Poor Adherence Predictors and Factors Associated with Antiretroviral Treatment Failure among HIV Seropositive Patients in Western Nigeria

Abstract

Background: The efficiency and success of antiretroviral therapy (ART) depends on a good level of patient’s adherence to a life-long regimen of antiretroviral (ARV) which is beneficial in reducing the risk of emergence of HIV resistant strains. This adherence is however influenced by several factors related mainly to patient and medication. This study is therefore carried out to determine the adherence rate of adult patients infected with HIV and identify the factors associated with antiretroviral therapy (ART) interruption or poor adherence. Methods: This cross sectional study was carried out in Ondo & Ekiti States, South Western Nigeria. The target population was adult patients living with HIV and already initiated on ART. Data was collected by trained volunteers and supervised by appointed supervisors, by a face-to-face interview. All data were statistically analysed, using statistical package for the social sciences (SPSS) and statistical test of significance was performed with Chi-Square test. Results: A total of 412 consenting respondents participated in the study with a mean age ± SD is 37.93 ± 9.30 years. 116 (40.8%) of them are males while 244 (59.2%) are females. ART adherence level was 79.6%. The main factor associated with ART adherence was educational status (χ² = 16.18, df = 3, P = 0.001). Drug reminder strategy have lower association with missing ART drug (OR: 0.51, 95% CI: 0.28 – 0.92) while patients experiencing ART drug side effect have higher association with missing ART drug (OR: 1.82, 95% CI: 1.01 – 3.28). Conclusion: ART adherence is sub-optimal, with barriers largely patient-dependent thus it is imperative to intensify medication adherence counselling in an holistic behavioural educational improvement strategy aimed at improving the ability to fit therapy into own lifestyle, avoid drug exhaustion, achieve optimal adherence and remarkable patient outcome.