Abstract
IntroductionAdherence is vital to effective antiretroviral therapy (ART) for reducing viral load and HIV/AIDS-related morbidity and mortality. This study was aimed at evaluating the adherence of HIV seropositive patients to ART in a tertiary institution in Nigeria.MethodsA cross sectional observational study was conducted among 400 HIV seropositive patients. The study was carried out between December 2016 and February 2017 at the HIV clinic of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.ResultsThe mean age of the HIV patients was 42.2±9.5 years with a predominant female gender (Male:Female = 1:2.8). The median CD4 counts increased from 302.1±15.0cells/mm3 at diagnosis to 430.8±13.3cells/mm3 at the time of the study. Majority of participants were unaware of their spouses' HIV status (59.3%) while 32.5% of participants had a serodiscordant spouse. Poverty was a major challenge as 73.3% earned less than 140 dollars per month. Depressive symptoms, anxiety disorder and insomnia were also reported in 40.7%, 33.2% and 47.2% respectively. Poor adherence to ART was observed in almost 20% of the patients. Logistic regression indicated that predictors of poor adherence were depression, anxiety and low CD4 counts.ConclusionAdherence to anti-retroviral therapy was good amongst the majority of HIV seropositive patients. Depression, anxiety disorder and low CD4 count were however associated with poor adherence. This emphasizes the role of the psychology units as integral part of the HIV clinic to assist patients' adherence to anti-retroviral regimens.
Highlights
HIV remains a major pandemic that has claimed more than 35 million lives over the last three decades [1]
Achieving the UNAIDS 90-90-90 targets (90% of all people living with HIV will know their HIV status, 90% of those people will be on Antiretroviral therapy (ART) and 90% of them will be virally suppressed) issues of adherence to ART and viral suppression need to be given more attention [10]
Drug adherence is a major challenge to effective ART patient management and the development of ART adherence intervention research is crucial for effective HIV management with the aim of achieving the 90-90-90 goal of the UNAIDS/WHO [7]
Summary
HIV remains a major pandemic that has claimed more than 35 million lives over the last three decades [1]. Nearly 40 million people are living with the disease, with a decline in the annual death from AIDS-related causes by nearly half in the past ten years, but this is still higher than the proposed UN target of 500,000 deaths in 2020 [3]. Drug adherence is the key factor in disease control, as ART adherence of ≥95.0% can achieve suppression of viral load to undetectable levels, improve immune system function and reduce AIDS-related morbidity and mortality [8, 9]. Drug adherence is a major challenge to effective ART patient management and the development of ART adherence intervention research is crucial for effective HIV management with the aim of achieving the 90-90-90 goal of the UNAIDS/WHO [7].
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