Abstract:

The research study was aimed at assessing the factors that contribute to non-adherence to Ant-Retroviral Therapy (ART) treatment among HIV patients at Nchanga North General Hospital-Chingola. With regards to the objectives, they were to establish the individual factors, social-cultural factors, social-economic factors, environmental factors, and health care provider factors contributing to non-adherence to Ant-Retroviral Therapy (ART) treatment among HIV patients. A descriptive cross-sectional design that was quantitative in nature was used for the study. The study targeted 162 non-adherent patients. In collecting data, structured questionnaires were used. A purposive sampling technique was used to select 115 respondents. The collected data was entered into data sets and analysed using Statistical Package for Social Sciences (SPSS) version 23.0 software to dissolve the portents and to evaluate the extent of ART non-adherence amongst male patients. The study concluded that non- adherence at Nchanga North Hospital is brought about by factors such as individual factors, social-cultural factors, social-economic factors, environmental factors, and health care provider factors. The research recommends that patient’s preventive interventions such as community adherence supporter programs ought to be developed and implemented for the purposes of improving and ensuring ART adherence.

References:

[1] UNAIDS., 2012, UNAIDS Report on the global AIDS epidemic. Accessed 11 Jan 2022 from https://www.unaids.org/en/resources/documents/2019/2019-UNAIDS-data.

[2] Zambian Demographic Health Survey (2018). Zambia Statistics Agency, Ministry of health. Accessed 3 Jan 2022 from http://www.zamstats.gov.zm/phocadownload/Demography/ZDHS%20Key%20Indicator%20Report%202018.pdf.

[3] UNAIDS, 2020, Country progress report – Zambia: Global AIDS Monitoring 2020. Accessed Jan 11, 2022, from https://www.unaids.org/sites/default/files/country/documents/ZMB_2020_countryreport.pdf.

[4] Lane, N. S., 2021, How Close Are We to a Cure for HIV? Accessed 2 Jan 2022 from https://www.verywellhealth.com/cure-for-hiv-5088720.

[5] Sasaki, Y., Kakimoto, K., Dube, C. et al. 2012, Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients. Annals of Clinical Microbiology and Antimicrobials 11(34), 202-228. https://doi.org/10.1186/1476-0711-11-34.

[6] Boateng D., Kwapong, G. D., Agyei-Baffour, P., 2013, Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Women’s Health, 13: 2-8. Doi: http://dx.doi.org/10.4314/thrb.v20i4.x.

[7] Skovdal, M., Campbell, C., Nhongo, K., Nyamakupa, C., & Gregson, S., 2011, Contextual and psychosocial influences on antiretroviral therapy adherence in rural Zimbabwe: towards a systematic framework or progamme planners. International Journal of Health Planning and Management, 1(26), 296-318. https://doi.org/10.1177/1359105318788692.

[8] Monjok, E., Smesny, A., Okokon, I. B., Mgbere, O., & Essien, E. J., 2010, Adherence to antiretroviral therapy in Nigeria: an overview of research studies and implications for policy and practice. HIV/AIDS - Research and Palliative Care, 2, 69 - 76. doi: 10.2147/hiv. s9280

[9] Mbuagbaw, L., Thabane, L., Ongolo-Zogo, P. et al., 2012, Trends and determining factors associated with adherence to antiretroviral therapy (ART) in Cameroon: a systematic review and analysis of the CAMPS trial. AIDS Res Ther 9(37), 9-37, https://doi.org/10.1186/1742-6405-9-37.

[10] Mwanza, D., 2020, The increase in HIV infection cases in Zambia, have we forgotten about the 4A? Singapore, Penguin Publishers.

[11] Mwanza, D., 2020, HIV/AIDS Patients’ Adherence to Antiretroviral Therapy at Chawama Hospital. Lusaka, UNZA Press.

[12] Mwila, B., 2019, Adherence to antiretroviral therapy among HIV-infected subjects in a resource limited setting in Luano. Unpublished thesis, Rusangu University.

[13] Hanass-Hancock J, Bond V, Solomon P, Cameron C, Maimbolwa M, Menon A, and Nixon S., 2020, Perspectives on ART adherence among Zambian adults living with HIV: insights raised using HIV-related disability frameworks. AIDS Care, 32(5), 623-629. doi: 10.1080/09540121.2019.1653441.

[14] National AIDS Council., 2013, Hiv and Aids situation. Retrieved January 11, 2022, from National Aids Council Website: https://www.nac.org.zw.

[15] Jones, D., Cook, R., Spence, A., Weiss, S. M. and Chitalu, N., 2014, Antiretroviral Therapy in Zambia: Do Partners on ART Enhance Adherence? Journal of the International Association of Providers of AIDS Care, 13(6), 497-500. https://doi.org/10.1177/2325957414553843.

[16] Yamanie, T. (1964). Statistics: An Introductory Analysis. Portland: Hamper and Row Publishers.

[17] Tabachnik, B., Fidell, L., & Tabachnick B, F. L. (2017). Using Multivariate Statistics. London, Harper Collins College Publishers.

[18] Cohen, J. W. (2018). Statistical Power Analysis for the Behavioral Sciences (8^th ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.

[19] Koe, W.-L. (2016). The Relationship between Individual Entrepreneurial Orientation (IEO) and Entrepreneurial Intention. Journal of Global Entrepreneurship Research, 6(13), 121-132. https://doi.org/10.1186/s40497-016-0057-8.

[20] Pallant, J. (2016). SPSS Survival Manual: A Step-by-Step Guide to Data Analysis Using SPSS Program (6th ed.). London, McGraw-Hill Education.

[21] Fisher, J. D., Fisher, W. A., Amico, K. R., & Harman, J. J. (2016). An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology, 25(4), 462-473. doi:10.1037/0278-6133.25.4.462.

[22] Nozaki, I., Dube, C., Kakimoto, K., Yamada, N. and Simpungwe, J. B., 2011, Social factors affecting ART adherence in rural settings in Zambia, AIDS Care, 23:7, 831-838, DOI: 10.1080/09540121.2010.542121.

[23] Langebeek, N, Gisolf, E.H, Reiss, P, et al., 2014, Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis. BMC Med, 12(1), 142-156. doi:10.1186/preaccept-1453408941291432.

[24] Birbeck, G. L., Kvalsund, M. P., Byers, P. A., Bradbury, R., Mang’ombe, C., Organek, N., Kaile T., Sinyama, A. M., Sinyangwe, S. S., Malama, K., Malama, C., 2011, Neuropsychiatric and socioeconomic status impact antiretroviral adherence and mortality in rural Zambia. AmJTrop Med Hyg, 85 (4), 782-789. 10.4269/ajtmh.2011.11-0187.

[25] Basti, B. D., Mahesh, V., Bant, D. D., & Bathija, G. V., 2017, Factors affecting antiretroviral treatment adherence among people living with human immunodeficiency virus/acquired immunodeficiency syndrome: A prospective study. Journal of family medicine and primary care, 6(3), 482–486. https://doi.org/10.4103/2249-4863.222014.

[26] Altice, F. L., Mostashari, F., & Friedland, G. H. (2001). Trust and the Acceptance of and Adherence to Antiretroviral Therapy. JAIDS Journal of Acquired Immune Deficiency Syndromes, 28(1), 47-58. DOI:10.1097/00042560-200109010-00008.

[27] Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N.,
Fleming, T. R. (2011). Prevention of HIV-1 Infection with Early Antiretroviral Therapy. New England Journal of Medicine, 365(6), 493-505. doi: doi:10.1056/NEJMoa1105243.

[28] Mills, E. J., Nachega, J. B., Bangsberg, D. R., Singh, S., Rachlis, B., Wu, P., Cooper, C. (2016). Adherence to HAART: A Systematic Review of Developed and Developing Nation Patient-Reported Barriers and Facilitators. PLoS Med, 3(11), e438. doi: 10.1371/journal.pmed.0030438.