Factors Influencing Adherence to Antiretrovirals (ARVS) Among Persons Living With HIV in the Eastern Regional Hospital, Ghana.

Abstract

Background: Sub-Saharan Africa continues to bear the brunt of new and prevailing HIV infections and several countries in this region were unable to meet the UNAIDS 90-90-90 target by 2020. Antiretrovirals are free and readily accessible in Ghana yet adherence levels continue to be suboptimal. There is the need to explore the factors that account for adherence to ARVs in order to capitalize on them and improve adherence levels and ultimately achieve the 95-95-95 agenda by 2030. Objectives: The aim of this study was to determine factors that influence adherence to antiretrovirals among adult PLHIVs in the Eastern Regional Hospital in Ghana. Method: This study was a cross sectional one involving 330 participants who were attendants at the ART clinic of the Eastern Regional Hospital, Koforidua. Questionnaires employed in the study were pretested and participants were selected over a 4-week period using consecutive sampling. Factors influencing adherence were categorized as individual, economic, treatment-related and health system factors. Adherence was determined using the self-report 3-day recall and 7-day recall methods. The most recent viral loads of these participants were also recorded and the association between the viral load measurement and the adherence level was determined using the crude odds ratio and the adjusted odds ratio. Level of significance for the study was set at a value of p < 0.05. Results: With a response rate of 100%, a majority (77%) of the respondents were females and the dominant age group was the 40 – 49 age bracket. A majority of the respondents (84.2%) had some form of formal education. Though most of the respondents denied missing their ARVs, those who missed some of their medications cited forgetfulness as the reason for missing their medications. Using the 7-day recall method, adherence was capped at 85% and 84% of respondents were found to have achieved virological suppression with values professionalism among health workers in the HIV sector and reduced pill burden will improve upon ARV adherence. respondents were on the single pill combination of tenofovir/lamivudine/dolutegravir and side effects attributable to the ARVs were not found to affect the adherence levels. There was a positive association between adherence and virological suppression with an adjusted odds ratio of 2.811. Conclusion: Ghana has made strides when it comes to HIV care. There is however room for improvement and this study has revealed that strong social support, decentralization of HIV care with resultant reduced hospital waiting time, professionalism among health workers in the HIV sector and reduced pill burden will improve upon ARV adherence.