Comparative level of knowledge on adherence to ART among HIV patients attending Jinja regional referral Hospital.

Otieno Elizabeth Atieno

Faculty of Clinical Medicine and Dentistry Kampala International University Uganda

ABSTRACT

Adherence to antiretroviral therapy among HIV-infected patients contributes to better treatment outcomes and is also important in reducing the development of drug resistance. It also enhances the patient’s quality of life and allows them to live longer and healthier lives. The objective of the study was to determine level of adherence as well as patient factors influencing adherence to antiretroviral therapy among HIV infected patients attending Jinja Regional Referral Hospital, Jinja district. A cross sectional study was conducted Jinja Regional Referral Hospital among HIV infected patients aged 15 years and above who attended ART Clinic. Systematic sampling method was employed to obtain a total of 206 patients. Face to face interviews were conducted using structured questionnaires Data was processed using SPSS software version 25, and Chi-square statistic used to test for association. This study had 206 participants in total, with 58.7% (121) of them being female. 98.1% (202) of the 206 participants showed high knowledge scores on ART adherence. Despite participants’ extensive understanding of ART, there was limited adherence to treatment in the sample of the current study. Participants with poor adherence to ART were those who had not told their sexual partner or families about their HIV sero-status. Additionally, patients who claimed to have gone through stigmatizing incidents were less likely to stick with ART. Therefore, adherence counseling and education should be provided to all patients before initiation of antiretroviral therapy in order to enhance adherence to Antiretroviral Therapy. Interventions to reduce stigma to people living with HIV/AIDS are of importance in increasing adherence to antiretroviral therapy, both at community level and among people living with HIV/AIDS. Keywords: Knowledge, adherence, ART, HIV, patients, Jinja, regional referral Hospital

INTRODUCTION

With over 35 million deaths to date, the human immunodeficiency virus (HIV) infection is one of the deadliest epidemics the world has ever seen. World Health Organization (WHO) African Region is the most afflicted region, with 25.7 million people living with HIV in 2017. In 2017, there were 940 000 deaths worldwide due to HIV-related causes, and there were roughly 36.9 million individuals living with the virus by the end of the year [1]. The African region also accounts for over two thirds of the global total of new HIV infections. Uganda has made tremendous progress in combating the HIV and AIDS epidemic with a decline in the prevalence from 18% in the early 1980s to the current 6.0% according to the Uganda HIV and AIDS country progress report 2017 [2]. Globally, 21.7 million HIV-positive people were getting antiretroviral medication (ART) in 2017. Between 2000 and 2017, this rise in ART coverage resulted in a 36% decrease in new HIV infections, a 38% decrease in HIV-related mortality, and a saving of 11.4 million lives thanks to ART [3]. HIV is progressively turning into a chronic, controllable condition with the advent of ART [4]. However, for a treatment to be successful, individuals must adhere to their treatment for the rest of their lives and clinics must have a steady supply of ART [5]. According to [6], non-adherence is the most frequent cause of treatment failure, with a potential for drug resistance due to insufficient viral suppression. The demand for second-line therapy rises as a result of subsequent transmission of first-line ART-resistant HIV strains, which is frequently accompanied by worse patient outcomes and rising healthcare costs [7]. Because of these factors, it is crucial to have a complete grasp of what influences ART compliance [8]. Studies on ART adherence have revealed that predictors and risk variables vary by geographical location [9], prompting the construction of non-adherence profiles that are context-specific. This will make it possible for medical professionals to provide patients who are at risk of non-adherence with care that is specifically customized to their needs. Long distances to medical facilities, the availability and affordability of ARVs, the cost of food and transportation, the quality of life during ARV treatment, the length of wait times at medical facilities, and the congestion at the medical facilities are all factors that contribute to non-adherence in the African context [10]. Implementing programmatic ways can assist address some of these issues, but due to the settings’ constrained resource availability, such efforts might not have the expected results [11]. In the past, a number of programs have been launched to increase adherence. These included ART supply chain management training, HIV prevention training, clinical care training, counseling, community support programs, and the utilization of experienced ART patients (expert clients) who support other patients who are just starting treatment [12]. Maintaining proper ART treatment adherence over time is still a challenge, especially in settings with minimal resources, such sub-Saharan African nations [13]. In Uganda, the absence of organized appointment processes plagues many health facilities that provide ART therapy. Overcrowding has been linked to this issue, particularly when patients arrive early in the hopes of being the first to obtain medical care. The resulting congestion that arises at such healthcare facilities eventually has a negative impact on the quality of services and patients’ satisfaction with the healthcare service [9]. ART adherence and influencing factors in the Jinja district and Jinja Regional Referral Hospital (JRRH) is not known. A study in Kamuli health center IV indicated that; forgetting treatment was the most cited factor [14]. Other factors included, feeling better after some medication period, being too ill to take medication, stigma associated with taking ART medication, alcohol consumption and drug stock out [14]. However, it is known if these factors are the same for JRRH. Therefore, this study seeks to explore the patient factors that influence adherence to ART among HIV-positive patients at Jinja Regional Referral Hospital.

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CITE AS: Otieno Elizabeth Atieno (2023). Comparative level of knowledge on adherence to ART among HIV patients attending Jinja regional referral Hospital. NEWPORT INTERNATIONAL JOURNAL OF SCIENTIFIC AND EXPERIMENTAL SCIENCES (NIJSES)3(3):50-57.

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