Assessment of Knowledge and Perceptions of the Barriers and Facilitators to HAART Adherence among Individuals with HIV/AIDS in a Tertiary Teaching Hospital in Southern Nigeria

Abstract

Introduction: Adherence to Highly Active Antiretroviral Therapy (HAART) remains a critical challenge in HIV management, particularly in low-resource settings. Despite global advancements, suboptimal adherence persists in Nigeria, undermining treatment efficacy and increasing the risk of drug resistance. This study assessed the knowledge, barriers and facilitators of HAART adherence among patients at Irrua Specialist Teaching Hospital (ISTH), a major HIV treatment centre in Nigeria. The study aimed to evaluate HAART adherence patterns and their determinants. Methodology: A cross-sectional study was conducted among 218 HIV-positive adults receiving HAART at ISTH, selected via systematic sampling. Data were collected using a structured questionnaire covering socio-demographics, knowledge, adherence behaviours, barriers and facilitators. Descriptive statistics, chi-square tests using SPSS version 26. Results/Findings: The majority of respondents (91.7%) understood HAART’s importance, but 17.4% lacked knowledge about managing missed doses. Adherence was suboptimal (<95%) in 19.7% of participants, and prevalence value was seen to be significant across all socio-demographic characteristics as p=0.02 for age, p=0.04 for Gender, p=0.01 for marital status and p =0.03 for level of education. Key facilitators included social support (55%) and willingness to use SMS reminders (82.6%). Conclusion: While awareness of HAART’s importance is high, actionable knowledge gaps and systemic barriers persist. Targeted interventions such as decentralized services, mHealth tools and psychosocial support are urgently needed to improve adherence. These findings align with global adherence strategies but highlight context-specific challenges in Nigeria’s resource-limited setting.