Antiretroviral Treatment Adherence Among Patients in Selected Health Facilities in East London, South Africa: A Cross-Sectional Study

Abstract

Studies on antiretroviral therapy (ART) adherence reported variations about the predictors and risk factors, which warrant regional and context-specific research on non-adherence profiles. The purpose of this study was to examine the underlying contributing factors to antiretroviral treatment non-adherence among HIV positive patients in selected health facilities. Methods: This was a descriptive cross-sectional study involving 371 HIV positive patients on antiretroviral treatment in six primary health care facilities in East London, South Africa. A self- designed structured questionnaire was the tool for data collection. Result: The majority (70%) of the participants were non-adherents. About 64% of the participants had been counselled before starting ARV treatment (92.2%) so had a good knowledge of HIV. The majority of the participants experienced no side effects. About 55.0% of the participants had a history of non-adherence, with 26.0% non-adherence rate in the previous month and 19.0% recorded in the previous week. Marital status (married) (p=0.005), having no formal education (p=0.035), being Christian (p=0.007), alcohol consumption (p= 0.021) and viral load suppression had significant associations with non-adherence to ARV treatment. After adjusting for confounders, only non-Christians and unsuppressed viral loads were the independent predictors of non-adherence. Participants who were non-Christians had 3.2 times the likelihood of failing to adhere to ARVs compared to those who were Christians. Furthermore, participants with unsuppressed viral loads were 3 times more likely to be non-adherent to their ARVs compared to participants with suppressed viral loads. The majority of the participants were satisfied with the quality of care they received while accessing the health facility. Concerning viral load distribution, 52% were undetectable, 26% unsuppressed and 22% suppressed. Conclusion: The main contributing factors to ART non-adherence among the participants on ARVs were marital status, level of education, religion and alcohol consumption. Non-Christians and unsuppressed viral loads independently predicted non-adherence among patients in this setting. The majority of the participants, though satisfied with other indicators of quality of care they received, had to wait for more than two hours before receiving service.

Keywords

• Antiretroviral
• Non-adherence
• HIV
• East London
• South Africa