ART adherence and associated factors among Female Sex Workers in Fort Portal, Mid- western Uganda: A cross-sectional study

Introduction : Adherence to antiretroviral therapy (ART) is crucial for viral suppression and improved health outcomes among people with HIV. Female sex workers (FSWs) may face unique barriers to ART adherence, but data on their adherence levels and associated factors remain limited. The study was conducted to determine the level of ART adherence and associated factors among FSWs. Materials and methods A cross-sectional study was conducted in Fort portal City among 206 FSWs between July 2024 and August 2024. Interviewer-administered questionnaire was used to collect data on level of ART adherence and associated factors among female sex worker aged above 18 years and currently on ART using consecutive sampling method. ART adherence was assessed using self-reports and validated using records. Logistic regression was used to infer factors which were significantly associated with poor adherence to ART. Results In our study, 78% of the FSWs had good adherence (adherence >95%), 22% had ever stopped taking ART, while 14% had missed taking ART in the last two weeks from the study period. The main reasons for poor adherence were travelling/moving to a new place (32%), forgetfulness (29%), and food scarcity (13%), imprisonment (5.4%), hospital admission (5.4%), non-disclosure (5.4%), and side effects (5.4%). Experiencing Intimate Partner Violence (IPV)(aOR 2.59 (95% CI: 1.10-6.1) and having one child (aOR 8.69 (95% CI: 1.4-53.91) was significantly associated with poor adherence to ART among FSWs. Conclusion Our study indicates optimal ART adherence practices among FSWs. Poor adherence was associated with forgetfulness, food scarcity and travelling to a new place. Having one child and experiencing IPV significantly increased the odds of failing to adhere to ART medications. We recommend Measures that reinforce the Ugandan policy that aims at community mobilization and sensitization to both men and women about the dangers of IPV in relationships.