Factors that constrain adherence to antiretroviral therapy among HIV positive patients in the Sekondi-Takoradi Metropolis
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Date
2015-07-02
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Abstract
Background: The lack of adherence to antiretroviral therapy (ART) is a major
challenge to HIV care and has serious public health implications as it can accelerate
the emergence of drug resistant strains of HIV. As Ghana scales up access to ART in
all health facilities, there is the need to estimate the level of adherence and
understand the factors that prevent adherence in order to design appropriate
interventions.
Method: A total of 426 HIV positive adult patients on ART were interviewed using
structured questionnaire. Adherence rate was estimated using the patient self-report
assessment of adherence. Data was analysed using SPSS for frequencies, cross-tabulations and Chi-Square tests using a statistical significance set at p<0.05.
Variables found to be statistically significant under univariate analysis were
subjected to multivariate logistic regression analysis. Odds ratio (OR) and its 95%
confidence interval (CI) were computed.
Results: The optimal adherence level was 67%. Thirty seven percent (37%) of the
respondents had missed at least one clinic appointment in the last six months. Three
variables remained significant using logistic regression. These included forgetfulness
(Adjusted OR=5.76; 3.89-8.59) being away from home (Adjusted OR=5.49; 3.76-8.02) and missing clinic appointment (Adjusted OR=1.78; 1.65-1.91).
Conclusion: Patients who miss clinic appointment should be monitored, the reasons
behind the missed appointment investigated and appropriate support given. Patients
who miss a dose because of forgetfulness should be educated on the use of prompters
such as mobile phone alarm and text messages. Patients should also be encouraged to
carry their ARVs on them when they are away from home.
Description
A thesis submitted to the Department of Health
Promotion and Education, College of Health Sciences,
School of Public Health, in partial fulfilment of
requirements for the degree of Master of Public Health
in Health Promotion and Education.