Adherence to Antiretroviral Therapy among HIV-infected Patients in UBTH, Benin City, Nigeria

Abstract

Background: Evidence from clinical studies has shown that for most HIV positive patients near perfect adherence(> 95%) are required for virological suppression and clinical success. This degree of adherence is far greater than that commonly associated with other chronic diseases and this is quite difficult for most patients to maintain over the course of a lifelong illness. The study was therefore carried out to determine the level of adherence to antiretroviral therapy and to identify predictors of adherence and nonadherence.

Methodology: A descriptive cross-sectional study design was utilized for the study and it was carried out over a period of four months (Oct 2007 to Feb 2008). Systematic sampling was used to select 278 HIV positive patients receiving treatment at PEPFAR clinic, UBTH, Benin City. An interviewer administered questionnaire was used to collect data. Adherence was assessed using patients self-report on the percentage of prescribed doses taken within a one month period. Adherence score of95% was taken as the cut-off point. Data analysis was by SPSS version 15.0, and the level of significance was set at p<0.05.

Results: The level of adherence to antiretroviral chemotherapy was 241 (88.8%). The most common reason for non-adherence to chemotherapy was being busy 88(80.4%) and forgetfulness 88(26.4%), whereas adherence was associated with the duration of treatment.

Conclusion: Adherence level in the study was 88.8%, whereas the optimal adherence required to achieve clinical success is > 95%. This adherence gap remains a source of concern, therefore adherence counseling is strongly recommended.

Keywords: Adherence; antiretroviral therapy; Benin City, Nigeria