Factors Affecting Antiretroviral Drug Adherence among HIV Adult Patients attending HIV Clinin at the University Teaching Hospital in Lusaka

Abstract

1.0 Abstract Introduction The effectiveness of anti-retroviral therapy (ART) relies on a strict adherence to it. To achieve optimum therapeutic levels and reduce drug resistance requires levels ≥95% adherence. As such, identifying factors to adherence is essential. We sought to determine factors associated with ART adherence within the context of patient demographics and factors, andfactors and to explore care treatment and support strategies used by patients and health workers. Method A Mixed Method Sequential Explanatory Design (MMSED)was employed to study adult patients receiving ART from the Adult Centreof Excellence (ACOE), UTH, Lusaka. Adherence was measured by missed clinic appointments and pharmacy collections over the last six months. The quantitative method involved assessing 715 complete medical and pharmacy records.We developed a logistic model for both bivariate and multivariate logistic regression analysis.Qualitative research involved participants’ self-reports of missed doses in the past four days. Research questions were drawn up from the quantitative findings and indepth interviews were conducted with 2 key informants and 5 participants. Thematic analysis was used. Results The mean age in years was 38 (±10.5). Results showed 79.4 % of the patients were adherent to clinical appointments while 46.3 % were adherent to pharmacy refills. Multivariate analysis showed lower adherence amongst the widowed on clinical appointments (OR = 0.3; 95% CI: 0.1–0.9). The stepwise regression analysis revealed significant factors for adherence on clinical appointment and pharmacy refills for widowed, co-habiting and no education, (p = 0.008, p = 0.044, and p = 0.018), respectively. About 80 % of patients interviewed were adherent to ART. Conclusion The results show moderate ART adherence (80%). However, in view of the identified factors affecting adherence, concerted and collaborative efforts through effective counselling and social support are needed to improve the adherence levels to at least ≥95%.