTG-based regimens at Bule Hora University Teaching Hospital. By identifying gaps and misconceptions, the findings will inform strategies to strengthen patient-centered HIV care, support public health goals of reducing transmission, and enhance the long-term effectiveness of ART programs.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy area and period\u003c/h2\u003e\n \u003cp\u003eThe study was conducted from September 1 to October 31, 2024 at Bule Hora University Teaching Hospital (BHUTH), located 474 km southeast of Addis Ababa in the West Guji Zone of Oromia Region, Ethiopia. BHUTH provides a wide range of medical services, including an antiretroviral therapy (ART) clinic, and serves as a referral center for surrounding health facilities.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eStudy design\u003c/h3\u003e\n\u003cp\u003eA facility-based cross-sectional study was employed.\u003c/p\u003e\n\u003ch3\u003eSource population\u003c/h3\u003e\n\u003cp\u003eAll patients living with HIV who were receiving ART with dolutegravir (DTG)-based regimens at BHUTH.\u003c/p\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003ePatients on DTG-based ART regimens at BHUTH during the study period who met the eligibility criteria.\u003c/p\u003e\n\u003ch3\u003eEligibility criteria\u003c/h3\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eInclusion criteria:\u003c/h2\u003e\n \u003cp\u003ePatients receiving ART with DTG-based regimens.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eExclusion criteria:\u003c/h3\u003e\n\u003cp\u003ePatients with incomplete demographic or clinical information.\u003c/p\u003e\n\u003cp\u003ePatients unable to participate in interviews due to physical, cognitive, or communication limitations.\u003c/p\u003e\n\u003ch3\u003eSample size determination\u003c/h3\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eThe required sample size for study was calculated by statically formula (confidential interval approach) using the simple population proportion formula.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\n \u003cdiv class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e$$\\:\\text{n}=\\frac{(\\text{Z}\\:{\\alpha\\:}/2)2\\:\\text{p}\\:(1-\\text{p})}{{\\text{d}}^{2}}$$\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhere;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;initial sample size\u003c/p\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;50% (0.5; proportion of KAP ART to ward DTG based regimen in the study area from a similar survey (\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eZ\u0026thinsp;=\u0026thinsp;the standard normal value at (1- \u0026alpha;) % confidence level and \u0026alpha; is mostly 5%, i.e. with 95% Confidence level\u003c/p\u003e\n \u003cp\u003ed\u0026thinsp;=\u0026thinsp;the margin of sample error tolerated\u003c/p\u003e\n \u003cp\u003eSo using the above formula, initial sample size, n\u0026thinsp;=\u0026thinsp;384\u003c/p\u003e\n \u003cp\u003eSince the total population is \u0026lt;\u0026thinsp;10,000 which is 1567 (patient on ART in BHUTH at ART clinic); the final sample size by using reduction formula:\u003c/p\u003e\n \u003cp\u003e\u003cimg src=\"data:image/png;base64,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\" style=\"width: 110px;\"\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003cp\u003e\u003cstrong\u003eNF\u0026thinsp;=\u0026thinsp;308\u003c/strong\u003e\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eWhere\u003c/p\u003e\n \u003cp\u003eNF \u003csub\u003e=\u003c/sub\u003e final sample size included in the reviews\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003eN\u0026thinsp;=\u0026thinsp;study population\u003c/p\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;initial sample size\u003c/p\u003e\n \u003cp\u003eThe study was conducted on 308 patients receiving ART to ward DTG-based regimens who were under follow-up at the ART Clinic of BHUTH.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003eSampling Techniques\u003c/h2\u003e\n \u003cp\u003eSystematic sampling technique was followed for study subject identification. This sampling interval was explained using the formula: K\u0026thinsp;=\u0026thinsp;N/n, where: K\u0026thinsp;=\u0026thinsp;the sampling interval used to select every K\u003csup\u003eth\u003c/sup\u003e item/ subject from the sampling frame. N\u0026thinsp;=\u0026thinsp;total population size of patients with HIV in Bule Hora University Teaching Hospital\u0026thinsp;=\u0026thinsp;1,567, n\u0026thinsp;=\u0026thinsp;sample size (n\u0026thinsp;=\u0026thinsp;308 patients). Therefore K\u0026thinsp;=\u0026thinsp;1657/308\u0026thinsp;=\u0026thinsp;5.08\u0026thinsp;~\u0026thinsp;5. Systematic sampling technique was used to select every 5th patient from the total sample frame of 1,567 HIV-positive patients who had receiving antiretroviral therapy to ward dolutegravir-based regimens who were under follow-up at the ART Clinic to compose the 308 patients as the sample size.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003eData collection and management\u003c/h2\u003e\n \u003cp\u003eData were collected using a structured interviewer-administered questionnaire adapted from prior KAP studies in HIV and ART (\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e). The tool was developed in English, translated into Amharic and Afan Oromo, and back-translated to English for consistency.\u003c/p\u003e\n \u003cp\u003eThe questionnaire consisted of five sections: Socio-demographic and clinical information, Four items on knowledge of DTG-based regimens, Four items assessing attitudes toward DTG-based regimens, Five items assessing practices toward DTG-based regimens, ART history and related factors Data collection was conducted by three trained health professionals.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003eData quality control\u003c/h2\u003e\n \u003cp\u003eA pre-test was conducted on 5% of the sample at a nearby health facility, and necessary modifications were made. Daily supervision and completeness checks were performed by the principal investigator.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n \u003ch2\u003eData processing and analysis\u003c/h2\u003e\n \u003cp\u003eData were entered and analyzed using SPSS version 27. Descriptive statistics, including frequencies and percentages, were used to summarize the findings.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy variables\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent variables\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eSocio-demographic characteristics, pregnancy status, co-morbidities, and presence of opportunistic infections.\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDependent variables\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eKnowledge, attitudes, and practices toward DTG-based regimens\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003eOperational definitions\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eUnderstanding and awareness of DTG-based regimens, including purpose, benefits, side effects, and correct use (\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eBeliefs, feelings, and perceptions toward DTG-based regimens (\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePractice\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eActual behaviors and actions regarding the use of DTG-based regimens (\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eRegimen\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eCombination of three or more antiretroviral drugs.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDTG-based regimen\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAny ART regimen that contains dolutegravir.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHAART\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eUse of a combination of three or more antiretroviral drugs for treating HIV infection (\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHAART toxicity\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAdverse effects associated with HAART, such as gastrointestinal disturbances or central nervous system abnormalities (\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\n \u003ch2\u003eEthical considerations\u003c/h2\u003e\n \u003cp\u003eEthical approval was obtained from Institute of Health, Bule Hora University (Ref. No: BHU/IoH/ERC/0390/67/2024). Permission letters were submitted to BHUTH administration. Verbal informed consent was obtained from all participants after explaining the study purpose. Confidentiality and anonymity were ensured throughout the study, in accordance with the Declaration of Helsinki.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003eSocio-demographic characteristics\u003c/h2\u003e\u003cp\u003eA total of 308 patients on antiretroviral therapy (ART) with dolutegravir (DTG)\u0026ndash;based regimens participated in the study. All eligible patients completed the questionnaire, yielding a 100% response rate. Of the respondents, 171 (55.5%) were female. The majority, 167 (54.2%), were aged above 35 years. A significant proportion, 118 (38.3%), had no formal education, and more than half, 178 (57.8%), resided in urban areas. Most participants were married 182 (59.1%), had never smoked 297 (96.4%), and had never consumed alcohol 287 (93.2%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-demographic characteristics of patients on ART at BHUTH, 2024 (n\u0026thinsp;=\u0026thinsp;308).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5\u0026ndash;12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u0026ndash;17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u0026ndash;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(19.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26\u0026ndash;35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(25.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAbove 35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(54.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(45.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e171\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(55.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eMaritalStatus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(20.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e182\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(59.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(15.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWidowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(4.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eLevel of Education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIlliterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e118\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(38.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrimary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e112\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(36.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSecondary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(18.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTertiary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(7.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eResidency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e178\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(57.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(42.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eOccupation:\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGovernment employees\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(10.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFarmer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(29.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMerchant\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(30.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(10.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(19.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003ePatient ethnicity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOromo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e288\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(93.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAmhara\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(2.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSNNPR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(3.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eDuration of Antiretroviral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLess than 1 year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(8.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;2 Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(15.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u0026ndash;5 Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(28.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMore than 5 Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(48.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePatient smoking status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(3.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e297\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(96.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePatient alcohol taking status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(6.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e287\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(93.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003eKnowledge of DTG-based regimens\u003c/h2\u003e\u003cp\u003eOverall, 184 (59.7%) respondents had heard of DTG-based regimens, while 124 (40.3%) had not. Among those who were aware, healthcare providers were the main source of information 110 (59.8%), followed by friends or family 64 (34.8%) and media 10 (5.4%). Regarding perceived benefits, 59 (19.2%) participants believed DTG-based regimens were more effective than other ART regimens, 37 (12.0%) thought they had fewer side effects, 142 (46.1%) recognized the once-daily dosing advantage, and 56 (18.2%) noted that DTG can be safely used during pregnancy. In terms of overall knowledge levels, 57 (18.5%) participants demonstrated excellent knowledge, 89 (28.9%) good knowledge, 88 (28.6%) fair knowledge, and 74 (24.0%) poor knowledge. These findings reveal substantial gaps in patient awareness and highlight the need for targeted health education (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eKnowledge about DTG-based regimens among patients on ART at BHUTH, 2024 (n\u0026thinsp;=\u0026thinsp;308).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e\u003cp\u003eResponse \u003cem\u003en\u003c/em\u003e (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you heard about Dolutegravir-based regimens?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e184 (59.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e124 (40.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eIf yes where did you first heard about Dolutegravir-based regimens?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHealthcare provider\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFriends/Family\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003eMedia\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e110 (59.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e64 (34.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003e10 (5.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eWhich of the following statements about Dolutegravir-based regimens do you believe to be true?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIt is more effective than other ART regimens\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIt has fewer side effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIt is taken once daily\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eIt can be\u003c/p\u003e\u003cp\u003eused by\u003c/p\u003e\u003cp\u003ePregnant women\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (19.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37 (12.0 )\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e142 (46.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e56 (18.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14 (4.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHow would you rate your overall knowledge of Dolutegravir-based regimens?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExcellent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFair\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57(18.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e89(28.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e88(28.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e74(24.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u003ch2\u003eAttitudes toward DTG-based regimens\u003c/h2\u003e\u003cp\u003e A majority of participants, 230 (74.7%), reported positive attitudes toward switching to DTG-based regimens, while 71 (23.1%) expressed neutral views and only 7 (2.3%) held negative beliefs. When asked about quality-of-life benefits, 256 (83.1%) agreed that DTG-based regimens could improve their well-being, while 47 (15.3%) were neutral and 5 (1.6%) disagreed. The main concern raised by patients was drug availability 195 (63.3%), followed by efficacy 47 (15.3%) and side effects 12 (3.9%). A smaller group 54 (17.5%) reported no concerns. Encouragingly, most patients 253 (82.1%) expressed confidence in their ability to adhere to DTG-based therapy. However, 49 (15.9%) were neutral, and 6 (1.9%) reported lacking confidence (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAttitudes toward DTG-based regimens among patients on ART at BHUTH, 2024 (n\u0026thinsp;=\u0026thinsp;308).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e\u003cp\u003eResponse \u003cem\u003en\u003c/em\u003e (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHow do you feel about switching to a Dolutegravir-based regimen?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePositive\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eNegative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e230 (74.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e7 (2.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e71 (23.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eWhat are your main concerns about Dolutegravir-based regimens?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEfficacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSide effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAvailability\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eI have no concerns\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e47 (15.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (3.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e195 (63.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e54 (17.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDo you believe Dolutegravir-based regimens will improve your quality of life?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAgree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eDisagree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e256 (83.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e5 (1.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e47 (15.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHow confident are you in your ability to adhere to a Dolutegravir-based regimen?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eConfident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eNot confident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e253 (82.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e6 (1.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e49 (15.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec23\" class=\"Section3\"\u003e\u003ch2\u003ePractices related to DTG-based regimens\u003c/h2\u003e\u003cp\u003eNearly all participants 288 (93.5%) reported taking their medication as prescribed, while 15 (4.9%) admitted to occasional non-adherence, and 5 (1.6%) were unsure. Thirty participants (9.7%) experienced side effects while on DTG-based regimens. The most commonly reported adverse effects were fatigue 11 (36.7%), nausea 9 (30%), headache 4 (13.3%), diarrhea 2 (6.7%), and other unspecified symptoms 4 (13.3%). Among those experiencing side effects, only 8 (26.7%) reported them to healthcare providers, while 6 (20%) used home remedies and 16 (53.3%) employed other coping mechanisms. None reported discontinuing or adjusting medication on their own (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePractices related to DTG-based regimens among patients on ART at BHUTH, 2024 (n\u0026thinsp;=\u0026thinsp;308).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"8\" nameend=\"c9\" namest=\"c2\"\u003e\u003cp\u003eResponse \u003cem\u003en\u003c/em\u003e (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAre you currently taking a Dolutegravir-based regimen?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c9\" namest=\"c4\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e308 (100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c9\" namest=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHow often do you take your current ART as prescribed?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eAlways\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u003cp\u003eSometimes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c9\" namest=\"c7\"\u003e\u003cp\u003eNot sure\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e288 (93.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e15 (4.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003e5 (1.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDo you experience any side effects from your current ART?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c9\" namest=\"c4\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e30 (9.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c9\" namest=\"c4\"\u003e\u003cp\u003e278 (90.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eIf yes, what is the most common side effect you experience?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNausea\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFatigue\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eHeadache\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e\u003cp\u003eDiarrhea\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9 (30%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11(36.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e4 (13.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e\u003cp\u003e2 (6.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e4 (13.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHow do you manage side effects if they occur?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eReport to healthcare provide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUse home remedies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eAdjust medication schedule\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e\u003cp\u003eStop taking the medication\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eOther method\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (26.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e6 (20%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e16 (53.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study assessed the knowledge, attitudes, and practices (KAP) of patients receiving antiretroviral therapy (ART) toward dolutegravir (DTG)\u0026ndash;based regimens at Bule Hora University Teaching Hospital, southeast Ethiopia. Approximately one-fourth of participants demonstrated low levels of knowledge regarding DTG-based ART, which is comparable to findings from a study conducted in Nepal (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn the current study, 74 (24.0%) participants exhibited poor knowledge about ART. This contrasts with a study in southwest Nigeria, where 237 (72%) participants had poor knowledge (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Conversely, our results were substantially higher than reports from North Korea 102 (11.9%) and a Nigerian treatment clinic 200 (16.3%) (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). These discrepancies may be attributed to differences in educational level, sample size, and study design; for instance, the Nigerian clinic study had a larger sample and employed a retrospective cross-sectional design.\u003c/p\u003e\u003cp\u003ePoor knowledge of ART has been consistently associated with suboptimal adherence (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). In this study, many participants demonstrated fair or poor knowledge, reflecting insufficient counseling on DTG regimens, their benefits, and the importance of adherence provided by healthcare professionals in the clinic (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Notably, 124 (40.3%) participants were unaware of the names of their ART regimens, which is higher than the 63 patients reported at Tikur Anbessa Specialized Hospital (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). This gap likely reflects limited information from doctors, pharmacists, or ART counselors and may be influenced by socio-economic factors.\u003c/p\u003e\u003cp\u003eRegarding attitudes, most participants expressed positive perceptions of DTG-based regimens, consistent with findings from southwest Nigeria, where participants preferred DTG over efavirenz-based regimens (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn terms of practices, only 30 (9.7%) participants reported experiencing side effects, while 278 (90.3%) were unsure of how to manage adverse effects. These rates are higher than those reported in Ghana 90 (58%) and Debre Elias Health Center, Ethiopia 302 (36%) (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). The discrepancy may be explained by insufficient counseling by healthcare providers regarding side effect management.\u003c/p\u003e\u003cp\u003eThe most commonly reported adverse effects included fatigue (36.7%), nausea (30%), headache (13.3%), diarrhea (6.7%), and other unspecified effects (13.3%). These findings differ slightly from studies conducted in Medan, Indonesia (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), possibly due to heterogeneous patient practices, socio-economic status, and variability in counseling by physicians, pharmacists, and nurses regarding ART intake.\u003c/p\u003e\u003cp\u003eOverall, the study highlights that while attitudes toward DTG-based regimens were predominantly positive, knowledge gaps remain, and patient practices regarding side effect management require reinforcement. Targeted educational interventions and regular counseling may improve adherence and clinical outcomes.\u003c/p\u003e\u003cdiv id=\"Sec25\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThe study has several limitations:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eIt employed a single-center design, limiting generalizability.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e The sample size was relatively small.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eData were collected via self-reported interviews, which may introduce reporting bias.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eThe study period was short.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eMany participants were illiterate, which may have affected comprehension and response accuracy.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study demonstrates that among patients on DTG-based regimens, knowledge levels were generally fair to poor, with nearly one-fourth exhibiting poor knowledge. While attitudes toward ART were largely positive, accurate knowledge regarding regimen benefits, side effects, and adherence strategies was insufficient. Practices related to adherence were generally good, although management of adverse effects was suboptimal. These findings underscore the need for continuous patient education and counseling to optimize ART effectiveness.\u003c/p\u003e\u003cdiv id=\"Sec27\" class=\"Section2\"\u003e\u003ch2\u003eRecommendations\u003c/h2\u003e\u003cp\u003eBased on the findings, the study recommends:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eBule Hora University Teaching Hospital should provide targeted counseling regarding ART, including DTG-based regimens, their benefits, and side effect management.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eHealthcare professional\u0026rsquo;s doctors, nurses, and pharmacists should routinely assess patients\u0026rsquo; knowledge, attitudes, and practices during follow-up visits.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eEducational interventions should be developed to address identified knowledge gaps and misconceptions to improve adherence and treatment outcomes.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eEthics Approval and Consent to Participate\u003c/h2\u003e\u003cp\u003e Ethical clearance was obtained from the Bule Hora University, Institute of Health (Ref. No: BHU/IoH/ERC/0390/67/2024). Permission was also obtained from the hospital administration and relevant officials. Verbal informed consent was obtained from all participants after explaining the purpose and procedures of the study. Confidentiality and privacy were maintained throughout the study.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003cp\u003eNot applicable. No individual person\u0026rsquo;s data in any form (including individual details, images, or videos) are included in this manuscript.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eCompeting Interests\u003c/h2\u003e\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eClinical trial number:\u003c/h2\u003e\u003cp\u003eNot Applicable\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAliyi Gerina conceptualized the study, designed the methodology, supervised data collection, analyzed and interpreted the data, and drafted the manuscript. Woyesa Elema were advising the entire research paper and drafting of manuscript. Kedir Husen, and Bahiru Bergene were involved in the data collection. They were also involved in data analysis and interpretation of the data. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003e The authors would like to thank the study participants, Bule Hora University Teaching Hospital staff, and data collectors for their cooperation and support during the study.\u003c/p\u003e\u003ch2\u003eAvailability of Data and Materials\u003c/h2\u003e\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGlobal, H. \u003cem\u003eAIDS statistics\u0026mdash;2018 fact sheet\u003c/em\u003e (UNAIDS, 2019).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHeath, K., Levi, J. \u0026amp; Hill, A. The Joint United Nations Programme on HIV/AIDS 95-95-95 targets: worldwide clinical and cost benefits of generic manufacture. \u003cem\u003eAids\u003c/em\u003e \u003cb\u003e35\u003c/b\u003e (Supplement 2), S197\u0026ndash;S203 (2021).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eETHIOPIA I, Federal, H. I. V. A. I. D. S. \u0026amp; Prevention and Control Office Federal Ministry of Health July 2007. (2007).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOrganization, W. H. World health statistics 2020. (2020).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDeeks, S. G., Lewin, S. R. \u0026amp; Havlir, D. V. The end of AIDS: HIV infection as a chronic disease. \u003cem\u003elancet\u003c/em\u003e \u003cb\u003e382\u003c/b\u003e (9903), 1525\u0026ndash;1533 (2013).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGelaw, Y. \u0026amp; Abateneh, A. Ocular morbidity among refugees in Southwest Ethiopia. \u003cem\u003eEthiop. J. health Sci.\u003c/em\u003e \u003cb\u003e24\u003c/b\u003e (3), 227\u0026ndash;234 (2014).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWare, N. C., Wyatt, M. A. \u0026amp; Bangsberg, D. R. Examining theoretic models of adherence for validity in resource-limited settings: a heuristic approach. \u003cem\u003eJAIDS J. Acquir. Immune Defic. Syndr.\u003c/em\u003e \u003cb\u003e43\u003c/b\u003e, S18\u0026ndash;S22 (2006).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBezabhe, W. M. et al. Barriers and facilitators of adherence to antiretroviral drug therapy and retention in care among adult HIV-positive patients: a qualitative study from Ethiopia. \u003cem\u003ePloS one\u003c/em\u003e. \u003cb\u003e9\u003c/b\u003e (5), e97353 (2014).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRotheram-Borus, M. J., Swendeman, D. \u0026amp; Chovnick, G. The past, present, and future of HIV prevention: integrating behavioral, biomedical, and structural intervention strategies for the next generation of HIV prevention. \u003cem\u003eAnn. Rev. Clin. Psychol.\u003c/em\u003e \u003cb\u003e5\u003c/b\u003e (1), 143\u0026ndash;167 (2009).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOrganization, W. H. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach June 2013. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach June 20132013. p. 272-.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVitoria, M. et al. The transition to dolutegravir and other new antiretrovirals in low-income and middle-income countries: what are the issues? \u003cem\u003eAids\u003c/em\u003e \u003cb\u003e32\u003c/b\u003e (12), 1551\u0026ndash;1561 (2018).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOkeke, N. L., Ostermann, J. \u0026amp; Thielman, N. M. Enhancing linkage and retention in HIV care: a review of interventions for highly resourced and resource-poor settings. \u003cem\u003eCurr. HIV/AIDS. Rep.\u003c/em\u003e \u003cb\u003e11\u003c/b\u003e (4), 376\u0026ndash;392 (2014).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eForleo, C. et al. Targeted next-generation sequencing detects novel gene\u0026ndash;phenotype associations and expands the mutational spectrum in cardiomyopathies. \u003cem\u003ePloS one\u003c/em\u003e. \u003cb\u003e12\u003c/b\u003e (7), e0181842 (2017).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShrestha, S. et al. Knowledge, attitude, practice, and adherence to antiretroviral therapy among people living with HIV in Nepal. \u003cem\u003eAIDS Res. Treat.\u003c/em\u003e \u003cb\u003e2023\u003c/b\u003e (1), 7292115 (2023).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAdejumo, O. A., Malee, K. M., Ryscavage, P., Hunter, S. J. \u0026amp; Taiwo, B. O. Contemporary issues on the epidemiology and antiretroviral adherence of HIV-infected adolescents in sub‐Saharan Africa: a narrative review. \u003cem\u003eJ. Int. AIDS. Soc.\u003c/em\u003e \u003cb\u003e18\u003c/b\u003e (1), 20049 (2015).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCharan, J. \u0026amp; Biswas, T. How to calculate sample size for different study designs in medical research? \u003cem\u003eIndian J. Psychol. Med.\u003c/em\u003e \u003cb\u003e35\u003c/b\u003e (2), 121\u0026ndash;126 (2013).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUmar, D. et al. Impact of tenofovir/lamivudine/dolutegravir (Tld) on the health-related quality of life and clinical outcomes of HIV/AIDS patients at a tertiary health facility in Niger state. (2020).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKim, G. S., Kwon, S., Kim, L. \u0026amp; Baek, S. Exploring barriers to the HIV care continuum among people living with HIV in South Korea: a cross-sectional descriptive study. \u003cem\u003eAIDS care\u003c/em\u003e. \u003cb\u003e37\u003c/b\u003e (9), 1482\u0026ndash;1492 (2025).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOsuagwu, T. R. Behavioural change communication and response to Nigeria\u0026rsquo;s 2024 cholera outbreak: sustainable solution at last? \u003cem\u003eHealth New. Media Res.\u003c/em\u003e \u003cb\u003e9\u003c/b\u003e (1), 84 (2025).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUNAID D, Global, H. I. V. \u0026amp; AIDS statistics\u0026mdash;2018 fact sheet. \u0026amp;. UNAIDS org (2018). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www/unaids/org/en/resources/fact-sheet)[Accessed\u003c/span\u003e\u003cspan address=\"http://www/unaids/org/en/resources/fact-sheet)[Accessed\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e August 8 2018] Export Citation.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFernandez, R. K., Gupta, C. \u0026amp; Kalthur, S. G. Age-related histological changes in vena caval system of human foetus and adult: a comparative study. \u003cem\u003eEthiop. J. health Sci.\u003c/em\u003e ;\u003cb\u003e30\u003c/b\u003e(3). (2020).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEley, B. Journal of the African Society for Paediatric Infectious Diseases. Bulletin was held on. (2022).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBirmeka, M., Bekele, D. \u0026amp; Anteneh, M. HIV incidence, knowledge, attitude and practices of HIV/AIDS and antiretroviral therapy use in HIV-infected patients at Debre Elias district, North West Ethiopia. \u003cem\u003eHealthc. Low-Resource Settings\u003c/em\u003e ;\u003cb\u003e12\u003c/b\u003e(2). (2024).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBenya, P. D. et al. Pulsed electromagnetic field (PEMF) transiently stimulates the rate of mineralization in a 3-dimensional ring culture model of osteogenesis. \u003cem\u003ePLoS One\u003c/em\u003e. \u003cb\u003e16\u003c/b\u003e (2), e0244223 (2021).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eThangaraju, P., Kumar, A. \u0026amp; Venkatesan, S. Vigilance in selection of low-dose versus high-dose steroids in COVID-19. \u003cem\u003eInt. J. Infect. Dis.\u003c/em\u003e \u003cb\u003e109\u003c/b\u003e, 54 (2021).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Dolutegravir, antiretroviral therapy, knowledge, attitudes, practices, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-7759122/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7759122/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Human immunodeficiency virus (HIV) remains a major global health challenge. In 2018, an estimated 37.9 million people were living with HIV/AIDS worldwide, of whom 95% were adults. Approximately 1.7 million new infections occurred, and one million people died from AIDS-related illnesses. Dolutegravir (DTG) has emerged as a preferred antiretroviral drug due to its high efficacy, safety profile, and strong barrier to resistance. Current WHO guidelines recommend DTG-based antiretroviral therapy as the preferred first-line regimen, particularly in resource-limited settings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e To assess the knowledge, attitudes, and practices (KAP) of patients receiving antiretroviral therapy toward dolutegravir-based regimens at Bule Hora University Teaching Hospital, Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A facility-based cross-sectional study was conducted from September 1 to October 31, 2024. A total of 308 patients receiving dolutegravir-based antiretroviral regimens were included. Data were collected using structured questionnaires and analyzed to determine levels of knowledge, attitudes, and practices.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Among the 308 participants, 171 (55.5%) were female and 166 (53.9%) were older than 35 years. A considerable proportion, 118 (38.3%), had no formal education. More than half of the respondents 178 (57.8%) resided in urban areas. Most were married 182 (59.1%), while the majority reported never smoking 297 (96.4%) or consuming alcohol 287 (93.2%). Overall, patients demonstrated fair to poor knowledge about DTG-based regimens, with nearly one-fourth showing poor knowledge. Despite some negative attitudes, many patients reported good practices toward DTG-based therapy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The study revealed gaps in knowledge and attitudes toward dolutegravir-based regimens among patients on antiretroviral therapy, despite relatively good treatment practices. Strengthening patient education and counseling is essential to improve knowledge and foster positive attitudes, which may enhance treatment adherence and outcomes.\u003c/p\u003e","manuscriptTitle":"Assessment of knowledge, attitudes, and practices toward dolutegravir-based regimens among patients receiving antiretroviral therapy at Bule Hora University Teaching Hospital, Ethiopia, 2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-03 06:10:35","doi":"10.21203/rs.3.rs-7759122/v1","editorialEvents":[{"type":"communityComments","content":1}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"17c028d9-f388-4c06-8ea4-b103d2034212","owner":[],"postedDate":"October 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":55628509,"name":"Health sciences/Diseases"},{"id":55628510,"name":"Health sciences/Health care"},{"id":55628511,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-03-17T09:41:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-03 06:10:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7759122","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7759122","identity":"rs-7759122","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}