Factors influencing non-adherence to anti-retroviral treatment: a case of patients at Nyeri Provincial General Hospital
Anti-retroviral therapy is considered a lifelong treatment; once an HIV / AIDS positive patient is started on AR V drugs, he or she will continue taking the medication throughout life. ART medication is supposed to be adhered to faithfully wlthout failure and taking into account timing of the dosage. Instructions on drug intake are given at various points: in the clinician room, at the triage room by the nurse and at the pharmacy where pills are refilled. Return dates are given before each patient leaves the comprehensive care clinic. However, not all patients are able to adhere fully to the vital instructions hence default on ART intake is experienced. Factors contributing to non-adherence range from family support, attitude of service providers, stigma and discrimination, nutrition and economic well-being of patients. The broad objective of this research study was to establish factors influencing non- adherence to anti-retroviral treatment among adult patients attending Comprehensive Care Clinic at Nyeri Provincial General Hospital. The specific objectives included types of drug side effects on ART, influence of family support on adherence to ARV treatment, impact of health care providers and effects of health care facility on adherence to ART. This was a case study and used simple random sampling, 170 respondents were selected. Patients who turned up to the clinic on wrong appointment dates were purposively included in the study. Using a pre-tested structured questionnaire and focus group discussions both quantitative and qualitative data was collected from the respondents respectively. The study also employed observation technique at the facility and personal interview to gather further information regarding the study subject. The data was then coded and analyzed using descriptive statistics for quantitative, data and thematic categorization for qualitative data. The study findings revealed that majority of patients who missed clinic appointments was because of stigma and discrimination. The study also found out that family support is central to optimal adherence to anti-retroviral treatment. Other factors like psychosocial support, therapy groups, and disclosure are essential in enhancing adherence. Other underlying factors influencing adherence are inclinations to herbal treatments, religious beliefs and rituals and peer pressure. The study recommended frequent adherence during counselling sessions for all patients. Scheduling daily health talks are given to patients on different topics. Quality time and individual attention to be given to all patients attending comprehensive care clinic. However there was need for further study on adherence to ARV treatment among adults attending comprehensive care clinic at Nyeri General Hospital.
University of Nairobi, Kenya