Knowledge of People Living With HIV and Its Effect on Adherence to Antiretroviral Therapy in the New Juabeng Municipality

Abstract

Background: HIV remains one of the most devastating diseases in Africa. Even though antiretroviral therapy has been introduced the problem of non-adherence persists. High level of knowledge has been associated with a positive attitude towards treatment and consequently high level of adherence. Non-adherence can hamper interventions aimed at controlling HIV as a public health threat. There is therefore the need to explore gaps hindering adherence to treatment to effectively manage the disease. Objective: The aim of the study was to determine knowledge on antiretroviral therapy and its effect on adherence among PLHIV in the New Juabeng Municipality. Methods: An analytical cross-sectional study was carried out among 277 patients who were 18 years and above, who reside in Koforidua and are seeking ART services at the Eastern Regional Hospital. A structured questionnaire was used to gather information on knowledge and adherence to ART. Morisky scale was used to measure adherence. Chi Square test was used to test for association between background factors and adherence. Multivariate regression analysis was used to determine factors influencing adherence to ART. A p-value of 0.05 and below was considered statistically significant. STATA 15 was used to analyse data. Results: PLHIV had high ART knowledge (84.5%). More than half (61%) of the participants had low ART adherence. There was a significant association between level of income and adherence to ART (χ2 =14.05, p=0.001, α=0.03) but no significant association between age (χ2 =6.78, p=0.148, α=0.05), sex (χ2 =0.365, p=0.550, α=0.05), educational (χ2 =2.43, p=0.0.657, α=0.05) viral load (χ2 =0.28, p=0599, α=0.05) and adherence to ART. Factors that influence adherence to ART are employment status [AOR = 0.09, CI = (0.01-0.95), p value = 0.046], level of income [AOR = 0.17, CI = (0.06-0.45), p value <0.001] and knowledge on ART [AOR = 2.73, CI = (1.10-6.75), p value = 0.030]. Factors such as forgetfulness, sleeping away from home and alcohol use were identified as major challenges to ART adherence among patients. Conclusion: Even though the level of knowledge on ART was found to be high majority of participants had low ART adherence. There is the need to intensify education to improve adherence to treatment.