Factors Associated with Non-Adherence to Antiretroviral Therapy among Adult Clients in a Comprehensive Care Center at a Health Center; Kiambu County, Kenya

Abstract

Background: Non-adherence which is the leading cause of active Antiretroviral Therapy (ART) resistance among clients is basically the failure to use antiretroviral drugs as prescribed for Human Immunodeficiency Virus (HIV) by clients. Internal and external factors contribute to this. Objective: The aim of the study was to determine factors associated with Non-adherence to ART among adult HIV clients in Ng’enda Health Center, Kiambu County, Kenya. Methods: A descriptive cross-sectional study design was used. Target population was adult HIV clients seeking ART services at Ng’enda Health Center Comprehensive Care Clinic (CCC). Simple Random sampling was used and a sample size of 141 (98.6%) was achieved. A structured interview schedule was used to collect quantitative data. Data was analysed using Statistical Package for Social Science (SPSS) version 22.0 and findings presented in frequency tables, bar graphs and pie charts. Results: Fifty four percent (54.6%) of the respondents were female and 45.4% males, 36.2% had attained secondary education and 31.9% college education. Forty five percent (45.4%) had been on ART for 1 to 5 years, 70.9% had adequate knowledge on ART adherence, however 63.4% had ever failed to adhere and 51.1% had not adhered in a month prior to the study. Main reasons for non-adherence were forgetfulness (43.9%); busy work schedule (18.4%), distance/fare to the clinic (21%), long queue (25.5%), lack of family support (14.8%), and long waiting time (41.1%). Forty two percent (42.6%) of clients lacked treatment supporters and 16.3% had not disclosed their status. Only 37.6% did not receive family support. Forty percent (40.4%) experienced stigma at family level while 87.9% reported stigma existed at community level. Fifty seven percent (57.7%) of the respondents associated spiritual healing with non-adherence. Conclusion: Personal and facility factors contributing to ART non-adherence among clients were identified. The facility management team therefore needs to identify interventional programs to improve ART adherence among HIV clients. This requires collaborative efforts of all stakeholders involved in HIV prevention and control in the CCC.