Factors influencing antiretroviral therapy adherence in adult HIV positive patients attending Kendu sub county hospital, Kenya

Abstract

Adherence to ART is a patient's ability take the prescribed medication and advises accordingly. Factors influencing adherence vary across different settings. Sustaining adherence presents a significant challenge at Kendu sub county hospital as evidenced by the defaulters’ rate (3 in 10) and high viral load (5 in 10) patients on ART treatment. This study determined factors influencing ART adherence in adult patients on care at Kendu sub-county hospital. The study determined the influence of patient, medication and patient-health provider relationship factors on ART adherence among the patients. Using a cross sectional study, a sample of 316 patients aged ≥18 years were systemically selected from a population of 1013 HIV patients on care. Self administered questionnaires were used to collect data on patient, clinical and patient-provider relationship factors. Secondary data on eligible respondents was obtained from hospital records. Data on demographic features was descriptively analyzed. Binary logistic regression analyzed influence of study factors on ART adherence. Patient factors [distance (CI= -.1080, -.049; OR= -.078; P = .000), stigma and denial (CI= -.160, -.089; OR= -.124; P= .000) and literacy level (CI=-.202, -.081; OR= -.141; p= .000)] were statistically significant at P<0.05. Medication factors [side effects (CI= -.207, -.072; OR= -.139; P= .000), adverse drug reactions (CI= .185, .294; OR= .239; P= .000), dose complexity (CI= -.197, -.153; OR= -.175; P= .000) and pill burden (CI= -.166, -.043; OR= -.104; P = .001)] were statistically significant at P<0.05. Patient-provider factors [effective communication (CI= -.132, -.074; OR= -.103; p= .000), health provider’s personality and attitude (CI= -.255, -.178; OR= -.216; P= .000), professionalism (CI= -.188, - .122; OR= -.155; P= .000), and timeliness (CI= -.406, -.270; OR= -.338; P= .000)] were statistically significant at P<0.05. Factors that influence adherence should be exploited further to improve patients’ adherence. These findings will inform strategies on improving adherence in the effort towards health management in HIV positive patients.