Factors predicting antiretroviral medication adherence among people living with HIV in Asunafo South District, Ghana. A cross-sectional study

Abstract

Background Comorbidities among HIV positive individuals may have an impact on adherence to antiretroviral medication. Antiretroviral therapy's effectiveness is impacted by poor adherence, which also hastens the spread of the virus and increases medication resistance. This study was set to determine the level of adherence to antiretroviral treatment and identify the factors which predict ART medication adherence among people living with HIV who are on ART in Asunafo South District, Ghana. Methods Retrospective records review and analytical cross-sectional study designs were used. Systematic random sampling was used to collect the data. The data collection was conducted between 5th July 2023 and 28th July 2023. The literature for this study was reviewed and completed from 20th January 2023 and 28th April 2023. Descriptive statistics were performed. Bivariate analysis was done, where variables with p-values < 0.1 were employed in multivariate logistic regression analysis. Independent factors having p-values < 0.05 in multivariate logistic regression analysis were considered significantly associated with adherence. Correlation and regression analyses were performed on how ART adherence was related with viral load and CD4 cell counts. Lastly, direct and indirect relationships was done using structural equation modeling. The analysis was performed using Stata version 17.0. Results The study revealed a suboptimal ART adherence of 23.1%. Comorbidities such as hypertension, hepatitis B and C, psychiatric disorders, substance abuse, and pneumonia were found. The presence of hepatitis B and C, and ART site were significantly associated with ART adherence [(χ² = 5.21 (1); p = 0.022; site (χ² = 39.70 (1); p < 0.001) respectively)]. Younger patients (18–29 years and 30–39 years old) and increase in educational level of respondents were significantly more likely to influence adherence to treatment compared to older, less educated respondents. Males with higher education (senior high school and tertiary) were more likely to predict adherence to antiretroviral therapy. Respondents with two or more comorbidities were more likely to achieve optimal adherence, and a positive correlation was found between ART adherence and CD4 cell counts. Conclusions The study revealed that ART site, age, education, and gender, contributed significantly to influencing ART adherence in the Asunafo South District.