Determinants of adherence to heart treatment among HIV patients in Mbeya region, Tanzania.

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University of Dar es Salaam
Background: High level of Highly Active Antiretroviral Therapy (HAART) adherence (>95%) is required for a patient to have a significant decrease in viral load. HAART non-adherence has been associated with higher risk of developing resistant strains of HTV that may necessitate changing the regimen to a second line, which is costly. Objective: The aim of the study was to determine the level of adherence to HAART and its determinants among HTV patients attending treatment in Mbeya Region. Specifically, the study determined how adherence is influenced by the patient’s knowledge on HIV, use of alcohol, serostatus disclosure, perception on severity to the disease, the discrimination by the family members and side effect of the drugs. Methods: Cross-sectional study was conducted involving a total of 268 HIV patients who were attending three HAART clinics in three rural hospitals of Tukuyu, Igogwe and Kyela in Mbeya Region, Tanzania, for at least three months prior to interview. An assessment of adherence among HAART users who 15 years were or older was done using a two weeks recall and one month pill count. Data were collected through a structured questionnaire; with open and closed questions. Data were entered into Epi info version 6 software and analyzed using the same software. Results: Of the 268 respondents, 125(46.6%) were males and 143(53.4%) were females. Their mean age was 36.2 years, range from 15 to 62 years, standard deviation of 8.2 years, and 74% of the patients above 30 years. Of all the respondents, 42.2% were married with proportion of males (62.4%) greater than females (24.5%) Thirty five percent of the patients (34.7%) interviewed were not adhering to treatment. Among those who had high perception on severity of HIV/AIDS, 13.9% of them missed the dose as compared with 31.1% of those whose perception was low. Among those who developed side effects 30.9% reported they had missed their dose compared to 10.7% who had no side effect and did not miss the dose Conclusion: The reasons given for non-adherence to treatment were perceptions of severity about HTV/AIDS, long waiting time at the clinic, discrimination at the family and community level and fear of side effects of the drugs. Therefore it is recommended that, patients should be educated on the possible side effects that can occur during treatment and that they should not stop taking the drugs against medical advice; this should be done at all levels from the Doctors, Nurses and dispensers. Continuous sensitization and education in the community to reduce stigma and misconception is required. Time motion studies should be done to assess why there are long waiting times at the hospitals. Patients should be encouraged to take their drugs when they go for their daily activities. Counseling has been shown to improve adherence and therefore this should be emphasized and maintained in all clinics.
Available in printed form, East Africana Collection, Dr. Wilbert Chagula Library, Class mark (THS EAF RA644.A25T34R93)
Aids (Disease), AIDS related complex, Heart, Diseases, Treatmet, Immunotherapy
Rwehumbiza, P. R (2006) Determinants of adherence to heart treatment among HIV patients in Mbeya region, Tanzania. Master dissertation, University of Dar es Salaam. Dar es Salaam.