FACTORS INFLUENCING ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG PEOPLE LIVING WITH HIV/AIDS RECEIVING CARE AT ADEOYO MATERNITY TEACHING HOSPITAL, YEMETU, IBADAN, NIGERIA

Abstract

Maintaining optimal adherence to Anti-Retroviral Therapy (ART) is essential for HIV infection management. The long-term maintenance of ART remains an important issue, especially in limited -resource setting where additional barriers exist. Thus, there is need for more information on the level of and factors influencing adherence to ART which can be used as baseline information to design intervention to promote ART adherence in Nigeria. This study was therefore designed to identify factors influencing adherence to ART among People Living with HIV and AIDS (PLWHA) receiving care at the Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria. The study was a cross-sectional survey using simple, random sampling technique to select the study site out of the two ART centres in Ibadan metropolis. Systematic random sampling technique was used to select 402 out of 6700 PLWHA. A validated questionnaire which included perception and attitudinal scales was used for data collection. Seven -item scale was used to examine perception of the respondents on anti-HIV medication adherence and a score >4 was considered as favourable perception. A 6-point attitudinal scale was used to determine respondents' attitude and scorces >4 were considered as positive attitude towards adherence to anti-HIV medication. Data were analysed using descriptive statistics and Chi-square test at α.₀₅. Age of respondents was 40.6±9.0 years and 38.6% were within 40-49 years age bracket .Over half (58.7%) of the respondents were females and 48.5% had secondary education. Most (91.0%) respondents were married, 70.4% had between 2-4 children and 97.0% were currently employed. Most (97.5%) respondents confirmed adherent to their medications. The proportion of respondents who took herbal\traditional remedies was 4.5%. Reasons for non-adherence to anti-HIV medication included: poor access to information (93.5%); inattention of doctors to complaints(92.8%); forgetfulness (91.0%); confusion but dosage instructions (90.5%); preference for herbal remedies (30.2%) and tiredness (28.8%). Perception score was 5.5±1.2 and 93.5% had favourable perception. Respondents' attitudinal score towards adherence to anti-HIV medication was 4.5±0.9 with 87.8% of them having positive attitude. Major challenges of adherence to ART services included: poverty (45.3%); cultural belief (26.1%); poor knowledge about clinic follow-up (18.9%): nonchalant attitude of healthcare workers to PLHWA (11.4%) and stigmatisation/discrimination (7.0%). The reported means of overcoming these impediments included: awareness creation (47.5%): technological modification to make anti-HIV drugs less bitter (10.0%) and more knowledge but ART (9.0%). Respondents with better knowledge about ART (21.7%) had better adherence to their ART (p<0.05). Socio-cultural factors were identified constraints to Anti-Retroviral Therapy adherence in Adeoyo. Strategies such as sensitization and wealth creation activities are advocated to improve patients' adherence.