Socio-cultural Factors Influencing Adherence to Antiretroviral Therapy Among People Living with HIV/AIDS in a Tertiary Hospital in Southwestern Nigeria
International Journal of HIV/AIDS Prevention, Education and Behavioural Science
Volume 5, Issue 2, December 2019, Pages: 124-133
Received: Aug. 22, 2019;
Accepted: Sep. 24, 2019;
Published: Nov. 8, 2019
Views 484 Downloads 284
Okunola Oluseye Ademola, Sociology and Anthropology Department, Obafemi Awolowo University, Ile-Ife, Nigeria
Muoghalu Caroline, Sociology and Anthropology Department, Obafemi Awolowo University, Ile-Ife, Nigeria
Irinoye Adedayo Ishola, Medical and Health Services, Obafemi Awolowo University, Ile-Ife, Nigeria
The study investigated the socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. It investigated the influence of various socio-cultural factors on adherence of PLWHA to treatment regimen People Living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife and assessed the prevalence of adherence to ART among PLWHA in the study area. These were with the view to ascertaining the influence of socio-cultural factors in the PLWHA’s adherence to antiretroviral therapy in the study location. The study design was a cross-sectional where both qualitative and quantitative research methods were adopted. The quantitative data were collected using structured questionnaire. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife where ages were between 18 and 60 years. Also two focus group discussion sessions were held with 10 males and 10 females living with HIV and currently on ART. Furthermore, in-depth interviews were conducted on three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) in the clinic. The quantitative data were analyzed using descriptive statistics such as tables and percentages and inferential statistics such as Chi Square and cross-tabulations. The qualitative data were analyzed in themes based on the objectives. The findings from the study indicated level of adherence to ART was 89.0% among the respondents. There was a statistically significant relationship (χ2 = 22.14; p < 0.01) between social and family supports and the degree of adherence to ART among PLWHA. There was a statistically significant relationship between level of adherence and respondents’ age (χ2 = 66.05, p < 0.05). The older the respondents’ age, the higher the level of adherence to ART. Also the relationship between educational level and adherence to ART was explored and found to be statistically significant (χ2 = 26.04, p < 0.05). Adherence is inversely proportional to educational attainment. Nutrition, polygyny, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religious belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that socio-cultural factors exert very strong influences on PLWHA’s adherence to antiretroviral therapy.
Okunola Oluseye Ademola,
Irinoye Adedayo Ishola,
Socio-cultural Factors Influencing Adherence to Antiretroviral Therapy Among People Living with HIV/AIDS in a Tertiary Hospital in Southwestern Nigeria, International Journal of HIV/AIDS Prevention, Education and Behavioural Science.
Vol. 5, No. 2,
2019, pp. 124-133.
UNAIDS, “FACT SHEET – GLOBAL A I DS UPDATE 2019,” 2019.
O. A. Okunola, “Antiretroviral Therapy (ART): Evaluation of Art’s Perception among People Living with HIV/AIDS in South Western Nigeria,” J. AIDS Clin. Res., vol. 08, no. 01, pp. 1–6, 2017.
E. Wilson and I. Sereti, “Immune restoration after antiretroviral therapy: the pitfalls of hasty or incomplete repairs,” Immunol Rev, vol. 254, no. 1, pp. 343–354, 2013.
C. Shoko and D. Chikobvu, “A superiority of viral load over CD4 cell count when predicting mortality in HIV patients on therapy,” BMC Infect. Dis., vol. 19, no. 169, pp. 1–10, 2019.
S. Wakibi, Z. Ng’ang’a, and G. Mbugua, “Factors associated with non-adherence to highly active antiretroviral therapy in Nairobi, Kenya,” AIDS Res. Ther., vol. 8, no. 43, pp. 1–8, 2011.
T. F. F. Ferguson, K. E. S. Tewart, E. F. Unkhouser, J. T. Olson, A. O. W. Estfall, and M. S. S. Aag, “Patient-perceived barriers to antiretroviral adherence : associations with race,” AIDS Care, vol. 14, no. 5, pp. 607–617, 2002.
D. R. Bangsberg et al., “Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population,” AIDS, vol. 14, pp. 357–366, 2000.
S. A. Iacob, D. G. Iacob, and G. Jugulete, “Improving the adherence to antiretroviral therapy, a difficult but essential task for a successful HIV treatment-clinical points of view and practical considerations,” Front. Pharmacol., vol. 8, no. NOV, pp. 1–12, 2017.
K. Peltzer, N. F. Preez, S. Ramlagan, and J. Anderson, “Antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa,” BMC Public Health, vol. 10, no. 111, pp. 1–10, 2010.
A. O. Oku, E. T. Owoaje, O. K. Ige, and A. Oyo-ita, “Prevalence and determinants of adherence to HAART amongst PLHIV in a tertiary health facility in south-south Nigeria,” BMC Infect. Dis., vol. 13, no. 1, p. 1, 2013.
M. Mukhtar-yola, S. Adeleke, D. Gwarzo, and Z. F. Ladan, “Preliminary investigation of adherence to antiretroviral therapy among children in Aminu Kano Teaching Hospital, Nigeria,” African J. AIDS Res., vol. 5, no. 2, pp. 141–144, 2009.
G. Ritzer, Ritzer - Contemporary Sociologists. 2008.
D. O. Case, Looking for Information A Survey of Research on Information Seeking. 2007.
W. Max, Methodology of Social Sciences. 2017.
J. D. Fisher, W. A. Fisher, K. R. Amico, and J. J. Harman, “An Information – Motivation – Behavioral Skills Model of Adherence to Antiretroviral Therapy,” Heal. Psychol., vol. 25, no. 4, pp. 462–473, 2006.
C. Anyaike et al., “Adherence to combined antiretroviral therapy (cART) among people living with HIV/AIDS in a tertiary hospital in Ilorin, Nigeria,” Pan Afr. Med. J., vol. 32, no. 10, pp. 1–12, 2019.
U. U. Onyeonoro, U. E. Ebenebe, C. C. Ibeh, U. N. Nwamoh, A. U. Ukegbu, and O. F. Emelumadu, “human immunodeficiency virus / acquired immunodeficiency syndrome in a tertiary health facility in South Eastern Nigeria,” J. HIV Hum. Reprod., vol. 1, no. 2, pp. 2–7, 2013.
P. O. Erah and J. E. Arute, “Adherence of HIV / AIDS patients to antiretroviral therapy in a tertiary health facility in Benin City,” vol. 2, no. 7, pp. 145–152, 2008.
S. P. Wasti, P. Simkhada, J. Randall, J. V Freeman, and E. Van Teijlingen, “Barriers to and Facilitators of Antiretroviral Therapy Adherence in Nepal : A Qualitative Study,” vol. 30, no. 4, pp. 410–419, 2012.