Poor Adherence Predictors and Factors Associated with Antiretroviral Treatment Failure among HIV Seropositive Patients in Western Nigeria
Saheed Opeyemi Usman *
Department of Clinical Laboratory Services, Equitable Health Access Initiative, Lagos, Nigeria
Gbemiga Peter Olubayo
Department of Community Medicine, Equitable Health Access Initiative, Lagos, Nigeria
Oluwole Tosin Oluwaniyi
Department of Clinical and Quality Improvement Services, Equitable Health Access Initiative, Lagos, Nigeria
Abayomi Joseph Afe
Department of Community Medicine, Equitable Health Access Initiative, Lagos, Nigeria
Ganiyu Babatunde Agboola
Department of Clinical Laboratory Services, Equitable Health Access Initiative, Lagos, Nigeria
Olufunmi Abodunde
Department of Clinical and Quality Improvement Services, Equitable Health Access Initiative, Lagos, Nigeria
Timothy Akinmurele
Department of Clinical and Quality Improvement Services, Equitable Health Access Initiative, Lagos, Nigeria
Olatoun Adeola
Department of Clinical and Quality Improvement Services, Equitable Health Access Initiative, Lagos, Nigeria
Maduakolam Onyema
Department of Strategic Knowledge Management, Equitable Health Access Initiative, Lagos, Nigeria
*Author to whom correspondence should be addressed.
Abstract
Background: The efficiency and success of antiretroviral therapy (ART) depends on a good level of patient’s adherence to a life-long regimen of antiretroviral (ARV) which is beneficial in reducing the risk of emergence of HIV resistant strains. This adherence is however influenced by several factors related mainly to patient and medication. This study is therefore carried out to determine the adherence rate of adult patients infected with HIV and identify the factors associated with antiretroviral therapy (ART) interruption or poor adherence.
Methods: This cross sectional study was carried out in Ondo & Ekiti States, South Western Nigeria. The target population was adult patients living with HIV and already initiated on ART. Data was collected by trained volunteers and supervised by appointed supervisors, by a face-to-face interview. All data were statistically analysed, using statistical package for the social sciences (SPSS) and statistical test of significance was performed with Chi-Square test.
Results: A total of 412 consenting respondents participated in the study with a mean age ± SD is 37.93 ± 9.30 years. 116 (40.8%) of them are males while 244 (59.2%) are females. ART adherence level was 79.6%. The main factor associated with ART adherence was educational status (χ² = 16.18, df = 3, P = 0.001). Drug reminder strategy have lower association with missing ART drug (OR: 0.51, 95% CI: 0.28 – 0.92) while patients experiencing ART drug side effect have higher association with missing ART drug (OR: 1.82, 95% CI: 1.01 – 3.28).
Conclusion: ART adherence is sub-optimal, with barriers largely patient-dependent thus it is imperative to intensify medication adherence counselling in an holistic behavioural educational improvement strategy aimed at improving the ability to fit therapy into own lifestyle, avoid drug exhaustion, achieve optimal adherence and remarkable patient outcome.
Keywords: Antiretroviral therapy, adult, Nigeria, adherence