Is adherence to antiretroviral therapy by recipients of HIV care and treatment receiving care in Akwa Ibom state, Nigeria determined by their behaviors? A cross-sectional study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20233426Keywords:
Akwa Ibom state, ART, HIV/AIDS, Nigeria, Stage of Change modelAbstract
Background: There has been limited use of stage of change model in scaling up self-care for optimal adherence to ART. The study aimed to assess the pattern of behavior and its associated factors among recipients of care (RoC) receiving treatment in Akwa Ibom state, Nigeria.
Methods: A descriptive cross-sectional study was conducted among 423 RoC between August and October 2022. The pattern of behavior of RoC was determined using descriptive statistics, and factors associated with behavior were assessed using chi-square analysis and subsequently binary logistic regression at an alpha level of <0.05 at a 95% confidence interval using SPSS version 25.
Results: Out of 423 recipients on care interviewed, 85% were in maintenance phase, and 13% in action phase. The correlates of behaviors of RoC were HIV diagnosis and on ART for over a year (p<0.001), residing in rural settings (p<0.001), and those in clinically stable DSD models (p<0.001). Over 87% of those in maintenance phase were adherent to ART, however, this was not statistically significant (p=0.21).
Conclusions: Almost all the RoC were in good behavior and majority of them were adherent to ART. The factors associated with behavior of recipients of care were those diagnosed and on ART for over a year, residing in rural settings, and those in clinically stable differentiated service delivery (DSD) models. Interventions that utilize stage of change model to scale up the self-care of RoC particularly among those in the urban settings is highly imperative.
Metrics
References
UNAIDS calls for greater urgency as global gains slow and countries show mixed results towards 2020 HIV targets. 2020. Available from: https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2019/july/20190716_PR_UNAIDS_global_report_2019. Accessed on 2 May 2023.
Federal Ministry of Health (FMOH). Nigeria HIV/AIDS Indicator and Impact Survey. 2018. Available from: https://www.naiis.ng/. Accessed on 2 May 2023.
Geng B, Chen Q, Varshney PK. Cognitive Memory Constrained Human Decision Making based on Multi-source Information, ICASSP 2021. 2021 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP). 2021;5325-9.
Tulchinsky TH, Lalonde M. The health field concept and health promotion. Case Stud Public Health. 2018:523-41.
Bangsberg DR, Perry S, Charlebois ED, Clark RA, Roberston M, Zolopa AR, et al. Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS. 2001;15(9):1181-3.
Arnsten JH, Demas PA, Farzadegan H, Grant RW, Gourevitch MN, Chang CJ, et al. Antiretroviral therapy adherence and viral suppression in HIV-infected drug users: comparison of self-report and electronic monitoring. Clin Infect Dis. 2001;33(8):1417-23.
Gifford AL, Bormann JE, Shively MJ, Wright BC, Richman DD, Bozzette SA. Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. J Acquir Immune Defic Syndr. 2000;23(5):386-95.
Miller LG, Hays RD. Adherence to combination antiretroviral therapy: synthesis of the literature and clinical implications. AIDS Read. 2000;10:177-85.
DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991;59:295-304.
Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12:38-48.
Willey C, Redding C, Stafford J, Garfield F, Geletko S, Flanigan T, et al. Stages of change for adherence with medication regimens for chronic disease: development and validation of a measure. Clin Therap. 2000;22(7):858-71.
Highstein GR, Willey C, Mundy LM. Development of stage of readiness and decisional balance instruments: tools to enhance clinical decision-making for adherence to antiretroviral therapy. AIDS Behav. 2006;10(5):563-73.
Kirkwood B, Sterne J. Essential medical statistics. 2nd edn. Oxford, UK: Blackwell Science Ltd; 2003:423.
Genberg BL, Lee Y, Rogers WH, Willey C, Wilson IB. Stages of change for adherence to antiretroviral medications. AIDS Patient Care STDS. 2013;27(10):567-72.
Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol. 1992;47(9):1102-14.
Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski W, et al. Stages of change and decisional balance for 12 problem behaviors. Health Psychol. 1994;13(1):39-46.
Imeri H, Toth J, Arnold A, Barnard M. Use of the transtheoretical model in medication adherence: a systematic review. Res Soc Admin Pharm. 2022;18(5):2778-85.
Tamburrino MB, Nagel RW, Chahal MK, Lynch DJ. Antidepressant medication adherence: a study of primary care patients. Prim Care Comp J Clin Psychiatr. 2009;11(5):205-11.
Falang KD, Akubaka P, Jimam NS. Patient factors impacting antiretroviral drug adherence in a Nigerian tertiary hospital. J Pharmacol Pharmacother. 2012;3:138-42.
Agu KA, Okojie O, Oqua D, King RC, Omonaiye O, Onuoha C, et al. Medication adherence and risk factors for non-adherence among patients taking highly active antiretroviral therapy. West Afr J Pharm. 2011;22(1).
Yaya I, Landoh DE, Saka B, Patchali P, Wasswa P, Aboubakari AS, et al. Predictors of adherence to antiretroviral therapy among people living with HIV and AIDS at the regional hospital of Sokodé, Togo. BMC Public Health. 2014;14(1):1-10.
Mbengue MAS, Sarr SO, Diop A, Ndour CT, Ndiaye B, Mboup S. Prevalence and determinants of adherence to antiretroviral treatment among HIV patients on first-line regimen: a cross-sectional study in Dakar, Senegal. Pan Afr Med J. 2019;33:95.
Oladigbolu RA, Oche MO, Raji MO, Gana GJ, Ezenwoko ZA. Effect of telephone calls and text message reminder interventions on the adherence to antiretroviral drugs among HIV/AIDS clients receiving care in Sokoto state, Nigeria. Int J Community Med Public Health. 2020;7(10):3773-86.
Okoronkwo I, Okeke U, Chinweuba A, Iheanacho P. Nonadherence factors and sociodemographic characteristics of HIV-infected adults receiving antiretroviral therapy in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. ISRN AIDS. 2013;2013:843794.
Olowookere SA, Fatiregun AA, Akinyemi JO, Bamgboye AE, Osagbemi GK. Prevalence and determinants of non-adherence to highly active anti-retroviral therapy among people living with HIV/AIDS in Ibadan, Nigeria. J Infect Develop Countries. 2008;2(5):369-72.
National AIDS and STIs control programme federal ministry of health (FMOH). Differentiated Service Delivery Operational Manual for HIV Prevention, Treatment and Care. 2021. Available from: https://www.differentiatedservicedelivery.org/wp-content/uploads/DSD-guidelines-Nigeria.pdf. Accessed on 3 May 2023.
