| dc.description.abstract | This paper identifies Factors influencing Levels of Adherence to Antiretroviral Therapy Treatment (ART) among people living with HIV/AIDS (PLWHA) in Kibera, a Resource-Poor Urban Setting with a high HIV prevalence in Kenya.
The purpose of this study was to determine the levels of adherence to ART among people living with HIVIAIDS who were on the ART programs. Adherence to Antiretroviral Therapy Treatment (ART) is one of the most social/medical challenges in the treatment of HIVIAIDS. An increasing concern in the world by the World Health Organization (WHO) with mitigating programmes in Kenya performed by bodies such as National AIDS Control Council (NACC), National AIDS and STD Control Program (NASCOP) and the Ministry of Health (MOH) reflect the concern.
The population of interest for this study was all adults living with HIVIAIDS residing in Kibera, Nairobi in the year 2007. The population that was accessible to this study consisted of both patients (117ARV users) and 6 key informants who included Health Care Providers from the health facility between October and November 2007. The total sample size from the study site was 123 participants.
This was a sample survey study which used both quantitative and qualitative research methods. To achieve the objectives of study, the research project was based on a combination of in-depth semi-structured interviews, self-completion questionnaires and an extensive literature review. Key informants were interviewed using a combination of in depth semi-structured interviews and self completion questionnaires. The analyses of the interviews through verbatim and questionnaires were then compared to a generalized view of the extensive literature review so that commonalities and differences were assessed. Research involving human subjects requires ethical clearance; so before the start of the study and collection of data, ethical clearance was sought from the Health Facility and Africa Medical Research and Foundation (AMREF) which
runs the facility and has its own Ethical Review Committee. This study took into consideration all the ethical requirements by putting into account the important issues like Confidentiality, Informed Consent, and Objectivity.
The findings showed that ART Adherence Levels were Modest based on the categorized patient adherence levels of observation. There are 3 major possible explanations that were identified for this outcome. First, it seems reasonable to state that patient related factors and Socio-economic factors did influence Levels of Adherence to ART among people living with HIV/AIDS in Kibera, Nairobi. Another factor that was identified as influencing Levels of Adherence to ART is the mechanisms that were used by Health Care Providers to maintain ongoing treatment and enhance adherence to the treatment. Self completion questionnaires and Voice recorder transcripts analyses from key informants identified drug resistance/adverse reaction monitoring and reporting, educational approaches, laboratory tests and patients tracking system as some of the intervention programs that were used to maintain ongoing treatment and to ensure ART adherence. The study also revealed that adherence to ART has medical, psychological, social and financial dimensions and is an important public health priority.
The study concludes that ART is a lifelong treatment whereby adherence is a continuous interaction of both social and clinical processes and outcomes. A Near Perfect adherence however, is required to maximize the likelihood of long term clinical success. Adherence to ART depends on many factors, most important is personal motivation and determination by the patient to be healthy and live longer.
The study recommends that in order for HIV patients to achieve higher levels of adherence to treatment, intervention programs regarding the patient, the clinician and the treatment should be made. To ensure this is achieved however requires a multifaceted, dynamic, socially and culturally specific approach. | en |
