Factors influencing treatment of HIV/aids among married women in Kenya: a case of partners for health and development in Africa (phda) project, Kasarani constituency, Nairobi county, Kenya

Abstract

This study sought to establish the factors associated with ART adherence among married women in Kenya. This study used a cross-sectional survey research design owing to its ability to allow quantitative and qualitative data from a large population. The target population of this study comprised of all married women living with HIV in PHDA project, Baba dogo health centre, Kasarani Constituency, Nairobi County. This study used two instruments; a questionnaire and an interview schedule. Quantitative data was analyzed using descriptive and inferential statistics. Content analysis was used to analyze qualitative data. Inferential statistics such as Pearson chi-square test were used to analyze quantitative data. The study found that there is a statistically significant association between informing spouse HIV status and adherence to ART program. The study established that there is a statistically significant association between having a treatment buddy and adherence to ART program. The study found that there is a statistically significant association between self esteem after knowing HIV status and adherence to ART program. The study established that there is a statistically significant association between society's attitude towards people living with HIV and adherence to ART program. The study revealed that there is a statistically significant association between the extent ARVs side effects affected married women living with HIV in Baba Dogo daily life and adherence to ART program. The study found that there is a statistically significant association between problems experienced in dietary requirements of ART and adherence to ART program. The study established that there is a statistically significant association between perceived ease of ART program by the respondents and adherence to ART program. The study has shown a statistically significant association between empathy of healthcare providers and adherence to ART program. The study revealed that there is a statistically significant association between nature of communication with healthcare provider and adherence to ART program. The study also revealed that there is a statistically significant association between healthcare providers’ know-how as perceived by married women living with HIV in Baba Dogo and adherence to ART program. Adherence to ART program by married women living with HIV in Baba Dogo as measured by number of missed doses for one week was found to be 73.6% and for two weeks was 67.9% while adherence to ART program for four weeks was 35.8%. This study concluded that informing spouse HIV status and having a treatment buddy have been shown to promote adherence to ART program. Being accompanied by spouse or not among married women living with HIV does not have an impact on adherence to ART program. This study concluded that stigma has reduced as majority of married women living with HIV in Baba Dogo have not experienced prejudice based on their HIV status. Reduced stigma has led to high self esteem even after knowing their HIV status among married women living with HIV. The fact that married women living with HIV in Baba Dogo have termed society’s attitude towards people living with HIV as positive serves to show reduced stigma. This study concluded that high self esteem encourages adherence to ART program. This study concluded that ARVs side effects affected married women living with HIV in Baba Dogo daily life either to a little extent or not at all. This study concluded that ART program is easy or moderately easy to adhere. This study concluded that healthcare providers at Baba Dogo health centre have empathy as they were described by married women living with HIV in Baba Dogo as either compassionate or very compassionate. The same apply to communication between patients and healthcare providers as well as perceived healthcare providers’ know-how by the patients. The study concluded that adherence as measured by self report matched adherence measured using missed doses for one and two weeks but differed with that for four weeks. This could be attributed to recall bias among the studied population. This study recommends that married women living with HIV should be encouraged to inform spouse their HIV status and have a treatment buddy to enhance adherence to ART program. Although stigma has reduced, the government through the Ministry of Health and other stakeholders should sustain efforts to ensure it does not recur as it can negatively affect adherence to ART program. Ease of drug regimen has encouraged adherence to ART program hence manufacturers and researchers should put more efforts towards even easier drug regimens. Patient-healthcare provider relationship should be positive as it can affect adherence to ART. Healthcare providers should be compassionate and ensure good communication with their patients. The healthcare providers should also be knowledgeable as the perception of patients on their know-how can affect adherence to ART.