Factors Influencing Adherence to Antiretroviral Drugs among HIV Positive Young Women and Adolescent Patients in North Central Nigeria

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DOI: 10.21522/TIJPH.2013.SE.19.01.Art015

Authors : Oluwasina, Folajinmi Oluyemi, Matthew Adeoye, Ifeoluwa Makinde, Bodunde Onifade, Taofeek Adeleye, Adebimpe Olalekan


The impact of HIV in the world especially in sub-Saharan Africa has led to an extraordinary global effort to ensure adherence to antiretroviral (ARV) therapy to treat the disease in every country where HIV is a threat including Nigeria. However, starting patients on ARVs without ensuring full adherence through an adequate support system is likely to lead to treatment failure and the emergence of drug‐resistant virus which can be transmitted to other. Factors influencing adherence to medication are both patients and service provider related. A descriptive, cross sectional study using a systematic sampling technique to select 473 young women and adolescent living with HIV in North central ART clinics in Nigeria. 77% of respondents have been on ARV regimen in the last 3 years. About 82% had good knowledge of medication adherence while 18% do not understand what adherence to medication means. Most (79%) of HIV patient’s adequate adherence to ART while others (13%) usually had stopped taking their medication when they feel better about their health. The commonest source of information about medication adherence to ARV was through the adherence counselor at during ART clinics (77%). Sixty percent of the respondents agreed that adherence to ARV medication helps in improving standard of living Factors that hindered effective adherence to treatment included poor providers’ attitude (28%) and forgetfulness to take their medication and pill burden (25%). Respondents who did not adhere to treatment were less likely to subsequently adhere to ARV medication (OR= 0.258, 95%CI= 0.1-0.5). Use of treatment supporters was the major determinant of medication adherence (OR = 4.2, 95%CI = 1.4-7.2). Majority of the respondents are knowledgeable about medication adherence.

Keywords: Adolescent, Antiretroviral therapy, HIV, Adherence, Young women


[1].Ampofo KW. (2009). Editorial commentary: Current status of HIV/AIDS treatment, care and support services in Ghana. Ghana Med J. 43(4):142–143.

[2].Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical trials Group. (2010). AIDS Care; 12:255–66.

[3].Bangsberg DR, Moss AR, Deeks SG. (2010) Paradoxes of Adherence and Drug Resistance to HIV Antiretroviral Therapy. J Antimicrob Chemother; 53:696–9.

[4].Bennet SJ, Lane KA, Welch J, Perkins SM, Brater CD (2006). Medication and Dietary Compliance Beliefs in Heart Failure. Western Journal of Nursing Research. 27(8): 977-993.

[5].Brass AL, Dykxhoorn DM, Benita Y, Yan N, Engelman A, Xavier RJ, Lieberman J, Elledge SJ. (2008). Identification of host proteins required for HIV infection through a functional genomic screen.319:921–926.

[6].Catz, S., Heckman, T.G., Kochman, A.R., &DiMarco, M. (2011). Rates and predictors of adherence to HIV medications among late middle-aged and older adults living with HIV/AIDS. Psychology, Health, and Medicine, 6, 47-58.

[7].Cervone D. (2004). Thinking about self-efficacy. Behavior Modification. 24(1): 30-56.

[8].DanelC. (2016). Early ART and IPT in HV-infected African adults with high CD4 count (Temprano trial).2016 Conference on Retroviruses and Opportunistic Infections (CROI), Seattle, USA,

[9].Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl B. (2014) Self-Reported Adherence to Antiretroviral Medications Among Participants in HIV Clinical Trials; the AACTG Adherence Instruments. Patients care Committee and Adherence

[10]. Fonner VA, Denison J, Kennedy CE, O'Reilly K, Sweat M. (2012) Voluntary counseling and testing (VCT) for changing HIV‐related risk behavior in developing countries. The Cochrane Library.

[11]. Fonner VA, Denison J, Kennedy CE, O'Reilly K, Sweat M. (2012). Voluntary counseling and testing (VCT) for changing HIV‐related risk behavior in developing countries. The Cochrane Library;

[12]. Global Burden of Disease Pediatrics Collaboration. Global and national burden of diseases and injuries among children and adolescents between 1990 and 2013. (2016) Findings from the global burden of disease 2013 study. JAMA Pediatrics. 170(3):267–87.

[13]. Igwegbe O, Ugboaja J.O, Nwajiaku L.A (2010) “Prevalence and determinants of non-adherence to antiretroviral therapy among HIV- positive pregnant women in Nnewi, Nigeria,” International Journal of Medicine and Medical Sciences, vol. 2, no. 8, pp. 238–245, 2010. View at Google Scholar.

[14]. Kouanda S, Bocoum FY, Doulougou B, Bila B, Yaméogo M, Sanou MJ, Sawadogo M, Sondo B, Msellati P, Desclaux A. (2010). User fees and access to ARV treatment for persons living with HIV/AIDS: implementation and challenges in Burkina Faso, a limited-resource country. AIDS Care. 22(9):1146–1152.

[15]. Mutevedzi PC, Newell M. (2014) the changing face of the HIV epidemic in sub-Saharan Africa. Trop Med Int Health. 19(9):1015–1028. doi: 10.1111/tmi.12344.

[16]. Nachega, J.B A. R. Knowlton, A. Deluca l (2006). “Treatment supporter to improve adherence to antiretroviral therapy in HIV-infected South African adults: a qualitative study,” Journal of Acquired Immune Deficiency Syndromes, vol. 43, supplement 1, pp. S127–S133.

[17]. Palella FJ, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, (2014). Declining Morbidity and Mortality among Patients with Advanced HIV Infection - HIV Out-Patients Study Investigations. N Engl J Med. 338:853–60.

[18]. Paterson DL, Swindell S, Mohr J, Brester M, Vergis E, Squire S. (2009) Adherence to Protease Inhibitor Therapy and Outcomes in Patients with HIV Infection. Ann Intern Med. 133:21–30.

[19]. Takarinda KC, Madyira LK, (2016). Factors associated with ever being HIV-tested in Zimbabwe: An extended analysis of the Zimbabwe Demographic and Health Survey (2010–2011). PLoS ONE. 2016; 11(1):1–18. doi: 10.1371/journal.pone.0147828 .

[20]. WHO. Guidelines on HIV self-testing and partner notification: supplement to consolidated guidelines on HIV testing services. (2016). Geneva, Switzerland: World Health Organization.

[21]. W. L. Holzemer, I. B. Corless, K. M. Nokes et al. (2009). “Predictors of self-reported adherence in persons living with HIV disease,” AIDS Patient Care and STDs, vol. 13, no. 3, pp. 185–197,

[22]. Whitley HP, Fermo JD, Ragucci K, Chumney EC. (2009). Assessment of patient knowledge of diabetic goals, self-reported medication adherence, and goal attainment. Pharmacy Practice. 4(4): 183-190.

[23]. WHO. (2015). Global health sector response to HIV: Focus on innovations in Africa: Progress report. Geneva, Switzerland: World Health Organization.

[24]. UNAIDS. (2015) Access to antiretroviral therapy in Africa: status report on progress towards the 2015 targets. Geneva, Switzerland: UNAIDS; 2015

[25]. UNAIDS. (2014) 90-90-90 An ambitious treatment target to help end the AIDS epidemic. Geneva, Switzerland: UNAIDS.

[26]. UNAIDS. (2015). Access to antiretroviral therapy in Africa: status report on progress towards the 2015 targets. Geneva, Switzerland: UNAIDS; 2015.

[27]. WHO.(2015.) Antiretroviral therapy; http://www.who.int/topics/antiretroviral_therapy/en/

[28]. WHO. (2013). Number of people receiving antiviral therapy (ART) and percentage of all people living with HIV receiving ART in low- and middle-income countries overall and by WHO region, 2013.