75-Article Text-329-1-10-20220929

Madonna University Journal of Medicine and Health Sciences.
Volume2 issue
3(2022),Pp. 42-57© Madonna University Press,
Inc.2022http://madonnauniversity.edu.ng/journals/index.php/medicine
ANALYSIS OF THE FACTORS AND PREDICTORS OF ADHERENCE TO

HEALTHCARE OF PEOPLE LIVING WITH HIV/AIDS IN TERTIARY
HEALTH INSTITUTIONS IN ENUGU STATE
Matthew Chibunna Igwe1, *Emmanuel Ifeanyi Obeagu2https://orcid.org/0000-
0002-4538-0161 , Alphonsus Ogbonna Ogbuabor1,
1
Department of Medical Laboratory Science, College of Medicine, Enugu State
University of Science and Technology, Enugu State, Nigeria.
2
Department of Medical Laboratory Science, Imo State University, Owerii, Imo State,
Nigeria.
[email protected]
ABSTRACT
Survival of people living with HIV/AIDS (PLWHA) has increased since the emergency
of High active antiretroviral therapy (HAART) in 1996. The study was aimed to analyse
the factors and predictors of adherence of people living with HIV/AIDS in tertiary health
institutions in Enugu state. This was a descriptive cross-sectional study design. The study
population consisted of those diagnosed for HIV / AIDS at tertiary health institutions in
Enugu State. The total numbers of clients enrolled were 793 and 249 clients were loss to
follow up, majority was males. Those initiated on ART were 544. Clients of age <15
years were excluded and they were 31 clients. Finally, 500 clients were selected, males
were 138 and female were 362 by simple random sampling techniques. Data was
collected from HIV / AIDS patients ART record cards, registers and institutions data units
for those initiated on ART in 2014 using a designed proforma. Those clients aged 15
years and above were retrospectively studied between the year 2014- 2018 and some of
them that survived after five years (60 months) on ART were interviewed by applying
simple random sampling technique. Cohort inclusion begins at initiation on ART with
follow-up clinical information collected year by year for five years. IBM SPSS statistics
version 24.0 was used. Chi square test was used to assess association between categorical
variables and the level of statistical significance of the proportions was determined by a
P-value less than 0.05. Manual content analysis was used for the interview and probability
of dying and surviving analysis. Adherence was statistically significant, p<0.001 among
Igwe, M.C., Obeagu, E.I. and Ogbuabor, A.O.(2022). ANALYSIS OF THE FACTORS
AND PREDICTORS OF ADHERENCE TO HEALTHCARE OF PEOPLE LIVING
WITH HIV/AIDS IN TERTIARY HEALTH INSTITUTIONS IN ENUGU STATE.
Madonna University Journal of Medicine and Health Science. 2 (3):42-57
[Type text] Page 1
Madonna University Journal of Medicine and Health Sciences. Volume2 issue
clients who had obtained tertiary 105 (92.1%) and secondary, 124 (57.7%) education,
who lived within the state with the place of care, 234 (76.0%), and those retired, 12
(63.2%) and the unemployed, 46 (61.3%). None missing of ART intake (100%), lack of
stigmatization (66.7%), urban residence (66.7%), having employment (75%), and middle
class wealth index (58.3%) were discovered as factors responsible for the survival of
those under care after five years of study. Financial constraints, occupational and
educational factors and stigmatization were the major reasons accounting for non-
adherence which could affect PLWHA. Implementing policies and programmes that will
involve the contribution of local government councils are recommended to assist those in
rural areas.
Key words: People living with HIV/AIDS, HIV, adherence, ART
INTRODUCTION
The HIV epidemic continues to be a major global public health issue until is totally
eradicated. In 2018, there were 37.9 million men, women, and children living with
HIV/AIDS globally, while those newly infected with HIV in 2018 were 1.7 million men,
women and children and there were 770,000 AIDS-related deaths in 2018.1 Cameroon,
Cόte d’Ivoire and Nigeria account for close to 60% of new HIV infections and 54% of
AIDS-related deaths each year. Decisive improvements in their national HIV
programmes would have a major impact on the region’s overall HIV response. The recent
Nigeria AIDS Indicator and Impact Survey (NAIIS) found lower HIV prevalence than
earlier surveys, which led to a revision of the country’s HIV estimate. The latest regional
estimates reflect this additional information, with lower estimates of people living with
HIV, AIDS-related deaths and HIV infections than previous eatimates.1
Nigeria is among the six nations facing the triple threat of high HIV burden, low ART
coverage, and unsatisfactory decline in new HIV infections and poor viral suppression. 2
Globally, about 3.8 million Nigerians are estimated to be living with HIV.4 Together with
South Africa and Uganda, Nigeria accounted for half of the new HIV infections in Sub-
Saharan Africa in 2017.3 Even though the number of people placed on ART in Nigeria
has slowly improved over the years to 970,000 in 2016.4, only 34 percent of adult positive
clients are said to be receiving treatment.5
Survival of people living with HIV / AIDS (PLWHA) has increased since the emergency
of High active antiretroviral therapy (HAART) in 1996. Fewer HIV / AIDS-related deaths
and cohort have resulted in an increase in the proportion of HIV / AIDS patients dying
from non-HIV/AIDS-related disorders6-10. Low level of access to antiretroviral treatment,
inadequate laboratory facilities (for monitoring their viral load, CD4 cell counts etc) ,
knowledge and attitude of some patients, cultural believe, punitive laws against
homosexual, and increase in HIV and TB co-infection remain an issue for PLWHA,
meaning that there are still many HIV / AIDS related deaths in Nigeria.4
METHODOLOGY
,
Igwe, M.C., Obeagu E.I. and Ogbuabor, A.O.(2022). ANALYSIS OF THE FACTORS
[Type text] Page 2
Study Area
The study was conducted in Enugu state, Nigeria.
Study Design:
A descriptive cross-sectional study design was adopted.
Study Duration
The study was conducted from the year 2014-2018 (for a period of 5 years).
Study Population and Health Facilities
The study population consisted of those diagnosed for HIV / AIDS at two tertiary health
institutions in Enugu State; Enugu State University of science and technology teaching
hospital, Parklane (ESUTHP) and University of Nigeria teaching hospital (UNTH).
These tertiary health facilities are where most persons diagnosed with HIV/AIDS are
referred to. This is because they are very equipped with all the necessary services. And
they are located in both urban (ESUTHP) and rural area (UNTH) of the State. Baselines
for clinical and laboratory investigations such as; viral load, CD4 cell counts,
haematological and biochemical parameters and general management are carried out
there. Those clients aged 15 years and above were followed-up between 2014 and 2018
and some of those survived after five years (60 months) on ART were interviewed by
applying simple random sampling selection.
Inclusion criteria: all PLWHA aged 15 years and above that were initiated on ART in the
year 2014 at both health institutions. Exclusion criteria: all PLWHA less than 15 years of
age that were initiated on ART in the year 2014 at both health institutions.
The minimum sample size was determined by using a Fisher’s formula.
N = Z2pq/d2
Where:
n = desired sample size
Z = the standard normal deviate set at 1.96 which correspond to 95% confidence level.
P = estimated proportion of the attribute present in the population. And q = 1- P
d = degree of precision desired set at 0.05 (error margin of 5%)
Therefore
n = 1.96²×0.5× (1-0.5)/0.05²
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n =384 + 10 % attrition
Therefore, a minimum sample (n) = 384+38=422.
A total of 500 PLWHA aged 15 years and above were studied.
Sampling Technique
A multistage sampling technique was adopted.
Selection of participants
A simple random sampling technique was used to select PLWHA that were 15 years of
age and above from clinic records, registers and data units.
Data Collection Tools
Data was collected from HIV / AIDS patients ART record cards, registers and institutions
data units at UNTH and ESUTH for those initiated on ART in 2014 using a designed
proforma and one-on-one structured interview of those survived after five years on ART.
Data collected include; socio-demographic variables, clinical and immunological
characteristics (CD4 cell counts, Viral Load). Microsoft Excel, 2013 was used to clean
those collected data to ensure missing variables will be re-collected and confirmed using
paper-based patient ART records and registers. Socio-demographic and clinical
characteristics were considered as the independent variables, and three trained graduates
research assistants were involved.
Statistical Analysis
Cohort inclusion begins at initiation on ART with follow-up clinical information

collected year by year for five years. The Excel dataset was imported into IBM SPSS
statistics version 24.0 (IBM Corp; Amonk, NY, USA). Socio-demographic and clinical
characteristics were described using the frequency and proportion for categorical
variables. Chi square test was used to assess association between categorical variables
and statistical significance of the proportions was set at P-value less than 0.05. Manual
content analysis was used based on the topic guide of the interview. Probability of dying
and surviving was done using Manual content analysis also.
Manual content analysis was used for both interview and probability of dying.
Formular for probability of dying:
Number of persons on ART in a giving period – ( Number dead +transferred+LOFU)

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Number of persons dead
Therefore probability of surviving = 1 – probability of dying.
And proportion = 1 – probability of dying x 100
Ethical Considerations
Ethical clearances were obtained from Enugu State University of science and technology
teaching hospital, Parklane (ESUTHP) with reference number: ESUTHP/C-
MAC/RA/034/100 and University of Nigeria teaching hospital (UNTH) with reference
number: UNTH/CSA/329/VOL.5 through their Ethics and Research committees.
Confidentiality was maintained at all stages of the data collections.
Strength of this Study
The major strength of this study is that it was conducted at all the tertiary health
institutions in Enugu state that are fully equipped for the management of PLWHA.
RESULTS
Table 1a: Analysis for the Factors and Predictors of Adherence among PLWHA at
12 Months
VARIABLE FREQUENCY ADHERENCE X2 P- DECISIONS

n = 500 value
Good (%) Poor (%)
AGE AT
DIAGNOSIS
15-24 34 19 (55.9) 15 (44.1) 4.118 >0.05 Not
significant
25-34 150 103 (68.7) 47 (31.3)
35-44 180 110 (61.1) 70 (38.9)
45-54 75 49 (65.3) 26 (34.7)
≥ 55 61 43 (70.5) 18 (29.5)
GENDER
MALE 138 86 (62.3) 52 (37.7) 0.514 >0.05 Not
significant
FEMALE 362 238 (65.7) 124
(34.3)
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MARITAL STATUS
SINGLE 138 87 (63.0) 51 (37.0) 7.892 >0.05 Not
significant
MARRIED 272 182 (66.9) 90
(33.1)
DIVORCED 7 7 (100) 0 (0.0)
SEPARATED 8 3 (37.3) 5 (62.5)
WIDOWED 75 45 (60.0) 30 (40.0)
RELIGION
NOT SPECIFIED 1 1 (100) 0 (100) 4.300 >0.05 Not
significant
CHRISTIANITY 450 290 (64.4) 160
(35.6)
ISLAMIC 27 7 (25.9) 20 (74.1)
TRADITIONAL 17 12 (70.6) 1. (29.4)
OTHERS 6 2(33.3) 4(66.7)
Table 1b: Analysis for the Factors and Predictors of Adherence among PLWHA at 12
Months
VARIABLE FREQUENCY ADHERENCE X2 P- DECISIONS
n = 500 value
Good (%) Poor (%)
OCCUPATION
UNEMPLOYMENT 75 49 (65.3) 26 (34.7) 8.166 >0.05 Not
significant
SELF 267 165 (61.8) 102
EMPLOYMENT (38.2)
PUBLIC SERVANTS 113 73 (64.6) 40 (35.4)
RETIRED 20 14 (73.7) 6 (26.3)
STUDENTS 25 22 (88.0) 3 (12.0)
EDUCATION
NOT SPECIFIED 18 10 (55.6) 8 (44.4) 67.95 <0.001 Significant
1
PRIMARY 118 54 (45.8) 64 (54.2)
SECONDARY 215 124 (57.7) 91 (42.3)
[Type text] Page 6
TERTIARY 114 105 (92.1) 9 (7.9)

NO FORMAL EDU 35 11 (31.4) 24 (68.6)
PLACE OF
RESIDENCE
ENUGU STATE 308 234 (76.0) 74 (24.0) 54.16 <0.001 Significant
9
ANAMBRA 72 42 (58.3) 30 (41.7)
EBONYI 57 30 (52.6) 27 (47.4)
IMO 43 18 (52.9) 16 (47.1)
ABIA 14 3 (21.4) 11 (78.6)
OTHERS 15 4 (26.7) 11 (73.3)
Table 1a above shows the adherence at 12 month. Adherence was statistically significant
among clients who had obtained tertiary and secondary education, 105 (92.1%) and 124
(57.7%) respectively when compared with other educational level, p<0.001. It also
showed that adherence was highest for subjects who lived within the state with the place
of care, 234 (76.0%) and those who lived in Anambra State, 18 (58.3%), p<0.001.
Though marital status, gender and age are not significant, but devoiced (100.0%), female
(65.7%) and age ≥55 years (70.5%) had highest proportion to adherence when compared
with others.
24 Months
VARIABLE FREQUENCY ADHERENCE DECISION
n=500 (%) Good (%) Poor X2 P-value S
(%)
AGE AT
DIAGNOSIS
15-24 34 (100) 13 (38.2) 21 (61.8) 6.568 >0.05 Not
significant
25-34 150 (100) 68(45.3) 82 (54.7)
35-44 180 (100) 79 (43.9) 101
(56.1)
45-54 75 (100) 38 (50.7) 37 (49.3)
≥ 55 61(100) 34 (55.7) 27 (44.3)
GENDER
MALE 138 (100) 60 (43.5) 78 (56.5) 2.497 >0.05 Not
significant
FEMALE 362 (100) 186 (51.4) 176
(48.6)
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MARITAL
STATUS
SINGLE 138 (100) 68 (49.3) 70 (50.7) 4.226 >0.05 Not
significant
MARRIED 272 (100) 133 (48.9) 139
(51.1)
DIVORCED 7 (100) 6 (85.7) 1 (14.3)
SEPARATED 8 (100) 3 (37.5) 5 (62.5)
WIDOWED 75 (100) 39 (52.0) 36 (48.0)
Table 2b: Analysis for the Factors and Predictors of Adherence among PLWHA at 24 Months
VARIABLE FREQUENCY ADHERENCE DECISIONS

n=500 (%) Good (%) Poor (%) X2 P-value
RELIGION
NOT 1 (100) 1 (100) 0 (0.00) 2.474 >0.05 Not
SPECIFIED significant
CHRISTIANITY 450 (100) 224 226 (50.2)
(49.8)
ISLAMIC 27 (100) 11 16 (59.3)
(40.7)
TRADITIONAL 16 (100) 6 10 (62.50)
(37.5)
OTHERS 6 (100) 2 4 (66.7)
(33.3)
OCCUPATION
UNEMPLOYME 75 (100) 46 29 (38.7) 18.49 <0.001 Signific
NT (61.3) 3 ant
SELF 267 (100) 120 147 (55.1)
EMPLOYMENT (44.9)
PUBLIC 133 (100) 52 61 (54.0)
SERVANTS (46.0)
RETIRED 19 (100) 12 8 (36.8)
(63.2)
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STUDENTS 25 (100) 10(40.0 15 (60.0)

)
EDUCATION
NOT 18 (100) 6 12 (66.7) 104.7 <0.001 Signific
SPECIFIED (33.3) 32 ant
PRIMARY 118 (100) 28 90 (76.3)
(23.7)
SECONDARY 215 (100) 86 129 (60.0)
(40.0)
TERTIARY 114 (100) 94 20 (17.5)
(82.5)
NO FORMAL 35 (100) 13 22 (62.9)
EDU (37.1)
Table 2c: Analysis for the Factors and Predictors of Adherence among PLWHA at 24 Months
VARIABLE FREQUENCY ADHERENCE DECISIONS
n=500 (%) X2 P-value
Good (%) Poor (%)
PLACE OF
RESIDENCE
ENUGU 308 (100) 187 121 (39.3) 48.49 <0.001 Significant
(60.7) 2
ANAMBRA 72 (100) 22 50 (69.4)
(30.6)
EBONYI 57 (100) 16 41 (71.9)
(28.1)
IMO 34 (100) 14 20 (58.8)
(41.2)
ABIA 14 (100) 6 8 (57.1)
(42.9)
OTHERS 15 (100) 1 (6.7) 14 (93.3)
Table 2 above shows the adherence at 24 month. Those retired, 12 (63.2%) and the
unemployed, 46 (61.3%) were highest in adherence to treatment regimen than the other
occupation, p<0.001. It also showed adherence was statistically significant among
patients who had obtained tertiary education when compared with other educational level,
[Type text] Page 9
p<0.001. Also patients who lived in the same city with the place of care had highest level
of adherence when compared to the others, p<0.001.
60 Months
VARIABLE FREQUE ADHERENCE DECISIO
NCY X2 P-value NS
Good (%) Poor
n=500(% (%)
)
AGE AT
DIAGNOSIS
15-24 34 (100) 9 25 (73.5) Not
(26.5) 7.479 >0.05 significant
25-34 250 (100) 48 102 (68.0)
(23.0)
35-44 180 (100) 36 144 (80.0)
(20.0)
45-54 75 (100) 17 58 (77.3)
(22.7)
≥ 55 61 (100) 19 42 (68.9)
(31.1)
GENDER
MALE 138 (100) 33 105 (76.1) 0.355 >0.05 Not
(23.9) significant
FEMALE 362 (100) 96 266 (73.5)
(26.5)
MARITAL
STATUS
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SINGLE 138 (100) 38 100 (72.5) 5.331 >0.05 Not

(27.5) significant
MARRIED 272 (100) 70 202 (74.3)
(25.7)
DIVORCED 7 (100) 4 (57.1) 3 (42.9)
SEPARATED 8 (100) 1 (12.5) 7 (87.5)
WIDOWED 75 (100) 16 59 (78.7)
(21.3)
RELIGION
NOT 1 (100) 1 (100) 0 (0.00) Not
SPECIFIED 8.403 >0.05 significant
CHRISTIANIT 450 (100) 116 334 (74.2)
Y (25.8)
ISLAMIC 27 (100) 5 (18.5) 22 (81.5)
TRADITIONAL 16 (100) 7 (43.8) 9 (56.2)
OTHERS 6 (10010 0 (0.00) 2. (100)
3.
Table 3b: Analysis for the Factors and Predictors of Adherence among PLWHA at 60
Months
VARIABLE FREQUE ADHERENCE DECISIONS
NCY 2
X P-value
n=500(%)
Good (%) Poor (%)
OCCUPATION
UNEMPLOYM 75 (100) 33 (44.0) 42 (56.0) 12.233 <0.001 Significant
ENT
SELF 267 (100) 61 (22.8) 206 (77.2)
EMPLOYMEN
T
PUBLIC 113 (100) 25 (22.1) 88 (77.9)
SERVANTS
RETIRED 20 (100) 9 (45.0) 11 (55.0)
STUDENTS 25 (100) 10 (40.0) 15 (60.0)
EDUCATION
NOT 18 (100) 8 (44.4) 10 (55.6) 45.079 <0.001 Significant
SPECIFIED
PRIMARY 118 (100) 15 (12.7) 103 (87.3)
[Type text] Page 11
SECONDARY 215 (100) 46 (21.4) 169 (78.6)

TERTIARY 114 (100) 54 (47.4) 60 (52.6)
NO FORMAL 35 (100) 6 (17.1) 29 (82.9)
EDU
PLACE OF
RESIDENCE
ENUGU 308 (100) 102 (33.1) 206 (66.9) 23.700 <0.001 Significant
ANAMBRA 72 (100) 12 (16.7) 60 (83.3)
EBONYI 57 (100) 7 (12.3) 50 (87.7)
IMO 34 (100) 4 (11.8) 30 (88.2)
ABIA 14 (100) 3 (21.4) 11 (78.6)
OTHERS 15 (100) 1 (6.7) 14 (93.3)
Table 3 above shows the adherence at 60 month. A significant higher proportion were
seen among those retired (45.0%) and the students (44.0%) when compared with other
occupations, p<0.001. Also adherence at 24 months was consistently significant with
those who had tertiary education as 47.4% of them adhere, p<0.01. Even though marital
status, gender and age are not significant, devoiced (57.1%), female (26.5%) and age ≥55
years had highest proportion to adherence when compared with others. Finally, the result
showed a statistically significant to adherence with patients who live in the same location
with the place of care (33.1%) when compared with other place of residence, P<0.001.
DISCUSSION
Predictors of death include being illiterate, bedridden, with a low baseline CD4 cell
counts, and on the second-line ART regimen.11
It was discovered that some of the reasons PLWHA did not attain virologic suppression
were: Skipping medication due to perceived side effects such as nightmares, religious
perceptions about healing, and missing appointments due to one reason or the other.
Young people are known to forget to take their medications on weekends after a night
out.12, 13
The findings suggested that sex has no significant influence or association with
adherence. This finding agreed with the study conducted by Illyasu from Kano, that sex
has no significant influence to adherence.14 But this is contrary to the findings by
Uzochukwu from Southeastern Nigeria15 and Sudawa from Kano.16 Even though the
number of female clients attending ART clinic disproportionately outweigh the number
of males. This is evident from the preponderance of females to the tune of 72.4% among
the study participants. Males in our setting hardly come to routine clinics and usually get
their refill drugs from their wives under the pretext of being at work. Others get supplied
through health workers acting as touts for financial gain; hence, vital services like
adherence counseling are inadvertently missed. Again males are more likely to travel,
have a busy schedule or omit taking drugs in the presence of others to avoid disclosure.16
[Type text] Page 12
Defaulting from treatment is one of the most important problems in the management of
HIV/AIDS. Low adherence can result in cross-resistance to other antiretroviral
drugs.17Based on the in-depth interview on those survived after five years, adherence
level was 100.0% and survival rate range from 97.6% to 99.8% which agreed with the
report that ninety-five percent adherence to antiretroviral drugs regimen is often needed
to achieve optimal rates of viral suppression in people living with HIV/AIDS.18
Adherence level of 95% implies that a patient taking a twice-daily regiment cannot miss
or delay more than 3 doses per month. This can be more difficult than it might seem
particularly if the need to refill prescriptions every month, to have medications available
when working and traveling, and to avoid predictable side effects of medication, are
considered.19 It is even more problematic in developing countries like Nigeria where
illiteracy, poverty, long distance from HIV/AIDS care centers and poor health care
facilities are common. Although there is no gold standard for evaluating adherence to
medication20, patient self-reporting and pill counts have frequently been used in
evaluating adherence to ART in different parts of sub-Saharan Africa.21-24 I adopted a
combination of both patient self-reporting and one-on-one in-depth interview in this
study. The low educated people, low income earners and the unemployed had lower
adherence levels than the other patients. Although high level of education cannot be
directly linked to higher knowledge of HIV/AIDS, better educated people generally have
greater access to information and are more likely to make better-informed decisions. Even
though majority of the clients in this study were Christians, yet, religion is not a predictor
for adherence.
The issue of the location/residential area of the clients of this study was also not statistic
significantly associated to adherence, but those clients resident in a place where health
facility is situated adhered more.
CONCLUSIONS
Adherence is dependent on medication adverse effects and level of education of patients.

Financial constraints, medication side effects, confidentiality, occupational factors and
stigmatization were the major reasons accounting for non-adherence. A programme that
will take medicines near the door step of poor patients, and implementing policies and
programmes that will involve the contribution of local government councils are
recommended.
REFERENCE
1. UNAIDS Data 2019. Available at https://www.unaids.org/en/resources/

presscentre. Accessed 10th October, 2019.
2. NAIIS (2018). About Nigeria HIV/AIDS Indicator and Impact Survey Avaliable
at https://naca.gov.ng/naiis-national-summary-sheet. Accessed 20th May, 2019.
[Type text] Page 13
3. Avert. HIV AND AIDS in Nigeria. 2018. Available at https://www.avert.org

/professionals/hiv-aroundworld. Accessed 23rd May, 2019.
4. UNAIDS DATA 2017. Available at http://www.unaids.org/sites/default/files/

media_asset. Accessed 2nd June, 2019.
5. Odimegwu, C. O., Akinyemi, J. O., & Alabi, O. O. HIV-Stigma in Nigeria:

Review of Research Studies, Policies, and Programmes. AIDS Research and
Treatment, 2017, 13 pages.
6. Jakheng SPE, Obeagu EI. Seroprevalence of human immunodeficiency virus

based on demographic and risk factors among pregnant women attending clinics
in Zaria Metropolis, Nigeria. J Pub Health Nutri.2022; 5(8):137
7. Odo M, Ochei KC, Obeagu EI, Barinaadaa A, Eteng UE, Ikpeme M, Bassey JO,
Paul AO. TB Infection Control in TB/HIV Settings in Cross River State, Nigeria:
Policy Vs Practice. Journal of Pharmaceutical Research
International. 2020;32(22), 101-109.
https://doi.org/10.9734/jpri/2020/v32i2230777
8. Offie DC, Obeagu EI, Akueshi C, Njab JE, Ekanem EE, Dike PN, Oguh DN
Facilitators and Barriers to Retention in HIV Care among HIV Infected MSM
Attending Community Health Center Yaba, Lagos Nigeria. Journal of
Pharmaceutical Research International.2021; 33(52B), 10-19.
https://doi.org/10.9734/jpri/2021/v33i52B33593
9. Ezeoru VC, Enweani IB, Ochiabuto O, Nwachukwu AC, Ogbonna US, Obeagu
EI Prevalence of Malaria with Anaemia and HIV Status in Women of
Reproductive Age in Onitsha. Journal of Pharmaceutical Research International.
2021;33(4):10-19. DOI: 10.9734/jpri/2021/v33i431166
10. Ifeanyi OE, Uzoma OG, OMTB, O, Ejike Felix C , Stella EI, Chinedum O.
Evaluation of Some Cytokines, CD4, Hepcidin, Iron Profile and Some
Haematological Parameters of Pulmonary Tuberculosis Patients Coinfected with
HIV in Southeast of Nigeria. Journal of Pharmaceutical Research
International, 2020;32(13), 118-130.
https://doi.org/10.9734/jpri/2020/v32i1330592
11. Zaw Zaw Aung, Yu Mon Saw, Thu Nandar Saw, New Oo. Survival rate and
mortality risk factors among TB-HIV co-infected patients at an HIV specialist
hospital in Myanmar: A 12-years retrospective follow-up study. Elsevier Ltd. 80
(2019) 10-15.
12. Achappa, B., Madi, D., Bhaskaran, U., Ramapuram, J. T., Rao, S., &
Mahalingam, S. Adherence to Antiretroviral Therapy Among People Living with
HIV.(d.10.4103/1947-2714.109196, Ed.) North American Journal of Medical
Sciences. 2013. 5(3), 220-223.
[Type text] Page 14
13. Kim, J., Lee, E., Park, B.-J., Bang, J. H., & Lee, J. Y. (2018, February 16).
Adherence to antiretroviral therapy and factors affecting low medication
adherence among incident HIV-infected individuals during 2009–2016: A
nationwide study. Scientific Reports, 8.
14. Iliyasu Z, Kabiru M, Abubakar I. Compliance to antiretroviral therapy among

AIDS patients in Aminu Kano Teaching Hospital, Kano Nigeria. Niger J Med.
2005; 14(3):290-294.
15. Uzochukwu BS, Onwujekwe OE, Onoka AC, Okoli C, Uguru NP, Chukwuogo
OI. Determinants of non-adherence to subsidized antiretroviral treatment in
southeast Nigeria. Oxford Journals Medicine & Health Health Policy and
Planning. 2008; 24(3):189 196.
16. Sudawa Aminu Usman, Adamu Shehu, Olufemi Ajumobi, Saheed Gidado,
Ibrahim Dalhatu, Muhammad Balogun. .Predictors of non-adherence to
antiretroviral therapy among HIV patients in secondary health care facilities in
Kano State- Nigeria: a case-control study. The Pan African Medical Journal.
2017. 1937-8688.
17. Leake H, Home R. Optimizing adherence to combination therapy. J. HIV. Ther.

1998. 3: 67-71.
18. Peterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, Wagener
MM, Singh N. Adherence to protease inhibitor therapy and outcomes in patients
with HIV infection. Ann. Intern. Med. 2000. 133: 21-30.
19. Hardy WD. New Strategies: Optimizing Antiretroviral Therapy for Treatment-
Experienced Patients. iMedOptions, LLC, USA. 2003. 1-24.
20. Osterberg L, Blaschke T. Adherence to medication. N. Engl. J. Med. 2005. 353:

487-497.
21. Liu H, Golin CE, Miller LG, Hays DR, Beck K, Sanandaji S, Christian J,
Maldonado T, Duran D, Kaplan AH, Wenger NS.. A Comparison study of
multiple measures of adherence to HIV protease inhibitors. Ann. Intern. Med.
2001. 134: 968-977.
22. Idigbe EO, Adewole TA, Eisen G, Kanki P, Odunukwe NN, Onwujekwe DI,
Audu RA, Araoyinbo ID, Onyewuche JI, Salu OB, Adedoyin JA, Musa AZ.
Management of HIV-1 infection with a combination of nevirapine, stavudine, and
[Type text] Page 15
lamivudine: a preliminary report on the Nigerian antiretroviral program. J.

Acquir. Immune Defic. Syndr. 2005. 40(1): 65-69.
23. Mukhtar M, Adeleke S, Gwarzo D, Ladan ZF Preliminary investigation of

adherence to antiretroviral therapy among children in Aminu Kano Teaching
Hospital, Nigeria. Afr. J. AIDS Res. 2006. 5(2): 141-144.
24. Nwauche CA, Erhabor O, Ejele OA, Akani CI. Adherence to antiretroviral
therapy among HIV-infected subjects in a resource limited setting in the Niger
Delta of Nigeria. Afr. J. Health Sci. 2006. 13(3-4): 13-7.
[Type text] Page 16

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Madonna University Journal of Medicine and Health Sciences.

ANALYSIS OF THE FACTORS AND PREDICTORS OF ADHERENCE TO

Matthew Chibunna Igwe1, *Emmanuel Ifeanyi Obeagu2https://orcid.org/0000-

0002-4538-0161 , Alphonsus Ogbonna Ogbuabor1,

The study was conducted in Enugu state, Nigeria.

A descriptive cross-sectional study design was adopted.

Study Population and Health Facilities

n = desired sample size

P = estimated proportion of the attribute present in the population. And q = 1- P

d = degree of precision desired set at 0.05 (error margin of 5%)

Therefore, a minimum sample (n) = 384+38=422.

A total of 500 PLWHA aged 15 years and above were studied.

A multistage sampling technique was adopted.

Data Collection Tools

Cohort inclusion begins at initiation on ART with follow-up clinical information

Formular for probability of dying:

Number of persons on ART in a giving period – ( Number dead +transferred+LOFU)

Number of persons dead

Therefore probability of surviving = 1 – probability of dying.

And proportion = 1 – probability of dying x 100

Strength of this Study

VARIABLE FREQUENCY ADHERENCE X2 P- DECISIONS

TERTIARY 114 105 (92.1) 9 (7.9)

VARIABLE FREQUENCY ADHERENCE DECISIONS

STUDENTS 25 (100) 10(40.0 15 (60.0)

SINGLE 138 (100) 38 100 (72.5) 5.331 >0.05 Not

SECONDARY 215 (100) 46 (21.4) 169 (78.6)

Adherence is dependent on medication adverse effects and level of education of patients.

1. UNAIDS Data 2019. Available at https://www.unaids.org/en/resources/

3. Avert. HIV AND AIDS in Nigeria. 2018. Available at https://www.avert.org

4. UNAIDS DATA 2017. Available at http://www.unaids.org/sites/default/files/

5. Odimegwu, C. O., Akinyemi, J. O., & Alabi, O. O. HIV-Stigma in Nigeria:

6. Jakheng SPE, Obeagu EI. Seroprevalence of human immunodeficiency virus

14. Iliyasu Z, Kabiru M, Abubakar I. Compliance to antiretroviral therapy among

17. Leake H, Home R. Optimizing adherence to combination therapy. J. HIV. Ther.

20. Osterberg L, Blaschke T. Adherence to medication. N. Engl. J. Med. 2005. 353:

lamivudine: a preliminary report on the Nigerian antiretroviral program. J.

23. Mukhtar M, Adeleke S, Gwarzo D, Ladan ZF Preliminary investigation of

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