Factors associated with Adherence to Anti-retroviral therapy among HIV clients, Kadoma city, Zimbabwe 2015

Abstract

Abstract Introduction: Adherence is defined as the extent to which patient follows prescribed health care regimen. Non-adherence is associated with resistance and the risk of resistance is 80-90% with incomplete adherence. A review of the ART registers during one of the ART clinics in Kadoma City showed that 40% of ART clients were not adhering to their medication. Key informant discussions and records showed an increase in the number of patients in adherence classes. Methods: An analytical cross sectional study was carried out using an interviewer administered questionnaire to collect information. Record review was also conducted to verify information that was given by the study participants. Key informant interviews were conducted for more information on the running of the ART program. Patients 18 years and above accessed ART services in Kadoma City for more than 3 months were recruited. Random sampling method was used to select participants as they visited the health facilities for their ARV resupply. Results: A total for 227 HIV clients patients were recruited, 67% were females. The median age of the participants was 37 years (Q1=18; Q3=44) .Use of memory aids was reported by 200 (88%) of the participants. Among the participants 45 (20%) took alcohol and 33 (15%) had experienced stigma. In multivariate analysis paying to travel to the health centre (OR 0.16 95%CI 0.06-0.43) and taking Cotrimoxazole (OR 2.38 95% CI 1.04-5.47) were independent factors associated with ART adherence. Self reported adherence among the participants was 87%. Adherence based on pill count among 80 participants was 65%. Conclusion: The self reported ART adherence was high among the participants but was low using pill count. The findings suggest that taking alcohol and having side effects were barriers to ART adherence. Having memory aide to taking medication enhanced adherence. Paying consultation fee was an independent factors associated with adherence to ART. Key Words: Adherence, ART, HIV, Kadoma City