Determinants of optimal adherence to antiretroviral therapy among people living with HIV/AIDS registered for antiretroviral therapy in Zimbabwe

Abstract

Background: Successful Antiretroviral therapy (ART) was shown to rely on high levels of medication adherence to enable maximum and durable viral suppression for the prolongation of life among people living with HIV/AIDS.

Objective: The study sought to determine individual and environmental factors that influence optimal adherence to antiretroviral therapy among HIV/AIDS patients registered at Morgester hospital.

Materials and methods: The study was a cross sectional study. Out of 515 registered patients, a sample of 330 HIV/AIDS patients on ART meeting the eligibility criteria was obtained from people seeking services from the Opportunistic Infection (OI) clinic at Morgenster hospital. Adherence was determined using the self-report 9 Item Morisky Medication Adherence Scale (MMAS) with scores ranging from 0 to 13 where a score of 11 corresponds to 95% level dose adherence.

Results: The level of drug adherence (corresponding to 95% dose adherence) was 65% (n=215) among the study participants. Distance from the health institution, medication side effects and adolescence were associated with non-adherence (p = 0.029, p= 0.019 and p= 0.001 respectively). Demographic variables including sex, marital status, employment status and level of education had no association with non-adherence. Access to health education on the benefits and risks of non-adherence, and participation in ART support groups were seen to promote ART adherence among the study participants.

Conclusions: More research and interventions are required focusing on reasons and challenges of nonadherence to ART among adolescent HIV/AIDS patients, especially the social determinants of health surrounding ART adherence.

Keywords: Optimal adherence; antiretroviral therapy (ART); HIV/AIDS