Determinants of Adherence to Antiretroviral Therapy among HIV-Infected Patients in Africa

Abstract

Background. There are only a few comprehensive studies of adherence to ART and its challenges in Africa. This paper aims to assess the evidence on the challenges and prospects of ART adherence in sub-Saharan Africa. Methods. The authors reviewed original and review articles involving HIV-positive individuals that measured adherence to ART and its predictors in the past decade. Findings. Against expectations, sub-Saharan Africa patients have similar or higher adherence levels compared to those of developed countries. The challenges to ART adherence include factors related to patients and their families, socioeconomic factors, medication, and healthcare systems. Conclusion. Despite good adherence and program-related findings, antiretroviral treatment is challenged by a range of hierarchical and interrelated factors. There is substantial room for improvement of ART programs in sub-Sahara African countries.

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“…The challenges to ART adherence were financial constraints, forgetting to take medication, lack of family care, depression, alcohol use, social stigma and side effects to ART [13,28,32], substance and alcohol abuse [26]. Thus, health care providers must identify possible barriers to adherence at the earliest possible time and provide appropriate solutions.…”

Association between Psychological Wellbeing and Antiretroviral Therapy Adherence in North-Central, Nigeria

“…Optimal adherence to antiretroviral drugs (ARV) dosage schedule and timing at a threshold of 95% or more is required to attain an undetectable viral level in infected persons [28,31,34]. Studies have reported the difficulties in attaining optimal adherence as people living with HIV/AIDS tend to miss doses or ignore nutrition recommendation [4].…”

“…Findings from various studies across the world have presented different levels of ART adherence, albeit higher in Africa compared to Europe and America [8,28,33]. Similarly, an earlier meta-analysis review of 28 North American and 27 Sub-Sahara African studies reported a pooled ART adherence estimate of 55% for North America and 77% for Sub-Sahara Africa (Mills et al, 2006).…”

Community Perception, Misconception, and Discord Regarding Prevention and Treatment of Infection with Human Immunodeficiency Virus in Addis Ababa, Ethiopia

“…[1][2][3][4][5][6][7] Although disparity in access to treatment is undoubtedly a well-documented barrier to treatment, misconceptions and lack of knowledge only compound the problem. 1,2,5,8,9 Limited research from eastern Africa and Ethiopia has suggested that a belief in alternate cures might conflict with adherence to medically necessary treatments. [10][11][12][13] Reasons for default from antiretroviral (ARV) programs in Ethiopia include community pressure and misconception about treatment.…”