Abstract
Adherence to antiretroviral therapy is a major predictor of the survival of individuals living with HIV/AIDS. Appropriate use of antiretroviral (ARV’s) has improved the health of many human immunodeficiency virus (HIV) positive individuals. The effectiveness of HIV treatment depends on sustenance of high levels of adherence to ARV; however, ARV regimens are often complicated and can be affected by varying dosing schedules, failing to have proper dietary requirements and patients developing adverse effects. The objective of this study was to determine therapy and health system related factors influencing adherence to Anti-retroviral drugs among adult HIV/ AIDS patients in Embu County Teaching and Referral Hospital Comprehensive Care Clinic. The study applied cross sectional descriptive design with stratified random sampling used to obtain relative proportion of male and female adult respondents in the sample population. 332 HIV positive patients were chosen from a total of 1694 patients who were active in ART for more than one year. A semi-structured interview schedules was used to obtain patients view on various dimension or ART services at the facility. ART adherence was at 48.2%. There was significant association between adherence to ART treatment and the type of drug a respondent was in with AZT, ddl, NFV having the highest proportion of sub-optimal adherence to treatment while respondents on D4T, 3TC, NVP had the lowest proportion of sub-optimal adherence to treatment. Convenience of the facilities for people with chronic ailments and waiting time at the facilities were reported to be good (73.0%) and excellent (75.3%) respectively.
Highlights
More than 1.5 million people were infected with human immunodeficiency virus (HIV) in Kenya by the year 2005 but in the year 2012, 1.6 million people were living with HIV with a prevalence rate of 6.1% [1, 2]
In the Kenya Aids Strategic Framework 2014/2015 – 2018/2019, Kenya aims at reducing new HIV infections by 75% and reduce AIDS related mortality by 25% in the five years [3]
Similar findings were made among HIV patients attending Moi Teaching and Referral Hospital where it was reported that the overall adherence levels based on timing of taking ARVs was low for all respondents 43.2%, clearly indicated that there were serious barriers to adherence [11]
Summary
More than 1.5 million people were infected with HIV in Kenya by the year 2005 but in the year 2012, 1.6 million people were living with HIV with a prevalence rate of 6.1% [1, 2]. Kenyan new HIV infections are estimated to have stabilized at an average of 89,000 among adults and about 11,000 among children annually. Progress has been made with HIV prevalence dropping from 10.5% in 1996 to 6.1% in 2012 HIV continues to contribute the highest mortality rates, increase households burden and straining national health systems [2]. In the Kenya Aids Strategic Framework 2014/2015 – 2018/2019, Kenya aims at reducing new HIV infections by 75% and reduce AIDS related mortality by 25% in the five years [3]. Kenya’s Vision 2030 aims at achieving comprehensive HIV prevention, treatment and care
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