Factors that influence non-adherence to antiretroviral therapy among HIV and AIDs patients in central province, Kenya

Abstract

The main objective was to determine factors influencing non-adherence to Antiretroviral therapy among HIV and AIDS patients. This cross sectional study was carried out at PGH Nyeri, Karatina District Hospital Nyeri and Thika District Hospital in Central Province Kenya. Data was collected using structured questionnaire with open and closed type questions where a total of 300 participants were interviewed. Three focus group discussions with 8 members each were conducted. Key informant interviews for health care providers were conducted and a checklist material was used to assess how well health facilities were equipped. Data was presented using charts, graphs and frequency tables. Data was analyzed using SPSS software version 11.50. Results show that the prevalence of non-adherence to ART was 26%. Factors that were significantly associated with non-adherence were age (c2 =12.078, df = 5, p = 0.034), household size c2=12l,df=9,p=0.0001), occupation (c2=87.103,df=7,p=0.0001), lack of food (c2=13.932,df=2,p=0.001), level of education 2 =8.38,df3,p=0.039), co-treatment of HIV and other infections (c2=l2.l93,df--4,p=0.016), ability to follow ART (c2 =5.059,df=l,p=0.024) and stigma (c2=l0.526,df=l,p=0.001). Some respondents believed in spiritual healing and therefore they abandoned ART. From FGDs it was found that transport cost and user fee for other medical services influenced non-adherence to ART. Other respondents preferred traditional medicine and this affected adherence to ART. Lack of appropriate paediatric formulations, unpalatability of some ARV drugs and dependence on caregivers influenced paediatric ART non-adherence. Facilities where the study was carried out were dispensing twice daily ARV regimen to their clients. Health care providers were committed to their work. Patients appreciated the care they received and generally felt better on therapy. It was concluded that the prevalence of nonadherence of 26 % (that is adherence level of 74%), was sub-optimal (less than 95%) but comparable to those in other developing countries. Based on these findings, to enhance ART adherence the study recommends to the government and other stakeholders to develop strategies to ensure food security in households with people living with HIV and AIDS. Intensify health education campaigns against stigma and promote family and community support for people living with HIV and AIDS. Develop adequate and appropriate paediatric ARV drugs formulations that are palatable. Ensure that all public health facilities have a functioning laboratory, adequate personnel and stock of ARV drugs