Factors Affecting Adherence to Antiretroviral Therapy among HIV/AIDS Patients in Cape Coast Metropolis, Ghana

Abstract

Background: Optimal adherence to antiretroviral therapy (ART) among HIV/AIDS patients has proved elusive despite increasing access to ART worldwide. Methods: This analytical cross-sectional study was conducted to assess factors that influence adherence to ART among HIV/AIDS patients in Cape Coast, Ghana. Three hospitals that provide full ART services were used as study sites. Data collection was done using a semi-structured questionnaire that was interviewer administered. The primary outcome of this study was respondents’ lifetime adherence to ART. Data was analyzed using SPSS version 20.0 with a p-value of 0.05 considered as statistical evidence of an association. Results: A total of 381 patients (mean age: 43.9 ± 11.8 years) were involved in the study. Life time adherence was found to be 73.0%. Only 79.5% adhered to their ART clinic appointments. Lifetime non-adherence was predicted by male sex (AOR 2.0, 95% CI 1.1–3.5, p=0.021), more than once daily dosing ART regimens (AOR 1.7, 95% CI 1.1-2.8, p=0.024), not disclosing HIV status (AOR: 2.4, CI:1.3-4.5, p=0.005), not having a way to remember to take drugs (AOR: 1.9, CI:1.1-3.4, p=0.033) and not having a treatment monitor (AOR: 2.9, 95% CI 1.7-5.0, p=0.011). Conclusions and Recommendation: Patients on ART in the Cape Coast metropolis, Ghana, were found to have a sub optimal life time adherence to their medications as well as a high rate of missed clinic visits. The study results suggest that clinicians should ensure that the clients are well educated on the importance of disclosing their serostatus and obtaining a treatment monitor prior to initiating ART for optimal adherence.