Socio Cultural and Regimen Related Factors Influencing Adherence to Antiretroviral Therapy Among Youth (15-24 Years) in Selected Health Facilities in Nyeri County

Authors

  • Huguette Irakoze Kenya Methodist University, Meru, Kenya
  • Eunice Nyavanga Kenya Methodist University, Meru, Kenya
  • Rose Juma Kenya Methodist University, Meru, Kenya

DOI:

https://doi.org/10.53555/hsn.v6i10.1409

Keywords:

Adherence, ART, Denial, Socio-cultural, Regimen, Pills, Stigma, Youth

Abstract

The number of youths living with HIV is rising globally. In Nyeri County, the prevalence of HIV is reported to be 5.1% and viral load suppression is 77.1%. Adherence continues to pose a serious challenge among the youth receiving antiretroviral therapy; barriers include dosing schedules, pill burden stigma, denial, lack of social support and drug adverse side effect. The study aimed at assessing the socio cultural and regimen related factors influencing adherence to antiretroviral therapy among youth (15-24 Years) in selected health facilities in Nyeri County. A descriptive cross sectional research design was adopted, 227 young people (15-24 years) living with HIV on antiretroviral therapy for more than 6 months were selected from Karatina district hospital, Nyeri referral hospital, and Tumutumu PCEA. Study sites were purposive sampled and the participants were sampled using probability proportionate to size. Quantitative data was collected using structured questionnaires while qualitative data was collected from two focused group discussion (FGD). Qualitative data was analysed using both descriptive and inferential statistical techniques, qualitative data was analyzed using thematic analysis approach. From the results, 115 were females while males were 112. Majority (159) were between the ages of 18-24 years, 215 were single with 155 having attained secondary school education. Most (221) had started medication before 15 years of age. Many (153) were virally suppressed, 135 were supported by the family and community, 96 had not experienced stigma and 151 had not denied their HIV infection status. Community, friends and family support, stigma, denial were significantly associated adherence to ART (<0.05). Regimen related results depicted that (61.8%) took 2 pills per day, 22.4 % more than 2 pills while 15.8 % took only one pill. Further, 29.1 % felt the drug burden while 18.5% reported side effects from the treatment. The number of pills per day was shown to be significantly associated with adherence (p=0.04). The study recommends concerted effort between the patients, family, community, health care providers and policymakers in Nyeri County to reduce stigma and denial. School management should create an enabling environment to help students take drugs regularly and privately. The Ministry of Education to develop strategies and guidelines as part of school-based support systems for HIV infected youth. Acceptance of status and disclosure necessitates good preparation through counselling and support to navigate ongoing challenges due to the lifelong treatment of the HIV. The county needs to strengthen Operation Triple Zero strategy in order to realize 90-90-90 UNAID targets.

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References

Ammon, N., Mason, S., & Corkery, J. M. (2018). Factors impacting antiretroviral therapy adherence among human immunodeficiency virus–positive adolescents in Sub-Saharan Africa: A systematic review. Public Health, 157, 20–31. https://doi.org/10.1016/j.puhe.2017.12.010
Croome, N., Ahluwalia, M., Hughes, L. D., & Abas, M. (2017). Patient-reported barriers and facilitators to antiretroviral adherence in sub-Saharan Africa. AIDS (London, England), 31(7), 995–1007. https://doi.org/10.1097/QAD.0000000000001416
de Jager, G. A., Crowley, T., & Esterhuizen, T. M. (2018). Patient satisfaction and treatment adherence of stable human immunodeficiency virus-positive patients in antiretroviral adherence clubs and clinics. African Journal of Primary Health Care & Family Medicine, 10(1). https://doi.org/10.4102/phcfm.v10i1.1759
Hornschuh, S., Dietrich, J. J., Tshabalala, C., & Laher, F. (2017). Antiretroviral Treatment Adherence: Knowledge and Experiences among Adolescents and Young Adults in Soweto, South Africa. AIDS Research and Treatment, 2017(5192516), 1–8. https://doi.org/10.1155/2017/5192516
Iacob, S. A., Iacob, D. G., & Jugulete, G. (2017). Improving the Adherence to Antiretroviral Therapy, a Difficult but Essential Task for a Successful HIV Treatment—Clinical Points of View and Practical Considerations. Frontiers in Pharmacology, 8. https://doi.org/10.3389/fphar.2017.00831
Jima, F., & Tatiparthi, R. (2018). Prevalence of nonadherence and its associated factors affecting on HIV adults follow-up at antiretroviral therapy clinic in Batu Hospital, Eastern Ethiopia. Indian Journal of Sexually Transmitted Diseases and AIDS, 39(2), 91–97. https://doi.org/10.4103/ijstd.IJSTD_37_17
Kioko, M., & Pertet, A. (2017). Factors contributing to antiretroviral drug adherence among adults living with HIV or AIDS in a Kenyan rural community. African Journal of Primary Health Care & Family Medicine, 9. https://doi.org/10.4102/phcfm.v9i1.1343
Laisaar, K.-T., Uusküla, A., Sharma, A., DeHovitz, J. A., & Amico, K. R. (2013). Developing an adherence support intervention for patients on antiretroviral therapy in the context of the recent IDU-driven HIV/AIDS epidemic in Estonia. AIDS Care, 25(7), 863–873. https://doi.org/10.1080/09540121.2013.764393
Laxmeshwar, C., Acharya, S., Das, M., Keskar, P., Pazare, A., Ingole, N., Mehta, P., Gori, P., Mansoor, H., Kalon, S., Singh, P., Mathur, T., Ferlazzo, G., & Isaakidis, P. (2020). Routine viral load monitoring and enhanced adherence counselling at a public ART centre in Mumbai, India. PLoS ONE, 15(5). https://doi.org/10.1371/journal.pone.0232576
MacCarthy, S., Saya, U., Samba, C., Birungi, J., Okoboi, S., & Linnemayr, S. (2018a). “How am I going to live?”: Exploring barriers to ART adherence among adolescents and young adults living with HIV in Uganda. BMC Public Health, 18(1), 1158. https://doi.org/10.1186/s12889-018-6048-7
MacCarthy, S., Saya, U., Samba, C., Birungi, J., Okoboi, S., & Linnemayr, S. (2018b). “How am I going to live?”: Exploring barriers to ART adherence among adolescents and young adults living with HIV in Uganda. BMC Public Health, 18(1), 1158. https://doi.org/10.1186/s12889-018-6048-7
Micheni, M., Kombo, B. K., Secor, A., Simoni, J. M., Operario, D., van der Elst, E. M., Mugo, P., Kanungi, J., Sanders, E. J., & Graham, S. M. (2017). Health Provider Views on Improving Antiretroviral Therapy Adherence Among Men Who Have Sex with Men in Coastal Kenya. AIDS Patient Care and STDs, 31(3), 113–121. https://doi.org/10.1089/apc.2016.0213
Nabunya, P., Bahar, O. S., Chen, B., Dvalishvili, D., Damulira, C., & Ssewamala, F. M. (2020). The role of family factors in antiretroviral therapy (ART) adherence self-efficacy among HIV-infected adolescents in southern Uganda. BMC Public Health, 20(3), 34–49. https://doi.org/10.1186/s12889-020-8361-1
National AIDS Control Council. (2018). Kenya HIV Estimates. https://www.google.com/search?q=kenya+hiv+estimates+2020&oq=kenya+HIV+estimates&aqs=chrome.1.69i57j0l2.9743j0j1&sourceid=chrome&ie=UTF-8
National AIDS and STI Control Programme. (2020). Preliminary KENPHIA 2018 Report.
Reif, L. K., Abrams, E. J., Arpadi, S., Elul, B., McNairy, M. L., Fitzgerald, D. W., & Kuhn, L. (2020). Interventions to Improve Antiretroviral Therapy Adherence Among Adolescents and Youth in Low- and Middle-Income Countries: A Systematic Review 2015–2019. AIDS and Behavior, 24(10), 2797–2810. https://doi.org/10.1007/s10461-020-02822-4
Ridgeway, K., Dulli, L. S., Murray, K. R., Silverstein, H., Dal Santo, L., Olsen, P., Darrow de Mora, D., & McCarraher, D. R. (2018). Interventions to improve antiretroviral therapy adherence among adolescents in low- and middle-income countries: A systematic review of the literature. PLOS ONE, 13(1), e0189770. https://doi.org/10.1371/journal.pone.0189770
Turkova, A., Moore, C. L., Butler, K., Compagnucci, A., Saïdi, Y., Musiime, V., Nanduudu, A., Kaudha, E., Cressey, T. R., Chalermpantmetagul, S., Scott, K., Harper, L., Montero, S., Riault, Y., Bunupuradah, T., Volokha, A., Flynn, P. M., Bologna, R., Ramos Amador, J. T., … on behalf of the BREATHER (PENTA 16) trial Group. (2018). Weekends-off efavirenz-based antiretroviral therapy in HIV-infected children, adolescents and young adults (BREATHER): Extended follow-up results of a randomised, open-label, non-inferiority trial. PLOS ONE, 13(4), e0196239. https://doi.org/10.1371/journal.pone.0196239
United Nations Programme on HIV/AIDS. (2020). Global HIV & AIDS statistics. https://www.unaids.org/en/resources/fact-sheet
Yu, Y., Luo, D., Chen, X., Huang, Z., Wang, M., & Xiao, S. (2018). Medication adherence to antiretroviral therapy among newly treated people living with HIV. BMC Public Health, 18(1), 825. https://doi.org/10.1186/s12889-018-5731-z

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Published

2020-11-30

How to Cite

Irakoze, H., Nyavanga, E., & Juma, R. (2020). Socio Cultural and Regimen Related Factors Influencing Adherence to Antiretroviral Therapy Among Youth (15-24 Years) in Selected Health Facilities in Nyeri County. International Journal For Research In Health Sciences And Nursing, 6(10), 35–45. https://doi.org/10.53555/hsn.v6i10.1409