ANALYSIS OF THE FACTORS AND PREDICTORS OF ADHERENCE TO HEALTHCARE OF PEOPLE LIVING WITH HIV/AIDS IN TERTIARY HEALTH INSTITUTIONS IN ENUGU STATE

Abstract

Survival of people living with HIV/AIDS (PLWHA) has increased since the emergency of High active antiretroviral therapy (HAART) in 1996. The study was aimed to analyse the factors and predictors of adherence of people living with HIV/AIDS in tertiary health institutions in Enugu state. This was a descriptive cross-sectional study design. The study population consisted of those diagnosed for HIV / AIDS at tertiary health institutions in Enugu State. The total numbers of clients enrolled were 793 and 249 clients were loss to follow up, majority was males. Those initiated on ART were 544. Clients of age <15 years were excluded and they were 31 clients. Finally, 500 clients were selected, males were 138 and female were 362 by simple random sampling techniques. Data was collected from HIV / AIDS patients ART record cards, registers and institutions data units for those initiated on ART in 2014 using a designed proforma. Those clients aged 15 years and above were retrospectively studied between the year 2014- 2018 and some of them that survived after five years (60 months) on ART were interviewed by applying simple random sampling technique. Cohort inclusion begins at initiation on ART with follow-up clinical information collected year by year for five years. IBM SPSS statistics version 24.0 was used. Chi square test was used to assess association between categorical variables and the level of statistical significance of the proportions was determined by a P-value less than 0.05. Manual content analysis was used for the interview and probability of dying and surviving analysis. Adherence was statistically significant, p<0.001 among

clients who had obtained tertiary 105 (92.1%) and secondary, 124 (57.7%) education, who lived within the state with the place of care, 234 (76.0%), and those retired, 12 (63.2%) and the unemployed, 46 (61.3%). None missing of ART intake (100%), lack of stigmatization (66.7%), urban residence (66.7%), having employment (75%), and middle class wealth index (58.3%) were discovered as factors responsible for the survival of those under care after five years of study. Financial constraints, occupational and educational factors and stigmatization were the major reasons accounting for non-adherence which could affect PLWHA. Implementing policies and programmes that will involve the contribution of local government councils are recommended to assist those in rural areas.