Factors associated with adherence to anti-retroviral therapy among adult males living with hiv in Lira Regional Referral Hospital, Lira City, Northern Uganda.  A cross-sectional study.

Lucy  Alobo; Derick  Modi; Bosco Opio

doi:10.51168/sjhrafrica.v6i12.2206

Authors

Lucy Alobo Department of Environmental Health and Disease Control, Faculty of Public Health, Lira University, P.O. Box 1035, Lira-Uganda.
Derick Modi Department of Community Health, Faculty of Public Health, Lira University, P.O. Box 1035, Lira-Uganda.
Bosco Opio Department of Epidemiology and Biostatistics, Faculty of Public Health, Lira University, P.O. Box 1035, Lira-Uganda.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2206

Keywords:

Adherence, Antiretroviral therapy, Lira Regional Referral Hospital, Lira City

Abstract

Background

The use of anti-retroviral therapy (ART) in the management and prevention of HIV/AIDS. This study aims to assess the level of adherence and factors associated with adherence to ART among Adult males living with HIV in Lira Regional Referral Hospital.

Methodology

A cross-sectional study that assessed self-reported treatment adherence among adult males living with HIV who are accessing drugs for the treatment from LRH. Random sampling was employed to select 380 participants, and data were collected using a questionnaire and entered into SPSS software for analysis.

Results

341 respondents were included, 58.7% aged between 18 and 30 years, 24% were in the range of 31-45 years, 17.0% between 46 and 60 years, and a mere 0.3% aged 61years and above. Non-adherence to ART was perceived to result from individual factors such as forgetfulness, alcohol abuse, disclosure, knowledge about HIV and its treatment, among others, and health system-related factors such as distance to the health facility, waiting time at the facility, relationship with the healthcare provider, and privacy, among others. Most respondents (49.9%) take one pill daily, with 31.7% taking two pills, 18.2% taking more than two, and 0.3% not taking any pills. Weekly adherence data showed that 39.0% never miss a dose, while others miss one (23.5%), two (20.5%), or more than two doses (17.0%) per week. This results in 43.1% of respondents having good weekly adherence and 56.9% having poor adherence. Monthly adherence reveals that 37.5% never miss a dose, but 4.1% miss one dose, 15.5% miss two doses, and 42.8% miss more than two doses, leading to 46.9% good adherence and 53.1% poor adherence monthly.

Conclusion

Non-adherence to ART was attributed to 48 various factors, such as alcohol consumption, forgetfulness, and stigma.

Recommendation

Healthcare providers should minimize waiting times in healthcare facilities to improve adherence.

Author Biographies

Lucy Alobo, Department of Environmental Health and Disease Control, Faculty of Public Health, Lira University, P.O. Box 1035, Lira-Uganda.

is a public Health officer and WASH specialist from Lira University.

Derick Modi, Department of Community Health, Faculty of Public Health, Lira University, P.O. Box 1035, Lira-Uganda.

is a Monitoring and Evaluation (M&E) Officer from the Uganda Management Institute, a Public Health specialist expert from Lira University, and a course facilitator at Ristal University, Juba, South Sudan.

Bosco Opio, Department of Epidemiology and Biostatistics, Faculty of Public Health, Lira University, P.O. Box 1035, Lira-Uganda.

is a senior lecturer from Lira University.

References

Anuradha, S., Rajeshwari, K., Dewan, R., & et al. (2013). Factors influencing adherence to ART: New insights from a centre providing free ART under the national Programme in Delhi, India. Journal of the International Association of Providers of AIDS Care, 12(1), 46-53. https://doi.org/10.1177/1545109711431344

Mengistu, Z., Berhane, Y., & Worku, A. (2012). Adherence to antiretroviral therapy and its associated factors among people living with HIV/AIDS in Addis Ababa, Ethiopia. Journal of the International Association of Physicians in AIDS Care (JIAPAC), 11(1), 20-26. https://doi.org/10.1177/1545109712438286

Letta, S., Demissie, A., Oljira, L., & Dessie, Y. (2015). Factors associated with adherence to Antiretroviral Therapy (ART) among adult people living with HIV and attending their clinical care, Eastern Ethiopia. BMC International Health and Human Rights, 15, 33. https://doi.org/10.1186/s12914-015-0071-x

Legesse, T. A., & Reta, M. (2019). Adherence to antiretroviral therapy and associated factors among people living with HIV/AIDS in Harar Town and its surroundings, North-Eastern Ethiopia. Ethiopian Journal of Health Sciences, 29(3), 299-308. https://doi.org/10.4314/ejhs.v29i3.2

Dorcélus, L., Bernard, J., Georgery, C., & Vanessa, C. (2021). Factors associated with antiretroviral therapy adherence among people living with HIV in Haiti: A cross-sectional study. AIDS Research and Therapy, 18, 81. https://doi.org/10.1186/s12981-021-00405-4

Buh, A., Domegan, C., & et al. (2023). Prevalence and factors associated with HIV treatment non-adherence among people living with HIV in three regions of Cameroon: A cross-sectional study. PLOS ONE, 18(4), e0283991. https://doi.org/10.1371/journal.pone.0283991

Note: This study states: “From the start of the epidemic to the end of 2021, 84.2 million (64.0-113.0 million) people have been infected with HIV and about 40.1 million (33.6-48.6 million) people have died of HIV.”

Adrawa, N., Alege, J. B., & Izudi, J. (2020). Alcohol consumption increases non-adherence to ART among people living with HIV enrolled in the community-based care model in rural northern Uganda. PLOS ONE, 15(11), e0242801. https://doi.org/10.1371/journal.pone.0242801

This gives the figure: “the East and Southern African region where 20.7 (54.0%) million people were living with HIV by the end of 2019.”

Nabunya, P., et al. (2020). The role of family factors in antiretroviral therapy (ART) adherence self-efficacy among HIV-infected adolescents in southern Uganda. BMC Public Health, 20, 340. https://doi.org/10.1186/s12889-020-8361-1

Ministry of Health (Uganda), & ICAP at Columbia University. (2022, August). Uganda Population-based HIV Impact Assessment (UPHIA) 2020-2021: Summary Sheet. Kampala, Uganda. Retrieved from https://phia.icap.columbia.edu/wp-content/uploads/2022/08/UPHIA-Summary-Sheet-2020.pdf

Parker, E., et al. (2021). HIV infection in Eastern and Southern Africa has the highest burden, the largest challenges, and the greatest potential. [Journal/Source]. Retrieved from https://www.ncbi.nlm.nih.gov/articles/PMC8182467/Twekambe, E., Epuitai, J., Kawala, E. K., Namanya, V., Ayikobua, E. T., Obakiro, S. B., Napyo, A., & Kiyimba, K. (2023). A qualitative exploration of the psychosocial factors affecting antiretroviral therapy adherence among HIV infected young adults in Eastern Uganda (p. 2023.02.04.23285423). medRxiv. https://doi.org/10.1101/2023.02.04.23285423