Factors Associated With Non Adherence To Art Among Hiv Infected Patients Attending Art Clinic At Kitagata Hospital, Sheema District Western Uganda.

ABSTRACT Background: Patient adherence to Antiretroviral Treatment (ART) is an issue that is growing in prominence and generating a burgeoning interest with ART roll-out. In the absence of a cure, ART is the only available option that offers the possibility of dramatically reducing HIV/AIDSrelated morbidity and mortality. Therefore, successful administration of this treatment depends on sustained and strict adherence to the prescribed regimens. However, sustaining adherence to antiretroviral therapy (ART) over the long term is still a particular challenge for countries in subSaharan Africa. Therefore, this study was based on finding the proportion of participants who are non adhering to ART, the pill burden related factors, individual factors and the healthcare related factors associated with non adherence to ART among patients attending ART clinic at Kitagata Hospital. Methods: The study employed a descriptive cross-sectional design where both quantitave and qualitative methods were used to collect data from the study population which consisted of patients (20-50 years) attending ART clinic at Kitagata Hospital. The sample size of 150 participants was calculated from the Kish Leslie, 1965 formula and a systematic sampling method was used to get the participants. Results: Majority of the participants were females (60.7%) where, most of them were between 31-40 years, 75(50%). Among the 150 study participants, the magnitude of non adherence to ART in the past 7 days was 13.3% only 8(40%) men and 12(60%) females non adhering. The main reasons for non adherence were forgetting (63.2%), being busy (26.3%) and the long distances to the ART clinic since most, 59(39.3%) of them were staying over 10km away from the ART clinic. Conclusion: Compared to other similar studies done in Kitagata, in this study a relatively low adherence rate was found. Forgetfulness was the most common reason for the non adherence followed by the long distance to the ART clinic. Therefore, the ART counseling needs to give emphasis to using memory aids and Government should provide clinic annex in strategic locations across the villages as a means of bringing treatment closer to patients. In addition, a further study on adherence rate and the factors associated with non adherence is recommended.  

TABLE OF CONTENTS

DECLARATION ................... ERROR! BOOKMARK NOT DEFINED.

SUPERVISOR’S APPROVAL: ........... ERROR! BOOKMARK NOT DEFINED.

DEDICATION......................................................................................... II

ACKNOWLEDGEMENT.......................................................................IV

TABLE OF CONTENTS ....................................................................... V

LIST OF FIGURES.........................................................................VII

LIST OF TABLES .................................................................................VII

LIST OF ABREVIATIONS ...............................................................VIII

OPERATIONAL DEFINITIONS ...........................................................IX

ABSTRACT.......................................................................................... X

CHAPTER ONE ....................................................................... 1

1.1 BACKGROUND ......................................................................... 1

1.2 PROBLEM STATEMENT ............................................................... 3

1.3 BROAD OBJECTIVE...................................................................... 3

1.4 SPECIFIC OBJECTIVES ........................................................ 4

1.5 RESEARCH QUESTIONS................................................................ 4

1.6 SIGNIFICANCE OF THE STUDY ............................................ 4

1.7 STUDY SCOPE .............................................................................. 5

1.7.1 Geographical scope ............................................................. 5

1.7.2 Content scope......................................................................... 5

1.8 CONCEPTUAL FRAMEWORK ................................................. 6

CHAPTER TWO ..................................................................... 7

2.0 INTRODUCTION ....................................................................... 7

2.1 IMPORTANCE OF ADHERENCE TO ART.............................. 7

2.2 PROPORTION OF HIV POSITIVE PATIENTS NON ADHERING TO ART. ........................................... 8

2.3 FACTORS ASSOCIATED WITH ADHERENCE TO ART..................................................................... 9

2.3.1 Individual factors..................................................................... 9

2.3.2 Pill burden related factors............................................... 11

2.3.3 Health care related factors................................................ 12

CHAPTER THREE.................................................................. 14

3.0 INTRODUCTION ................................................................. 14

3.1 STUDY DESIGN.......................................................................... 14

3.2 STUDY AREA............................................................................ 14

3.3 STUDY POPULATION ............................................................ 14

3.4 SAMPLE SIZE DETERMINATION............................................ 15

3.5 SAMPLING PROCEDURE........................................................... 16