Factors Associated with Non-Adherence to Antiretroviral Therapy among Attendees of Federal Medical Centre, Gusau, Zamfara State, Nigeria, 2014
Abstract:
Background:
HIV infection/AIDS remains a worldwide public health challenge. Globally, there were approximately 36.9
million people living with HIV (PLWHIV) at the end of 2017. We conducted this study
to determine
factors influencing non-adherence to antiretroviral therapy among PLWHIV attending
Federal Medical Centre (FMC), Gusau, Zamfara State, Nigeria.
Method:
We conducted a mixed-methods study (cross-sectional
study and focus group discussions) 183 respondents were sampled from ART unit of
FMC Gusau, using systematic random sampling technique. A semi-structured questionnaire
was used to collect data on socio demographic and adherence related information.
All HIV/AIDS patients who have been on ART for at least 30 days were included in
the study. Adherence was self-reported (30 days recall), and those with at least
95% were classified as adherent. Bivariate and multivariate analyses were conducted.
Qualitative data was analyzed using content analysis.
Results:
of 183 respondents, 141 (77.05%) were females with mean age of 34.2 ±8.7 years.
155 (84.7%) had ≥95% adherence level. Fear of stigma (AOR 126.47; C.I: 12.06-1326.75),
Forgetfulness (AOR 30.40; C.I: 7.61- 121.48), Being too ill (AOR 37.80; C.I: 5.00-287.25),
Felt better (AOR 31.94; C.I: 1.86-547.93), Inability to pay for transport to clinic
(AOR 31.84; C.I: 2.15-472.23), were significantly correlated with non-adherence
to ART. Similarly, the FGDs also revealed stigma and discrimination, Forgetfulness,
and side effects contributing to non-adherence.
Conclusion:
The level of adherence to ART was slightly lower than the optimum desirable level.
The decentralization of treatment centers to primary health care centers and intensification
of public enlightment was recommended.
Keywords:
HIV/AIDS, Adherence, Antiretroviral therapy, Nigeria.
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