Factors Associated With Adherence to Antiretroviral Therapy Among Older Adults (50 Years and Above) at Busia County Referral Hospital Comprehensive Care Center in Busia County, Kenya

Abstract

Background: The advent of efficacious antiretroviral therapy (ART) has caused human immunodeficiency virus (HIV) to become a manageable chronic disease and subsequently resulted in longevity of life for people living with HIV (PLWH) worldwide. This longevity has also resulted in an increased population of older adults living with HIV. It is predicted that there will be an estimated 9.1 million older adults living with HIV by the year 2040 in low- and middle-income countries (LMICs). In Kenya, despite changing demographics, little attention has been given to studying HIV in older adults. Objective: This study aimed to determine the factors associated with adherence to antiretroviral therapy among older adults (50 years and above) at the Busia County referral hospital comprehensive care center in Busia County in Kenya. Methods: This was an analytical cross-sectional study. The participants were older adults aged 50 years and above with HIV. The data were collected via questionnaires administered by a researcher. Adherence was assessed via a self-reported method based on three-week recall. Data were also collected on factors believed to be associated with adherence to ART. Descriptive analysis was used to summarize the data, and multivariable logistic regression was conducted to identify factors significantly associated with adherence via IBM SPSS Statistics software version 27. Results: The mean age of the study participants was 58.6 years (SD = 6.351; R=50--86). Female participants accounted for 57% (n=121) and 59% (n=125) of the participants who adhered to ART. Older adults who received support from family (O.R. = 5.391, 95% CI 2.525–11.508, p=0.00) and those who were retired (O.R. = 4.367, 95% CI 1.167–16.349, p=0.029) adhered better to antiretroviral therapy. Conclusion and Recommendation: Support from family and retirement status are significant predictors of adherence to ART among older adults at Busia County Hospital Comprehensive Care Clinic (CCC). The findings underscore the critical role played by family involvement in ensuring treatment compliance. This finding also suggests that retirement may provide more stability and flexibility, hence promoting adherence to the regimens. During intervention design, policy makers and stakeholders should prioritize family involvement and enhance tailored interventions for

retired individuals to promote treatment adherence and, ultimately, quality of life for this growing demographic