Factors affecting non-adherence to anti-retroviral therapy among people living with HIV

Abstract

Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is a major public health problem, and in recent years has been considered as a manageable chronic disease. Anti-retroviral therapy (ART) is the only available option that offers the possibility of dramatically reducing HIV related illness and death. This study aimed to explore the proportion of non-adherence to ART and its associated factors among people living with HIV/AIDS (PLWHA) in Ganta City, Liberia. A cross-sectional study was conducted among 185 participants age 18 years and above and the data were collected by a pretested interviewer administered structured questionnaires from April to May 2020. Of 185 participants, (62.2%) did not adhere to ART. Among the general characteristics, significant association was only found between occupation (p-value = 0.014) and non-adherence to ART. Almost half (47.6%) of study participants displayed a good knowledge on ART while (11.9%) reported misconception about ART. Information support constituted the highest proportion (48.1%) of the domains of social support and there was significant association with non-adherence (p-value = 0.014). Among the domains of stigma and discrimination, (70.8%) of participants reported internalized stigma. There was association between experienced stigma and non-adherence (p-value = 0.025). The study results also revealed association between accessibility to ART (p-value = 0.006), ART side effects (p-value = 0.001) and non-adherence to ART. From this study it was determined that non-adherence was mostly found among age 40-49 years and female participants. Employment and high income, poor knowledge on ART, poor social supports, high levels of stigma and discrimination, long distance and high transportation cost contributed towards high level of non-adherence to ART. Health education on the importance of adherence especially among age 40 and above is recommended. Participants should be counseled and encouraged to take ART at a nearby facility. In order to reduce stigma and increase the levels of social support, there should be a collaborative process among family members, health care providers and PLWHA.