| Summary: | The cornerstone in the fight against HIV/AIDS is prevention followed by the
access to and use of highly active antiretroviral treatment (HAART). Adherence
is the greatest patient- enabled predictor of treatment outcome for the patients on
HAART, as good adherence leads to a decrease in disease progression and
death.
There is no ‘gold standard’ in the measurement of adherence. Also, factors that
influence adherence and hence the prevalence of adherence differ across
different settings making it necessary to determine local adherence prevalence
as well as factors that might impact on it.
This was a cross sectional study which assessed the prevalence of one- week
adherence to antiretroviral therapy at St Rita’s hospital through an abridged
version of the questionnaire developed by the Adult Aids Clinical Trials Group in
the United States.
Results from the questionnaires were compared to the results from a decrease in
plasma viral load to undetectable limits within six months.
The study found out that the prevalence of one- week adherence by self-report
was 96.8% (95% CI: 93.2 – 98.9%). Using a decrease in viral load to
undetectable limits within six months of initiating treatment as a tool to assess
adherence, the prevalence in this study was 96%. A combined prevalence of
94% was found for this study. These results were identical to a few results
locally but it was much higher than most local studies. The explanation for this
apparent higher adherence rate might be that the study site has not reached its
maximum capacity for the delivery of service as it is still operating at just below
the staff/patient ratio recommended by the Department of health. The study also
found out that being a member of an AIDS support group was a facilitator to
adherence while lack of adherence counselling and monitoring is a barrier.
Based on these findings it is therefore recommended that measures should be
put in place to ensure improving existing adherence counselling and monitoring,
encouraging patients to belong to at least one AIDS support group, more
decentralization of antiretroviral therapy roll out to the districts that are yet to roll
out and providing financial assistance through improved access to disability
grants for those who qualify and income generating activities for the unemployed
that do not qualify for disability grant.
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