ADHERENCE WITH ANTI-RETROVIRAL THERAPY AMONG PEOPLE LIVING WITH HIV/AIDS AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI.

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ADHERENCE WITH ANTI-RETROVIRAL THERAPY AMONG PEOPLE LIVING WITH HIV/AIDS AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI.

Abstract

ABSTRACT
Adherence is known to be the most important factor influencing outcome of treatment among people living with HIV/AIDS (PLWHAs). A number of factors which are patient-related, health system-related, disease related and drug related are known to influence adherence. Implications of non adherence to ART includes; emergence of resistance, treatment failure, limited treatment options and eventually death. This study is aimed at identifying factors associated with adherence/non adherence, patient’s self risk perceptions as well as assessing ongoing adherence support provided to HIV positive patients receiving ARVs in NAUTH, Nnewi.
The study design is both descriptive and exploratory. A total of 282 patients were selected using systematic random sampling from the ARV clinic register obtained from the Medical Records Department, NAUTH, Nnewi. Data was collected using a semi-structured interviewer-administered questionnaire and analysed using Epi-info version 3.3.2 and SPSS version 11. This was complemented with 6 sessions of focus group discussions, involving 6-8 participants purposively selected. Data collected were analysed both thematically and by cut-and paste method.
The findings showed that 66.3% of the respondents were females while 33.7 % were males. The mean age of respondents was 36.63±8.56 years. About 44% of them were married, 25% were widowed and 28% were unmarried and there is a significant difference in pattern of marital status observed between both sexes (X2= 11.3 p<0.05). Females in the study were found to be better educated than their male counterparts (X2=27.8 p<0.05). The mean rate of adherence among the patients was 97.9 %, while a total of 85.8% attained optimal adherence level of ≥ 95%. Reasons identified for missing medications include traveled out, forgot, ran out of medication and inability to pay. Adherence was found not to be related to sociodemographic characteristics. However, most patients (>70%) have good knowledge and perception of ART and adherence except that only half of them believe that ART reduces the risk of HIV transmission. Few (10.2%) of them still engaged in high risk behaviour despite their HIV status with 18% of them adopting no protective measure. Most (60%) of them discussed problems relating to their medication with the doctor. Only the use of alcohol was found to be significantly related to non adherence (X2=4.38 p<0.05). More than half (55%) of them do not feel free taking their medication before others who were not aware of their serostatus. Majority of them (97%) had plans for the future, as ART has changed their perception of AIDS. FGDs showed that ART has markedly changed their perception of HIV/AIDS. It also revealed that most of them had at one time or the other missed their medication mainly due to financial and cultural reasons. Fear of stigmatization was identified as a major barrier to adherence to ART and also limiting access to ARVs. However, most of the patients enjoyed support of their spouse and family members.
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In conclusion, it is evident that high level ART adherence is attainable in resource-constrained setting like Nigeria. However, it must be pointed out that free ART services and comprehensive adherence support (counseling) provided to the patients contributed largely to the high adherence level observed among the patients.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

ADHERENCE WITH ANTI-RETROVIRAL THERAPY AMONG PEOPLE LIVING WITH HIV/AIDS AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI.

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