Survey of antiretroviral therapy adherence and predictors of poor adherence among HIV patients in a tertiary institution in Nigeria

Abstract

Introduction: adherence is vital to effective antiretroviral therapy (ART) for reducing viral load and HIV/AIDS-related morbidity and mortality. This study was aimed at evaluating the adherence of HIV seropositive patients to ART in a tertiary institution in Nigeria. Methods: a cross sectional observational study was conducted among 400 HIV seropositive patients. The study was carried out between December 2016 and February 2017 at the HIV clinic of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Results: the mean age of the HIV patients was 42.2±9.5 years with a predominant female gender (Male: Female= 1:2.8). The median CD4 counts increased from 302.1±15.0cells/mm³ at diagnosis to 430.8±13.3cells/mm³ at the time of the study. Majority of participants were unaware of their spouses' HIV status (59.3%) while 32.5% of participants had a serodiscordant spouse. Poverty was a major challenge as 73.3% earned less than 140 dollars per month. Depressive symptoms, anxiety disorder and insomnia were also reported in 40.7%, 33.2% and 47.2% respectively. Poor adherence to ART was observed in almost 20% of the patients. Logistic regression indicated that predictors of poor adherence were depression, anxiety and low CD4 counts. Conclusion: adherence to anti-retroviral therapy was good amongst the majority of HIV seropositive patients. Depression, anxiety disorder and low CD4 count were however associated with poor adherence. This emphasizes the role of the psychology units as integral part of the HIV clinic to assist patients' adherence to anti-retroviral regimens.