Original Research

Factors contributing to antiretroviral drug adherence among adults living with HIV or AIDS in a Kenyan rural community

Mary T. Kioko, Anne M. Pertet
African Journal of Primary Health Care & Family Medicine | Vol 9, No 1 | a1343 | DOI: https://doi.org/10.4102/phcfm.v9i1.1343 | © 2017 Mary T. Kioko, Anne M. Pertet | This work is licensed under CC Attribution 4.0
Submitted: 10 October 2016 | Published: 31 July 2017

About the author(s)

Mary T. Kioko, Department of Nursing, Kenya Medical Training Institute, Kenya
Anne M. Pertet, Department of Community Health, Great Lakes University, Kenya


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Abstract

Background: Antiretroviral (ARV) adherence of ≥ 95% is recommended for suppressing HIV. However, studies have shown that the ≥ 95% recommended level is rarely achieved.
Objective: This cross-sectional community-based study sought to assess factors contributing to ARV drug adherence among adults living with HIV or AIDS.
Setting: The study was conducted in a rural community in Machakos County, Kenya.
Methods: The questions used for the study were adapted from the Patient Medicine Adherence Questionnaire (PMAQ), a tool grounded in the Health Belief Model. Adherence to ARV was measured using self-reports and pill counts. The perception social support was measured with a 5-point Likert scale, whereas the type and the number of side effects experienced were recorded using ‘yes’ and ‘no’ questions. We used the chi-square test to test associations and binary logistic regression to assess factors explaining dose adherence to ARV.
Results: The levels of adherence of 86% using self-reports were significantly higher (p < 0.001) than the pill count of 58.6%. The immediate family was rated high in providing social support (3.7 ± 0.6) followed by social support groups (3.1 ± 0.8). A binary logistic regression analysis was conducted to predict ARV adherence (adherent, non-adherent) using social support, side effects and marital status as explanatory variables. The Wald criterion demonstrated that marital status (p = 0.019) and burden of side effects (p ≤ 0.001) made a significant contribution to the prediction of ARV adherence.
Conclusion: The burden of side effects and being a divorcee are primary predictors of ARV adherence.

Keywords

social support; side effects; age; sex; marital status; education ARV adherence; household Kenya

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