SOCIO-CULTURAL, DEMOGRAPHIC, KNOWLEDGE AND ECONOMIC FACTORS INFLUENCING ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG PEOPLE LIVING WITH HIV AND AIDS (PLWHA) IN THREE SELECTED HOSPITALS OF ANAMBRA STATE, NIGERIA

Abstract

  Despite the availability of treatment regime for PLWHA, especially in major cities on Nigeria, adherence to drug regimen seem to be facing some challenges towards achieving success in combating the issue of HIV/AIDS. A knowledge of the possible challenges that may be. A cross-sectional survey using self-reported tool was employed to determine the factors that influence adherence to Antiretrovirals among people living with HIV/AIDS currently on Antiretroviral Therapy in three selected hospitals in Anambra State, Nigeria. A purposive sampling technique was used to select five hundred and fifty four respondents who are currently on Antiretroviral Therapy for the study. The analyses consisted of basic summaries of respondents’ characteristics, and bivariate analysis of the relation between adherence and the various factors that influence it. Further analysis using the inferential statistics (chi-squares) was carried out to test the significance of association between adherence and various factors associated with. Five hundred and fifty four people living with HIV/AIDS completed the questionnaire from the study settings. Nnamdi Azikiwe Teaching Hospital had a higher percentage of respondents (38.1%) than the two other institutions. The longest duration of being on Antiretroviral Therapy  was one hundred and seventy-three months (14 years, 5 months) with almost all the respondents (95.5%) reporting  Antiretroviral Therapy as helpful to them. An adherence level of 85.2% was reported by self-report tool with alarm-clocks (66.1%) being the major reminder. The non-adherents reported  forgetfulness, high transport cost to the clinic, and long waiting time at the clinic as their reasons for not adhering to their Highly Active Antiretrovirals Therapy (HAART). There is significant association between adherence and marital status, religion, long waiting time at the clinic, and poor supply of Antiretrovirals. The adherence rate to antiretrovirals  found in this study is 85.2% and is fairly appreciable when compared with WHO (≥95%)  recommendation. Respondents recommended certain measures to ensure adherence to antiretroviral therapy which include, improved Antiretroviral services and continuous supply of free Antiretroviral medications, provision of functional CD4 T-cell machines, employment of more trained staff as well as the provision of more improved Antiretroviral drug. The conclusion is however reached that Antiretroviral medication still remains the best way to manage the virus in People living with HIV/AIDS. Therefore, everything should be done to mitigate factors that facilitate non-adherence among People living with HIV/AIDS.   Key words: Antiretrovirals, Adherence, CD4 T-cell, Virus, PLWHA, HAART