Barriers to HIV Treatment Adherence: Findings from a Treatment Center in South-South, Nigeria

Maduka, Omosivie; Tobin-West, Charles

doi:10.9734/ijtdh/2014/12186

Cited by 4 publications

(9 citation statements)

References 15 publications

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“…We found that being away from home and forgetfulness were reported as the major reasons for missing medication; similar factors were noted in some other studies29,30. Other, less frequently reported reasons for missed doses included stock control problems for drugs, discomfort/side effects, being ashamed of taking medication in front of others and fasting.…”

Section: Discussionsupporting

confidence: 86%

Rates and predictors of adherence and retention for antiretroviral therapy among HIV-positive adults in Enugu, Nigeria

2019

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BackgroundHIV infection and AIDS are majorpublic health challenges in Nigeria, a country with one of the highest rates of new infection in sub-Saharan Africa and the second largest HIV epidemic in the world.Non-adherence to medication and defaulting from treatment are the two major challenges faced by anti-retroviral therapy (ART) programs in resource-constrained settings. This study was undertaken to determine the rate and predictors of adherence to medication and retention among people living with HIVin Enugu State, Nigeria.MethodsThis was a cross-sectionalretrospective study conducted among adults living with HIV(PLHIV) receiving ARTs in eightcomprehensive health facilities in Enugu, Nigeria. We used self-reported adherence and recorded clinic visits to assess adherence and retention, respectively. Descriptive statistics (frequencies, proportions, mean and standard deviation) and regression analysis were then conducted to identify the association between adherence, retention and demographic and health-related factors. ResultsThe mean age of respondents was 38.5±9.8 years. Predictors of good adherence to medication includedbeing male(adjusted odds ratio [AOR]:2.08; 95% confidence interval [CI]:1.12–3.85), having been on anti-retroviral medications for more than 5 years (AOR:1.92; 95% CI: 1.17–3.16), the non-consumption of alcohol(AOR: 3.67; 95% CI: 2.01–6.70),not usingtraditional medicine (AOR: 2.76; 95% CI:1.33–5.73) and having a baseline CD4count exceeding 500 cells/μl (AOR: 5.67; 95% CI: 1.32–24.32).Adequate retention was predicted by being resident in the urban area (AOR: 1.90; 95% CI: 1.17–3.06). Being away from home (41.8%) and forgetfulness (35.0%) were reported as the major reasons for missing medication.ConclusionThe rates of adherence and retention found in this study were similar to those reported forother resource-limited settings. Health education and behavioural modification interventions should be intensified to reduce the consumption of alcohol and the use of traditional medicine by people living with HIV. Identifying other factors may help to design effective strategies to ensure that people living with HIV adhere to their medications and remain in care.

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Section: Discussionsupporting

confidence: 86%

Rates and predictors of adherence and retention for antiretroviral therapy among HIV-positive adults in Enugu, Nigeria

2019

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“…This reaffirms the postulation that peers may deliver behavioural modification interventions that reduce risky behaviours and may possibly improve treatment outcomes among PLWHA. 21 Being away from home and forgetfulness were reported as the main reasons for missing medication among respondents in both study groups in this study, and in other studies. 18,21 Other reasons for missed doses among respondents in this study included: ran out of drugs; discomfort/side effects; ashamed of taking medication in front of others; and fasting.…”

Section: Discussionsupporting

confidence: 63%

“…18,21 Other reasons for missed doses among respondents in this study included: ran out of drugs; discomfort/side effects; ashamed of taking medication in front of others; and fasting. However, other reasons for missed doses reported in other studies included: sleeping through dose time; 21 non-availability of food 18,19,33 (as most medications are required to be taken with food); and too many and too large tablets. 34 Adherence self-rating influenced medication adherence among respondents in peer support group in this study, whereas number of children, alcohol intake, number of years on HAART and adherence self-rating influenced adherence among respondents not in peer support groups.…”

Section: Discussionmentioning

confidence: 94%

Do peer support groups have an effect on medication adherence? A study among people living with HIV/AIDS in Enugu State, Nigeria

Chime

Arinze-Onyia

Obionu

2018

Proceedings of Singapore Healthcare

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Background: The health benefits of antiretroviral treatment greatly depend on the extent to which people living with HIV/ AIDS adhere to the prescribed daily dosing regimens. Peer support groups are expected to have a high impact on adherence to medication among people living with HIV/AIDS. Objectives: This study was designed to determine factors affecting adherence to medication among people living with HIV/ AIDS in peer support and non-support groups attending antiretroviral clinics in Enugu State, Nigeria. Method: This was a cross-sectional, comparative study using qualitative and quantitative instruments among 840 people living with HIV/AIDS attending antiretroviral clinics in Enugu, Nigeria. Quantitative data was analysed using IBM SPSS version 22. A Chi-square test of statistical significance, a student t-test and multivariate analysis using binary logistic regression were used in the analysis. Manual content analysis was done for the qualitative data. Results: The mean age of respondents was comparable in both study groups: support group 38.5±9.6; and non-support group 38.5±10.1. A significantly higher proportion of respondents in the support group (91.9%) achieved good adherence compared with those in the non-support group (87.1%). A good medication adherence self-rating was a predictor of adherence in both study groups: support group (AOR 5.8, 95% CI: 2.7-12.2, p=<0.001) and non-support group (AOR 0.2, 95% CI: 0.1-0.4, p=<0.001). Conclusion: The peer-based intervention is a viable and effective tool for maintaining optimal adherence among people living with HIV/AIDS in resource-limited settings; hence, research should concentrate on interventions that do not focus on individuals alone, but rather on those that strengthen the capacity of groups to collectively participate in HIV programmes.

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“…Good clinical outcomes have also been observed as a direct effect of HAART adherence with a known reduction in morbidity and mortality in children infected with HIV in Kenya [7]. Non-adherence is defined as the discontinuation of part or all of the treatment regimen that includes missing dose, under-dose, over-dose and drug holidays [8]. The key drivers of nonadherence include lack of insight, forgetfulness, busy work schedule, distance to clinic and medication beliefs, and it has been shown that African states do share similar drivers of non-adherence with western nations [9].…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study on caregivers’ perspective of the quality of life and adherence of paediatric HIV patients to highly active antiretroviral therapy

et al. 2020

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Background: Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART. Methods: We conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children's Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee. Results: The study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p = 0.019*) to the physical health domain (mean = 64.61 SD = 8.1). Caregiver HIV status showed a strong association with the physical (mean = 58.3, SD = 11.7 and p = 0.024*), and psychological health domains (mean = 68.2, SD = 14.7 and p = 0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean = 58.0, SD = 10.6, p < 0.001), psychological (mean 68.2 SD = 14.81 p < 0.001) and environmental health domains (mean = 59.7, SD = 13.47, p < 0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p = 0.014) and adherent paediatric patients (p = 0.005). Nuclear family also showed a strong association with psychological (p < 0.001) and environmental (p = 0.001) health domains. Conclusion: This study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.

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Barriers to HIV Treatment Adherence: Findings from a Treatment Center in South-South, Nigeria

Cited by 4 publications

References 15 publications

Rates and predictors of adherence and retention for antiretroviral therapy among HIV-positive adults in Enugu, Nigeria

Rates and predictors of adherence and retention for antiretroviral therapy among HIV-positive adults in Enugu, Nigeria

Do peer support groups have an effect on medication adherence? A study among people living with HIV/AIDS in Enugu State, Nigeria

A cross-sectional study on caregivers’ perspective of the quality of life and adherence of paediatric HIV patients to highly active antiretroviral therapy

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