Factors Associated with Adherence to Antiretroviral Therapy among Clients Aged Eighteen Years and above Attending Opportunistic Infection Clinic at Zvishavane District, Zimbabwe

Abstract

Strict adherence to antiretroviral therapy (ART) is key to sustained HIV suppression, reduced risk of drug resistance, improved overall health, quality of life, and survival. The purpose of the study was to examine the relationship between social support, socio-demographic factors, client related factors, health providers and regime related factors and adherence to ART among HIV positive clients attending opportunistic infections (OI) clinics in Zvishavane District. A descriptive correlational study was conducted with a convenience sample of 81 participants. Permission to conduct the study was sought from respective ethical review boards. Participants gave written informed consent. Data was collected using a structured questionnaire from March to April 2010. Interviews were carried out in a private room and each lasted about 30 minutes. Code numbers appeared on completed questionnaires which were kept by the researcher in a lockable cupboard. Data was analysed using SPSS version 12. Descriptive statistics were used to analyze data on demographics and levels of adherence to ART and social support. Inferential statistics (Pearson’s correlation [r]) were used to examine the relationship between social support and level of adherence to ART. Nineteen participants (23%) were male while 62 (77%) were female. Ages ranged from 18 to 65 years. Fifty-eight (71%) had high adherence to ART while 50 (61.7%) had moderate level of social support. There was a very weak positive correlation between social support and adherence to ART (r = .165), a negative significant correlation between worry and adherence (r = -.366 p<.01), a weak positive correlation between income and adherence (r = .248 p<.05) and a weak positive correlation between ability to pay user fees and adherence (r = .266 p<.05). Social support tended to increase with adherence to ART. Worry increased as adherence decreased. As income increased adherence also increases. There is need for comprehensively assessment of clients before commencement on ART to address factors that might negatively affect adherence.