Prevalence and Factors Associated with Non-adherence to Anti-Retroviral Therapy among Adult HIV Patients in the Catchment Ruhango Provincial Hospital
DOI:
https://doi.org/10.53573/rhimrj.2024.v11n8.002Keywords:
Prevalence, Non-adherence, Antiretroviral Therapy, Adult HIV Patients, Factors Associated, RwandaAbstract
Background: Antiretroviral Therapy (ART) significantly improves health and prolongs the lives of individuals living with HIV. However, maintaining optimal adherence to ART remains a critical challenge. This study aims to investigate the incidence and contributing factors of non-adherence to ART among HIV patients at Ruhango Provincial Hospital in Rwanda. Methods: This cross-sectional study utilized a quantitative approach, conducted from January 2 to March 30, 2024. A total of 414 respondents participated, comprising 273 females (65.9%) and 141 males (34.1%). The mean age was 39.17 years (SD = 10.9), with age groups as follows: under 30 (18.6%), 30-39 (37.2%), 40-49 (26.8%), and 50 and above (17.4%). Marital status varied, with 263 (63.5%) married. Educational attainment was predominantly primary level (96.4%). Results: Out of the respondents, 334 (81%) were adherent to ART, while 80 (19%) exhibited non-adherence, defined as less than 90% adherence. Notably, individuals aged 30 to 39 (OR = 0.341, p = 0.014) and 40 to 49 (OR = 0.370, p = 0.030) were less likely to be non-adherent compared to those aged 50 and above. Additionally, those with lower perceived threat regarding HIV were also less likely to be non-adherent (OR = 0.510, p = 0.030). Conclusion: The prevalence of non-adherence to ART in Ruhango District Hospital is 19%. To improve adherence, tailored education addressing misconceptions about ART is essential, particularly for older patients. Future qualitative studies could further elucidate the personal experiences and barriers affecting adherence.
References
S. Nsanzimana et al., “HIV incidence and prevalence among adults aged 15-64 years in Rwanda: Results from the Rwanda Population-based HIV Impact Assessment (RPHIA) and District-level Modeling, 2019,” Int. J. Infect. Dis., vol. 116, pp. 245–254, Mar. 2022, doi: 10.1016/j.ijid.2022.01.032.
Ministry of Health, “Health Sector Annual Performance Report 2020-2021,” Minist. Health, p. 150, 2023.
N. E. Thomford, D. Mhandire, C. Dandara, and G. B. Kyei, “Promoting Undetectable Equals Untransmittable in Sub-Saharan Africa: Implication for Clinical Practice and ART Adherence,” Int. J. Environ. Res. Public. Health, vol. 17, no. 17, p. 6163, Aug. 2020, doi: 10.3390/ijerph17176163.
R. A. Atinga, L. Yarney, and N. M. Gavu, “Factors influencing long-term medication non-adherence among diabetes and hypertensive patients in Ghana: A qualitative investigation,” PLOS ONE, vol. 13, no. 3, p. e0193995, Mar. 2018, doi: 10.1371/journal.pone.0193995.
A. Buh, R. Deonandan, J. Gomes, A. Krentel, O. Oladimeji, and S. Yaya, “Adherence barriers and interventions to improve ART adherence in Sub-Saharan African countries: A systematic review protocol,” PLOS ONE, vol. 17, no. 6, p. e0269252, Jun. 2022, doi: 10.1371/journal.pone.0269252.
D. Ntabanganyimana, L. Rugema, J. Omolo, O. Nsekuye, and S. S. Malamba, “Incidence and factors associated with being lost to follow-up among people living with HIV and receiving antiretroviral therapy in Nyarugenge the central business district of Kigali city, Rwanda,” PLOS ONE, vol. 17, no. 10, p. e0275954, Oct. 2022, doi: 10.1371/journal.pone.0275954.
R. D. C. A. Soares, A. M. D. Brito, K. Lima, and T. M. Lapa, “Adherence to antiretroviral therapy among people living with HIV/AIDS in northeastern Brazil: a cross-sectional study,” Sao Paulo Med. J., vol. 137, no. 6, pp. 479–485, Dec. 2019, doi: 10.1590/1516-3180.2019.0212170919.
H. S. Jones et al., “Association between HIV stigma and antiretroviral therapy adherence among adults living with HIV: baseline findings from the HPTN 071 (PopART) trial in Zambia and South Africa,” Trop. Med. Int. Health, vol. 25, no. 10, pp. 1246–1260, Oct. 2020, doi: 10.1111/tmi.13473.
N. Adrawa, J. B. Alege, and J. Izudi, “Alcohol consumption increases non-adherence to ART among people living with HIV enrolled to the community-based care model in rural northern Uganda,” PLOS ONE, vol. 15, no. 11, p. e0242801, Nov. 2020, doi: 10.1371/journal.pone.0242801.
M. Raberahona et al., “Knowledge, attitudes, perception and practices regarding antiretroviral therapy among HIV-infected adults in Antananarivo, Madagascar: a cross-sectional survey,” BMC Health Serv. Res., vol. 19, no. 1, p. 341, Dec. 2019, doi: 10.1186/s12913-019-4173-3.
L. Chirambo, M. Valeta, T. M. Banda Kamanga, and A. L. Nyondo-Mipando, “Factors influencing adherence to antiretroviral treatment among adults accessing care from private health facilities in Malawi,” BMC Public Health, vol. 19, no. 1, p. 1382, Dec. 2019, doi: 10.1186/s12889-019-7768-z.
