Therapy and Health System-Related Factors Influencing Adherence to ART Treatment among HIV/AIDS Patients in Embu Teaching and Referral Hospital Comprehensive Care Clinic
American Journal of Nursing Science
Volume 5, Issue 5, October 2016, Pages: 169-174
Received: Jul. 26, 2016; Accepted: Aug. 4, 2016; Published: Aug. 21, 2016
Views 3912      Downloads 182
Authors
Evangeline Kananu Njue Mugoh, Department of Community Health, Kenyatta University, Nairobi, Kenya
Ephantus Kabiru, Department of Community Health, Kenyatta University, Nairobi, Kenya
Joyce Mwaniki, Department of Plant Sciences, Kenyatta University, Nairobi, Kenya
Article Tools
Follow on us
Abstract
Adherence to antiretroviral therapy is a major predictor of the survival of individuals living with HIV/AIDS. Appropriate use of antiretroviral (ARV’s) has improved the health of many human immunodeficiency virus (HIV) positive individuals. The effectiveness of HIV treatment depends on sustenance of high levels of adherence to ARV; however, ARV regimens are often complicated and can be affected by varying dosing schedules, failing to have proper dietary requirements and patients developing adverse effects. The objective of this study was to determine therapy and health system related factors influencing adherence to Anti-retroviral drugs among adult HIV/ AIDS patients in Embu County Teaching and Referral Hospital Comprehensive Care Clinic. The study applied cross sectional descriptive design with stratified random sampling used to obtain relative proportion of male and female adult respondents in the sample population. 332 HIV positive patients were chosen from a total of 1694 patients who were active in ART for more than one year. A semi-structured interview schedules was used to obtain patients view on various dimension or ART services at the facility. ART adherence was at 48.2%. There was significant association between adherence to ART treatment and the type of drug a respondent was in with AZT, ddl, NFV having the highest proportion of sub-optimal adherence to treatment while respondents on D4T, 3TC, NVP had the lowest proportion of sub-optimal adherence to treatment. Convenience of the facilities for people with chronic ailments and waiting time at the facilities were reported to be good (73.0%) and excellent (75.3%) respectively.
Keywords
ART Adherence, Treatment-Related Factors, Health System Factors
To cite this article
Evangeline Kananu Njue Mugoh, Ephantus Kabiru, Joyce Mwaniki, Therapy and Health System-Related Factors Influencing Adherence to ART Treatment among HIV/AIDS Patients in Embu Teaching and Referral Hospital Comprehensive Care Clinic, American Journal of Nursing Science. Vol. 5, No. 5, 2016, pp. 169-174. doi: 10.11648/j.ajns.20160505.11
Copyright
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
UNICEF. (2013) UNICEF Kenya. [Online]. http://www.unicef.org/infobycountry/kenya_statistics.html
[2]
Avert. (2015) Avert. [Online]. http://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/kenya
[3]
NACC, "Kenya AIDS Strategic Framework 2014/2015 - 2018/2019," National AIDS Control Council, Ministry of Health, 2014.
[4]
NACC, "Kenya AIDS Response Progress Report 2014: Progress towards Zero," Nairobi, 2014.
[5]
NASCOP, "Kenya HIV Estimates: June 2014," Nairobi, 2014.
[6]
Sarah Wangui Karanja, "Factors Influencing Adherence to Antiretroviral Medications Among Patients Living With HIV in Kenya," Department of Sociology and Social Work, University of Nairobi, Thesis 2013.
[7]
Samwel N Wakibi, Zipporah W Ng'ang'a, and Gabriel G Mbugua, "Factors associated with non-adherence to highly active antiretroviral therapy in Nairobi, Kenya," AIDS Research and Therapy, vol. 8, no. 43, 2011, doi: 10.1186/1742-6405-8-43.
[8]
Onyango Daniel Oloo, "Barriers To Antiretroviral Treatment Adherence Among Hiv Infected Tuberculosis Patients In Jaramogi Oginga Odinga Teaching And Referral Hospital Kisumu, Kenya," Department of Extra Mural Studies, University of Nairobi, Master's Thesis 2013.
[9]
Woldesellassie M. Bezabhe et al., "Barriers and Facilitators of Adherence to Antiretroviral Drug Therapy and Retention in Care among Adult HIV-Positive Patients: A Qualitative Study from Ethiopia," PLoS One, vol. 9, no. 5, p. e97353, 2014, doi: 10.1371/journal.pone.0097353.
[10]
Sarah Finocchario-Kessler et al., "Patient Communication Tools to Enhance ART Adherence Counseling in Low and High Resource Settings," Patient Education and Counseling, vol. 89, no. 1, pp. 163–170, 2012, doi: 10.1016/j.pec.2012.03.020.
[11]
N. C Talam, P. Gatongi, J. Rotich, and S. Kimaiyo, "Factors Affecting Antiretroviral Drug Adherence Among HIV/AIDS Adult Patients Attending HIV/AIDS Clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya.," East African Journal of Public Health, vol. 5, no. 2, pp. 74-78, August 2008.
[12]
NASCOP & NACC, "Kenya HIV County Profiles," Nairobi, 2014.
[13]
Joyce Kgatlwane et al., "Factors that facilitate or constrain adherence to antiretroviral therapy among adults at four public health facilities in Botswana: a pre-intervention study," 2006.
[14]
Mathieu Rougemont, Beat E Stoll, Nadia Elia, and Peter Ngang, "Antiretroviral treatment adherence and its determinants in Sub-Saharan Africa: a prospective study at Yaounde Central Hospital, Cameroon," AIDS Research and Therapy, vol. 6, no. 21, October 2009.
[15]
Karen S. Ingersoll and Jessye Cohen, "The impact of medication regimen factors on adherence to chronic treatment: a review of literature," Journal of behavioral medicine, vol. 31, no. 3, pp. 213–224, 2008.
[16]
Walter H Curioso, Deanna Kepka, Robinson Cabello, Patricia Segura, and Ann E Kurth, "Understanding the facilitators and barriers of antiretroviral adherence in Peru: A qualitative study," BMC Public Health, vol. 10, no. 13, 2010.
[17]
Camelia Protopopescu, François Raffi, Perrine Roux, Jacques Reynes, and Pierre Dellamon, "Factors associated with non-adherence to long-term highly active antiretroviral therapy: a 10 year follow-up analysis with correction for the bias induced by missing data," Journal of Antimicrobial Chemotherapy, vol. 64, no. 3, pp. 599-606, 2009.
[18]
Bruce A Larson et al., "ART treatment costs and retention in care in Kenya: a cohort study in three rural outpatient clinics," Journal of the International AIDS Society, vol. 16, no. 1, p. 18026, 2013, doi: 10.7448/IAS.16.1.18026.
[19]
Bentsi Sam Ophelia, "Factors That Constrain Adherence to Antiretroviral Therapy among HIV Positive Patients in the Sekondi-Takoradi Metropolis," School of Public Health, Kwame Nkrumah University of Science and Technology, Master's Thesis 2015.
[20]
Leslie R Martin, Summer L Williams, Kelly B Haskard, and M Robin DiMatteo, "The challenge of patient adherence," Therapeutics and Clinical Risk Management, vol. 1, no. 3, pp. 189-199, 2005.
[21]
Monica Malta, Maya L. Petersen, Scott Clair, Fernando Freitas, and Francisco I. Bastos, "Adherence to antiretroviral therapy: a qualitative study with physicians from Rio de Janeiro, Brazil," Cadernos de Saúde Pública, vol. 21, no. 5, pp. 1424-1432, 2005, http://dx.doi.org/10.1590/S0102-311X2005000500015.
[22]
Daniel P. Kidder et al., "HIV Prevention in Care and Treatment Settings: Baseline Risk Behaviors among HIV Patients in Kenya, Namibia, and Tanzania," PLoS ONE, vol. 8, no. 2, p. e57215, February 2013.
[23]
Heila E Aspeling and Neltjie Van Wyk, "Factors associated with adherence to antiretroviral therapy for the treatment of HIV-infected women attending an urban care facility," International Journal of Nursing Practice, vol. 14, no. 1, pp. 3-10, 2008, doi: 10.1111/j.1440-172X.2007.00659.x.
[24]
Sarah Bott et al., "Rewards and challenges of providing HIV testing and counselling services: health worker perspectives from Burkina Faso, Kenya and Uganda," Health Policy Planning, pp. 1–12, 2014, doi: 10.1093/heapol/czu100.
[25]
M. H. Chung et al., "A randomized controlled trial comparing the effects of counseling and alarm device on HAART adherence and virologic outcomes," PLoS Medicine, vol. 8, no. 3, p. e1000422, 2011.
[26]
Sheri Weiser et al., "Barriers to Antiretroviral Adherence for Patients Living with HIV Infection and AIDS in Botswana," JAIDS Journal of Acquired Immune Deficiency Syndromes, vol. 34, no. 3, pp. 281–288, 2003.
[27]
Lawrence Mbuagbaw et al., "Trends and determining factors associated with adherence to antiretroviral therapy (ART) in Cameroon: a systematic review and analysis of the CAMPS trial," AIDS Research and Therapy, vol. 9, no. 37, 2012, DOI: 10.1186/1742-6405-9-37.
[28]
AIDSinfo, "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents," Panel on Antiretroviral Guidelines for Adults and Adolescents, Department of Health and Human Services, 2016.
[29]
Amsalu Alagaw, Wanzahun Godana, Mohammed Taha, and Tariku Dejene, "Factors Associated with Antiretroviral Treatment Adherence among Adult Patients in Wolaita Soddo Hospital," Journal of Tropical Diseases, vol. 1, no. 4, 2013.
[30]
Ogbochi McKinney, Naomi N. Modeste, Jerry W. Lee, Peter C. Gleason, and Gisele Maynard-Tucker, "Determinants of Antiretroviral Therapy Adherence among Women in Southern Malawi: Healthcare Providers’ Perspectives," AIDS Research and Treatment, vol. 2014, no. 2014, December 2014.
[31]
Mariana Posse, Filip Meheus, Henri Van Asten, Andre Van Der Ven, and Rob Baltussen, "Barriers to access to antiretroviral treatment in developing countries: a review," Tropical Medicine & International Health, vol. 13, no. 7, pp. 904–913, 2008, DOI: 10.1111/j.1365-3156.2008.02091.x.
[32]
Sharada P. Wasti, Padam Simkhada, Julian Randall, Jennifer V. Freeman, and Edwin van Teijlingen, "Factors Influencing Adherence to Antiretroviral Treatment in Nepal: A Mixed-Methods Study," PLOS ONE, vol. 7, no. 5, p. e35547, 2012, http://dx.doi.org/10.1371/journal.pone.0035547.
[33]
M Skovdal, C Campbell, K Nhongo, C Nyamukapa, and S Gregson, "Contextual and psychosocial influences on antiretroviral therapy adherence in rural Zimbabwe: towards a systematic framework for programme planners.," International Journal of Health Planning and Management, vol. 26, no. 3, pp. 296–318, 2011.
[34]
S Biadgilign, A. A Reda, and A Deribew, "Knowledge and attitudes of caregivers of HIV-infected children toward antiretroviral treatment in Ethiopia" Patient Education and Counseling, vol. 85, no. 2, pp. e89–e94, 2011.
[35]
Beena Joshi et al., "Level of suboptimal adherence to first line antiretroviral treatment & its determinants among HIV positive people in India," The Indian Journal of Medical Research, vol. 140, no. 1, pp. 84–95, 2014.
[36]
Kwasi E. Torpey et al., "Adherence Support Workers: A Way to Address Human Resource Constraints in Antiretroviral Treatment Programs in the Public Health Setting in Zambia," PLOS One, vol. 3, no. 5, pp. 1-9, 2008.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186