Self-reported adherence to highly active antiretroviral therapy in a tertiary hospital in Nigeria.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: Ghana Medical Association Country of Publication: Ghana NLM ID: 0073210 Publication Model: Print Cited Medium: Internet ISSN: 2616-163X (Electronic) Linking ISSN: 00169560 NLM ISO Abbreviation: Ghana Med J Subsets: MEDLINE
    • Publication Information:
      Original Publication: Accra : Ghana Medical Association
    • Subject Terms:
    • Abstract:
      Background: Non-adherence to highly active antiretroviral therapy (HAART) favours drug resistance and wastes resources. These have negative implications for personal and public health.
      Objective: To assess adherence levels, the associated factors and its association with increase in CD4 cell count in people living with HIV (PLHIVs).
      Methods: In a cross-sectional survey, systematically selected adult PLHIVs attending a tertiary hospital in Nigeria self-reported their 28-day adherence to HAART and reasons for missing doses using an interviewer-administered questionnaire. Their 6-month difference in CD4 cell count was also assessed.
      Results: The participants totalled 425. Their mean age was 38.6 (SD, 10.1) years and 309 (72.7%) had secondary or tertiary education. The 28-day mean adherence level was 96.8% (SD, 7.9%) and 354 (83.3%) participants had optimal adherence (≥ 95%). Socio-demographic characteristics, side effects and having human reminders were not associated with adherence level, but 100% adherence level since placement on HAART was positively associated with a 6-month increase in CD4 cell count ( p < 0.01; OR = 1.87, 95%CI = 1.21 - 2.89). Reasons given by 156 respondents for missing doses included being too busy, 100 (64.1%), forgetting, 85 (54.5%) and sleeping off, 42 (26.9%).
      Conclusion: Mean adherence was high and the majority of participants had optimal adherence. "Never missing a dose" was associated with improved CD4 cell counts, indicating better prognosis. Socio-demographic factors, side effects and human reminders were not associated with an increase in adherence. However, as there is no evidence that adherence improvement measures are detrimental, their use is still recommended.
      Funding: None declared.
      Competing Interests: Conflict of interest: None declared
      (Copyright © The Author(s).)
    • References:
      Behav Modif. 2005 Mar;29(2):286-317. (PMID: 15657412)
      Clin Infect Dis. 2011 Feb 15;52(4):493-506. (PMID: 21245156)
      Lancet. 2006 Nov 4;368(9547):1587-94. (PMID: 17084759)
      AIDS Res Ther. 2011 Dec 05;8:43. (PMID: 22141425)
      Afr J Med Med Sci. 2008 Mar;37(1):29-36. (PMID: 18756852)
      HIV Med. 2005 Sep;6(5):366-9. (PMID: 16156886)
      Sex Transm Infect. 2007 Dec;83(7):503-5. (PMID: 18024708)
      J Pharmacol Pharmacother. 2012 Apr;3(2):138-42. (PMID: 22629088)
      J Infect Dis. 2008 May 15;197 Suppl 3:S272-8. (PMID: 18447613)
      AIDS Care. 2005 Aug;17(6):661-73. (PMID: 16036253)
      J Acquir Immune Defic Syndr. 2003 Nov 1;34(3):281-8. (PMID: 14600572)
      HIV AIDS (Auckl). 2010;2:69-76. (PMID: 22096386)
      AIDS Care. 2007 Jul;19(6):740-8. (PMID: 17573593)
      BMC Infect Dis. 2013 Aug 30;13:401. (PMID: 24229404)
      J Clin Epidemiol. 2004 Oct;57(10):1107-10. (PMID: 15528063)
      AIDS Care. 2004 May;16(4):471-84. (PMID: 15203415)
      J Psychosom Res. 2003 Mar;54(3):271-8. (PMID: 12614837)
      J Acquir Immune Defic Syndr. 2005 Sep 1;40(1):65-9. (PMID: 16123684)
      J Infect Dev Ctries. 2008 Oct 01;2(5):369-72. (PMID: 19745505)
      AIDS Behav. 2009 Feb;13(1):42-5. (PMID: 18521736)
      Med Care. 2006 Oct;44(10):893-9. (PMID: 17001259)
      Hum Resour Health. 2013 Jun 14;11:26. (PMID: 23768178)
      Indian J Virol. 2011 Dec;22(2):90-7. (PMID: 23637509)
      Handb Exp Pharmacol. 2009;(189):347-74. (PMID: 19048207)
    • Contributed Indexing:
      Keywords: HAART; HIV; Medication adherence; Nigeria; drug resistance
    • Publication Date:
      Date Created: 20200901 Date Completed: 20210607 Latest Revision: 20220416
    • Publication Date:
      20240105
    • Accession Number:
      PMC7445700
    • Accession Number:
      10.4314/gmj.v54i1.5
    • Accession Number:
      32863410