The influence of counselling on adherence to anti-retroviral therapy (ART) amongst people living with HIV/AIDS; the case of Kilindini District, Kenya
Oluoch, Benson O
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HIV / AIDS in Kenya and the world over generally had a huge impact to an extent that every sector as well as every population virtually got affected. A highlight of the effects included increased pressure in the provision of healthcare services, increased mortality rates of the productive age group, and increased number of Orphans & Vulnerable Children, just to mention a few. Even as tireless efforts were being made by key stakeholders to find cure to HIV/AIDS, the scourge continued to manifest its devastating effects. On a positive note however, remarkable gains had been made in mitigating its effects, not only in Kenya but also other countries in the world. The availability of free Anti-retroviral drugs (ARVs) was arguably the biggest milestone towards this end. This had significantly reduced mortality rates associated to HIV/AIDS related illnesses. However, provision of free ARVs to people living with HIV/AIDS is one thing, but ensuring that there is optimal adherence to the same is yet another fairly tough task. In Kenya, averagely 10% of people on ART failed to adhere (APHIA II Western, Quarter 1 report, 2007). The key purpose of the study was to specifically examine the role of counseling in facilitating. adherence amongst people living with HIV/AIDS. First, the study aimed at finding out the extent to which counseling on disclosure and acceptance influences adherence to ART amongst PLHIV. Secondly, it aimed at determining how counseling on effective use of ARVs influences adherence to ART amongst PLHIV. The third objective of this study was to establish whether counseling on emotional support influences adherence to ART amongst PLHIV. Lastly, the study aimed at investigating the influence of counseling on regular medical check up on adherence to ART amongst PLHIV. The study used survey design where open and closed ended questionnaires were administered to the respondents who were specifically a sample of people living with HIV/AIDS in Kilindini district. This design was chosen because it makes it easier for a researcher to collect data from a sample rather than from every member of the population, and make descriptive inferences. The findings showed that counseling on disclosure and acceptance influences adherence to ART to a very great extent with 67.3% of the respondents having disclosed their status, and majority being women. Secondly, the findings showed that counseling on effective use of ARVs mainly influences adherence by providing essential information on ART. The study also showed that 57.3% of respondents were getting psychosocial/emotional support and agreed that this support influences adherence to ART. Also, the findings indicated that 88.3% of the total number of respondents attended medical checkups on a monthly basis. A total of 91.8% indicated that counseling on regular medical checkup significantly influences adherence to ART amongst people living with HIV. Based on findings, the study recommended that every client living with HIV should be diligently asked and supported to disclose their status to close family member(s), relative or member of the community before enrollment for ART. The study also recommended use of adequate trained adherence support workers and a strengthened coordination and collaboration of health workers at the health facilities and community health workers (or other resource persons) for effective follow-ups.