Assessment of Non-adherence to Therapy among HIV/AIDS Patients in Presidential Emergency Plan for AIDS Relief (PEPFAR) Unit of University of Benin Teaching Hospital (UBTH)

Abstract

Background: Antiretroviral therapy (ART) has made it possible for treating HIV/AIDS as a chronic and manageable infection. HIV patients who receive effective therapy and adhere to it have similar survival rates as people who are not infected. People living with HIV/AIDS (PLWHA) are given the medications without charge at authorized clinics across Nigeria. Despite being readily available, adherence with ARV medication therapy is still a serious challenge. Objective: This study was aimed at assessing the adherence level to antiretroviral therapy and medication knowledge among HIV/AIDS patients in the University of Benin Teaching Hospital, PEPFAR Unit. Methods: The cross-sectional study was conducted among 461 consenting participants aged 18 years and above who had been on ART for at least two months. Data were collected using a standardized self-reported structured questionnaire, covering demographic details, health-related information, medication adherence, and medication knowledge.The response rate was 86.8%. Data analysis involved descriptive statistics, cross-tabulation, Chi-square test, and binary logistic regression. Results: 64.3% of the respondents were within 38-57 years, 74.8% were female and 25.3% were male, 59.5% were married, 50.3% attended secondary School, 75.0% were self-employed, 98% Christian and their major monthly income fell within #21,000-#30,000 and 66.5% were on two (2) medications. Adherence to ART was observed in 74% of the study participants while 26% were non-adherent. Comorbidity (peptic ulcer disease) and increased number of medications taken were significantly (p <0.05) associated with ART non-adherence among the study participants. There was no statistically significant difference in adherence level across the age groups, gender, and level of education. Majority of the study participants (64.5%) had a good ARV medication knowledge and there was a positive association between medication knowledge and adherence to ARV medications. Hence, there is a need for medication knowledge education during counseling for both old and new patients. Conclusion: Despite relatively high adherence levels, challenges such as comorbidities and polypharmacy hinder optimal ART outcomes. Education on medication knowledge during counseling is essential for improving adherence among both new and existing patients. Limitations: This study relied on self-reported adherence data, convenience sampling method, single-site design, cross-sectional methodology, and relatively small sample size may limit the generalizability and validity of the findings.