Factors influencing adherence to antiretroviral therapy among the Youth attending Rift valley Provincial General Hospital Nakuru County, Kenya

Abstract

HIV and AIDs continues to be a major global public health issue. WHO report indicates that 36.9 million people were living with the virus by the end of 2017. African continent has been the most affected region with more than 25.6 million persons currently living with the virus. The introduction of Antiretroviral therapy has brought some relief as out of the 36.9 million persons globally living with HIV, 21.7% can have access to antiretroviral therapy. Young people aged between 15-24years contribute to an approximately 45% of new HIV infections across the world. In Kenya, 12% of the new infections which adds up to 184,719 were among youth 15-24 years. In Nakuru County, the number of youth who are currently infected is 5,509 and those who are actively registered on treatment at the Rift valley provincial general hospital are 566. The purpose of this study was to find out the factors influencing adherence to ART among the youth 15-24 years attending PGH. This is because despite the Governments’ efforts and commitment to provide free ARVS to all public health facilities across the country, people living with HIV and AIDs including the youth still continue dying at an alarming rate as a result of non-adherence to ART. Previous researchers have looked at factors such as culture, stigma and discrimination and religious factors as possible hindrances to adherence to ART. However; little has been done regarding gender preference, peer influence, denial of illness and parental supervision as influencing factors. The study sought to find out the factors which influence have adherence to ART among the youth attending PGH, in Nakuru County. It was based on three objectives which included examining the influence of patient-related factors on adherence to ART, assessing the influence of therapy-related factors on adherence to ART and establishing the influence of contextual factors on adherence to ART among the youth attending PGH, Nakuru County. The study was guided by the health belief model theory. Research design used was descriptive survey design. Data types and sources were both primary and secondary. Target population was the youth aged 15-24years, 10 nurses and 7 mentors. Sample population was 138 youth, 3 nurses and 2 mentors. Sampling techniques used were systematic random sampling and purposive sampling. Data collection tools used were questionnaires and key informant interviews. Data was analyzed both quantitatively and qualitatively. Data entry was subjected to closed ended questions using SPSS. Cross tabulation was used to determine response frequency and percentages. The findings were presented on frequency tables. Significant level was measured through Pearson chi square. Research permit was obtained from NACOSTI, Ministry of Education and PGH medical superintendent. Ethical considerations included confidentiality, anonymity, respect and do not harm principle. The study found out that denial of illness was a major influence to adherence and it was an observation that those who started medication immediately had a low rate of non-adherence. The study also found out that dosage complexity of ARVs and intensity of side effects influenced adherence. Knowledge on HIV and AIDS was also found to be a major influence to adherence. The study recommended that HIV and AIDS be taught in all learning institutions and community levels, support and care be accorded to the youth living with HIV and AIDS, disclosure be encouraged by healthcare centers dealing with HIV patients and alternative measures like injection be considered in order to ease the dosage burden. The study suggested that further research be conducted to find out the effect of dosage, income and age on adherence to ART.