Non-adherence to Highly Active Antiretroviral Therapy and Occurrence of Opportunistic Infections among Adult Clients Accessing Care at a Secondary Health Facility in Imo State Nigeria
Chinomnso C. Nnebue *
Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria and Department of HIV Care, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
Chukwuma B. Duru
Department of Community Medicine, Imo State University/ University Teaching Hospital, Orlu, Nigeria
Donatus I. Iwuagwu
Department of Community Medicine, Madonna University Elele, Nigeria
Edwin O. Akor
Department of Community Medicine, Madonna University Elele, Nigeria
Blessing C. Ukasooanya
Department of Community Medicine, Madonna University Elele, Nigeria
Nseabasi A. Akpan
Department of Community Medicine, Madonna University Elele, Nigeria
*Author to whom correspondence should be addressed.
Abstract
Background: Non-adherence remains an issue of concern in highly active anti-retroviral therapy (HAART). It has been reported to reduce the immunological benefit of this regimen, while increasing morbidities and mortalities associated with HIV/AIDS.
Objective: To determine the relationships between non-adherence to HAART and occurrence of opportunistic infections (OIs) among adult HIV clients accessing care in a secondary health facility in Imo state Nigeria.
Materials and Methods: This was a health facility-based descriptive cross-sectional study of 350 respondents, selected by systematic sampling technique. Data were collected by interview using semi-structured questionnaire and analysed with statistical package for social sciences version 22.0. Test of statistical significance was done using chi-square test, while statistical significance was set at p value ≤ 0.05.
Results: Majority 220 (62.9%) of respondents were females, 218 (62.3%) were currently married, 263 (75.1%) attained at most secondary level of education, while 259 (74%) were resident outside the study area. Twenty (5.7%) of them were non adherent to HAART and reasons cited include: fourteen (4%) forgetting to take medicine and 11 (3.1%) drug is out of stock. Fifty seven (16.7%) ever had OIs with oral thrush 21 (36.8%) as the commonest. There was an association between non- adherence to HAART and occurrence of OIs (p=0.000).
Conclusions: This survey found an association between non- adherence to HAART and occurrence of OIs. We recommend interventions that combine early treatment of OIs and gender cum couple targeted behavioral change communication in addressing non-adherence.
Keywords: Nigeria, secondary health facility, opportunistic infections, non-adherence, HAART