Abstract

Adherence to highly active antiretroviral therapy (HAART) is pivotal in reducing viral transmission, preventing viral drug resistance and improving life expectancy of patients. A baseline cross-sectional survey of the level of adherence to ART and its challenges was carried out among adults accessing this service at Federal Medical Centre, Keffi, Nigeria. This was to assess the level of adherence and identify factors militating against it. Two hundred and fifty consenting human immunodeficiency virus (HIV) positive patients were recruited and interviewed using a structured questionnaire. The level of adherence to ≥ 95% of the prescribed medication within the 7 days preceding the interview in this population was 62.8% and only 31.2% of them in this category reported 100% adherence. Adherence was the highest (77.6%) and significantly associated with disclosure of HIV status to family members (p ≤ 0.05) and similarly among those living with their families (85.8%) (p ≤ 0.05). Neither the use an alarm, other people or self was found to be associated with better adherence to medication (p > 0.05). Common reasons for non-adherence were found to be forgetfulness (51.5%), avoiding drug side effect (14.5%), living far away from the medical centre (8.1%) and inability to afford the cost of transportation to the medical centre (6.5%). Patient’s educational level, marital status and occupation were found to be significantly associated with adherence ART in this study (p ≤ 0.05). On the whole, the level of adherence to HAART in this study population still needs improvement. The decentralization of HAART services to primary healthcare facilities and the intensification of patients’ education and counseling are advocated.

Key words: Human immunodeficiency virus (HIV), antiretroviral therapy, adherence, non-adherence, Nigeria.