Demographic and behavioural determinants related to ART adherence among HIV-positive patients in Luanda, Angola

Abstract

Introduction: Adherence to antiretroviral therapy (ART) allows for improvements in the quality of life of people living with HIV (PLHIV/AIDS), with an emphasis on improving their immune status, reducing viral load, and reducing the mortality rate from Human Immunodeficiency Virus (HIV). AIDS). Objective: To characterize the adherence situation to antiretroviral therapy and the factors associated with non-adherence in HIV adults patients in two referral health facilities for the care of people living with HIV/AIDS (PLHIV) in Luanda, the capital city of Angola (Divine Providence Hospital and Esperança Hospital/Rangel Health Center). Methods: This was a cross-sectional study conducted with 378 PLHIV on ART, undergoing semi-structured interviews to obtain sociodemographic data and filling out a questionnaire to evaluate adherence to ART. Results: In general, 95.5% of patients had moderate adherence, 4.20% had excellent adherence and 0.3% had low adherence. ART adherence was related to the amount of monthly income (p<0.05). Furthermore, a borderline significance was observed between adherence rate and education, with patients with basic or medium education having high rates of moderate (35% - 50%) or excellent adherence (38% - 56%). Patients over 30 years of age had a higher adherence rate, whether moderate (30% - 57%) or optimal (44% - 56%). Women had approximately twice the rates of moderate (75%) or optimal (63%) ART adherence compared to men. Low ART adherence was observed for married couples, and patients who use drugs or alcohol, whether moderate or optimal adherence. Conclusions: In conclusion, this study addressed adherence to antiretroviral therapy among HIV-positive individuals in Luanda, Angola. The findings highlight the fundamental role of socioeconomic factors, especially monthly income, in influencing adherence levels of HIV patients in Angola. Furthermore, age, gender, education and marital status emerged as additional determinants affecting adherence rates. These determinants emphasize the importance of personalized interventions aimed at addressing various barriers to adherence to ART, increasing the effectiveness of HIV/AIDS management to ensure a higher quality of life for people living with HIV in Angola.