Prevalence and Determinants of Adherence to Highly Active AntiRetroviral Therapy Amongst People Living with HIV/AIDS in a Rural Setting in South-South Nigeria

Afiong O. Oku, Eme T. Owoaje, Oboko O. Oku, Emmanuel Monjok

Abstract

Adherence to HAART is necessary to achieve the best virologic response and lower the risk of drug resistance amongst People living with HIV/AIDS (PLHIV). However, there is limited documentation of adherence amongst patients on HAART in the south-south region of Nigeria. This study aimed to determine the prevalence and determinants of adherence to HAART amongst PLHIV in a rural setting in Cross River State. A descriptive cross-sectional study was conducted among 393 patients on HAART attending the Heart to Heart centre Ugep using an interviewer-administered questionnaire.  Adherence was measured via self report and patients were termed adherent if they took at least 95% of prescribed doses. The self reported adherence rate based on a one week recall was 50.4%. The main reason for skipping doses were being busy (50.6%), simply forgetting to take medications (43.8%) and religious constraints (16%). Perceived improved health status [OR 2.7; CI: 1.37-5.39], Non use of herbal remedies, [OR 1.8; 95% CI: 1.23- 2.64] and ARV regimens devoid of dietary instructions [OR 1.49; 95% CI: 1.07- 2.06] were significant predictors of adherence. The adherence rate reported in this study was low. Appropriate adherence enhancing intervention strategies targeted at use of simplified ARV regimens and discouraging herbal use is strongly recommended. (Afr J Reprod Health 2014; 18[1]: 133-144).

Keywords: Adherence, PLHIV, HAART, rural setting, Nigeria.

 

Résumé

Adhérence thérapeutique est nécessaire pour atteindre la meilleure réponse virologique et réduire le risque de résistance aux médicaments chez les personnes vivant avec le VIH / SIDA (PVVIH). Cependant, il y a peu de documentation de l'adhésion chez les patients en multi thérapie (TARHA) dans la région sud-sud du Nigeria. Cette étude visait à déterminer la prévalence et les déterminants de l'adhérence à la multi thérapie antirétrovirale chez les PVVIH en milieu rural  de l’État de Cross River. Une étude descriptive transversale a été menée auprès de 393 patients en multi thérapie qui fréquentent le Heart to Heart Centre à Ugep à l'aide d'un questionnaire administré par un intervieweur. L'adhérence a été mesurée à travers des auto-déclarations par les patients. On a qualifié d’adhérents ceux qui ont pris au moins 95 % des doses prescrites. Le taux d’adhérence d’âpres l’auto déclaration  basé sur un rappel d'une semaine était de 50,4 %. Les principales raisons de sauter des doses comprenaient le fait

d’être  occupés (50,6 %), d’oublier tout simplement de prendre des médicaments (43,8 %) et les contraintes religieuses (16%). Le statut  de la sante améliorée perçue [OR 2,7, IC : 1,37 à 5,39], non utilisation de remèdes à base de plantes, [1,8 ; IC à 95% : 1,23 à 2,64 ] et les schémas ARV dépourvu de consignes alimentaires [OR 1,49, IC 95% : 1,07 2.06] sont des indices significatifs de l'adhésion. Le taux d’adhérence rapporté dans cette étude  était faible. Nous recommandons les stratégies d'intervention  qui favorisent l’adhérence ayant comme cible  l'utilisation des traitements antirétroviraux simplifiés et qui découragent l'utilisation de médicament à base de plantes. (Afr J Reprod Health 2014; 18[1]: 133-144).

Mots clés: adhérence, PVVIH, TARHA, cadre champêtre, Nigeria.

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