Determinants of Adherence to Antiretroviral Drugs among People Living with HIV/AIDS in Ife-Ijesa Zone of Osun State

Afolabi, Muhammed Olanrewaju (2015-03-27)

Thesis

This study was aimed at determining the factors that influence adherence to Antiretroviral (ARV) therapy among People Living with H1V/AIDS (PLWHA) in Ife- Ijesa Zone of Osun State. It assessed the knowledge of and attitudes towards ARV therapy among PLWHA and determined the level and correlates of adherence of the PLWHA to ARV therapy. This was is with a view to improving the adherence to ARV therapy in the study area. The study employed a cross-sectional descriptive design. One hundred and twenty subjects who received ARV drugs at the Obafemi Awolowo University Teaching Hospital Complex, Ile- Ife (OAUTHC) and Living Hope Care, Ilesa (LIHOC) between February and May 2006 were recruited and studied. Relevant data were collected using a pre-tested interviewer -administered, semi-structured questionnaire. Focus group discussions were also held among the subjects to further elicit qualitative information on factors influencing adherence to ARV. Descriptive and inferential statistical tests were employed in the analysis. Statistical significance was tested at the 5% level. The result showed that the age of respondents ranged from 21 to 65 years with a mean age of 40.2 ± 10.3 years. Eighty-five respondents (70.8%) were aged 15 to 44 years with a male to female ratio of 1: 1.9. Respondents had been on ARV drugs for a period ranging between 3 and 60 months. Ninety-seven (80.8%) of the PLWHA had good knowledge of ARV drugs while a sizeable proportion (77%) of them demonstrated a positive attitude towards it. The overall adherence rate in the study population was 44%. Sixty-six percent of participants who accessed ARV drugs from LIHOC, Ilesa had good adherence (namely those who took at least 95% of expected drugs over a defined time period). However, only 14% of participants who accessed ARV drugs from the OAUTHC, Ile-Ife had good adherence. Significant correlates of adherence to ARV drugs among study participants included sources of ARV access (public versus private) (X2 = 31.631, p < 0.05), educational attainment (X2= 27.758, p < 0.05), total monthly income of subjects (X 2 = 23.024, p < 0.05), support group attendance (X 2 = 9. 358, p < 0.05) as well as frequency of medications (X2 = 5.680, p < 0.05). Demographic factors like age, gender and marital status did not have any significant association with adherence level. Reasons given for missing doses of ARV were mainly lack of funds for investigations and the fear of stigma and discrimination. The study concluded that PLWHA in Ife- Ijesa Zone of Osun State demonstrated good knowledge of ARV therapy and also displayed a positive attitude towards it. They were however not able to translate these to good level of adherence of ARV therapy. The most important reasons for poor adherence being lack of funds for investigations and the fear of stigma and discrimination.

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