Adolescents and Young Adults Knowledge, Adherence and Experiences While on Antiretroviral Therapy in a Tertiary Hospital in Lagos, Nigeria: A Mixed-Method Study

Aderemi-Williams, Roseline Iberi; BPharm, Ayomikun Rofiat Razaq; Abah, Isaac Okoh; BPharm, FPCPharm Olabisi Oluranti Opanuga; MBBS, MWCP Alani Sulaimon Akanmu

doi:10.1177/23259582211062754

Cited by 6 publications

(4 citation statements)

References 18 publications

(38 reference statements)

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“…These studies consistently reported a positive relationship between higher education levels and improved PrEP adherence. Conversely, some studies indicated that individuals with lower education levels, including those with limited HIV knowledge, exhibited poorer PrEP adherence [ 17 , 25 ]. These findings underscore the potential impact of education on PrEP adherence and emphasize the importance of considering individuals’ educational backgrounds and HIV knowledge in understanding adherence behaviors.…”

Section: Discussionmentioning

confidence: 99%

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis

Hudrudchai,

Suwanwong,

Prasittichok

et al. 2024

JPMPH

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Objectives: The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors.Methods: The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale.Results: Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM.Conclusions: Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.

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Section: Discussionmentioning

confidence: 99%

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis

Hudrudchai,

Suwanwong,

Prasittichok

et al. 2024

JPMPH

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“…Women have been known to have better health seeking behaviour [44,45] and better adherence to treatment than men [46] which would consequently lead to improved viral suppression [47]. Similarly, adults have been shown to be more likely to be adherent to ART compared to adolescents and young persons [48][49][50], while MMD and community-based ART models are proven strategies for improving ART adherence [22,23,32]. Targeted program interventions to these affected socio-demographics may enhance viral suppression.…”

Section: Plos Onementioning

confidence: 99%

Effects of the COVID-19 pandemic on HIV service delivery and viral suppression: Findings from the SHARP program in Northern Nigeria

Mugo,

Adedokun,

Alo

et al. 2024

PLoS ONE

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During the COVID-19 pandemic, HIV programs scaled up differentiated service delivery (DSD) models for people living with HIV (PLHIV). We evaluated the effects of COVID-19 on HIV service delivery and viral suppression in facilities in Northern Nigeria, and determined factors associated with viral suppression among adolescents and adults. We analysed a cross-sectional survey data from facility heads, and retrospective, routinely collected patient data from 63 facilities for PLHIV ≥10 years old in care between April 2019-March 2021, defining study periods as “pre-COVID-19” (before April 2020) and “during COVID-19” (after April 2020). For the pre-COVID and the COVID-19 periods we compared uptake of antiretroviral therapy (ART) refills of ≥3 months (MMD3), and ≥6 months (MM6), missed appointments, viral load (VL) testing, VL testing turnaround time (TAT) and viral suppression among those on ART for ≥6 months using two proportions Z-test and t-tests. We fit a multivariable logistic regression model to determine factors associated with maintaining or achieving viral suppression. Of 84,776 patients, 58% were <40 years, 67% were female, 55% on ART for >5 years, 93% from facilities with community-based ART refill, a higher proportion were on MMD3 (95% versus 74%, p<0.001) and MMD6 (56% versus 22%, p<0.001) during COVID-19 than pre-COVID-19, and a higher proportion had VL testing during COVID-19 (55,271/69,630, [84%]) than pre-COVID-19 (47,747/68,934, [73%], p<0.001). Viral suppression was higher during COVID-19 pandemic compared to the pre-COVID era (93% [51,196/55,216] versus 91% [43,336/47,728], p<0.001), and there was a higher proportion of missed visits (40% [28,923/72,359] versus 39% [26,304/67,365], p<0.001) and increased VL TAT (mean number of days: 38 versus 36, p<0.001) during COVID-19 pandemic and pre-COVID period respectively. Factors associated with maintaining or achieving suppression during COVID-19 were receiving MMD3 and MMD6 refills (OR: 2.8 [95% CI: 2.30–3.47] and OR: 6.3 [95% CI: 5.11–7.69], respectively) and attending clinics with community-based ART refill (OR: 1.6 [95% CI: 1.39–1.87]). The program in Northern Nigeria demonstrated resilience during the COVID-19 pandemic and adoption of MMD had a positive impact on HIV care. Though VL TAT and missed clinic visits slightly increased during the pandemic, VL testing improved and viral suppression moved closer to 95%. Adoption of MMD and community-based models of care at scale are recommended for future pandemic preparedness.

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“…Regular education and sensitization equipped respondents with adequate information about the importance of adherence to antiretroviral treatment. In relation, a study carried out in Nigeria found that adolescents who had routine education and sensitization about ART were more adherent to ART as compared to those who were not health-educated [35,36]. This was because both studies were carried out in rural settings where the social demographic characteristics of the respondents were similar.…”

Section: Drug-related Factors Associated Withmentioning

confidence: 99%

Factors Influencing Adherence to Antiretroviral Therapy among HIVpositive Youth Patients Attending ART Clinic in Kiryandongo General Hospital Kiryandongo District

Jethro

2023

IDOSR JBCP

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This research aimed to assess the factors influencing adherence to antiretroviral therapy (ART) among HIV-positive youth patients attending the ART Clinic in Kiryandongo General Hospital, Kiryandongo District. The study utilized a descriptive cross-sectional research design, with a sample of 355 respondents between the ages of 10 and 25 who were receiving antiretroviral treatment. The study found a low level of adherence to antiretroviral treatment (33%), significantly lower than the national target of 90%. Adherence was influenced by various individual, drug-related, and healthcare factors. Individual factors included gender, age, marital status, education, place of residence, family size, and religion. Drug-related factors included having all the required drugs, challenges with the drugs, the frequency of taking ARV pills, challenges during medication intake, and accessibility to ARV drugs. Health-related factors encompassed routine education and counseling, sources of information, proximity to healthcare facilities, distance from home to the facility, availability of ARVs on appointment days, availability of healthcare workers, frequency of ARV refill visits, and waiting time during appointments. The low adherence was attributed to missing doses due to stigma, forgetfulness, drug stockouts, lack of routine education about ART, long distances to healthcare facilities, inadequate information, and extended waiting times. Keywords: HIV, Antiretroviral therapy, Adherence, Youths, Stigma

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Adolescents and Young Adults Knowledge, Adherence and Experiences While on Antiretroviral Therapy in a Tertiary Hospital in Lagos, Nigeria: A Mixed-Method Study

Cited by 6 publications

References 18 publications

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis

Effects of the COVID-19 pandemic on HIV service delivery and viral suppression: Findings from the SHARP program in Northern Nigeria

Factors Influencing Adherence to Antiretroviral Therapy among HIVpositive Youth Patients Attending ART Clinic in Kiryandongo General Hospital Kiryandongo District

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