Factors associated with poor adherence amongst patients receiving antiretroviral therapy at the intermediate hospital Oshakati in Namibia

Abstract

Namibia is severely affected by the HIV/AIDS epidemic, with an estimated HIV prevalence of 17.8%. A comprehensive, public HIV/AIDS treatment and care programme was established in 2003 by the government of Namibia in association with its development partners. The introduction of antiretroviral therapy [ART] has dramatically decreased HIVrelated mortality and morbidity, improved quality of life, revitalized communities and transformed perceptions of HIV/AIDS from a plaque and death sentence to a manageable chronic condition. Intermediate Hospital Oshakati (IHO) in the Oshana region, is one of the six pilot hospitals where highly antiretroviral therapy (HAART) was initiated. Adherence to antiretroviral therapy (ART) is a key factor in ensuring optimal clinical outcomes and is associated with improved survival among HIV and AIDS patients. Sustained high levels of adherence (taking 95% or more of medication as prescribed) are essential for treatment success. Suboptimal adherence to treatment has been associated with virologic, immunologic and clinical failure, and may increase the risk of resistance to first-line ART drugs. Studies conducted in various parts of the country including the Oshakati district, report small proportions of patients defaulting on ART. Defaulting from treatment raises questions about adherence to ART as it can be assumed that poor adherence would precede defaulting from treatment. This study explored factors that influence poor adherence to ART among patients at Intermediate Hospital Oshakati.