Abstract
BackgroundAntiretroviral (ARV) adherence of ≥ 95% is recommended for suppressing HIV. However, studies have shown that the ≥ 95% recommended level is rarely achieved.ObjectiveThis cross-sectional community-based study sought to assess factors contributing to ARV drug adherence among adults living with HIV or AIDS.SettingThe study was conducted in a rural community in Machakos County, Kenya.MethodsThe questions used for the study were adapted from the Patient Medicine Adherence Questionnaire (PMAQ), a tool grounded in the Health Belief Model. Adherence to ARV was measured using self-reports and pill counts. The perception social support was measured with a 5-point Likert scale, whereas the type and the number of side effects experienced were recorded using ‘yes’ and ‘no’ questions. We used the chi-square test to test associations and binary logistic regression to assess factors explaining dose adherence to ARV.ResultsThe levels of adherence of 86% using self-reports were significantly higher (p < 0.001) than the pill count of 58.6%. The immediate family was rated high in providing social support (3.7 ± 0.6) followed by social support groups (3.1 ± 0.8). A binary logistic regression analysis was conducted to predict ARV adherence (adherent, non-adherent) using social support, side effects and marital status as explanatory variables. The Wald criterion demonstrated that marital status (p = 0.019) and burden of side effects (p ≤ 0.001) made a significant contribution to the prediction of ARV adherence.ConclusionThe burden of side effects and being a divorcee are primary predictors of ARV adherence.
Highlights
Antiretroviral (ARV) adherence of ≥ 95% is recommended for suppressing HIV
Such high levels of adherence have been difficult to achieve among persons living with HIV or AIDS (PLWHA), even in developed countries like United States where the use of antiretroviral therapy (ART) among HIV-infected adults was 85%
The majority (82.5%) used short message service (SMS) to remind them to take their drugs; 1% used watches; 6% were reminded by a family member, whereas 10.5% moved with their dose
Summary
Antiretroviral (ARV) adherence of ≥ 95% is recommended for suppressing HIV. studies have shown that the ≥ 95% recommended level is rarely achieved. Other African studies have reported lower adherence levels These include 70% in Botswana, Tanzania and Uganda7; 62.6% in Togo8; 68% in Kenya[9]; and 25% in South East Nigeria.[10] Studies that have used pill counts came up with much lower levels. These include 67% using pill count at a hospital set-up[11] and between 28.3% and 69.8% using pill count and pharmacy refill methods in the United States.[12] These statistics show that the ideal adherence levels (≥ 95%) were not achieved, and self-reports tended to give higher prevalence levels. This study explores factors contributing to ARV adherence in a rural Kenyan community
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