Determinants of non-adherence to subsidized anti-retroviral treatment in southeast Nigeria

Abstract

The anti-retroviral (ARV) treatment programme in Nigeria is delivered through selected teaching and mission hospitals at a free/subsidized rate. The government aims to scale up ARV treatment in the country. However, non-adherence to ARV medication can lead to viral resistance, treatment failure, toxicities and waste of financial resources. This study examined the factors responsible for non-adherence to free/subsidized ARV treatment in south-east Nigeria. The study was cross-sectional and descriptive. Information was collected from 174 patients selected by simple random sampling from the register of all patients who had been on anti-retroviral therapy (ART) for at least 12 months at the beginning of the study period. Patients were identified during their clinic visits. Information on their socio-demographic profile, ARV treatment and determinants of non-adherence to ARV treatment was obtained from those who gave consent, using pre-tested interviewer-administered questionnaires. All patients clearly understood the need to take ARV drugs throughout their lives, and what the costs entailed. They understood the need for periodic testing, the probability that complications would develop, cost of transportation to treatment site and the daily treatment regimen. Seventy-five per cent of respondents were not adhering fully to their drug regimen; the mean number of days that respondents had been off drugs was 3.57 days the preceding month. Reasons for non-adherence included: physical discomfort (side effects); non-availability of drugs at treatment site; forgetting to carry drugs during the day; fear of social rejection; treatment being a reminder of HIV status; and selling of own drugs to those unable to enrol in the projects. Being female, under 35 years, single, and having higher educational status were significantly associated with non-adherence. It is important that policy makers and programme managers address the factors responsible for non-adherence when scaling up subsidized ARV treatment in Nigeria and other parts of sub-Saharan Africa.

Client’s Satisfaction with Waiting Time in HIV Treatment Centers: An Urban Rural Comparison in Anambra State, Nigeria

“…This is similar to the findings in an HIV treatment center in Enugu, Nigeria [29,30]. Also in other HIV treatment centers in Nigeria [31][32][33].…”

“…Majority of the respondents in this study were married (56.2%) this is similar to the findings of a study done in Enugu [30] and a study done at Ibadan [31]. This is dissimilar to the 2010 National HIV Seroprevalence sentinel survey which reported that the prevalence of HIV was higher among the single women than the married [35].…”

“…As high as 45.6% of the respondents in this study are business owners. This is similar to the finding of a study in Enugu also in Southeast Nigeria [30], but dissimilar to the finding of a study in Ibadan Southwest Nigeria [33]. This may be because the people of Southeast Nigeria are known to engage in trading more than the other geo-political zones in the country.…”

Knowledge and attitudes regarding HIV/AIDS and antiretroviral therapy among patients at a Nigerian treatment clinic

“…With the rapid increase in patient access to ART in Nigeria, it has become vital to continuously monitor treatment adherence and identify interventions that can encourage its sustainability [19,20]. Systematic reviews have indicated that the most important and frequent factors that negatively impact adherence in developing countries are cost, stigma, alcohol abuse, and structural barriers such as lack of transportation and pharmacy stock-outs [19,21].…”

La mala calidad de sueño se asocia a una menor adherencia al tratamiento antirretroviral de gran actividad en pacientes peruanos con infección por VIH/SIDA

“…El nivel de adherencia adecuada encontrado en nuestro estudio es bajo (27%) y se encuentra en niveles inferiores a lo reportado por tres estudios desarrollados en Sudáfrica: 54,5%, 49,2% y 43,2% 56,57,58 . Esto podría estar relacionado al instrumento utilizado (CEAT-VIH).…”