Predictors of adherence to antiretroviral therapy among people living with HIV and AIDS at the Quthing District Hospital and Villa-Maria Health Centre, Lesotho.

Abstract

Background: The introduction of antiretroviral drugs generated much optimism in the survival of people living with HIV. The optimism had been dissipated in the light of enormous challenge being faced by ART patients in maintaining a perfect adherence since successful treatment is dependent on the maintenance of a near perfect adherence. In the context of Lesotho, there is hardly any study done on factors influencing adherence to antiretroviral drugs yet it is widely known that adherence to ART is influenced by numerous factors. These factors could be health system related, patients related and the medication itself. The study, therefore, sought to assess the factors that affect adherence to ART and also, determine the level of adherence to ART among people living with HIV and AIDS at Quthing District Hospital and Villa Maria Health Centre, Lesotho. Method: An analytical cross-sectional study was used to determine the predictors of adherence to ART among PLWHA who had been on ART for not less than three months before the study. The study was conducted among 382 participants between April 2016 and June 2016. Results: A considerable number of participants were found to comply with global adherence using pill count adherence, appointment adherence, and self-report as adherence instruments. Of the 382 participants recruited for this study, the majority (63.6%) were females out of which 156 (40%) of them were married. The majority of the participants were on first line regimen (92.1%) and have been on ART for more than three years 228 (59.7%). The majority of the respondents lived in urban areas 296 (77.5%) and had formal education 343 (89.8%). The results of the study indicated global adherence to be 85.1%. The bivariate analysis showed significant relationships among all the variables. However, when subjected to multivariate analysis, three factors were significantly associated with global adherence to ART. These are: educational level (p<0.000; aOR = 87.9), knowledge of HIV status of sexual partner (p<0.020; aOR = .090), and ART perception (p<0.000; aOR = 0.005). Conclusion: The proportion of adherent participants in this study is sub–optimal, but relatively higher compared to most studies. A lot still needs to be done for the participants in this study especially those living in the rural areas to ensure improvement in the sub-optimal level of adherence obtained in this study. Thus it is important that recommendation such as health education campaigns, psychosocial support and the needs of the patients be utilised to improve adherence.