Prevalence and Predictors of Non-Adherence to Anti-Retroviral Drug Treatment in a Tertiary Institution in Rivers State https://doi.org/10.60787/NMJ-64-1-279

Abstract

Background: Advances in the drug treatment of Human Immune-deficiency Syndrome have led to improved prognosis. This pleasant outcome depends on strict adherence to treatment. With variations in service delivery between regions and healthcare facilities, it is important to have recent estimates of adherence. This study measured the prevalence, pattern, and predictors of non-adherence in a tertiary institution in Rivers State.

Methodology: An institutional-based cross-sectional study was conducted on 398 adult HIV patients who had been on ART for at least six months between September and December 2021 during routine clinic appointments at the University of Port Harcourt Teaching Hospital. Study participants were selected using stratified random sampling and interviewed using structured interviewer-administered questionnaires. Non-adherence was defined as missing more than one day’s dose over the past 30 days. Multivariable logistic regression was used in determining which independent variables predicted non-adherence. Statistical significance was measured using the odds ratio at a 95% confidence level and a 5% level of significance.

Results: The mean age was 42.9±10.4 years with 298 (74.9%) females. The prevalence of non-adherence to ART was 15.3% (n=61). Being female (AOR 3.09, 95%CI 1.30-7.39, P=0.011); mild anxiety (AOR 2.09, 95%CI 1.02-4.27, P=0.043); sleeping often away from home (AOR 1.80, 95%CI 1.02-3.17, P=0.043); smoking (AOR 6.239, 95%CI 1.73-22.56, P=0.005); and use of alcohol (AOR 2.21, 95%CI 1.07-4.54, P=0.032) where positive predictors of non-adherence. While the use of medication reminders (AOR 0.340, 95%CI 0.16-0.74, P=0.007); and increasing age (AOR 0.95, 95%CI 0.92-0.99, P=0.011) negatively predicted non-adherence.

Conclusion: The prevalence of non-adherence to ART in a tertiary institution in Rivers State was high. Being female, mild anxiety, sleeping away from home, smoking, and alcohol use were positive predictors of non-adherence while increasing age and using medication reminders were protective.