The Nyeri Provincial General Hospital (PGH) was one of the five pilot sites at which the
Government of Kenya started providing antiretroviral therapy (ART) to HIV-infected patients
in 2003. At this hospital, as in the other pilot sites, there was an increasing number of patients
requiring a switch from first line to second line ART drug regimens due to treatment failure.
There was little information available on levels of adherence to ART as well as the factors
that influence adherence among patients to guide adherence promotion strategies and thus
reduce the incidence of virologic and treatment failure. The objective of this study was to
assess factors that influence adherence to ART at Nyeri PGH. The study was retrospective
and cross-sectional. Two hundred and twenty nine patients were selected from a total of 705
patients who had been active on ART for at least one year and who were on solid drug dosage
forms. Stratified random sampling was used to obtain the same relative proportions of adults,
paediatrics, male and female respondents in the sample population as in the study population.
Semi-structured interview schedules were used to obtain demographic information and
patients’ views on various dimensions of ART services at the hospital. Pill count data of
patients collected over a period covering 3 clinic appointments was used to determine the
percentage adherence levels of the patients to ART. For 13% of the patients for whom pill
count data was not available, pharmacy refill dates were used to estimate adherence levels.
Univariate analysis of various factors was undertaken to examine the odds of adherence and
non-adherence to ART with respect to the various factors. Response values and categories
were assigned to questions. Patient responses on ART services at the hospital were grouped
into four categories: ART Acceptability, ART Accessibility, ART Affordability and ART
Availability. The response scores were aggregated per statement and averaged to get mean
scores for each category. The mean scores for each category of questions were subjected to
correlation analysis to check for the influence of patients’ views on their adherence level to
ART. The mean adherence rate for all the patients was 92.7% ± 8.5%. The number of patients
exhibiting optimal adherence (greater than 95%) to ART was 125, representing 55% of the
total patients interviewed. 197 (86%) of the patients exhibited greater than 85% adherence to
ART. Only 11 (5%) of the patients sampled had less than 75% adherence to ART. Being busy
with household chores and job-related tasks (39%) as well as travelling (21%) were cited by
the respondents as the most important factors affecting adherence. Occupation of patient was
found to influence adherence with employed patients exhibiting a higher rate of non-optimal
adherence (Odds Ratio of non-optimal adherence: 2.64, 95% CI, 1.3863 to 4.8708, P <
0.005). Age, gender, level of education, marital status and knowledge of HIV disease were
not found to significantly affect adherence. On correlation analysis, patients’ views on ART
availability and ART acceptability were significantly correlated with percentage adherence to
ART (Spearman’s r = −0.157, P < 0.05 and Spearman’s r = 0.255, P < 0.01 respectively).
Based on the adherence levels established in this study showing that about 14% of the study
population was at an elevated risk of virologic failure, there is urgent need to institute
measures to identify those patients with non-optimal adherence to ART and work out
strategies to improve their adherence. Particular effort should be made to prepare practical
medication taking plans for employed patients initiating ART therapy.
Edu, F (2021). Assessment Of Factors Influencing Adherence To Antiretroviral Therapy At Nyeri Provincial Hospital In Central Kenya. Afribary.com: Retrieved June 23, 2021, from https://afribary.com/works/assessment-of-factors-influencing-adherence-to-antiretroviral-therapy-at-nyeri-provincial-hospital-in-central-kenya
Frontiers, Edu. "Assessment Of Factors Influencing Adherence To Antiretroviral Therapy At Nyeri Provincial Hospital In Central Kenya" Afribary.com. Afribary.com, 04 Jun. 2021, https://afribary.com/works/assessment-of-factors-influencing-adherence-to-antiretroviral-therapy-at-nyeri-provincial-hospital-in-central-kenya . Accessed 23 Jun. 2021.
Frontiers, Edu. "Assessment Of Factors Influencing Adherence To Antiretroviral Therapy At Nyeri Provincial Hospital In Central Kenya". Afribary.com, Afribary.com, 04 Jun. 2021. Web. 23 Jun. 2021. < https://afribary.com/works/assessment-of-factors-influencing-adherence-to-antiretroviral-therapy-at-nyeri-provincial-hospital-in-central-kenya >.
Frontiers, Edu. "Assessment Of Factors Influencing Adherence To Antiretroviral Therapy At Nyeri Provincial Hospital In Central Kenya" Afribary.com (2021). Accessed June 23, 2021. https://afribary.com/works/assessment-of-factors-influencing-adherence-to-antiretroviral-therapy-at-nyeri-provincial-hospital-in-central-kenya