Factors Affecting Adherence to Anti-Retroviral Therapy among Women in Selected Health Facilities in the Greater Accra Region

Abstract

Background: HIV/AIDS was discovered as far back as 1981; however, a cure for it is yet to be found. The only remedy currently is to manage using Antiretroviral Therapy (ART). Standard ART consists of the combination antiretroviral (ARV) drugs to suppress the HIV virus and stop the progression of HIV disease. ART can limit transmission of HIV. Non-adherence to ART is a growing concern to clinicians, healthcare systems, and other stakeholders. Objective: To determine the factors associated with ART adherence among women seeking treatment from selected health facilities in the Greater Accra region. Method: The study was conducted on a sample size of 109 women using a cross sectional study design, selected conveniently from selected health facilities providing ART services. Quantitative data collection with structured questionnaire was used. Data was collected over a one-month period. Respondent seeking treatment services from five facilities (Ghana Atomic Energy Commission Hospital, Pantang Psychiatric Hospital, Pentecost Mission Hospital, Abokobi Health Center, and International Health Care Center) were recruited. Descriptive statistics such as means, standard deviation, frequency and percentage were used to describe demographic characteristics of the population under study. Chi-square statistic was used to for association between each independent variable (socio-cultural, socio-economic factors, HIV status disclosure factors and disclosure audience) and dependent variable (compliance to ART).Binary logistic regression was then used to determine the association between dependent variable and independent variables. Level of significance was set at 5%. Results: More than half of the women (67.6%) have disclosed their HIV status. Adherence to ART treatment among the women was poor, 73.3% did not adhere to medications as compared with good adherence rate of 26.73%. Socio-cultural factors (using herbal treatment instead of medical treatment; blame for family mishap; indifferent treatment from friends and family, loss of respect) had no significant association with adherence to ART (p>0.05). However, there was a significant association between adherence to ART and being perceived as promiscuous (χ2=6.2740; p=0.020). Women who did not disclose their status due to its association with promiscuous behavior were more likely to adhere to their ART‟s. ARV treatment factors (tablets swallowed daily, medication other than ARV, ease of swallowing tablet, loss of appetite because of ART intake) did not have any significant association with adherence to ART with a p>0.05. Nonetheless, effect of ART intake on daily activities predicted adherence to ART (p=0.026). Most of the women 58.6% indicated their preferred disclosure audience will be their parents. Participants who disclosed to their parents (40.70%) had poor adherence to ART (p>0.05). Conclusion: Adherence to ART was low. All the independent variables were not significantly linked with adherence to ART, except for disclosure (not disclosing status due to perceived promiscuous attachment to the disease) and drug related factors (drug side effects interrupting with daily activities) that had a significant association with adherence. Majority preferred to disclose to their parents and all of them did not adhere.