FACTORS AFFECTING ADHERENCE TO ANTIRETROVIRAL THERAPY IN PEOPLE LIVING WITH HIV IN BOYO DIVISION NORTH WEST RIGION CAMEROON.

Abstract

BACKGROUND A high rate of adherence to ART (Antiretroviral therapy) is needed in PLWHIV (people living with HIV) to have a viral suppression for them to live a healthy and prolonged life. The goal of ART is to have optimum viral suppression and this can only be obtained through a good adherence of >95%. Therefore, patients on ART needs to achieve this level of adherence so as to reduce the rate of morbidity and mortality amongst them. OBJECTIVES The study objective was to identify the factors that affects adherence to anti-retroviral therapy among people living with HIV on anti-retroviral therapy with specific objectives being: - To determine the patients related factors that affects adherence of PLWHIV to ART - To identify health system related factors that affects adherence of PLWHIV to ART - To explore the Socio-economic factors that affects adherence of PLWHIV to ART in St Martin De Porres Catholic General Hospital Management Unit in Fundong Health District of Boyo Division, North West Region of Cameroon. METHODS This cross-sectional, qualitative, semi-structured interviewed study carried out in April and May 2023 explore the factors affecting ART adherence in PLWHIV in St Martin De Porres Catholic General Hospital HIV Treatment Unit. This management unit is located in the North West Region of the Republic of Cameroon. This management unit has an enrollment of 964 patients (March 2023) on ART (Anti-retroviral therapy). Of this number, 270 of the clients took part in the study. Demographic data was gotten from this number of respondents of people living with HIV (PLWHIV). A semi-structured close ended pre-tested questionnaire was used to collect data for the study, the use of medical records, observation and software data were also used for data collection. Data analysis was done manually. The conceptual frame work was used to facilitate the study. RESULTS. The age of the study population was between 20 – 60years old, with 89 (32.9%) males and 181 (67.1%) females. The findings gotten from the study shows that the adherence rate in this site is 79.1%. The adherence rate was sub- optimal (<95%) despite the advances that had been made in the care and treatment programmes in Cameroon, by providing free HIV services including free ART. Following the objectives, the main patient related factors influencing non-adherence were, forgetfulness with 71% of the respondents being forgetful, 98% of non- disclosure, 88% of the respondents indulge in the use of alcohol, 18.5% denial of their status, but the respondents did not stop their ART even when they feel healthy and strong. As regard the health system related factors, it was noticed that there was a good provider-client relationship leading to good adherence, provision of free ART services, 2.6% of the client complaint having challenge with the distance reaching the facility, with 52% of them experiencing long waiting hours at the facility when they go for their ART pick-up. Lastly, for the socio-economic factors, 25.9% of the respondents had experience stigma and discrimination in their families and communities, 33% received support from their family and friends, 23.7% were self- employed with a low income level of US$32.7 with the rest being unemployed with the unemployed adhering more to ART, the respondents were not afraid to be seen at the facility when they go for their refill and they belie both in God and on their ART to become healthy and strong.

CONCLUSION Comparing the findings of this study to other similar studies in Cameroon, the rate of adherence in this study was found to be low, with non-disclosure, use of alcohol and forgetfulness being the most common reason for non-adherence. Therefore, improving adherence in ART treatment in this site requires continuous counselling on the action and benefits of ART, intensifying home visits and the formation of treatment partners and support groups of people living with HIV were some suggestions made that will go a long way to assist these persons adhere better to their treatment.