Impact of HIV/AIDS knowledge on adherence to combined antiretroviral therapy in Niger Delta

Background: The decision to change recommendations, medications, or communication style to promote adherence depend on valid and reliable measurement of adherence determinants which in turn ensures well focused interventions for improvement.

Objective: To determine the impact of knowledge and other determinants of adherence to combined antiretroviral therapy (cART) formerly referred to as highly active antiretroviral therapy (HAART) in Bayelsa State, Niger Delta.

Methods: The cross-sectional study involved the use of validated questionnaire to 601 consented patients attending the two human immunodeficiency virus (HIV) clinics in Bayesla State, Nigeria. Pieces of information collected include HIV knowledge, its prevention and transmission among others as well as patient's CD4+ T cells count from case notes. Adherence was assessed by asking patients to recall their intake of prescribed doses in the last fourteen days and subjects who had 95-100% of the prescribed antiretroviral drugs were considered adherent. At 95% confidence interval, a 2-tailed p-value less than 0.05 was considered significant.

Results: Non adherence rate in 26.6% subjects is very high. Nine out of the twelve variables studied were significantly associated with adherence to cART among the respondents. These include sex (p=0.0232), age (p< 0.0001), marital status (p=0.0007), level of education (p<0.0001), occupation (p=0.0470), depression in the past four weeks (p=0.0166), knowledge of HIV and anti-retroviral therapy (p<0.0001), cART regimen (p=0.0010) as well as duration on cART (p=0.0016).

Conclusion: Respondents with good knowledge of HIV generally had better adherence to cART and improved immune status. This indicates the fact that improved outcomes are assured with optimum adherence to therapy. Other modifiable factors such as level of education, social support, employment status and type of regimen were major determinants of adherence as well.