Assessment of ART knowledge and adherence to ARVs among PLWHA accessing care in two Nigerian Military HIV/AIDS Treatment sites

  • David Ufuoma Adje Delta State University, Abraka, Nigeria http://orcid.org/0000-0002-4196-2703
  • Felicia Esemekiphorar Williams Dept. of Clinical pharmacy and pharmacy practice, University of Ilorin, Nigeria
  • Chukwuka Nicholas Bezugbe Naval Hospital, Lagos
  • Dauda Audi Dangiwa Dept. of Clinical Pharmacy and Pharmacy Practice, University of Jos, Jos, Nigeria
Keywords: Adherence, antiretroviral medicines, Antiretroviral therapy, Knowledge, Nigeria, HIV

Abstract

Background:       Adherence to Highly Active Antiretroviral Therapy (HAART) is critical in achieving treatment goals, avoiding antimicrobial resistance, preventing treatment failure and improving the patient’s quality of life.

Objectives: To assess the knowledge of antiretroviral therapy (ART) and adherence to antiretroviral (ARVs) medicines amongst People Living With HIV/AIDS (PLWHA) accessing care in two Nigerian Military HIV/AIDS Treatment sites.

Methods: Four hundred patients on HAART who visited the study sites during the study period were recruited for the study using systematic random sampling method. A semi-structured, pretested, interviewer-administered questionnaire was used to obtain demographic details. Patients’ knowledge of HIV was assessed using an 8-item questionnaire while adherence was measured using the Simplified Medication Adherence Questionnaire (SMAQ).

Results: The predominant age group was 31-40 years (46.4%). There were more females (69%) than males (31%). Only 45.5% answered knowledge questions correctly. The adherence level in this study was 64.0%. The major reasons cited for non-adherence included being away from home (23.6%), forgetfulness (17.1%), busy schedule (14%), need to conceal medication (12.7%) and feeling better (11.6%).

Conclusion: Patients’ knowledge of ART and adherence to ARVs medicines were sub-optimal. Appropriate strategies to improve patients’ knowledge of ART and adherence to ARVs are recommended.

Author Biography

David Ufuoma Adje, Delta State University, Abraka, Nigeria

ASSOCIATE DEAN

References

1. UNAIDS. Fact sheet – Latest global and regional statistics on the status of the AIDS epidemics. [online] Available at:
http://www.unaids.org/en/resources/documents/2017/UNAIDS_FactSheet. [Accessed 26/1/2018].
2. UNAIDS. Country Factsheets: Nigeria. Available at:
http://www.unaids.org/en/regionscountries/countries/nigeria. [Accessed 27/1/2018].
3. Federal Ministry of Health Nigeria Integrated National Guidelines for HIV Prevention, Treatment and Care in Nigeria. Available at http://www.hivpolicywatch.org/duremaps/data/guidelines/NigeriaARTguidelines2014.pdf. [Accessed 16/3/15].
4. World Health Organization. Guidance on operation and service delivery: adherence to ART. Available at: http://www.who.int/hiv/pub/guidelines/arv2013/operational/adherence/en/. [Accessed 27/1/2108].
5. Federal Ministry of Health, Nigeria: Guidelines for the use of Antiretroviral (ARV) Drugs in Nigeria 2005: 19 – 49.
6. Obodozie OO. Pharmaceutical care in HIV/AIDS. In: Obiorah B.A., Johnson E.R and Agu K.A (Eds) GHAIN project skill certification workshop on HIV/AIDS, sexually transmitted infections and opportunistic infections for community pharmacists. Participants manual. Howard University Continuing Education. The Pace Center in collaboration with National Institute for Pharmaceutical Research and Development. Mindex Publishing Co Ltd, Benin City 2006:237-248.
7. Haynes RB, McDonald HP, Garg AX. Helping patients follow prescribed treatment: clinical applications. JAMA 2002; 288(22): 2880-2883.
8. Jackevicius CA, Mamdani M, Tu JV. Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA 2002; 288:462-467.
9. Adewuya AO, Afolabi MO, Ola BA, Ogundele OA, Ajibare AO, Oladipo BF, et al. The effect of psychological distress on medication adherence in person with HIV infection in Nigeria. Psychosomatics. 2010; 51(1): 68-73.
10. Monjok E, Smensy A, Okokon IB, Mqbere O, Essien EJ. Adherence to antiretroviral therapy in Nigeria: an overview of research studies and implications for policy and practice. HIV/AIDS (Auckl) 2010; 2: 69-76.
11. Simoni JM, Amico KR, Pearson CR, Malow R. Strategies for promoting adherence to antiretroviral therapy: A review of literature. Curr Infect Dis Rep 2008; 10(6): 515-521.
12. Enriquez M, MCKinsey DS. Strategies to improve HIV treatment adherence in developed countries: clinical management at the individual level. HIV/AIDS (Auckl) 2011; 3: 45-51.
13. Scanlon ML, Vreeman RC. Current strategies for improving access and adherence to antiretroviral therapies in resource limited settings. HIV/AIDS (Auckl) 2013; 5: 1-17.
14. Federal Ministry of Health, Nigeria. Guidelines for the use of Antiretroviral (ARV) Drugs in Nigeria. Abuja: Federal Ministry of Health. 2010.
15. The University of Florida. Determining sample size. Available at: https://www.tarleton.edu/academicassessment/documents/Samplesize.pdf. [Accessed 13/2/2018].
16. Knobel H, Alonso J, Casado J L, Collazaos J, Gonzalez J, and Ruiz I, Kindelan JM, Carmona A, Juega J. Ocampo A. GEEMA study group- Validation of a simplified medication adherence questionnaire in a large cohort of HIV- infected patients: the GEEMA study. AIDS 2002; 16(4): 605-613.
17. IBM Corp. IBM SPSS Statistics for windows, Version 21.0.Armonk.NY; IBM Corp; ??? Year.
18. Oyore JP, Mwanzo IJ, Orago AS, Odhiambo-Otieno GW Determinants of adherence to antiretroviral therapy (ART) among patients attending public and private health facilities in Nairobi, Kenya. J AIDS HIV Res 2013; 5(3): 70-74.
19. Yao P, Kpatcha T, Agnon B, Vincent PP, Innocent PG, Etienne KK. Knowledge and adherence to antiretroviral therapy amongst adult people living with HIV/AIDS treated in the health care centers of the association” Espoir Vie Togo” in Togo, West Africa. BMC Clin Pharmacol 2010; 10: 11.
20. Williams FE, Awoyemi AO, Parakoyi DB, Jolayemi ET, Akande TM. Medicine use among HIV/AIDS patients in public hospitals, Kwara State. Nig J Pharm Res 2017; 13(1): 53-64.
21. Iliyasu I, Kabir M, Abubakar I, Babashani M, Zubair Z. Compliance to antiretroviral therapy among AIDS patients in Amino Kano Teaching Hospital Kano. Niger J Med 2005; 14(3): 290-294.
22. Oku AO, Owoaje ET, Ige OK, Oyo-ita A. Prevalence and determinants of adherence to HAART amongst PLHIV in a tertiary health facility in south-south Nigeria. BMC Infect Dis 2013; 13: 401.
23. Bello SI. HIV/AIDS Patients’ Adherence to Antiretroviral therapy in Sobi Specialist Hospital, Ilorin, Nigeria. Global J Med Res 2011; XI (2): 16-21.
24. Olowookere SA, Fatiregun AA, Akinyemi JO, Bamgboye A. Prevalence and determinants of non- adherence to highly active antiretroviral therapy among people living with HIV/AIDS in Ibadan, Nigeria. J Infect. Dev Ctries 2008; 2(5): 369-372.
25. Agu KA,Okojie O, Oqua D, King RC, Omonaiye O, Onuoha C. Medication Adherence and Risk factors for non-adherence among patients taking Highly Active Antiretroviral Therapy. West Afr J Pharm 2011; 22(1): 19-26.
26. Amberbir A, Woldemichael K, Getachew S, Girma B, Deribe K. Predictors of adherence to antiretroviral therapy among HIV-infected persons: a prospective study in Southwest Ethiopia. BMC Public Health 2008; 8(265): 1-10.
27. Wakibi SN, Nga’ng’a ZW, Mbugua GG. Factors associated with non-adherence to highly active antiretroviral therapy in Nairobi, Kenya. AIDS Res Ther 2011; 43: 1-8.
28. Talaam NC, Gatongi P, Rotich S. Factors affecting antiretroviral Drug Adherence among HIV/AIDS Adult Patients attending HIV/AIDS clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya. East Afr J Public Health 2008; 5(2): 74-78.
29. Kleeberger C, Phair J, Strathdee S, Detels R, Kingsley L, Jacobson L. Determinants of heterogeneous adherence to HIV antiretroviral therapies in the multicenter AIDS Cohort Study. J Acquir Immune Defic Syndr 2001; 26(1): 82-92.
30. Uzochukwu B, Onwujekwe O, Onoka A, OkoliC, Uguru N, Chukwuogo O. Determinants of non-adherence to subsidized antiretroviral treatment in Southeast Nigeria. Health Policy Plan 2009; 24: 189-196.
31. Afolabi MO, Ijadunola KT, Fatusi AO. Determinants of adherence to antiretroviral drugs among people living with HIV/AIDS in the Ife-Ijesa of Osun State, Nigeria. Afri J Prim Health Care Fam Med 2009; I (1)1:6
Published
2018-06-17
Section
Original Research