An evaluation of determinants of adherence to antiretroviral therapy in AIDS patients in Gert Sibande district, Mpumalanga Province South Africa

Title: An Evaluation of determinants of adherence to antiretroviral therapy in AIDS patients in Gert Sibande District, Mpumalanga province South Africa

 Introduction
 In South Africa about 11.4% of the population is infected with HIV/AIDS and about  371731 are on antiretroviral therapy (ART). ART can improve the quality of life and socio-economic status for HIV positive patients. This study aimed to determine the factors that influence adherence in HIV patients on ART.

 Methods

The study was conducted on patients on ART from two district hospitals (urban and rural) of Mpumalanga Province, South Africa. This was an analytical, cross-sectional study. The sample size of study was 500. Appointment registers for the period June-August 2008 were used as the sampling frame. The respondents were recruited using systematic random sampling. An interviewer directed questionnaire and a record review were measurements tools. Adherence was measured using the Patient Medication Adherence Questionnaire. The Pearson chi-square test of association and binary logistic regression analysis was used for identifying significant predictors of non adherence.

 Results
 The questionnaires analysed were 429 and participant reported adherence was 92.54%. The mean age was 37.1 (SD 9.02), gender distribution (21.13% male and 78.87% female), and the mean duration (months) while on ART was 17.9 (SD 15.58). The variables that were significantly associated with non adherence included  site of ART (OR 0.33, CI 0.12-0.90), social support (OR 0.68, CI 0.50-0.92), and  lack of knowledge of last Saturday pills and doses (OR 6.93, CI 2.35-20.44).

 Conclusion

 There were qualitative variables that had a bearing on quality of healthcare services that could explain differences between the rural and urban sites. Good social support improved adherence to ART. Knowledge of last Saturday pills was used to validate adherence and was similar to adherence.