HIV status disclosure and ARV adherence among patients attending Jomo Kenyatta University comprehensive care clinic

Abstract

Although anti retroviral therapy (ART) is the single most important management of HIV infection, success in decreasing viral load depends on adherence to a strict regimen that requires taking the prescribed drugs daily at the specified times. Failure to daily intake of Anti Retrovirals (ARV) not only prevents treatment failure but may also lead to viral development of resistance to the drugs.   The fact that HIV is mainly sexually transmitted means that it is associated with socially unaccepted practices such as premarital and extramarital as well as multiple sexual partners.  Fear of such stigma related to these practices may thus prevent HIV status disclosure and deny the patient social support that may be important in management of the disease in general and adherence to ART in particular.  This study was carried out in a three month period among 89 HIV positive patients attending Jomo Kenyatta University Hospital’ comprehensive care clinic (CCC).  A questionnaire was administered to the patients to investigate their knowledge regarding adherence and determine any association between disclosure of HIV and adherence. Their socio-demographic characteristics were also documented and related to adherence levels.  The results indicate that although patients were aware of the importance of taking their medications on time, the adherence rate of 76% is below the recommended 95% optimum required for viral suppression to undetectable levels.  Those that had disclosed their status were more likely to be adherent than those that had not as indicated by a statistical correlation between disclosure adherence (P > 0.9).  This study recommends that psychosocial support of HIV positive patients should emphasize disclosure as a strategy for increasing adherence to the required optimum levels.