Improving Adherence to Anti-retroviral Therapy among Persons Living with HIV/AIDS in Enugu State, South East Nigeria

Main Article Content

C. P. Igweagu
O. H. Chime
C. N. Onwasigwe

Abstract

HIV/AIDS continues to be a major global public health issue, having claimed more than 32 million lives so far. There were approximately 37.9 million people living with HIV/AIDS (PLHIV) at the end of 2018. Anti-retroviral therapy (ART) has significantly reduced morbidity and mortality and improved quality of life among people with HIV infection.

Aims: The study was conducted to improve the knowledge and adherence to anti-retroviral therapy among PLHIV in Enugu state, southeast Nigeria.

Study Design: Interventional study.

Place and Duration of Study: Anti-retroviral Therapy clinics within Enugu metropolis in Enugu state Nigeria between June to December 2018.

Methodology: A health education intervention was carried out among 312 PLHIV receiving ART in Enugu metropolis to improve their perception and adherence to antiretroviral therapy. A structured questionnaire was used to collect data from 312 PLHIV (156 each in the study and control groups), who were selected by multistage sampling. Subsequently, health education was conducted among the study group. Three months after this intervention its effects were assessed through a survey using the same structured questionnaires employed in the baseline survey. 

Results: The most frequently occurring reason given by the respondents for poor adherence to ART was forgetfulness (65.4% for study and 69.9% for control groups). Knowledge of the factors and consequences of poor adherence to treatment was significantly higher among the study group than the controls post-interventions p<0.001. Adherence to ART improved from 42.3% pre-intervention to 81.4% post-intervention.

Conclusion: Intensive health education effectively improved adherence to ART among persons living with HIV/AIDS and this should be carried out regularly.

Keywords:
Adherence, anti-retroviral therapy, health education, knowledge.

Article Details

How to Cite
Igweagu, C. P., Chime, O. H., & Onwasigwe, C. N. (2019). Improving Adherence to Anti-retroviral Therapy among Persons Living with HIV/AIDS in Enugu State, South East Nigeria. International Journal of TROPICAL DISEASE & Health, 39(1), 1-9. https://doi.org/10.9734/ijtdh/2019/v39i130199
Section
Original Research Article

References

World Health Organization (WHO) HIV/AIDS Data and Statistics – WHO/ World Health Organization; 2019.
Available:www.who.int/hiv/data Accessed 13/10/19

Federal Ministry of Health (FMOH). National HIV/AIDS indicator and impact survery (NAIIS) fact sheet. Abuja, Nigeria. 2019;2.

Galo RC, Montagnier L. The discovery of HIV as the cause of AIDS. New Engl. J. Med. 2003;514-515.

Federal Ministry of Health (FMOH). National Guidelines on HIV/AIDS Care and Support. Abuja, Nigeria; 2014.

Monjok E, Smesny A, Okokon IB, Mgbere O, Essien EJ. Adherence to Antiretroviral Therapy in Nigeria: An Overview of Research Studies and Implications for Policy and Practice. HIV AIDS. 2010;2: 69–76.

Bartlett JG, Gallant JE. Text book on medical management of HIV infection. Baltimore, Johns Hopkins University, Division of Infectious Diseases; 2004

Smith DM, Richman DD, Little SJ. HIV super-infection. J. Infect Dis., 2005;192:438-444.

Sarr AD, Esien G. Gueye-Ndiaya A. Viral dynamics of primary HIV 1 infection in Senegal, West Africa. J. Infectious. Dis. 2005;191:1460-1467.

Olaleye D, Bernstein L, Ekwezor C. Prevalence of human immunodeficiency virus type 1 and 2 infection in Nigeria. J. Infect Dis. 1993;167:710-714.

Johnson S, Baraboutis JG. Adverse effects associated with use of nevirapine in HIV postexposure prophylaxis for 2 healthcare workers. JAMA. 2000;284:2722-2723.

Max B, Sherer R. Management of the adverse effects of antiretroviral therapy and medication adherence. Clin Infect Dis. 2000;30:96-116.

Sherer R. Adherence and antiretroviral therapy in injection drug users. JAMA. 1998;280: 567-568.

Sethi AK, Celantano DD, Gange SF, Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance. Clin. Infect. Dis. 2003;37:1112-1118.

Cooney EL. Clinical indicators of immune restoration following highly active antivetroviral therapy. Clinic Infect Dis. 2002;34:224-233.

National Population Commission (NPC). Population and housing census of Federal Republic of Nigeria: National and State Population Tables (Priority Tables) Abuja Nigeria. 2009;1.

Deolalla P, Knobel H, Carmona A. Impact of adherence on highly active antiretroviral therapy on survival in HIV infected patients. J. Acquire. Immune Defic Syndr. 2001;30:150-155.

Federal Ministry of Health National HIV seroprevalence sentinel survey Abuja Federal Ministry of Health; 2010.

Federal Government of Nigeria. National Policy on HIV/AIDS. Abuja Federal Government of Nigeria; 2010.

Federal Ministry of Health. HIV/AIDS Emergency Action Plan, 2001-2004. Abuja Federal Ministry of Health; 2001.

United Nations. Declaration of commitment on HIV/AIDS: United Nations General Assembly special session on HIV/AIDS, 25-27 June 2001 Genera: United Nations; 2001.

Tuomale RE, Shapiro D, Mofenson LM. Antiretroviral therapy during pregnancy and the risk of an adverse outcome. N. Engl. J. Med. 2002;346:1863-1870.

Federal Ministry of Health, National guidelines on prevention of mother to child transmission (PMTCT) of HIV infection. Abuja Federal Ministry of Health; 2010.

McNab J, Ross JW, Abriola K. Adherence to highly active antiretroviral therapy predicts virologic outcome at an inner city human immunodeficiency virus clinic. Clin. Infect Dis. 2001;33:700-705.

Chesney MA, Factors affecting adherence to antiretroviral therapy. Clin. Infect. Dis. 2000;30:171-176.

Sheri W, William W, David B. Barriers to antiretroviral adherence for patients living with HIV infection and AIDS in Botswana. J. Acquire-Immune. Defic. Syndro. 2003;34:281-288.

Arnsten JH, Demas PA, Farzadegan H. Antiretroviral therapy adherence and viral suppression in HIV infected drug users, comparison of self-report and electronic monitoring. Clin. Infect. Dis. 2001;33:1417-1423.

Domingo P, Torres OH, Ris J. Herpes zoster as an immune reconstitution disease after initiation of combination antiretroviral therapy in patients with human immunodeficiency virus type-1 infection. Am J. Med. 2001;110:605-609.