Assessments of the level of adherence to antiretroviral therapy and the health status of people living with HIV in Calabar, Nigeria

Abstract

Background: Medication adherence describes a patient's behavior of accurately following drug regimens; nonadherence describes a patient's inability to accurately follow drug regimens. Several factors such as psychosocial, educational, health-related, and environmental-related factors could contribute in determining the level of adherence to antiretroviral drug. This was a study to assess the level of adherence antiretroviral combination therapy and the health status of people living with HIV in Calabar, Nigeria. Materials and Methods: Questionnaires were administered to 350 HIV persons who attended antiretroviral treatment (ART) clinic to obtain their sociodemographic data, knowledge of ART, service received, and drug history. Stool samples were collected and examined using direct microscopy, formol–ether concentration technique, and modified Ziehl–Neelsen technique for enteric parasites, whereas blood samples were collected for HIV status examination using serial HIV testing algorithm, hemoglobin levels using cyanmethemoglobin method, and counting of CD4 using Partec CyFlow counter. Results: The results showed that 79.43% (278/350) of the participants adhered to antiretroviral drugs, with most of them (47.84%, 133/278) having CD4 counts between 201 and 400 cell/μl. Stigma was the major reason for nonadherence to treatment. Those who adhered to therapy had a lower infection rate and an elevated mean hemoglobin level than those who did not adhere. Conclusion: There was also an elevated hemoglobin level, lower enteric parasite infections, and an improved CD4 count among the adherents than those who did not adhere.

Keywords

• adherence
• antiretroviral therapy
• enteric parasites
• hemoglobin level
• hiv