Predictors of adherence to antiretroviral therapy among people living with HIV and AIDS at the regional hospital of Sokodé, Togo

Abstract

BackgroundAdherence to antiretroviral therapy (ART) is beneficial in reducing the risk of emergence of HIV resistant strains. Adherence to ART among Persons Living with HIV/AIDS (PLWHA) is influenced by several factors related to the patient, the medication, and health facilities. In Togo, previous studies on adherence to ART have reported good adherence to ART during the first year of follow-up. However these may hide many disparities dues to cultural specificities which may differ across geographic areas of the country. We sought to determine the level of adherence to ART and document the associated factors among PLWHA at the regional hospital of Sokodé, Togo.MethodsThis was an analytical cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months before the study.ResultsA total of 291 PLWHA on ART were enrolled in the study. The mean age (±SD) was 37.3 ± 9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 195 (67.0%) were living with their partners and 210 (72.2%) had formal education. Two-thirds (194/291; 66.7%) of the PLWHA interviewed lived in urban areas. The global adherence to ART was 78.4%; the factors associated with ART adherence were: level of education (aOR = 3.54; p = 0.027), alcohol consumption (aOR = 0.43; p = 0.033), ART perception (aOR = 2.90; p = 0.026) and HIV status disclosure to sexual partner (aOR = 7.19; p ≤ 0.001).ConclusionAlthough the level of adherence to ART in this study was higher than those reported in some studies in Sub-Saharan Africa, it remains sub-optimal and needs improvement. This may therefore hinder the implementation of efficient interventions related to access to ART services.

Factors Influencing Adherence to Antiretroviral Therapy among HIV Infected Patients in Nyamagana-Mwanza, Northern Tanzania: A Cross Sectional Study

“…Lower education was found to have associations with barriers to receiving HIV related health care, including ART. Other studies have been previously reported from African settings where the level of education has adversely affected adherence [19,27] similarly with what has been reported in the current study that those with secondary education and higher in this study had poor ART adherence compared to those with primary education. Educated participants are more likely to be employed and their time at work influencing negatively with the consistent use of medication.…”

“…However, other factors associated in India whereby 56% of the educated participants said that HIV could probably be controlled by ART [5]. Other literatures support that ART adherence rate was higher among participants who had a high level of formal education [19,25]. Our findings are inconsistent with that reported by Kalichman in United States of America, who had earlier identified low educational status as a major factor of poor adherence to ART [26].…”

“…A study done in Nigeria by Kasumu and Balogun indicated that the overall knowledge of the participants was 83.1% [21]. Knowledge levels has been reported in Togo to be 88.7% [19] and in India 97% [22]. Of 206 participants, 98.5% (203) agreed that ART reduces HIV related morbidity, consistent with the study conducted in Nigeria in which 92.5% of the participants agreed that ART reduces HIV related morbidity [21].…”

“…In Kenya for example, one study reported that the prevalence of adherence was 82% [18]. Similarly higher prevalence of ART adherence of 73% and 78.4% have been reported in Togo [19], and India [3] respectively. This disparity of adherence rates across studies may depend on the context where the study is done, the way adherence was measured and study design, which may vary from a study to another.…”

Efeito do álcool em pessoas com HIV: tratamento e qualidade de vida

“…(1) Regarding adherence to pharmacological treatment, it was observed that most patients had adequate adherence to ART, diverging from the previous research. (19)(20)(21) This result may be related to the fact that only 12 individuals in this study were classified as in harmful use of alcohol, probably due to the small number of people.…”