Assessment of determinants and levels of adherence to antiretroviral therapy in HIV-infected people in Opuwo district, Kunene region, Namibia

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Date
2016
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Publisher
University of Namibia
Abstract
Since the beginning of the outbreak of Acquired Immunodeficiency Syndrome (AIDS) epidemic, more than 78 million people have been infected with Human Immunodeficiency Virus (HIV) and 39 million people have died globally (UNAIDS, 2014, p. 123). In Namibia, AIDS is the leading cause of death accounting for 23% of deaths (CDC in Namibia, fact sheet, 2013, & WHO Namibia, 2011). Adherence to medication refers to the extent to which a patient takes a medication in the way intended by a health care provider (Machtinger & Bangsberg, 2006). Very high levels of adherence, taking at least 95% of prescribed doses, are required to achieve sustained suppression of HIV replication over time. Namibia has a national ART coverage of 84%, but the coverage per health district differs (MoHSS, 2012). A quantitative, descriptive, exploratory, cross-sectional, analytical research design was used to assess the levels and determinants of adherence to ART in HIV infected people in Opuwo district. Specific objectives were; to determine the levels of adherence to ART among HIV infected people in Opuwo district and to identify determinants of adherence to ART in Opuwo district. A structured questionnaire was used to collect data for self-reporting method, while the pill count was conducted by subtracting the number of pills left from those given. Pharmacy records were reviewed to determine the appoint keeping. Health workers were also interviewed. The study finds that the levels of adherence to ART measured by pill count and by self-reporting were 73% and 70% respectively. The determinant which is associated with adherence was educational level. Females had higher adherence, beingSince the beginning of the outbreak of Acquired Immunodeficiency Syndrome (AIDS) epidemic, more than 78 million people have been infected with Human Immunodeficiency Virus (HIV) and 39 million people have died globally (UNAIDS, 2014, p. 123). In Namibia, AIDS is the leading cause of death accounting for 23% of deaths (CDC in Namibia, fact sheet, 2013, & WHO Namibia, 2011). Adherence to medication refers to the extent to which a patient takes a medication in the way intended by a health care provider (Machtinger & Bangsberg, 2006). Very high levels of adherence, taking at least 95% of prescribed doses, are required to achieve sustained suppression of HIV replication over time. Namibia has a national ART coverage of 84%, but the coverage per health district differs (MoHSS, 2012). A quantitative, descriptive, exploratory, cross-sectional, analytical research design was used to assess the levels and determinants of adherence to ART in HIV infected people in Opuwo district. Specific objectives were; to determine the levels of adherence to ART among HIV infected people in Opuwo district and to identify determinants of adherence to ART in Opuwo district. A structured questionnaire was used to collect data for self-reporting method, while the pill count was conducted by subtracting the number of pills left from those given. Pharmacy records were reviewed to determine the appoint keeping. Health workers were also interviewed. The study finds that the levels of adherence to ART measured by pill count and by self-reporting were 73% and 70% respectively. The determinant which is associated with adherence was educational level. Females had higher adherence, being employed, being married or cohabitating also favoured higher adherence. Distance to facilities, travelling, alcohol usage, dietary requirements, side effects were identified as barrier to adherence by not statistically significant. The researcher recommended health education on ART, recruitments of more health worker, tracing of defaulters and late comers, a vehicle specific for ART services, and training at health worker at all facilities to enable them to give ART.
Description
A thesis submitted in partial fulfilment of the requirements for the Degree of Master of Science in Applied Field Epidemiology/ Laboratory Management
Keywords
Antiretroviral therapy, HIV infected people, Opuwo district
Citation