Nonadherence Factors and Sociodemographic Characteristics of HIV-Infected Adults Receiving Antiretroviral Therapy in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
Adherence to treatment instructions with antiretroviral therapy (ART) is very crucial for successful treatment outcome. However, sticking to treatment instructions pose-great challenges to HIV/AIDS patients. This cross-sectional study was on HIV infected adults attending ART clinic in Nigeria to explore nonadherence factors in relation to their socioeconomic characteristics. Validated structured questionnaire was administered to 221 participants. Results showed a high nonadherence rate of 85.1%. The commonest occurring factors of non-adherence were forgetfulness (53.8%), busy schedule (38.8%), side effects of drugs (31.9%), and stigma (31.9%). Males were more likely to complain from busy schedule, feeling healthy, fear of partner disclosure, long waiting period, and long term regimen. Patients with no formal education were more likely to attribute non-adherence to poor communication, side effects of drugs, and stigma. Employed patients seemed to miss their drugs more than the unemployed and artisans. The high non-adherence rate has serious implications for the control of HIV in infected individuals and management of HIV in general. Nurses should intensify efforts on patient education and counseling. 1. Introduction HIV/AIDS is one of the major public-health problems worldwide, affecting mostly people who are at the most productive stage of life. Out of the estimated 34 million people living with HIV/AIDS globally as at the end of 2010, 68% reside in Sub-Saharan Africa [1]. Nigeria has an HIV prevalence of 4.1% and currently an estimated 3.6 million people are living with HIV/AIDS [2] which puts Nigeria as the second country with the largest number of people living with HIV (PLWH) after South Africa. The development and availability of antiretroviral therapy (ART) became a turning point in the control and prevention of the epidemic. With the success of ART in improving the quality of life of PLWH and reducing morbidity and mortality, HIV has become a chronic manageable disease [3]. Studies have shown a correlation between higher levels of adherence and improved virological and clinical outcomes [4, 5]. However, ensuring that PLWH receive, and adheres to their highly active ART poses a challenge to the treatment efficacy [6]. In Nigeria ART was commenced (i.e., combining at least 3 drugs from various classes of ART into a cocktail that produces a dramatic reduction in viral load and allows immune suppression) in 2002 and coverage stood at 359,181 in 2010 [2]. Adherence to ART according to Carter [7] refers to timely intake of the right dose of prescribed
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