Spirituality and adherence to antiretroviral drugs among HIV positive patients at Federal Medical Center, Keffi, Nigeria

Abstract

Background to the study: Adherence to Antiretroviral Treatment (ART) is a major determinant of successful treatment outcomes among People Living with HIV/AIDS (PLWHA). Poor drug adherence is a major problem in the care of HIV patients on antiretroviral treatment. Spirituality is one of the several factors that affects drug adherence among HIV positive patients. The link between spirituality and drug adherence has been found to differ among several studies. This study aimed to determine the association between spirituality and adherence to antiretroviral drugs among PLWHA at Federal Medical Centre, Keffi to improve treatment outcomes among them.

Method: It was an observational, longitudinal study in which 215 consenting HIV positive patients aged 18 to 65 years who were on antiretroviral drugs were recruited through systematic random sampling technique. Socio-demographic characteristics, clinical history and physical examination findings were documented for each participant. The Functional Assessment of Chronic Illness Therapy- Spirituality (FACIT-Sp) tool was used to determine their level of spirituality. Participants were classified as having high or low spirituality. They were all followed up for three months during which they received routine care at the antiretroviral clinic. At the end of the study period, the level of adherence to antiretroviral drugs was assessed using the Morisky Medication Adherence Scale (MMAS).

Results: Most of the study participants were between 36 and 45 years old. Majority were females, married, Christians and unskilled workers with no formal education who earned less than 20,000 naira per month. Majority (69%) of the study participants also had a high level of spirituality. 46.7% of them had a high level of medication adherence while 27.6%and 26.3% had medium and low adherence respectively. There was a statistically significant association between level of spirituality and adherence to ARVs (χ²: 5.928, p: 0.015). A higher level of spirituality was associated with better levels of medication adherence.

Conclusion: High level of spirituality is a significant predictor of high level of adherence to antiretroviral medications. It is therefore recommended that spirituality should be routinely assessed as part of the initial evaluation of patients being enrolled for antiretroviral treatment.

Keywords: spirituality, adherence, antiretroviral drugs, HIV positive